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Artykuły w Czytelni Medycznej o SARS-CoV-2/Covid-19
© Borgis - New Medicine 1/2006, s. 11-14
Iwona Paradowska-Stankiewicz, Andrzej Grzybowski
Analysis of health-related behaviour in a selected group of elementary school students from the Łódź area
Nutrition, Hygiene and Epidemiology Unit, Department of Hygiene and Epidemiology, Medical University of Łódź, Łódź, Poland
Head of Department: Professor Andrzej Grzybowski MD, PhD
Aim: The aim of the study was to assess the mode of nutrition regarding the degree of attainment of energy standards and basic nutrients in the daily food rations of children from randomly selected Łódź elementary schools, as well as to assess the children´s physical activity and tobacco smoke exposure levels.
Material and method: The study concerned 312 children of grades 4-6 from randomly selected Łódź elementary schools; 46% girls and 54% boys. The mode of nutrition was assessed by a triple 24-hour nutritional recall questionnaire. The information on physical activity and tobacco smoke exposure was gathered during medical examination.
Results: Daily energy intake was analysed according to the subjects´ mode of nutrition. Protein supply was inadequate, lower by an average of 20% than the recommended standard; however, it surpassed the safe level by 19-76% with adequate dietary proportions of animal and vegetable proteins. Total fat intake was noted to be high (108%-122% of the standard recommendation); however, PUFA deficiency and fatty acids imbalance were observed in the diets. The carbohydrate intake was 90% of the standard, and the saccharose intake was 2.5 times higher. The medical history data show that the majority of the subjects attend physical education classes. Only 5 girls and 2 boys were periodically excused. 62% of girls and 40% of boys take part in extra-school sport activities and spend from 45 min. to 6-8 hours per week on them. The subjects´ passive exposure to tobacco smoke is high and concerns 67% of the respondents.
1. The mode of nutrition in the studied group shows irregularities, especially regarding protein and fat intake.
2. The physical activity level is adequate in girls and inadequate in boys.
3. Close to 70% of the respondents are passively exposed to tobacco smoke.
4. There is a growing need to promote healthy behaviour in children and their parents.
Health-related behaviour of children and adolescents and their conditioning have been widely studied [1]. The studies aim to recognize and understand the kinds of behaviour conducive or unfavourable to health, their conditioning and promotion of health-oriented behaviour in young people. Modern diseases have been directly linked with the human environment and lifestyle. The change of human behaviour and creation of health-oriented lifestyle conditions is becoming an efficient method of coping with modern health problems [1, 2]. The holistic health concept assumes that the basic health determinant is lifestyle, perceived as a function of health-related behaviour shaping individual health status in about 50% [3]. In children and adolescents the direct influence of health-related behaviour on developmental processes has been observed, as well as the consolidation of behaviour patterns influencing adult lifestyle [3].
The study objective was the analysis of specific kinds of health-related behaviour in a selected group of elementary school students. The analysis covered:
– mode of nutrition according to attainment of standards for daily energy and basic nutrients intake,
– physical activity,
– active and passive exposure to tobacco smoke.
Material and method
The study group comprised 312 children from the fourth, fifth and sixth grades, randomly selected from Łódź elementary schools, 46% girls and 54% boys. The mode of nutrition was assessed by a triple 24-hour nutritional recall questionnaire. The data were collected during the school year in early spring, using a "photographic album of food products and meals of differentiated rations” and of generally used home measures and conversion tables [4]. The data were analysed using Food 3.1 computer software based on food composition tables and menus balanced by the Institute of Food and Nutrition [5]. The study results included food component reduction and the results were compared with the food intake standards for the population of Poland [6]. The information on physical activity and tobacco smoke exposure was gathered during the medical examination.
The results of the energy and nutrients intake in the studied group are presented in Tables 1 and 2. The percentage of energy from proteins, fats and carbohydrates is presented in table 3.
Table 1. Energy and nutrients intake in the studied group.
meanSD% of normmeanSD% of normmeanSD% of normmeanSD% of norm
10 yearsGirls1927.81038N48.32913864.447N314.613889
11 yearsGirls2020.5622N63.82115975.527104298.49884
12 yearsGirls2011.1762N62.41813679.935108308.912088
13 yearsGirls2470.4973N66.21813889.740115377.013999
Table 2. Cholesterol and fibre supply in the studied group´s diet.
10 yearsGirls134.621.7275.523.911.235.5
11 yearsGirls259.984517.917.87.227
12 yearsGirls225.132496.120.84.648.8
13 yearsGirls221.3824012211.950.1
Table 3. Percentage of energy from proteins, fats and carbohydrates in the studied group.
AgeSex% of energy from proteins% of energy from carbohydrates% of energy from fats
10 yearsGirls9.77.511.462.856.47227.420.333.3
11 yearsGirls12.710.818.452.244.564.53322.844
12 yearsGirls127.118.852.343.260.535.526.746.5
13 yearsGirls10.7814.857.749.564.731.427.239.8
The subjects´ mode of nutrition in daily energy intake was analysed closely, both in girls and in boys. Comparable results were obtained by J. Czeczelewski et al., where the energy intake in children aged 10-15 years stayed within the limits of ± 10% of the standard deviation [7]. That study´s results showed correct percentage of energy from proteins and carbohydrates and incorrect percentage of energy from fats, by 5.5% higher than recommended.
The microelement intake study revealed the total protein supply, both in girls and in boys, to surpass the safe intake level by about 19-76%; however, it was lower than recommended in girls by about 8-30% and in boys by 15-35%, with adequate dietary proportions of animal and vegetable proteins. The fat intake was differentiated: from correct to elevated; 115% in girls and 129% in boys. PUFA deficiency was noted (2.5 times lower than the standard recommendation). Cholesterol intake was correct. In both girls and boys total carbohydrate intake was adequate, fibre intake was close to the lower standard limit, and saccharose intake was 2.5 times higher than the recommended norm. Similar tendencies were observed in the study of J. Czeczelewski et al., which applied concentration analysis to the assessment of 10-15-year-olds´ nutrition [8]. Excessive protein intake (128%, 160%, 170% of the standard) was noted in three concentrations, and insufficient fibre intake in three different concentrations. The fourth concentration revealed insufficient energy intake (79% of the standard).
Another population study regarding individual mode of nutrition in the general population [9] showed that the energy percentage in the daily food intake of girls and boys surpassed the standards by 5-20%, and the protein percentage by 40-60%. The proportions of animal and vegetable proteins were correct.
Another component of the study was the assessment of school and extra-school physical activities. The medical history data demonstrate that the majority of students attend physical education classes at school (Fig. 1). Only 5 girls and 2 boys were periodically excused from attendance. The reasons given were contusions of lower or upper extremities. Other extra-school organized sport activities were attended by 62% of girls and 40% of boys, with 45 min. to 8 school hours spent on them (Fig. 2). The most popular sports are: swimming, horse riding, cycling, football, combat sports, running, dancing and team sports. Physical activity is one of the most elementary needs of a child and is indispensable in shaping correct physical, motoric, psychological and social development [10]. The correlation between daily physical activity and health status conditioned by metabolic efficiency in children and adolescents is statistically significant, although at a relatively low level. The indices of physical activity, health status (metabolic efficiency-related) and physical efficiency of adolescents aged between 9 and 18 years were studied in a multifactorial analysis. The results suggest that higher activity level connected with greater energy expenditure (moderate and intensive physical exercises), as well as higher physical efficiency indices, are related to a more desirable profile of metabolic risk factors (low arterial blood pressure, low triglyceride, triaciglycerol, LDL-C and glucose concentrations and higher HDL-C concentration) [11]. The literature on the subject indicates that physical activity of the Polish population, including children, is inadequate [10]. Despite the acceleration of physical development of children and adolescents between 1970 and 1990, a constant regression of motoric agility of the young generation has been noted [12]. Simultaneously, between 1990 and 1998 the percentage of adolescents exercising in their leisure time only "adequately” frequently and long grew, and in almost every third boy and every second girl the exercises were infrequent and too brief. These subjects represent the risk group for development of hypokinesis-related disorders [10]. The study by M. Gacek, analysing elementary health behaviour in boys aged 16-19 years, noted inadequate frequency of motoric activity during leisure (at most once a week, or more seldom), reported more often in the fifth grade than the first [3].
Fig. 1. Children attending physical education classes.
Fig. 2. Children attending extra-school physical activities.
Tobacco smoking is one of the most alarming types of anti-health behaviour in Polish adolescents [12]. Passive tobacco smoke inhalation is one of the harmful environmental factors. Passive tobacco smoke exposure is a health risk factor for 20-80% of the population. About 4 million Polish children are assumed to be passively exposed to tobacco smoke [13]. The study assessed active and passive exposure of adolescents to tobacco smoke. Medical history data reveal that over 67% of pupils have been passively exposed to tobacco smoke, taking into consideration the fact of smoking by both or one parent/guardian. None of the respondents declared active tobacco smoking.
1. The mode of nutrition in the studied group shows irregularities, especially regarding protein and fat supply.
2. The physical activity level is adequate in girls and inadequate in boys.
3. Close to 70% of the respondents are passively exposed to tobacco smoke.
4. There is a growing need to promote healthy behaviour in children and their parents.

*The study was financed by the Medical University of Łódź from individual research fund no. 502-16-098.
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Adres do korespondencji:
Iwona Paradowska-Stankiewicz
Zakład Higieny Żywienia i Epidemiologii UM w Łodzi
ul. Jaracza 63, 90-251 Łódź, Poland
tel. +48 42 678-16-88, +48 42 678-67-66
e-mail: kathig@csk.umed.lodz.pl

New Medicine 1/2006
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