The Effect of Nutrition Education Interventions for Adolescents

The Effect of Nutrition Education Interventions on Nutritional Status, Nutritional Habits and Eating Behaviors in Adolescents

The aim of this study is to determine the effect of nutrition education on nutritional literacy, nutritional status, eating habits and eating behavior in high school students. The research will be conducted in six high schools, three of which are intervention schools and three of which are control schools It is planned that a total of 1000 students will be included in the study from the intervention school and 1000 students from the control school. At the beginning of the study (June 2022), an introductory form (sociodemographic characteristics, body image (Stunkart scale), dietary habits, knowledge about weight status) was applied to all students. Adolescent Nutrition Literacy Scale (ANLS), Instrument of Nutrition Literacy, Mediterranean Diet Quality Index (KID-MED), Eating Attitudes Test 26 (EAT-26), International Physical Activity Questionnaire Short Form (IPAQ) were applied, anthropometric measurements and three-day food consumption records were taken. During the study, nutrition initiatives consisting of 8 modules will be made to the intervention schools. Control schools will not be interfered with during this period.At the end of the study, the procedures applied at the beginning will be repeated.

Study Overview

• Status: Recruiting
• Conditions: Body Image; Eating Behavior; Nutrition, Healthy; Eating Habit; Nutrition Disorders in Adolescence
• Intervention / Treatment: Behavioral: Nutrition Education; Behavioral: nutritional status, eating habits

Detailed Description

Lack of knowledge about nutrition is one of the most important causes of nutritional problems. accordingly, wrong eating practices and habits can lead to many complications and health problems. Especially adolescent eating habits form the basis of adult eating habits. The habits acquired during this period can lead to behaviors and attitudes that persist for a long time and are difficult to change.The aim of this study is to determine the effect of nutrition education on nutritional literacy, nutritional status, eating habits and eating behavior in high school students. The research will be conducted in six high schools, three of which are intervention schools and three of which are control schools. Schools in the district will be divided into 3 layers as 1- Anatolian High Schools, 2- Technical and Vocational High Schools, 3- Imam Hatip High Schools, and a control school will be determined from each layer by means of a random numbers table. It is planned that a total of 1000 students will be included in the study from the intervention school and 1000 students from the control school. At the beginning of the study (June 2022), an introductory form (sociodemographic characteristics, body image (Stunkart scale), dietary habits, knowledge about weight status) was applied to all students. Adolescent Nutrition Literacy Scale (ANLS), Instrument of Nutrition Literacy, Mediterranean Diet Quality Index (KID-MED), Eating Attitudes Test 26 (EAT-26), International Physical Activity Questionnaire Short Form (IPAQ) were applied, anthropometric measurements and three-day food consumption records were taken. During the study, nutrition initiatives consisting of 8 modules (powerpoint supported classroom lesson, video demonstration, role-play, healthy plate model game, poster preparation, bookmarks, refrigerator magnets, etc. preparation of reminder messages, competitions such as slogan-painting contest, activities such as sports and nutrition festival) will be made to the intervention schools. Control schools will not be interfered with during this period.At the end of the study, the procedures applied at the beginning (anthropometic measurements, introductory form, scales, food consumption record) will be repeated.

• Study Type: Interventional
• Enrollment (Estimated): 1000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Özge KÜÇÜKERDÖNMEZ, PhD; Phone Number: 05352769596; Email: dytozgek@hotmail.com
• Study Contact Backup: Name: Reci MESERİ, PhD; Phone Number: 05324058863; Email: recimeseri@yahoo.com

Study Locations

• Turkey
  • İzmir, Turkey
    • Recruiting
    • Menemen District Directorate of National Education
    • Contact: Sibel ÖZER; Phone Number: (0232) 832 26 29

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• studying in the 9th and 10th grades in the selected schools
• agree to participate in the research

Exclusion Criteria:

• Type 1 diabetes
• Metabolic disorders (Phenylketonuria, Maple Syrup Urine Disease, Galactosaemia ect.)
• Pediatric Malabsorption (Celiac, cystic fibrosis, congenital sucrase isomaltase deficiency ect.)
• require a special diet

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention schools (educated about nutrition); The research will be conducted in six high schools, three of which are intervention schools . Schools in the district will be divided into 3 layers as 1- Anatolian High Schools, 2- Technical and Vocational High Schools, 3- Imam Hatip High Schools.	Behavioral: Nutrition Education; Nutrition interventions consisting of 8 modules (powerpoint supported classroom lesson, video demonstration, role-play, healthy plate model game, poster preparation, bookmarks, refrigerator magnets, etc. preparation of reminder messages, competitions such as slogan-painting contest, activities such as sports and nutrition festival).; Behavioral: nutritional status, eating habits; At the beginning of the study (June 2022), an introductory form (sociodemographic characteristics, body image (Stunkart scale), dietary habits, knowledge about weight status) was applied to all students. Adolescent Nutrition Literacy Scale (ANLS), Instrument of Nutrition Literacy, Mediterranean Diet Quality Index (KID-MED), Eating Attitudes Test 26 (EAT-26), International Physical Activity Questionnaire Short Form (IPAQ) were applied, anthropometric measurements and three-day food consumption records were taken
Sham Comparator: Control schools (non-educated about nutrition); The research will be conducted in six high schools, three of which are control schools. Schools in the district will be divided into 3 layers as 1- Anatolian High Schools, 2- Technical and Vocational High Schools, 3- Imam Hatip High Schools, and a control school will be determined from each layer by means of a random numbers table	Behavioral: nutritional status, eating habits; At the beginning of the study (June 2022), an introductory form (sociodemographic characteristics, body image (Stunkart scale), dietary habits, knowledge about weight status) was applied to all students. Adolescent Nutrition Literacy Scale (ANLS), Instrument of Nutrition Literacy, Mediterranean Diet Quality Index (KID-MED), Eating Attitudes Test 26 (EAT-26), International Physical Activity Questionnaire Short Form (IPAQ) were applied, anthropometric measurements and three-day food consumption records were taken

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
nutrition literacy	To investigate the effects of nutrition education interventions on nutrition literacy. We use Adolescent Nutrition Literacy Scale and Instrument of Nutrition Literacy scale to evaluate the nutrition literacy.	up to 10 months
Mediterranean Diet Quality Index (KID-MED)	In KIDMED, which is a scale consisting of sixteen questions, each question is answered "Yes" or "No". The scale includes 12 questions about eating habits appropriate for the Mediterranean diet and 4 questions about eating habits not appropriate for the Mediterranean diet. If "Yes" is answered to the questions questioning the eating habits appropriate for the Mediterranean diet, +1 point is obtained, if "Yes" is answered to the questions questioning the eating habits not appropriate for the Mediterranean diet, -1 point is obtained, and 0 point is obtained when no answer is given to the questions. The lowest score that can be obtained from the scale is -4 and the highest score is 12. The total score obtained from the scale is evaluated in three groups as optimal (good) diet quality if it is 8 and above (≥8 points), diet quality that needs to be improved (moderate) if it is between 4-7 points, and very low diet quality (low) if it is 3 and below (≤3 points).	up to 10 months
Eating Attitudes Test 26 (EAT-26)	It is used to determine whether there is an eating disorder. It is a 6-point Likert-type test consisting of a total of 26 questions. The answers include "always, very often, often, sometimes, rarely, never". A minimum score of "0" and a maximum score of "78" can be obtained from the test. If the test score is above 20, there is a risk of eating behaviour disorder. If the test score is below 20, there is no risk of eating behaviour disorder.	up to 10 months
weight and height measurement	Height measurement will be made with a portable height meter supported by the wall with light clothes without shoes, with the head upright, looking straight ahead, the line passing through the eyes and ears parallel to the ground, legs straight and closed, arms at the side, shoulders relaxed, heels, hips and shoulders on the Frankfurt plane against the wall. Weight measurement will be done with a 100 g sensitive digital scale. BMI will be obtained by dividing weight (kg) by the square of height (m), and age and gender appropriate percentile values will be determined. 85-95 percentile will be classified as overweight and ≥95 percentile as obese.	up to 10 months
waist circumference measurement	Waist circumference will be measured with the help of a non-flexible tape measure, with light clothes, while breathing normally, standing upright, with arms outstretched on both sides, at the point passing through the exact midpoint between the lower ribs and the hip bone.	up to 10 months
Food Consumption Record	The food consumption record form will be filled in by the researcher for 3 days with 24 hour reminder method. Food and food photo catalogues will be used to determine the measurements and quantities of food consumption. The amount of nutrients included in the meals consumed by the individuals will be calculated using standard recipes. Average energy and nutrient values of the food/drinks consumed will be calculated using the BEBIS programme. In the evaluation of energy and nutrient intakes, recommended daily energy and nutrient values according to gender and age will be used. Accordingly, those who consume ± 50% of the recommended amount of energy and nutrients will be considered adequate (50-150%), and those who consume < 50% will be considered inadequate (50%).	up to 10 months
International Physical Activity Questionnaire (IPAQ- Short Form)	It was developed by Craig et al. to determine the physical activity status of individuals (Craig et al., 2003). It is a 7-question form whose Turkish validity and reliability was performed by Öztürk (Öztürk, 2005). In this form in which walking, moderate activity, vigorous activity and time spent sitting are questioned, weekly MET values of individuals are calculated and individuals are classified as inactive, minimally active and very active according to the results. A score is obtained as "MET/min/week" by multiplying the minutes, days and MET values of the physical activity performed. In the calculation of the walking score, a walking time of 3.3 METs, 4 METs for moderate physical activity and 8 METs for vigorous physical activity are accepted. If the calculated value is 3000 MET/min/week, it is classified as very active	up to 10 months

Collaborators and Investigators

• Sponsor: Ege University
• Investigators: Principal Investigator: Murat URHAN, PhD, Ege University; Principal Investigator: Ezgi KARATAŞ, PhD, Ege University; Principal Investigator: Rana N AKDER, Msc, Ege University; Principal Investigator: Ceren AKANALÇI, Msc, Ege University; Principal Investigator: Reci MESERİ, PhD, Ege University; Study Director: Özge KÜÇÜKERDÖNMEZ, PhD, Ege University

Study record dates

Study Major Dates

• Study Start (Actual): June 6, 2022
• Primary Completion (Actual): December 30, 2023
• Study Completion (Estimated): June 30, 2024

Study Registration Dates

• First Submitted: January 18, 2023
• First Submitted That Met QC Criteria: February 16, 2024
• First Posted (Actual): February 23, 2024

Study Record Updates

• Last Update Posted (Actual): February 23, 2024
• Last Update Submitted That Met QC Criteria: February 16, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nutrition Disorders
• Other Study ID Numbers: 22-5.1T/2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No