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The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11–12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group—three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points (p < 0.001) and in the total sample by 0.4 (p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80–7.31 and 2.99, 1.60–5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required. [ABSTRACT FROM AUTHOR]

A holistic approach to understanding the relationship between diet, lifestyle and obesity is a better approach than studying single factors. This study presents the clustering of dietary and lifestyle behaviours to determine the association of these dietary-lifestyle patterns (DLPs) with adiposity, nutrition knowledge, gender and sociodemographic factors in teenagers. The research was designed as a cross-sectional study with convenience sampling. The sample consisted of 1549 Polish students aged 11–13 years. DLPs were identified with cluster analysis. Logistic regression modelling with adjustment for confounders was applied. Three dietary-lifestyle patterns were identified: Prudent-Active (29.3% of the sample), Fast-food-Sedentary (13.8%) and notPrudent-notFast-food-lowActive (56.9%). Adherence to Prudent-Active pattern (reference: notPrudent-notFast-food-lowActive) was 29% or 49% lower in 12-year-old or 13-year-old teenagers than in 11-year-old teenagers, respectively, and higher by 57% or 2.4 times in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score. To the contrary, adherence to Fast-food-Sedentary (reference: notPrudent-notFast-food-lowActive) was lower by 41% or 58% in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score, respectively. In Prudent-Active, the chance of central obesity (waist-to-height ratio ≥0.5) was lower by 47% and overweight/obesity was lower by 38% or 33% (depending on which standard was used: International Obesity Task Force, 2012: BMI (body mass index)-for-age ≥ 25 kg/m2 or Polish standards, 2010: BMI-for-age ≥ 85th percentile) when compared with the notPrudent-notFast-food-lowActive pattern. In Fast-food-Sedentary, the chance of central obesity was 2.22 times higher than the Prudent-Active pattern. The study identified a set of characteristics that decreased the risk of general and central adiposity in teenagers, which includes health-promoting behaviours related to food, meal consumption and lifestyle. Avoiding high-energy dense foods is insufficient to prevent obesity, if physical activity and the consumption frequency of health-promoting foods are low and breakfast and a school meal are frequently skipped. The results highlight the importance of the nutrition knowledge of teenagers in shaping their health-promoting dietary habits and active lifestyle to decrease adiposity risk and negative aspects of lower family affluence which promotes unhealthy behaviours, both related to diet and lifestyle. [ABSTRACT FROM AUTHOR]