Assessing the association between health promotion initiatives and student nutritional status and lifestyle: a regional observational study from Italy.

The prevalence of overweight or obesity was 25.1% among primary school children aged 8-9 in the FVG region.

• Data were derived from the 2023 OKkio alla Salute survey.
• The study used a cross-sectional observational design with a representative sample of primary school classes in Friuli-Venezia Giulia (FVG), Italy.
• Students were aged 8-9 years.

The prevalence of overweight or obesity was 16.7% among adolescents aged 11-17 in the FVG region.

• Data were derived from the 2022 Health Behaviour in School-aged Children (HBSC) survey.
• The study used a cross-sectional observational design with a representative sample of secondary school classes in FVG, Italy.
• Students were aged 11-17 years.

Most primary schools implemented nutrition and physical activity education, but with limited family and local health unit (LHU) involvement.

• 86.5% of primary schools implemented nutrition education initiatives.
• 97% of primary schools implemented physical activity (PA) education initiatives.
• Despite high rates of implementation, involvement of families and LHUs was described as limited.
• Data were collected via questionnaires completed by school principals.

Most secondary schools reported implementing policies on both nutrition and physical activity.

• 92.8% of secondary schools reported implementing nutrition-related policies.
• 97.3% of secondary schools reported implementing PA-related policies.
• Data were collected via questionnaires completed by school principals as part of the 2022 HBSC survey.

The only significant difference in primary school children was higher consumption of adequate mid-morning snacks among those attending schools that implemented healthy eating initiatives involving parents.

• This association was statistically significant (p < 0.001).
• No significant differences were found for weight status or physical activity habits in primary school children.
• The finding specifically required parental involvement in the healthy eating initiative, not just school implementation alone.

In secondary schools, the only significant difference associated with school health policies was fruit consumption at least once per day among adolescents attending schools with nutrition-related policies.

• Fruit consumption ≥ once/day was the sole dietary or lifestyle outcome significantly associated with school nutrition policies in secondary schools.
• No significant differences were found for weight status or physical activity habits in adolescents.
• The association applied specifically to schools with nutrition-related policies.

Overall, the association between school-based health promotion practices and students' nutritional status, dietary habits, and physical activity was limited across both primary and secondary school levels.

• Despite widespread implementation of health promotion initiatives, only two significant associations were identified across all outcomes examined.
• The findings highlight 'the limited benefits yielded by existing school practices and policies.'
• The authors underscore 'the potential importance of stronger parental involvement, multi-sectoral collaboration and more structured school health policies.'