Objective: To understand snack food consumption among students of grade four and grade five in six cities of China, and to provide evidence for conducting nutritional education and making intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 primary school students in grade four and grade five from 72 primary schools in Beijing,Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire survey on dietary behaviors. Results: The proportion of pupils who consumed snack food at home, school and elsewhere was 96.4%, 59.4% and 75.5% respectively. The most popular snacks at home were fruits & vegetables, milk, cereals (72.0%, 71.1%, 68.6%), the most popular snacks at school were fruits & vegetables, milk, cereals (30.0%, 28.2%, 23.8%), the most popular snacks in other places were sugars, cereals and beverages (36.6%, 36.2%, 35.7%). The top five reasons for snack food was being delicious, healthy/nutritious, clean, choices of peers and family members (68.5%, 49.3%, 42.2%, 24.7%, 17.8%, respectively). Conclusion Snack food consumption is popular among primary students, most of which are unhealthy. Nutrition education for students and parents should be encouraged to promote students to consume snacks reasonably and develop healthy eating behaviors.

Objective: To understand the status on beverages consumption among grade 4 and grade 5 primary school students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing, Guangzhou, Nanjing, Chongqing, Jinan and Harbin. All the participants were investigated with a self-administered questionnaire survey of dietary behaviors. Results: The proportion of students who consumed beverages at home, school and elsewhere was 92.5%, 51.4% and 70.6% respectively. The most popular beverages at home were milk, fruit & vegetable drinks, tea drinks (69.4%, 46.6%, 39.6%); the most popular beverages at school were milk, fruit & vegetable drinks, tea drinks (30.5%, 13.0%, 12.7%) while the most popular beverages in other places were milk, tea drinks, fruit & vegetable drinks(37.4%, 29.6%, 28.1%). The top five reasons for choosing beverages were taste delicious, healthy & nutritious, clean, choice of peers and family members(72.3%, 50.8%, 38.4%, 21.9%, 21.6%, respectively). Conclusion Consumption of drinking beverages is popular among students, most of which are unhealthy. Therefore, nutrition education for students and parents should be encouraged aiming to help students choose healthy drinks and eating behaviors.

Objective: To understand nutrition knowledge,related attitude and behavior among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in 6 cities of China, whom were administered with a questionnaire survey on nutrition knowledge, practice and practice. Results: Average nutritional knowledge was relatively low (12.0±6.4), practice score was moderate(11.4±2.4), while nutritional attitude was relatively high(17.0±2.4). The nutritional KAP scores of girls were higher than those of boys; the nutritional knowledge and practice scores of urban students were higher than those of suburban students; the nutritional knowledge score of fifth-grade students was higher than that of fourth-grade students(P<0.05). The overall nutritional knowledge awareness rate was 26.1%, with the highest in knowledge of whole grains(73.9%). About 83.5% of the students held positive nutritional attitude, 97.6% considered nutritional knowledge important. The overall rate of healthy eating behavior of students was 88.1%. Most students had breakfast almost every day(88.5%). About 34.9%, 38.0%,46.1% and 50.5% were reported of rarely consumption in snacks, fast food and drinks. Students in urban area and grade 5 were more likely have breakfast. Girls reported higher rates of having breastfast and low consumption of snack food and beverage while boys reported higher consumption of fast food. Students from suburban areas reported high consumption of western fast food but lower beverage(P<0.05). The score of students’ nutritional knowledge was positively correlated to attitude, so as attitude and practice(P<0.05). Conclusion Insufficient nutritional knowledge and unhealthy dietary behavior is observed in primary school students in China. Nutritional K-A-P varies in students with different gender, area and grade. Specific nutritional education in school-setting should be developed accordingly to culture healthy lifestyle among primary school students.

Objective: To understand food intake frequency among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing，Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire on dietary behaviors. Results: For the fourth and fifth grade primary school students, the highest proportion of "almost every day" was fresh vegetable(83.2%), and the highest proportion of "nearly eaten" was oat (50.2%). There was a remarkable difference between children of different genders, areas and grades. The intake of whole grains, meat and poultry, fishery products, eggs, soybeans and nutritional supplements of boys was higher than that of girls, while the intake of oats, fresh vegetables, fruits, fungi and algae of girls was higher than that of boys. The intake of oats, vegetables, fruits, fungi and algae, meat and poultry, milk of central urban areas students was higher than that of suburban areas students, while the intake of fishery products, soybeans and nutritional supplements of suburban areas students was higher than that of central urban areas students. The intake of oats, fresh vegetables, fruits, meat and poultry, eggs, milk and soybeans of fifth grade students was higher than that of fourth grade students, while the intake of whole grains, fishery foods and nutritional supplements of grade 4 students was higher than that of grade 5 students. The differences were all statistically significant(P<0.05). Conclusion The frequency of food intake varies among students of different genders, urbanities and grades. School teachers, parents and community workers should make efforts targeting at students with different characteristics to enhance nutritional literacy and cultivate healthy eating behaviors.

Objective: To understand the status on fast food consumption among grade 4 and grade 5 primary school students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing, Guangzhou, Nanjing, Chongqing, Jinan and Harbin. All the participants were investigated with a self-administered questionnaire survey of dietary behaviors. Results: Students consumed western fast food 1.48 times a week and Chinese fast food 2.08 times a week on average, which shows significant differences (χ2=643.86, P<0.05). The main reasons for choosing Chinese fast food were delicious(73.8%), nutritious(69.9%), safe and clean(52.2%), convenient (45.9%) and eating surrounding (41.4%), and for western fast food were delicious(80.1%), eating surrounding(53.0%), convenient(44.2%), safe and clean (41.6%) and nutritious(40.6%). Boys paid more attention to deliciousness and convenience, girls paid more attention to cleanliness and nutrition. About 43.9% of the students were aware of the high calorie in western fast food. Conclusion The consumption of fast food is popular among primary students. Schools and other relevant departments should launch nutrition education, deliver sufficient nutrition knowledge，help students establishing a good diet habit and reduce the consumption of western fast food with high calories.

Objective: To investigate the total amount and types of fluid intake among college students in Hebei Province during spring and to provide scientific basis for fluid-intake education. Methods: A simple random sampling method was used to select 156 college students from a college in Hebei Province. The information on amount and type of fluid intake was recorded using the 7-day 24-hour recording method. A separate analysis was performed on people who consumed beverages during the 7 days. Results: The median intake of plain water, milk, sugar-sweetened beverages and other beverages was 866 mL, 43 mL, 43 mL and 2 mL, respectively. The median of plain water, milk, sugar-sweetened beverages and other beverages by the beverage-consumers was 845 mL, 36 mL, 63 mL and 11 mL, respectively. The intake of plain water and sugar-sweetened beverages in male students was significantly higher(Z=2.31, 3.03; 2.31, 2.11, P<0.05), and milk consumption was lower than female students of these two groups of people(Z=-2.73, -2.23, P<0.05). The intake of other beverages in male students was higher than that of female students, but only significant among beverage-consumers(Z=3.31, P<0.01). There was no significant difference in the total amount of different fluid types among different BMI(P>0.05). Conclusion College students in Hebei Province mainly drink plain water. Sex difference is observed in the types of fluid intake.

Objectives: To investigate the total fluids intake among college students in spring from Hebei. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by duplicate portion method. The sources of total fluids intake among subjects were analysed. Results: The age of subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids and water from food were 2 324, 1 135 and 1 174 ml, respectively. The proportions of total drinking fluids and water from food in total fluids intake were 51%±9% and 49%±10%. Only 19.9% (n=31) and 18.6% (n=29) of college students had adequate total fluids intake and total drinking fluids, according to the recommendation of China. The median amounts of total fluids intake, total drinking fluids and water from food were 3 210, 1 860 and 1 093 ml/d, respectively. The proportion of total drinking fluids in total fluids intake was 61%±7%, which were all higher than those who did not reach the recommended intake (2 158, 1 000, 1 149 ml/d; drinking fluids accounting for 46%±8% of total fluids intake) (P<0.05). Conclusion The amounts of total fluids intake and total drinking fluids of college students in Hebei Province are lower than the recommended intake in China. The contributions of total drinking fluids and water from food to total fluids intake were nearly same.

Objective: To investigate the food source of water of college students from Hebei Province in spring. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. All foods were collected for 3 consecutive days using duplicate portion study combined with weighing method to test the water content of various foods. To analyze the water content of the food and calculate the proportion to the total amount of food water intake, the edible parts of each meal were divided into staple food, dishes, porridge, soup and snacks. Body mass index (BMI) was grouped according to quartiles, and the differences in food intake and food water sources among subjects of different genders and BMI were compared. Results: The age of subjects was (19.8±1.1) years old, including 80 male students. The median intake of staple food, dishes, porridge, soup and snacks per day was 562 g, 743 g, 111 g, 102 g and 0 g, respectively. The median intake of water from staple food, dishes, porridge, soup and snacks per day was 301 ml/d, 620 ml/d, 97 ml/d, 93 ml/d and 0 ml/d, respectively. The median ratio of water intake to total food water intake of staple food, dishes, porridge, soup and snacks was 27%, 53%, 8%, 8% and 0%, respectively. The median intake of water from staple food and dishes in male students was significantly higher than that of female students (P<0.05). The amount of water intake from porridge of female students was significantly higher than that of male students (P<0.05). There was no significant difference in the water intake from soup and snacks between different genders. There was no significant difference in food intake and food water sources among college students with different BMI (P>0.05). Conclusion The food source of water of college students from Hebei Province in spring is mainly based on dishes and staple foods. The food source of water for boys and girls is different.

Objectives: To investigate the total fluids intake, volume of urine and hydration status among college students from Hebei Province in spring. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by the duplicate portion method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality, pH and specific gravity of urine were measured. Hydration status was grouped to three types according to the urine osmolality (mOsm/kg), namely, optimal hydration (urine osmolality ≤500), middle hydration (500< urine osmolality ≥800) and dehydration (urine osmolality >800), and the differences among subjects in different genders and hydration statuses were compared. Results: The age of all subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids, water from food and urine volume were 2 324, 1 135, 1 174 and 1 279 ml/d, respectively. The volume of urine among males was 1 272 ml/d, which was not significantly different from that of females (1 304 ml/d) (P>0.05). The osmolality and specific gravity of urine among males were 688 mOsm/kg and 1.017, which were higher than those of females (493 mOsm/kg, 1.014) (P<0.05). But the pH of males was 6.6±0.3, which was lower than that of females (6.7±0.3) (P<0.05). Only 37.2% (n=58) of college students were in optimal hydration status. The median of the amount of total drinking fluids among subjects in optimal hydration status was 301, 448 ml/d higher than that in middle hydration status and dehydration, respectively (P<0.05). The proportion of females in optimal hydration status was 51.3% (n=39), which was higher than that of males 23.8% (n=19) (P<0.05). Conclusion Large proportion of college students in Hebei had lower total drinking fluids than the recommended intake of China, and the volume of urine was equal to the amount of total drinking fluids among the college students. Only 37.2% of college students were in optimal hydration status, and the proportion of female college students in optimal hydration status was larger than that of males.