Objective: To analyze the total fluids intake and sources of college students from Hebei in spring and summer, and to provide a scientific reference for appropriate fluids intake in different seasons. Methods: Subjects were recruited in a university in Baoding, Hebei Province, and investigations were conducted in April and June 2021. The number of people who completed both spring and summer investigations was 80. Quantitative instruments and 7 day 24 h Fluid Intake Questionnaire were used to investigate the total drinking fluids, and it was recorded for 7 consecutive days in spring and summer respectively. The duplicate portion method was used to investigate the water from food. The total fluids intake and sources among subjects were analyzed in spring and summer. Results: There was no statistical significance between the total drinking fluids and total fluids intake between spring and summer [1 141(715), 1 176(649)mL/d, (2 496±604)(2 458±554)mL/d] ( F=1.86, 0.59, P >0.05). Spring showed significantly higher water from food compared with summer [(1 318±274)(1 217±302)mL/d]( F=16.63, P <0.05). The proportions of total drinking fluids and water from food in spring were 46% and 54%, respectively, and both were 50% in summer, the differences were statistically significant ( F=12.97, 12.97, P <0.05). There were differences in total fluids intake,total drinking fluids and water from food of different genders in earch season ( t/Z =4.75, -3.63, 3.44; 4.80, -2.91, 4.01, P <0.05). There were differences in total water intake, total drinking fluids, the proportions of total drinking fluids and water from food of different BMI groups in each season ( F/H =8.08, 16.65, 3.03, 3.03; 7.11,17.97, 4.52, 4.52, P <0.05). In spring, only 13.8% of subjects achieved the recommended total drinking fluids of China, compared with 18.8% in summer. In spring and summer, the total fluids intake, total drinking fluids, the proportions of total drinking fluids in the group achieved the recommendation were all higher than those who did not reach the recommendation ( t/Z =6.64, -5.19, 5.79; 8.12, -5.97, 5.70, P <0.05). Conclusion Season is a factor that affects total fluids intake, and it should be taken into account when setting the recommendation on adequate water intake.

Abstract Children s school aged time is the key period for the formation of dietary behaviors and the dietary behaviors is affected by economic, social, cultural, family, and personal factors. Due to economic, geographical, and food culture reasons, there exists several nutritional problems in western China, such as lack of nutrition health education and poor food environment. These problems may lead to suboptimal dietary behaviors of school aged children, including but not limited to having single breakfast food and unhealthy snacks and drinks. The unhealthy dietary behaviors may further hinder the growth of children in western China. Experiences and lessons should be drawn from various effective interventions developed in other regions in China. It is necessary to develop a local adapted comprehensive intervention program which incorporates the aspects of policies and laws, nutritious meals, school nutrition health education, and social nutrition health atmosphere.

Objective: To investigate fast food consumption behaviors among 4th and 5th grade primary school students in agricultural and pastoral areas in Qinghai Province, and to provide scientific basis for nutrition education and intervention measures for school age children in agricultural and pastoral areas. Methods: Using multi stage stratified cluster random sampling method, a total of 969 fourth and fifth grade students were selected from 10 primary schools in 4 counties and districts in 3 cities of Haidong City, Hainan Prefecture and Haixi Prefecture from Qinghai Province. Self administered questionnaires were used to investigate the fast food consumption behaviors of participants. Results: The proportions of senior primary school students in agricultural and pastoral areas of Qinghai Province who had consumed western fast food and traditioal fast food in the past week were 45.8% and 75.6%, respectively, with statistically significant differences ( χ 2=290.24, P <0.05). The times of traditional fast food consumption in the past week among boarding students were higher than that of non boarding students( Z =6.44,5.84, P <0.05). The main reasons for senior primary school students in agricultural and pastoral areas of Qinghai Province to choose to consume western fast food were that it was delicious (84.7%), nutritious (62.6%), clean and hygienic (57.4%), and a better environment (57.0%). The top 4 reasons for chousing Chinese fast food were yummy(83.8%),nutritious(82.8%),clean and healthy(67.4%),and good environment(53.5%). Among the surveyed primary school students, 64.7% believed that diet structure of Chinese fast food was reasonable, 43.0% believed that the nutritional value of Chinese fast food was high, and 39.4% believed that the energy content of western fast food was high. Conclusion Fast food consumption is a common dietary behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province. Relevant departments should strengthen the nutrition education related to fast food, promote the dissemination of health knowledge, enable students to develop a good lifestyle and reduce fast food consumption.

Objective: To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies. Methods: A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups. Results: The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%). Conclusion The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.

Objective: To understand the current situation regarding snack food consumption among grade 4 and grade 5 primary school students in agricultural and pastoral areas of Qinghai Province, China, and to provide a scientific basis for nutrition education and intervention strategies. Methods: Multistage stratified cluster random sampling was employed. The research included 969 fourth and fifth grade students were selected from 10 primary schools in four counties and districts of three cities in Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. The self report questionnaire method was used to investigate the current status regarding snack food consumption in this population. Results: The proportion of students who consumed snack food at home, school and elsewhere were 98.2%, 88.5% and 75.4%, respectively. Male students reported a lower rate of snack consumption at school than female students ( χ 2=9.66). The fifth grade students reported a higher rate of snack consumption at home and other places than the fourth grade students ( χ 2=10.31, 6.77). The reported rate of snack consumption of students in the rural was higher than that in the county( χ 2=6.03,100.53, 24.77). The reported rate of snack consumption of boarding students at home was lower than that of non-boarding students ( χ 2=7.22), while the reported rate of snack consumption at school was higher than that of non-boarding students ( χ 2=9.04）（ P <0.01). The most popular snacks consumed at home included fruits and vegetables, cereals and nuts (76.9%, 67.2%, 63.7%), while the most popular snacks consumed at school were fruits and vegetables, cereals and candies (45.1%, 36.9%, 24.4%). The most popular snacks consumed in other settings included ice cream, candies and beverages(54.7%, 51.6%, 42.9%). The top three reasons for snacking were that snacks were regarded as delicious, healthy/nutritious and clean (76.9%, 65.5% and 59.0%, respectively). Conclusion Snacking is popular among students, although many snacks are unhealthy. Therefore, there is a need to improve food environments and nutrition education, so as to help students to choose healthy beverages and adopt healthy eating behaviors.

Objective: To examine breakfast consumption among primary school students in grades 4 and 5 in Qinghai Province, China, and to provide evidence for nutrition education and intervention strategies. Methods: We used a multistage stratified cluster random sampling method to select the participants. A total of 969 students were selected from 10 primary schools in four counties and districts of three cities, namely Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. A self rated questionnaire was administered to investigate breakfast consumption. Results: The proportion of students who consumed breakfast 5 to 7 times per week, 3 or 4 times per week, and 1 or 2 times per week were 82.0%, 9.7%, and 6.7%, respectively, while 1.5% never ate breakfast. In descending order, the breakfast food types consumed were cereals and tubers; milk, legumes and nuts; vegetables and fruits; fish and poultry; and meat and eggs (84.1%, 69.8%, 66.8%, and 37.7%, respectively). The proportion of vegetables and fruits in the breakfast of grade 5 students was higher than that of grade 4 students( χ 2=4.81, P = 0.03 ), the proportion of fish, poultry,meat and eggs in county urban areas was higher than that of students in rural( χ 2=6.94, P =0.03), while the proportion of vegetables and fruits in urban areas was lower than that of students in suburban areas( χ 2=53.33, P <0.01). The proportion of breakfast food containing fish,poultry,meat and eggs of boarding students was higher than that of non boarding students( χ 2=41.26, P <0.01), while the proportion of breakfast food containing vegetables and fruits, milk & legumens & nuts was lower than that of non-boarding students( χ 2=21.11, 4.41, P <0.01). A total of 44.8% of students had a poor quality breakfast, and only 16.3% had a good quality breakfast. Moreover, 47.5% of breakfasts were prepared by mothers, followed by the school canteen which prepared 29.9%. Except for students in different grades, there were statistically significant differences in the distribution of breakfast preparers in other groups( P <0.05). Conclusion In Qinghai Province,breakfast skipping is observed in some senior primary school students, and the quality of breakfast is poor. Diet and nutrition education should be provided for students, parents, and school canteen staff to improve the frequency and nutritional quality of children s breakfasts.

Objective: To understand the current situation of food intake frequency among schoolage children in agricultural and pastoral areas of Qinghai Province, and to provide a scientific basis for local education departments and schools to formulate scientific nutrition improvement plans and measures. Methods: A multi stage stratified cluster random sampling method was used to select 969 fourth and fifth grade primary school students from 10 primary schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All the participants were investigated with a questionnaire survey of dietary behaviors. Results: For the fourth and fifth grade primary school students, the highest proportion of "eaten almost every day" were cereal and tuber ( 84.3 %) and fruits (44.6%), and the highest proportion of "barely eaten" was aquatic product (68.1%) and nutritious supplementary (45.9%). The intake of livestock meat and poultry, fishery products, beverages and nutritional supplements of boys was higher than that of girls（ Z =-2.46，-2.46，-2.43，-2.37， P ＜0.05）. The intake of livestock meat and poultry and snacks of fifth grade students was higher than that of fourth grade students, while the intake of fishery products was lower than that of fourth grade students（ Z = -2.66 ，-4.33，-2.65， P ＜0.05）. Conclusion The frequency of food intake varies among students of differences genders, grades, areas, boarding situation and urbanities. Relevant departments should improve nutrition improvement plans for school age children with different characteristics. Schools and families should carry out nutrition education works to cultivate healthy eating behaviors of students.

Abstract School aged children grow and develop rapidly, and adequate nutrition is the material basis for their normal intellectual and physical development. It is necessary to formulate the dietary guidelines for school aged children on the basis of the dietary guidelines for the general population, and revise in time according to the changes in the nutritional health status of school aged children. The revision of the dietary guidelines for school aged children is based on the content of Dietary Guidelines for Chinese School aged Children (2016). In addition, according to the revision principles and procedures of the Dietary Guidelines for Chinese Residents, as well as comprehensive consideration of the current prominent dietary and nutritional problems of school aged children in China, Dietary Guidelines for Chinese School aged Children (2022) is finally issued after evidence based researches, discussion and consultation. Dietary Guidelines for Chinese School aged Children (2022) highlights the improvement of nutritional literacy, the cultivation of healthy eating behaviors, the building of healthy food environment, as well as updating the recommendation concerning diet and active physical activity. Dietary pagodas for school aged children of different three ages including 6-10 years, 11-13 years and 14-17 years are added to the guideline. The Guideline provides practical references for parents, teachers, school health workers, medical staff in child health services and workers in centers for disease control and prevention.

Abstract Obesity has become a global public health problem that affects human health and poses a huge threat to the health of children in China. More and more studies have shown that social environment including social culture, food tax, food advertising and marketing, community food environment and community built environment exerts impact on childhood obesity. With the aim of fully developing the Healthy China and building a moderately prosperous society in all respects, as well as achieving the goal of "Achieving socialist modernization by 2035", it is also necessary to strengthen the comprehensive social environment, develop a sustainable and health supported environment for childhood obesity control and healthy growth and development for all children.

Objective: To understand lunch satisfaction and leftovers of Changsha compulsory education schools under different supply modes served by school canteens and specialized enterprises,and to provide scientific basis for the government to formulate school lunch improvement policies. Methods: Multistage stratified cluster sampling method was used to random select 2 203 students from 8 primary and secondary schools in Changsha who were administered with questionnair survey in April to May of 2018. Results: For school lunch, the overall rate of satisfaction was 78.8%.The overall lunch satisfaction of female and primany school students were higher than that of male and junior high school students respectively,and the difference was statistically significant(P<0.05). Totally 76.0% of students had the highest satisfaction in food hygiene and the lowest satisfaction rate was 60.0% in food taste. By comparing different supply modes, the overall satisfaction rate of meal quantity was higher (47.8%) under school canteens, and that of dining environment was relatively high (43.7%) under specialized enterprises. "Don-t like some food" (63.8%) was the main reason for students leftovers under the two supply modes. The lunch leftover rate of specialized enterprises (37.8%) was significantly higher than that of school cafeteria (30.6%)(χ 2=12.81，P<0.05). Conclusion The satisfaction of food taste and the rate of lunch leftovers need to be further improved. School canteens environment and management should be strengthened, as well as the flexibility and communication under specialized enterprises and family-school communication. The joint efforts by school and family are needed for healthy eating education.