**3. Results**

## *3.1. Behaviors in Terms of Nutrition and Anthropometric Data*

Overall, 26 classes from 22 different schools distributed across the provincial territory were enrolled. Of the 563 students attending the 26 classes enrolled, 501 completed the questionnaire (89%): 47.5% were male and 52.5% female, with an average age of 8.3 years (range 7–9 years). Weight status categories by sex are reported in Table 1.

**Table 1.** Weight status categories by sex.


\* BMI: body mass index.

Overall, 41.3% of children had a weight excess, which included both overweight and obesity. With regard to sex, males showed a lower percentage of overweight and normal weight but a higher percentage of obesity. Nevertheless, the statistical analysis did not show a significant association between sex and nutritional status.

In our sample, only 59.8% of children ate a qualitatively adequate breakfast that included at least one fruit or a fruit juice, and 10.8% did not have breakfast at all. Only 23.7% of the children consumed an adequate mid-morning snack, which included a fruit or fruit juice. Most children took an inadequate snack, and 2.8% did not consume one; 40.1% of the total children played outdoors the afternoon before the survey. Overall, 45% of children, on the morning of the survey, reported that they went to school on foot or by bicycle; conversely, 55% used a public or private means of transport. In our sample, 59.6% of children watched TV in the morning before going to school. Overall, 83.5% and 83.7% of children watched television or used video games/tablets/mobile phones the afternoon and the evening of the previous day, respectively. In addition, 71.5% of the children reported that they had brushed their teeth the evening before the survey. Answers to the fourteen questions are presented in Figure 1. Table 2 reports the results of the answers to the items of the questionnaire, stratified by nutritional status of enrolled children.

**Figure 1.** Answers distribution in the sample of students. The answer "NO" is represented in green, while the answer "YES" is represented in yellow.


**Table 2.** Answers provided by students, stratified by nutritional status.


**Table 2.** *Cont.*

Figure 2 shows the correlation between the ratio of positive answers to the different questions in order to summarize data, and it gives a hint at possible clusters of co-occurring answers to groups of questions. Large values (close to 1) in this matrix indicate possible collinearity between the variables involved. Yellow cells show the maximum level of association between questions.

Our analysis suggests a mild correlation between the different children's habits and lifestyles: the association between affirmative answers such as eating lunch at the school canteen correlates with the positive answers of playing sport, but it also correlates with playing video games, computers, tablets, or mobile phones and with watching TV programs. It also emerged that the morning breakfast with fruits or juices was done while watching TV. On the other hand, it is interesting to notice that "playing video games, computers, tablets, or mobile phones" were habits not associated with "going to school on foot or by bicycle", analogously "play sport or play sport outdoor" was not associated with "going to school on foot or by bicycle". It came to light that healthy family habits and proper lifestyles, according to our analytic model, may play an essential role in children's health status.

In Figure 3 is reported the correlation matrix between answers compatible with a healthier lifestyle and nutritional status. A yellowish color shows a possibly unhealthier lifestyle. As it is notable, the large part of the yellower cells is distributed among obese and overweight subclasses: in particular, unhealthy habits were registered with regard to question nos. 4, 6, 7, 10, 11, and 14 in the obese/overweight classes. On the contrary, the greener cells, indicating healthy habits, are more represented in the subclass of those with normal weight.


**Figure 2.** Correlation matrix showing the association between the answers to the questions numbered progressively in Table 2.


**Figure 3.** Correlation matrix showing the association between answers to the questions and nutritional status.
