CHAPTER V WELLNESS AND EDUCATION Emergency Medicine Department of Child Neurosurgery and Emergency Medicine Clinic, School of Public Health in Bytom, Medical University of Silesia in Katowice, Katedra Neurochirurgii Dziecięcej i Medycyny Ratunkowej, Zakład Medycyny Ratunkowej, Wydział Zdrowia Publicznego w Bytomiu, Śląski Uniwersytet Medyczny w Katowicach * Department of Health Economics and Health Management, School of Public Health in Bytom, Medical University of Silesia in Katowice Zakład Ekonomiki i Zarządzania w Ochronie Zdrowia, Wydział Zdrowia Publicznego w Bytomiu, Śląski Uniwersytet Medyczny w Katowicach **Department of Palliative Medicine and Palliative Care, School of Health Sciences in Katowice, Medical University of Silesia in Katowice **Zakład Medycyny i Opieki Paliatywnej, Wydziału Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach DARIUSZ MYRCIK, MAGDALENA TRZEPIZUR, JOANNA MAKARSKA, KAROLINA JĘDRYSZEK, DOROTA SZAŁABSKA*, KAROLINA SOBCZYK*, WIKTORIA DYJAS, ADRIANNA DONIEC, AGATA ZYCH, MARTA KOWOLIK, MARCIN JANECKI**, ARKADIUSZ NICZYPORUK, TOMASZ STĘPIEŃ, BOGUSŁAW BUCKI, DZIECHCIARZ DOROTA, MAREK MANDERA Eating habits among students of selected secondary schools in Zawiercie Nawyki żywieniowe wśród uczniów wybranych szkół średnich w Zawierciu Key words: eating habits, teenagers, high school Słowa kluczowe: nawyki żywieniowe, młodzież, liceum ogólnokształcące
WELLNESS AND EDUCATION INTRODUCTION Nutrition behaviour we call activities related to feed the nutritional needs that are part of food culture and health behavior element. Health behavior is in us throughout his life [1, 2]. Dietary behavior repeated many times are called habits. After many repetitions they become steps which performed automatically, under the influence of some kind of stimulus. In shaping the dietary habits of the important role of perpetuating existing behavior. Consolidated habits are very hard to change, which is why it is so important to apply correct eating habits since the childhood. An important impact on human health has a composition, nutritional value and quality of the foods we eat. Eating habits associated with the choice of specific foods, often determine the risk of disease which depends on the diet. Bad eating habits can lead to many serious diseases including: obesity, diabetes, osteoporosis, other diseases of the cardiovascular system. A diet high in salt, animal fats or alcohol increases the risk of cancer [3, 4, 5, 6] Diabetes is a metabolic disease which is manifested by excess body fat. For a direct cause of obesity is considered a chronic positive energy balance, this balance can be affected, some hormones that affect the feeling of hunger and satiety and regulate fat storage in subcutaneous tissue and internal organs. Accumulated adipose tissue not only stores fat, but also produces many hormones that may be responsible for the development of obesity-related metabolic disorders [4, 7, 8]. Bad eating habits can also lead to malnutrition, which is the opposite of obesity. For the cause of malnutrition is considered too low supply of essential nutrients or their excessive loss. The effects of low body weight can be underestimated the resistance, reduced the capacity of the body and chronic diseases [10, 12]. Dietary behaviour determinants are factors: demographic, economic, biological, psychological, social, cultural and geographical. Speaking of biological factors we mean the ongoing processes in the body, such as: maturation, aging, illness or pregnancy. During pregnancy appetite fluctuations occur shall be subject to the needs of the fetus to food. Economic factors that influence our food intake are: food prices, income and food supply. The rising price of food usually determine the consumer to reduce the purchase of the goods or to purchase substitute. While lowering the price of a given product leads to increase its purchase. Demographic characteristics: age, sex, family size. Gender and age differentiates human nutrition behaviour, because the demand for men and women at different times of life for nutrients vary. Another group of factors determining diet are psychological factors. Various emotional States can affect what and in what quantities we consume. A highly significant factor affecting the nutritional behaviour among people is the social factor. A man from birth to social groups such as the family, school and later other subsequent, where each of them draws the patterns, which assimilates. Another factor determining the nutritional behavior is a factor. In this area the special role attributed to culture and religion. 58
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec, Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Dziechciarz Dorota, Marek Mandera Eating habits among students of selected secondary schools in Zawiercie Geographical features such as climate, terrain, availability of water, determine the type produced in the area of food and the structure of its consumption. Now these factors are less important than formerly for access to food because very expanded trade, so people can eat products that do not appear in their place of residence. However, this policy does not apply to poorer countries that cannot afford to purchase imported foods [1, 13]. A very important factor in maintaining a normal body weight is beside to the nutrition is a regular physical activity. Not only it supports the reduce excess fat and muscle growth, but also a prerequisite for the proper functioning of many important organs and systems of the body, thus preventing many diseases [4, 8]. Purpose the purpose of the work is the evaluation of the correct and incorrect eating habits among students of selected secondary schools. An additional goal is to evaluate the relationship between sex and dietary behaviors among youth test group. MATERIAL Food test material was carried out among students the following General Lyceum in Zawiercie: II Grammar School. Helena Malczewskiej and I Liceum Ogólnokształcące im. Stefana Żeromskiego. The study involved 150 individuals, including 60 students (40%) And LO and 90 (60%) II LO. Among the polled 57. 33% were women (86 people), while 42. 67% males (64 people). Participation in the study was voluntary and surveys were anonymous. METHODS Research methods were the original questionnaire surveys, consisting of 28 questions. Questions were, inter alia: age, weight, height, number of meals, now their eating and gaps between them, tranquilizers, the amount and type of fluid consumed and used. Data acquisition through structured surveys were transferred to Microsoft Office Excel in 2016. Statistical analysis of the results obtained was performed using STATISTICA 12. To determine whether there is a relationship between the sex habits and individual coefficient, Cramer's V. RESULTS The results showed that the% of people resulted 76. 0 proper nutritional status, 14. 7% was underweight and 9. 4% excessive body weight (overweight or obese), as shown in the figure. 1. 59
WELLNESS AND EDUCATION Figure. 1. Number and percentage of high school students taking part in the study with a specific nutritional status based on the classification based on the BMI On the figure. 2. Shows the number of meals consumed daily by the surveyed students. The overwhelming number of people (74,0%) ate 4 to 5 meals a day. 14. 0% of polled take into account in their diet of 3 meals a day 0. 1%-more than 5 meals, while the smallest number of meals (1 to 2) declared 2. 7%. It has not been demonstrated the relationship between sex, school, and the quantity of consumed meals Figure. 2. Number and percentage of people participating in the study, which reported consumption of a specific number of meals 60
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec, Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Dziechciarz Dorota, Marek Mandera Eating habits among students of selected secondary schools in Zawiercie A break between meals for 72. 0% of people were 2 to 4 hours, while for 22. 0%-more than four hours. The statistical characteristics of the empirical distribution is shown in the figure. 3. Figure. 3. Number and percentage of people participating in the study, which declared certain time intervals between meals for human consumption 75% of the women a break between meals were 2-4 hours. In turn, 24% of men consumed meals over a 4-hour intervals. The strength of the relationship between gender and the intervals between meals was low due to the calculated value of the coefficient of Cramer's V, which amounted to 0. 24. Among the surveyed secondary school students observed a high incidence of snacking. 87. 3% polled this happens a few times a week or daily. The statistical characteristic is analyzed and shown in Fig. 4. 61
WELLNESS AND EDUCATION Figure. 4. The number and the proportion of youth who test declared a certain frequency of snacking There was no significant statistical differences in the frequency of snacking between women and men. The most sneaked products: sweets (59%), fruit or vegetables (42%), as well as yogurts (21%). The most popular from the first type of breakfast were sandwiches among respondents. They were eaten by 57% of people under the first meal. Much less commonly eaten were cereal with milk (16%) and scrambled eggs (9%). On the figure. 5. the presented time after waking up (in hours), in which it was eaten first. There were larger differences in time of consuming the first breakfast by women and men. Figure. 5. Number and percentage of people participating in the study that reported eating the first breakfast in a specified period of time after waking up 62
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec, Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Dziechciarz Dorota, Marek Mandera Eating habits among students of selected secondary schools in Zawiercie The most common products of choice on breakfast sandwiches were II (54%). A relatively popular article were also fruits (22%), 18% of the interviewees do not consumed II. 67% students of selected secondary schools consumed followed by a dinner. In the case of 28% of the lunch consisted of only one dish, while 5%-soup, second dish and dessert. In the afternoon interviewee consumed: fruits (27%), yogurt (23%), as well as sandwiches (8%). In turn, 1\/3 of the respondents did not take afternoon tea in your menu. Better eating habits in terms of the profile of tea were found among women. Fruit in your diet take account of 34. 2% of the women and 23. 1% of men. This relationship took a moderate strength (Cramer's V coefficient = 0. 41). It has been shown that 36% of the respondents consumed last meal during the day in too short a time before bedtime or not at all. The most common products of choice for dinner were sandwiches (63%) and hot sausages or Wieners (12%). The majority of respondents ate vegetables rich in vitamin C and carotene several times a week or daily. The frequency was presented on fig. 47. Figure. 6. Number and percentage of surveyed people who declare themselves determined the frequency of consumption of vegetables rich in vitamin C and carotene It was also found that people often include vegetables to your diet, typically made in the same way for: fruit rich in vitamin C and carotene. 63
WELLNESS AND EDUCATION Figure. 7. The number and percentage of surveyed people who declare themselves determined the frequency of consumption of fruits rich in vitamin C and carotene Slightly less than vegetables rich in vitamin C and carotene were eaten fruit rich in these compounds. The frequency of turning to the diet this kind of fruit was presented on fig. 7. The relationship between sex and frequency of consumption of vegetables rich in vitamin C and carotene was poor. This is confirmed by the calculated value of the coefficient of Cramer's V, which amounted to 0. 18. It has been shown a weak relationship between sex and the consumption of fruits rich in vitamin C and carotene-cramer's V coefficient was 0. 09. A very popular product among the youth were sweets. 78% ate them a few times a week or daily. Frequency of joining sweets to a diet was illustrated in the figure. 8. 64
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec, Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Dziechciarz Dorota, Marek Mandera Eating habits among students of selected secondary schools in Zawiercie Figure. 8. Number and percentage of surveyed people who declare themselves determined the frequency of the incorporation of sweetness to the dish It has been shown a weak relationship between sex and the consumption of sweets. Cramer's V coefficient was equal to 0. 11. DISCUSSION A discussion in the presence of their own research weight 9. 4% among the stated excess high school students. The result obtained is smaller than the result from the study conducted among youth of Krakow, where overweight or obesity has been shown among 14. 4% of teenagers. Nutritional status of the respondents was examined also broken down by gender. It has been shown that low body weight frequently performed among women (16%) than men (4%). In turn, excessive body weight is mainly characterized by males and 14% compared to 5% of women [18]. In accordance with the principles of rational nutrition, it is advisable to consume at least 4 to 5 meals a day. Meals should be eaten often, but in small quantities. Consumption of 4 to 5 or more meals provided to 74. 0% polled. The results obtained show that tested young people shall be better habits than teenagers by other authors. Silesian Voivodeship about 60% of secondary school students has the correct eating habits. In research-maksymowicz Jaroszuk and Karczerwskiego, it was found that with the increase in the number of meals, decrease the time spacing between them. The same conclusions have been obtained on the basis of research [9, 11, 19]. 65
WELLNESS AND EDUCATION It is important to maintain adequate breaks between meals. They should not be longer than 4 hours. Long intervals between meals cause: decrease in glucose, which can affect the reduction of concentration, irritability, weakness, abdominal pain, and headaches and learning difficulties. Those surveyed high school students characterized behavior appropriate breaks between meals 72% of them were less than 4. This result is much better than that obtained by other authors [17, 19, 20] In the test group of 59% sneaked candy, what should be considered as a negative phenomenon. For positive should be considered within the framework of the snacking products such as fruit or vegetables (42%) and yogurt (21%). Snacking sweet snacks by a higher percentage of students (75%) observe inter alia Strainer et al. in a study carried out in middle school and high school. In their own research found a similar incidence of snacking (87,3%) as in the study of other authors [14, 15, 21]. Among the students surveyed, 8% of them do not consume. Similar results have Mine-Kołłajtis et al. -7% of children missed the meal. A much greater incidence of not consuming the first breakfast found Kiciak et al. and Strainer et al. (respectively 20% and 22% of those polled). In Indian studies have demonstrated that the reasons for not consuming the first breakfast could be inter alia: too late getting up, or lack of hunger [11, 14, 21, 22]. Lunch was a meal are less likely to be taken into account in the diet than the first. 18% of the interviewees do not eat the second. A much larger frequency skipping the second breakfast has been shown in studies Strainer et al. (46%) [21] on the basis of the research, it was found that 67% of respondents consume full, followed by a dinner. A similar result (57%) received Maksymovich-Jaroszuk and Rosa. Inclusion in the menu of only 1 lunch dishes can cause shortages of calories, vitamins and minerals. In turn, 3-course dinner can be a cause of excess body weight, as it provides the body with too much calories [19]. The most commonly consumed beverage article by high school students surveyed as part of afternoon tea were fruits (27%). Students attending elementary schools in New York and the surrounding area of the city in the afternoon also chose fruit, but with much greater frequency (82%). In a study of its own 33% of teenagers don't consume tea. Similar results obtain Wojtyla-Buciora et al. and Piotrowska et al.-meal this omits the 38% and respectively 38. 1% of respondents. In a study carried out by the Strainer et al. among the students of Warsaw secondary school, afternoon tea was taken into account by only 18% of people [23, 24]. In its own study found that 7% of the interviewees do not consume. This is a smaller percentage than that obtained by Piotrkowska street et al. (14. 7%) in a study on a group of girls aged 16-18 years old from Wroclaw. Other authors have shown that women more often than men do not consumed dinner 21. 2% and 5% respectively. In contrast, in a study of their own do not found the relationship between sex and not consuming dinner (women 4% and 3%) males. Piotrkowska studies et al. have shown that as many as% of consume female 50. 9 last meal after twenty [24]. On the basis of own research showed that men who ate dinner just before bedtime, and women for 2-3 hours before going to sleep. It can therefore be concluded that schoolgirls tested exhibited better habits than their peers of Wroclaw high school [24]. Vegetables rich in carotene and vitamin C daily consumed 35. 3% of respon- 66
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec, Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Dziechciarz Dorota, Marek Mandera Eating habits among students of selected secondary schools in Zawiercie dents, while a few times a week 41. 3% of high school students. Similar results obtained the Bat when researching among the elderly. However, this study does not include the Division into fruits and vegetables rich in vitamin C and carotene. It was shown that vegetables daily were consumed by 31. 3% of older Poles, while a few times a week-44. 9% of them. In studies of Bat 70. 15% of older people was eating fruit daily, while a few times a week made it 18% of them. In turn, research has shown that fruits rich in vitamin C and carotene eat daily: 22% of respondents, while a few times a week 48. 7% of high school students. In its own study, it was found so too low intake of fruits and vegetables [16]. In its own study found a very high incidence of consumption of sweets 78% of people take account of them in their diet a few times a week or daily. A similar percentage of Japanese (63%) spożywało sweets with the same frequency. Bielaszka et al. showed that the sweets are very popular among children. High frequency and high degree of liking this product group may be due to the fact that man innately prefers sweet taste and eating habits from childhood can be translated into dietary behaviors later in life [9, 25]. CONCLUSIONS Among secondary school students found correct eating habits: the number of meals and breaks applied between them and the profile of the tea party. In the test group has been observed abnormal eating habits for a low consumption of fruits and vegetables and too frequent consumption of sweets. Women with better habits than men in terms of the profile of afternoon tea. REFERENCES 1. Jeżewska-Zychowicz M. Zachowania żywieniowe i ich uwarunkowania. Warszawa: SGGW, 2007. 2. Ponczek D, Olszewska I. Styl życia młodzieży i jego wpływ na zdrowie. Probl Hig Epidemiol 2012; 93 (2): 260-268. 3. Urbańska I, Czarniecka-Skubina E. Częstotliwoś spożycia przez młodzież produktów spożywczych oferowanych w sklepikach szkolnych. ŻYWNOŚĆ. Nauka. Technologia. Jakość 2007; 3 (52): 193-204. 4. Małecka-Tendera E, Socha P, wyd. Otyłość u dzieci i młodzieży. Warszawa: PZWL; 2011. 5. Bielaszka A, Grochowska-Niedworok E, Kiciak A i wsp. Preferencje żywieniowe młodzieży uwarunkowania podmiotowe i rodzinne. Warszawa: Difin S.A., Engram; 2011. 6. Zadworna-Cieślak M, Ogińska-Bulik N. Zachowania zdrowotne młodzieży uwarunkowania podmiotowe i rodzinne. Warszawa: Difin S.A. Engram; 2011. 67
WELLNESS AND EDUCATION 7. Tatoń J, Czech A, Bernas M.Otyłość. Zespół metaboliczny. Warszawa: PZWL; 2007 8. Oblacińska A, Weker H, red. Profilaktyka otyłości u dzieci i młodzieży. Kraków: Help-Med. s.c.; 2008. 9. Ciborowska H, Rudnicka A. Dietetyka. Żywienie zdrowego i chorego człowieka. Warszawa: Wydawnictwo Lekarskie PZWL; 2012. 10. Szczygieł B, Ukleja A, Wójcik Z. Jak rozpoznać i leczyć niedożywienie związane z chorobą? Kieszonkowy poradnik dla lekarzy, pielęgniarek, położnych i dietetyków. Warszawa: Nutrica Polska Sp. z o.o., PZWL; 2012 11. Kiciak A, Całyniuk B, Grochowska-Niedworok E, Kardas M, Dul L. Zachowania żywieniowe młodzieży z województwa śląskiego. Med. Og Nauk Zdr. 2014; 20 (3): 296-300. 13. Gawęcki J, Roszkowski W, red. Żywienie człowieka a zdrowie publiczne 3. Warszawa: Wydawnictwo Naukowe PWN; 2011. 14. Kołłajtis-Dołowy A, Matysiuk E, Boniecka I. Zwyczaje żywieniowe wybranej grupy dzieci 11-12-letnich z Białegostoku. ŻYWNOŚĆ. Nauka. Technologia. Jakość 2007; 6 (55): 335-342. 15. Mazur A, Szymanik I, Matusik P, Małecka-Tendera E. Rola i reklam mediów w powstawaniu otyłości u dzieci i młodzieży. Endokrynologia, Otyłość i Zaburzenia Przemiany Materii 2006; 2 (1): 18-21. 16. Gacek M. Zchowania żywieniowe grupy osób starszych zamieszkałych w Polsce i Niemczech. Probl Hig Epidemiolo 2008; 89 (3): 401-406. 17. Jarosz M. Praktyczny podręcznik dietetyki. Warszawa: Instytut Żywności i Żywienia; 2010. 18. Klimek-Piotrkowska W, Koziej M, Hołda M et. Al. Anthropometry and Body Composition of Adolescents in Cracow, Poland. PLoS One 2015; 10 (3). 19. Maksymowicz-Jaroszuk J, Karczewski J. Ocena zachowań i zwyczajów żywieniowych gimnazjalistów z terenu Białegostoku. Hygeia Public Health 2010; 45 (2): 167-172. 20. Goluch-Koniuszy Z, Friedrich M, Radziszewska M. Ocena sposobu żywienia i stanu odżywienia oraz prozdrowotna edukacja żywieniowa dzieci w okresie skoku pokwitaniowego z terenu miasta Szczecin. Roczn. PZH 2009; 60 (2): 143-149 21. Sitko D, Wojtaś M, Gronowska-Sennger A. Sposób żywienia młodzieży gimnazjalnej i licealnej. Rocz Panstw Zakl Hig 2012; 63 (3): 319-327. 22. Chitra U, Radha Reddy C. The role of brekfast in nutrient intake of urban schoolchildren. Publick Health Nutrition 2007; 10 (1): 55-58. 23. Wojtyła-Buciora P, Żukiewicz-Sobczak W, Wojtyła K, Marcinkowski J. Sposób żywienia uczniów szkół podstawowych w powiecie kaliskim w opinii dzieci i ich rodziców. Probl Hig Epidemiol 2015; 96 (1): 245-253. 68
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek, Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec, Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk, Tomasz Stępień, Bogusław Bucki, Dziechciarz Dorota, Marek Mandera Eating habits among students of selected secondary schools in Zawiercie 24. Piotrowska E, Żechłko-Czajkowska A. Biernat J, Mikołajczak J. Ocena wybranych cech stylu życia kształtujących stan zdrowia 16-18 letnich dziewcząt. Cz. II. Zwyczaje żywieniowe. Roczn. PZH 2009: 60 (2): 151-157. 25. Czech N, Nowakowska-Zajdel E, Muc-Wierzgoń M. Sposób odżywiania Japończyków na podstawie badań ankietowych. Ann. Acad. Med. Siles. 2009; 63 (1): 28-34. ABSTRACT Dietary behaviour are closely linked to the implementation of the nutritional needs, and dietary habits is a well-established, repetitive behaviors. Proper eating habits, are dependent on many factors. The purpose of the work. Evaluation of the normal and abnormal eating habits among high school students. Check whether there is a link between sex and habits. The study was conducted among the 150 students, including 86 women and 64 men. Eating habits were assessed using a questionnaire survey. It was found that 74% of those from consume 4 to 5 meals a day. Most high school students save the proper breaks between meals. Fruit and vegetable intake is too low, while the sweets were a common item in the menu. The test showed the presence of young people among the correct and incorrect eating habits. It was found the relationship between gender and habits. STRESZCZENIE Zachowania żywieniowe są ściśle związane z realizacją potrzeb żywieniowych, natomiast nawyki żywieniowe to utrwalone, powtarzające się zachowania żywieniowe. Prawidłowe nawyki żywieniowe, uzależnione są od wielu czynników. Ocena prawidłowych i nieprawidłowych nawyków żywieniowych wśród licealistów. Sprawdzenie czy istnieje związek między płcią a nawykami żywieniowymi. Badanie przeprowadzono wśród 150 uczniów, w tym 86 kobiet i 64 mężczyzn. Nawyki żywieniowe zostały ocenione przy użyciu kwestionariusza ankiety. Stwierdzono, że 74% osób spożywało od 4 do 5 posiłków dziennie. Większość licealistów zachowywało prawidłowe przerwy między posiłkami. Spożycie warzyw i owoców jest zbyt niskie, podczas gdy słodycze były częstym elementem w jadłospisie. Wśród badanej młodzieży wykazano występowanie prawidłowych i nieprawidłowych nawyków żywieniowych. Stwierdzono zależność między płcią a nawykami żywieniowymi. Artykuł zawiera 23524 znaki ze spacjami + grafika 69