Cross-Cultural Analysis of Physical Activity and Nutritional Habits in American and Turkish Children

Öz

The purpose of this study was to compare physical activity and nutritional habits in Turkish vs. American elementary school children. A total of 220 American and Turkish children who aged 9-11 years were included in the study. Student Health Assessment Questionnaire (SHAQ) was used to collect data. The normality of continuous variables was investigated by Shapiro-Wilk’s test and graphical assessments. Independent samples t-test was used for comparison of two normally distributed groups of continuous variables, while Pearson chi-square test and Fisher’s exact test were used for analysis of categorical variables p<0.05 was considered statistically significant. American children were determined to consume more red meat, snacks, cheese, milk, and candy (p<0.001), while Turkish children were determined to consume more cream chocolate, yogurt, juice, and water (p<0.005). American vs. Turkish children were more likely to participate in vigorous-intensity physical activity and sports teams(p<0.01), whereas attendance to weekly physical education classes was more common in Turkish vs. American children (p=0.005).The main reasons for physical inactivity and unhealthy nutritional habitswere reported to be insufficient time (48.2%), lack of friends (41.8%), and unhealthy nutritional habits in the family(27.3%) by the American children, and to be unsafe playgrounds (55.5%), lack of sports facilities (41.8%), and insufficient (45.5%) and expensive healthy food (37.3%) by the Turkish children. Meat, fat, and sugar consumption and physical activity rates were higher among American vs. Turkish children. Insufficient time and lack of friends in American children, and unsafe playgrounds and lack of sports facilities in Turkish children seem to affect participating in physical activity. Children from both countries found healthy food untasteful, while the impact of family on unhealthy nutritional habits has also been emphasized by American children and limited access to healthy and inexpensive food by Turkish children.

Anahtar Kelimeler

• Child
• Physical Activity
• Nutrition
• Health.

Amerikalı ve Türk Çocukların Fiziksel Aktivite ve Beslenme Davranışlarının Kültürler Arası Analizi

Öz

Bu çalışmanın amacı, Amerikalı ve Türk ilkokul çocuklarında fiziksel aktivite ve beslenme davranışlarını karşılaştırmaktır. Araştırmaya, 9-11 yaş aralığında 220 Amerikalı ve Türk çocuk katılmıştır. Çalışmada “Student Health Assessment Questionnaire (SHAQ)” adlı ölçek kullanılmıştır. İstatistiksel analizlerde nicel verilerin normal dağılıma uygunlukları Shapiro-Wilk testi ve grafiksel incelemeler ile sınanmıştır. Normal dağılım gösteren nicel değişkenlerin iki grup arası karşılaştırmalarında Independent samples t test, nitel verilerin karşılaştırılmasında ise Pearson kay-kare test ve Fisher’sexact test kullanılmıştır. İstatistiksel anlamlılık p<,05 olarak kabul edilmiştir. Amerikalı çocuklar daha fazla kırmızı et, atıştırmalık, peynir, süt, şekerleme tüketirken (p<,001), Türk çocuklar daha fazla krem çikolata, yoğurt, meyve suyu, su tüketmektedir (p<,01). Amerikalı çocuklarda yüksek tempolu fiziksel aktiviteye katılma ve spor takımlarında yer alma oranı yüksek iken (p<,01), Türk çocukların haftalık beden eğitimi dersine katılma sayıları (p:0.005) daha fazladır. Amerikalı çocuklar, zaman ve arkadaş eksikliğinin (%48.2; %41.8), ailelerinin kötü beslenmesinin (%27.3), Türk çocuklar güvenli oyun alanları ve spor tesisi eksikliğinin (%55.5; %41.8) ve sağlıklı yiyeceklerin az (%45.5) ve pahalı (%37.3) olmasının aktivite ve beslenmelerini kötü etkilediğini belirtmişlerdir. Amerikalı çocukların et, yağ ve şeker tüketimi miktarı ve fiziksel aktiviteye katılım oranı Türk çocuklarından daha fazladır. Amerikalı çocuklarda zaman yetersizliği ve arkadaş eksikliği, Türk çocuklarında ise güvenli oyun alanı ve spor tesisi yetersizliği fiziksel aktiviteye katılımı etkilemektedir. Her iki ülkede de çocuklar sağlıklı yiyecekleri lezzetsiz bulurken, Amerikalı çocuklar sağlıksız beslenmelerinde ailelerinin etkisine, Türk çocukları ise sağlıklı ve ucuz yiyeceklere ulaşamadıklarına dikkat çekmektedirler.

Anahtar Kelimeler

• Çocuk
• Fiziksel Aktivite
• Beslenme
• Sağlık

Kaynakça

1. Akman, M., Akan, H., İzbirak, G., Tanrıöver, Ö., Tilev, S.M., Yıldız, A., Tektaş, S., Vitrinel, A., & Hayran, O. (2010). Eating patterns of Turkish adolescents: a cross-sectional survey. Nutrition Journal, 9(1),1-5. https://doi.org/10.1186/1475-2891-9-67
2. American Academy of Pediatrics, Committee on Public Education. (2001). Children, adolescents and television. Pediatrics, 107, 423- 426. https://doi.org/ 10.1542/peds.107.2.423
3. Banfield, E.C., Liu, Y., Davis, J.S., Chang, S., & Frazier-Wood, A.C. (2016). Poor adherence to US dietary guidelines for children and adolescents in the national health and nutrition examination survey population. Journal of the Academy of Nutrition and Dietetics, 116(1), 21-27. https://doi.org/10.1016/j.jand.2015.08.010
4. Büyüköztürk, Ş., Çakmak, E. K., Akgün, Ö. E., Karadeniz, Ş., & Demirel, F. (2016). Bilimsel araştırma yöntemleri (2. Basım). Pegem Akademi.
5. Centers for Disease Control and Prevention (CDCP, 2020). Healthy schools: Childhood obesity facts. 2017 [online]. Available at: https://www.cdc.gov/healthyschools/obesity/facts.htm. Accessed Jun 20, 2020.
6. Committee on Physical Activity and Physical Education in the School Environment. (C.P.A.P.E.S.E, 2020). Food and Nutrition Board; Institute of Medicine. Washington (DC): National Academies Press (US). 2013 [online]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK201493. Accessed Jun 02, 2020.
7. Dietary Guidelines for Americans 2015-2020 Eighth Edition [online, 2020]. Available at: https://health.gov/sites/default/files/2019-09/2015-2020_Dietary_Guidelines.pdf. Accesseed May 20, 2020.
8. Faigenbaum, A.D., & Myer, G.D. (2012). Exercise deficit disorder in youth: Play now or pay later. Curr Sports Med Rep, 11(4), 196-200. https://doi: 10.1249/JSR.0b013e31825da961

9. Fakhouri, T.H., Hughes, J.P., Brody, D.J., Kit, B.K., & Ogden, C.L. (2013). Physical activity and screen-time viewing among elementary school–aged children in the United States from 2009 to 2010. JAMA Pediatr, 167(3), 223-229. https://doi:10.1001/2013.jamapediatrics.122
10. Fulkerson, J.A., Friend, S., Horning, M., Flattum, C., Draxten, M., Neumark-Sztainer, D., & Kubik, M.Y. (2018). Family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus program: A randomized controlled trial. J Acad Nutr Diet, 118(2), 240-251. https://doi.org/10.1016/j.jand.2017.04.006
11. Hall, E., Chai, W., Koszewski, W., & Albrecht, J. (2015). Development and validation of a social cognitive theory-based survey for elementary nutrition education program. Int J Behav Nutr Phy, 12(1), 1-2. https://doi.org/10.1186/s12966-015-0206-4
12. Herbert, P.C., Lohrmann, D.K., Seo, D.C., Stright, A.D., & Kolbe, L.J. (2013). Effectiveness of the energize elementary school program to improve diet and exercise. J Sch Health, 83(11), 780-786. https://doi.org/10.1111/josh.12094
13. Hoelscher, D.M., Day, S.E., Kelder, S.H., & Ward, J.L. (2003). Reproducibility and validity of the secondary level school-based nutrition monitoring student questionnaire. J Am Diet Assoc, 103,186-194. https://doi.org/10.1053/jada.2003.50031
14. Kelsey, M.M., Zaepfel, A., Bjornstad, P., & Nadeau, K.J. (2014). Age-related consequences of childhood obesity. Gerontology, 60(3), 222-228. https://doi.org/10.1159/000356023
15. King, M. H., Lederer, A. M., Sovinski, D., Knoblock, H. M., Meade, R. K., Seo, D. C., & Kim, N. (2014). Implementation and evaluation of the HEROES initiative: a tri-state coordinated school health program to reduce childhood obesity. Health Promotion Practice, 15(3), 395-405. https://doi.org/10.1177/1524839913512835
16. Leech, R. M., McNaughton, S. A., & Timperio, A. (2014). The clustering of diet, physical activity and sedentary behavior in children and adolescents: A review. International Journal of Behavioral Nutrition and Physical Activity, 11(1), 1-9. https://doi.org/10.1186/1479-5868-11-4
17. Milicic, D., Drndarski, M., Trajkovic, J., Savic, T., Lucic, L., & Pavkovic-Lucic, S. (2017). “A matter of health”: Evaluation of health habits in pupils in Primary School in Serbia. Journal of Bioscience and Biotechnology, 6(3), 221-225.
18. Misra, A., & Bhardwaj, S. (2014). Obesity and the metabolic syndrome in developing countries: focus on South Asians. In International Nutrition: Achieving Millennium Goals and Beyond. Karger Publishers, 78,133-140.
19. OECD-Health-Statistics-2015-Frequently-Requested-Data [online, 2015]. Available at: http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequently-requested-data.htm. Accessed Jun 30, 2020.
20. Orava, T., Manske, S., & Hanning, R. (2017). Support for healthy eating at schools according to the comprehensive school health framework: evaluation during the early years of the Ontario School Food and Beverage Policy implementation. Health Promot Chronic Dis Prev Can, 37(9), 303–312. https://doi.org/10.24095/hpcdp.37.9.05
21. Özmert, E., Toyran, M., & Yurdakök, K. (2002). Behavioral correlates of television viewing in primary school children evaluated by the child behavior checklist. Archives of Pediatrics & Adolescent Medicine, 156(9), 910-914. https://doi.org/10.1001/archpedi.156.9.910
22. Pantea Stoian, A., Andronache, L. F., Hainarosie, R., Paduraru, D. N., Badiu, C. D., Arsene, A., ... & Nitipir, C. (2018). Dietary habits and lifestyle in school-aged children from Bucharest, Romania. Journal of Mind and Medical Sciences, 5(1), 85-92. https://doi.org/10.22543/7674.51.P8592
23. Sökülmez, P., & Uyar, E. (2015). Farklı bölgelerde yaşayan preadölesan çocukların beslenme alışkanlıkları ve besin tüketim sıklıklarının belirlenmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 5(3), 23-29.
24. Story, M., Kaphingst, K. M., Robinson-O'Brien, R., & Glanz, K. (2008). Creating healthy food and eating environments: Policy and environmental approaches. Annu. Rev. Public Health, 29, 253-272. https://doi.org/10.1146/annurev.publhealth.29.020907.090926
25. Swinburn, B. A., Sacks, G., Hall, K. D., McPherson, K., Finegood, D. T., Moodie, M. L., & Gortmaker, S. L. (2011). The global obesity pandemic: Shaped by global drivers and local environments. The Lancet, 378(9793), 804-814. https://doi.org/10.1016/S0140-6736(11)60813-1
26. Taşdemir, A. (2019). İlköğretim öğrencilerinde beslenme eğitimi üzerine bir araştırma. Sağlık Akademisi Kastamonu (SAK), 1(4), 34-52. https://doi.org/10.25279/sak.345061
27. Taşmektepligil, Y., Yılmaz, Ç., İmamoğlu, O., ve Kılcıgil, E. (2006). İlköğretim okullarında beden eğitimi ders hedeflerinin gerçekleşme düzeyi. Spormetre Beden Eğitimi ve Spor Bilimleri Dergisi, 4(4), 139-147.
28. Toruner, E. K., Ayaz, S., Altay, N., Citak, E. A., & Sahin, S. (2015). Efficacy of a school-based healthy life program in Turkey. Children's Health Care, 44(1), 69-86. https://doi.org/10.1080/02739615.2014.880918
29. Türkiye Beslenme ve Sağlık Araştırması (2010). Beslenme durumu ve alışkanlıklarının değerlendirilmesi sonuç raporu. Sağlık Bakanlığı Yayın No: 931.
30. Türkiye Çocukluk Çağı (İlkokul 2. Sınıf Öğrencileri) Şişmanlık Araştırması - COSI-TUR (2016). Sağlık Bakanlığı Yayın No: 1080.
31. Tremblay, M. S., LeBlanc, A. G., Kho, M. E., Saunders, T. J., Larouche, R., Colley, R. C., ... & Gorber, S. C. (2011). Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 1-22. https://doi.org/10.1186/1479-5868-8-98
32. Tural-Büyük, E. & Topçu, S. (2015). İki farklı ilkokulda okuyan birinci sınıf öğrencilerinin beslenme ve fiziksel aktiviteleri arasındaki ilişkinin belirlenmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 5(1), 10-15.
33. U.S. Department of Health & Human Services (2020). Office of the Surgeon General, Physical Activity and Nutrition Reports and Publications. [online]. Available at: https://www.hhs.gov/surgeongeneral/reports-and-publications/physical-activity-nutrition/index.html. Accessed May 09, 2021.
34. Wake, M., Hesketh, K., & Waters, E. (2003). Television, computer use and body mass index in Australian primary school children. Journal of Paediatrics and Child Health, 39(2), 130-134. https://doi.org/10.1046/j.14401754.2003.00104.x
35. Wall, D. E., Least, C., Gromis, J., & Lohse, B. (2012). Nutrition education intervention improves vegetable‐related attitude, self‐efficacy, preference, and knowledge of fourth‐grade students. Journal of School Health, 82(1), 37-43. https://doi.org/10.1111/j.1746-1561.2011.00665.x
36. Wang, Y. C., Bleich, S. N., & Gortmaker, S. L. (2008). Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988–2004. Pediatrics, 121(6), e1604-e1614. https://doi.org/10.1542/peds.2007-2834
37. WHO (2020). Global health observatory (GHO) data 2017. Child malnutrition [online]. Available at: http://www.who.int/gho/childmalnutrition/en/. Accessed Jun 20, 2020.
38. Yenal, T., Çamlıyer, H., & Saraçaloğlu, A. (1999). İlköğretim ikinci devre çocuklarında beden eğitimi ve spor etkinliklerinin motor beceri ve yetenekler üzerine etkisi. Gazi Beden Eğitimi ve Spor Bilimleri Dergisi, 4(3), 15-16.
39. Zalewska, M., Zubrycki, A., Sosnowski, Z., Jamiołkowski, J., Zakrzewski, M., & Maciorkowska, E. (2017). Selected nutritional behaviors and physical activity among elementary school children. Progress in Health Sciences, 7(1), 131-136.