الفهرس 
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Abstract
Healthy nutrition is a cornerstone for students health and wellbeing. Unhealthy nutritional behaviors are core contributors to chronic diseases and health problems. It helps protect against malnutrition. However there are two major types of nutritional problems, inadequate intake of some essential nutrients, and an excessive intake of food or certain type of nutrients. Thus, without proper healthy nutrition, health might be unattainable (Rippe, 2018).
Healthy nutritional pattern is the quantities, proportions and variety or combination of different foods, drinks, and nutrients in diets, and the frequency which they are habitually consumed. However a healthy nutritional pattern in school students should include eating breakfast every day while avoiding overnight eating, choosing a diet of moderate in sugars and salts, avoiding large amounts of sweet, soft drinks, fruit flavored colored, chips and candy, practicing proper hygiene at all times, eating in sitting position, avoiding eating during watch the television and practicing daily sports (Sackset al., 2017).
Schools provide a highly effective and efficient environmental setting for establishing nutritional healthy behaviors. Schools provide an ideal setting to improve eating behavior, health and nutritional knowledge and boost the ability of students to make informed choices (Hermans et al., 2018).
The nurse plays an important role in assessing the nutritional pattern for students and in seeking additional evaluation from dietitians and nutritionists in complex situations. The ability to assess a child’s nutritional status using anthropometry measurements. Additional measurement may include chest circumference and mid arm circumference. Also, child’s observation and history are vital. Therefore, it is important for the nurse to have an understanding of the implications of information gained during nutritional assessment of the child in schools (Williams et al., 2020).
Aim of the Study
The aim of this study was to ¬assess school students’ perception regarding the healthy nutritional pattern through:
Assess school students’ knowledge regarding healthy nutritional pattern.
Assess school students’ reported practices regarding healthy nutritional pattern.
Subject and Methods
Research design:
Descriptive study was used to ¬assess school students’ perception regarding the healthy nutritional pattern.
Setting:
This study was conducted at four primary schools namely Kastal and El Ewina School, Awlad Abd Alla School, Tenida School and Balat School affiliated to (The New Valley Governorate).The New Valley governorate includes five cities which are (El Kharga City – El Dakhla City – El Frafra City – Balat City – Paris City). Balat city was randomly selected by simple random sampling. It includes 15 primary schools; however thefour primary schools were randomly selected by simple random sample using tossing technique from the total list of schools to represent the total number.
Sampling:
The study was carried out three days (Sunday-Monday-Tuesday) per week during morning shift over six months period (each school took approximately 6 weeks for completing data collection) from November 2018 to April 2019 using the previously mentioned tools.The total number of students was 300 students.
The following tools were used for data collection:
First tool: Predesigned Questionnaire Format (Appendix II):
It was designed by the researcher in simple Arabic language after reviewing the related literature and studies. It was written in the form of close ended question (in the form of correct and incorrect, yes or no and matching) to suit the understanding level of the study subjects; it consisted of the following parts:
Part I: It was used to assess demographic characteristics of the studied student. It included (12 Questions) including the following , their gender, age, level of primary education, school attendance regularity, birth order, and number of the siblings. Also, data about the parents included their level of education, occupation, residence and the number of rooms.
Part II: This part was designed to assess the school environment and included (11 Question) including the following items: school cleanliness, number of bathrooms in the school , presence of canteen in the school , type of food bought by canteen , presence of visitor in the school , type of education given by visitor , check-up done for students , how Many time checkup is done/year, type of the examination and sporting activities.
Part III: This part was designed to assess students’ knowledge regarding healthy nutrition. it included (8 Questions) including the following: definition of healthy food, importance of healthy nutrition, the basic components of healthy food, meaning of nutritional pattern, examples of patterns of healthy food, food sources rich in proteins, food sources rich in carbohydrates, and food sources rich in vitamins and minerals.
Second tool: Assessment sheet for the students’ nutritional practice (Appendix III): it consisted of the following parts:
Part I: Students’ reported practice regarding healthy students’ nutritional pattern
This part was designed to assess students’ reported practice regarding healthy nutritional pattern it included (10 Questions) including the following: eat while watching TV, eat while playing on computer or mobile, eat candy/chips/fast food, take sandwiches daily from home, regular time of the basic meals (breakfast/lunch/dinner), adhere to the daily breakfast, adhere to the daily lunch adhere to the daily dinner and number of practicing sports.
Part II: Assessment for the students’ nutritional pattern:
It included the types of foods taken, food likes and dislikes, number of regular meals, number of snacks/day and physical exercises.
Third tool: Assessment for the students’ health status (Appendix IV): it consisted of the following parts:
Part 1: this part included data about assessment for occurrence of gastrointestinal problems, and data about the previous hospitalization of the studied students and its causes.
Part 2: Physical examination sheet:
This part of the tool was adopted by Duderstadt, (2013), it includes assessment of all body parts to detected signs of nutritional deficiencies such as skin, hair, lips, eyes, face, tongue, lips, teeth, gums, nails (heart beats and general appearance).
Part 3: include
A: Students’ anthropometric measurements:
This part of the tool was adopted by Javed et al., (2015): it consisted of 3 items related to anthropometric measurement including body weight in kilogram using standard scale, and measurement of height in centimeter using a standard tape. Weight and height were used to calculate (BMI) utilizing the following formula.
BMI=Weight/〖(Hight)〗^2
Accordingly the BMI was considered as the following (Appendix VII):
Less than 18.5 percentile(underweight)
from 18.5 to 24.9 percentile(normal weight)
from 25 to 29.9 percentile (over weight)
from 30 to 39.9percentile (obese) ) (Sukhonthachit et al., 2016).
B: Mid-Upper Arm Circumference (MUAC): Is the circumference of the left upper arm, measured at the mid-point between the tip of the shoulder and the tip of the elbow (olecranon process and the acromium). MUAC is used for the assessment of nutritional status. It is a good predictor of mortality, MUAC predicted death in students better than any other anthropometric indicator. This advantage of MUAC was greatest when the period of follow-up was short (Ralston and Myatt, 2016).
The study results can be summarized as follows:
More than two thirds of the studied students were 10-11 years old and the majority of them attended to their school regularly. More than one third of fathers had secondary school education, and the majority of them were employed. More than two thirds of studied students were underweight and the most of them had satisfactory total knowledge about food sources rich in protein and satisfactory total knowledge about the importance of healthy nutrition.
The majority of studied students had satisfactory total knowledge about food sources rich in carbohydrates, and two third of them had satisfactory total knowledge about food sources rich in vitamins and minerals. Also the majority of the studied students had good nutritional practices. There was a highly statistically significant weak negative correlation between the studied students knowledge and their age (r=-.226, p= .047), there were insignificant statistical differences in knowledge (χ2= 2.15, p=0.09) and reported practice (χ2= 2.07, p= 0.39) according to the studied students gender.
Also there was significant statistical difference in knowledge (χ2= 7.78, p=0.02) and there were insignificant statistical difference in reported practice (χ2= 1.45, p= 0.49) according to the studied students school attendance and there were significant statistical difference in knowledge (χ2= 12.21, p=0.007), insignificant statistical difference in reported practice (χ2= .27, p= 0.97) according to the studied students father education.
There was significant statistical difference in knowledge (χ2= 6.43, p=0.04) and there was insignificant statistical difference in reported practice (χ2= 4.21, p= .12) according to the studied students mother education. Finally there was statistically significant weak positive correlation between the studied students knowledge and their reported practice regarding proper nutrition (r=.097, p=.04) and there was statistically significant very weak positive correlation (r=.006, P=.015) between reported practice and weight. Also, there was statistically significant very weak positive correlation (r=.042, P=.04) between reported practice and BMI.
According to the findings it is recommended to:
1. The school should Provide nutritional programs for the students, aiming to improve nutritional pattern through health educational instructions.
2. Involve teachers, school personnel, parents, communities, and local government in the development and implementation of school nutrition programs.
3. Integration of nutrition education into the school activities for all age groups.
4 .Nutritional education should always employ a wide range of hands-on teaching/learning methods that can be applied through mass media in the classrooms of schools.