Prevalence and Risk Factors for Unhealthy Dietary Habits Among School Children in Hong Kong During COVID‐19 Pandemic: A Cross‐Sectional Study

Background and Aims: Evidence demonstrates unhealthy dietary patterns in early life may contribute to obesity and increased risk of chronic diseases in later life. The COVID-19 pandemic has the potential to impact the dietary habits of schoolchildren due to movement restrictions. Therefore, this study aims to investigate the prevalence of unhealthy dietary habits among primary and secondary school students in Hong Kong during COVID-19, along with associated factors. Methods: A cross-sectional study was conducted among the primary and secondary school students in Hong Kong from September 2021 to November 2021. Data on sociodemographic information, dietary habits, and lifestyle were collected using self-administered questionnaires. Multivariate logistic regression was conducted to investigate the association between variables and unhealthy dietary habits. Results: A total of 1541 participants were included, with 762 primary school students (mean age: 10.0) and 779 secondary school students (mean age: 13.6). Approximately 81.5% of primary school students and 89.5% of secondary school students reported inadequate intake of vegetables and fruits. 18.6% of primary students and 42.8% of secondary students reported skipping breakfast, while 46.4% of primary students and 49.2% of secondary students consumed unhealthy foods. Analysis indicates that inadequate vegetable and fruit intake was positively associated with physical inactivity in both groups (aORs = 3.26-3.39). Students who engage in excessive screen time on games or social media had higher odds of skipping breakfast and consuming unhealthy foods (aOR = 1.47-2.24). Secondary school students who perceived themselves as underweight had higher odds of consuming unhealthy foods (aOR = 1.81), while those who reported being overweight had higher odds of skipping breakfast (aOR = 1.51). Conclusion: Findings highlighted the high prevalence of unhealthy dietary habits among school children in Hong Kong and identified physical inactivity and excessive screen time as key contributing factors. Future research should develop and validate interventions to improve dietary habits.