Comparative survey of eating and lifestyle habits in Italian school age children using Nutripiatto as an educational tool.

Nutripiatto, a Mediterranean diet - based educational tool combining a colorful plate and recipe guide, was evaluated in 781 children (6-10 years) from Lazio, Piedmont, and Sicily, divided in age related-groups (A and B). Eating habits were assessed at baseline (T0) and after 2 months (T1) using a non-validate caregiver completed FFQ; 525 children (67%) completed both assessments. At T1, children showed greater awareness of portion sizes and food frequencies. In Group A, portion size awareness improved in Sicily (vegetable drinks, whole grain cereals) and Piedmont (cereals, yogurt, potatoes, meat). In both regions, children also increased their frequency of consumption of vegetables and fruit, while reducing red pizza, cold cuts, and meat in Piedmont, and French fries, crisps and cold cuts in Sicily. In Lazio, children increased their intake of crackers and fish while reducing French fries. In Group B, children in Piedmont increased the consumption of vegetables and fruit, in Lazio nuts while in Sicily they reduced crisps. Across both groups, water intake increased in Lazio and Sicily. Overall, regional dietary patterns persisted, characterized by higher processed and protein-rich foods (Lazio), greater bread and water intake (Sicily), and higher fruit and vegetable consumption (Piedmont). Despite the short duration and reliance on caregiver reports, Nutripiatto may appear to be a feasible, engaging school-based tool supporting healthier eating, warranting larger controlled studies.