The southern italian children, adolescents and parents cohort study on nutrition and health

An estimated 30% of Italian children are overweight or obese, with a clear north-to-south gradient. Parents play a powerful role in children's eating behaviour, by creating food environments and structuring their children’s first experiences with food and eating through their own beliefs, food practices, eating attitudes, and knowledge. Existing studies analysed parents and children’s diet almost exclusively by evaluating food composition (i.e. calorie, macro and micronutrient contents), with no or little attention paid to ultra-processed food (UPF) that now constitute a large part of the world’s food consumption and is remarkably high in children/adolescents. Large cohort studies worldwide found that a large dietary share of UPF is linked to shorter survival and an increased risk of non-communicable diseases. Given the rising popularity of UPF also in Mediterranean countries, the issue of food processing should be prioritized in relevant dietary recommendations with emphasis on consumption of minimally/unprocessed foods.

The Southern Italian Children, Adolescents and PaRents COhort Study on Nutrition and Health (ICARO) is designed as a web-based prospective cohort of children and adolescents (2-18 y) and their parents/caregivers residing in Southern Italy; recruitment will start in Molise, and will be later extended to the Sicily region and possibly involve other Southern regions willing to participate. The main objectives are to:

• evaluate the diet of participants in terms of food composition (i.e. calorie, macro- and micronutrient contents), adherence to Mediterranean diet, and consumption of UPFs;
• investigate key demographic, socioeconomic, behavioural, psychosocial, and other environmental factors as potential correlates of diet and diet-related habits of participants;
• analyse parental influence (e.g. food attitudes and knowledge) on children’s diet quality and eating habits;
• formal and informal educational digital content will be used as an intervention to increase awareness and promote adherence to a minimally-processed Mediterranean Diet and reduce the dietary share of UPFs.
   

• Provide an exhaustive map of nutritional status and dietary habits of school children and their families, also including an analysis of food processing.  
• Identify key correlates of adherence to an MD, and therefore highlight barriers/favouring factors to healthful eating patterns.
• Increase knowledge on key determinants/correlates of healthful diets at an early age that may help set effective public health prevention strategies at population level, to promote health and decrease the risk of developing diseases during later life.
• Increased awareness and adherence to a minimally-processed Mediterranean Diet and reduced dietary share of UPF in the intervention group.