move and munch - physical activity taskforce capans 2008 reprot.pdf · child and adolescent...

Final Report

Trends in physical activity, nutrition

and body size in Western Australian

children and adolescents: the Child

and Adolescent Physical Activity and

Nutrition Survey (CAPANS) 2008

Move and Munch

Page i

Child and Adolescent Physical Activity and Nutrition (CAPANS) Survey: 2008 Final Report

Trends in physical activity, nutrition and body size in Western

Australian children and adolescents: the Child and Adolescent

Physical Activity and Nutrition Survey (CAPANS) 2008 Final Report

Move and Munch

Page ii


CONTRIBUTION AND ACKNOWLEDGEMENTS

Project management team Dr Karen Martin (Project Manager), Edith Cowan University/The

University of Western Australia, Associate Professor Michael Rosenberg,

The University of Western Australia, Margaret Miller, Edith Cowan University

Physical activity consultants Professor Fiona Bull, The University of Western Australia

Professor Billie Giles-Corti, The University of Western Australia

Dr Gavin McCormack, University of Calgary

Steve Pratt, Cancer Council

Nutrition consultants Dr Amanda Devine, Edith Cowan University

Dr Anthea Magarey, Flinders University

Report writers Dr Karen Martin, Sarah French, Associate Professor Michael Rosenberg,

Margaret Miller

Report background

contribution Joanne Evans

Project coordinator Stephanie McFaull

Field-work coordinator Jennifer Tartaglia

Child consent coordinator Bree Shields

Team leaders Dane Waters, Mark Miraudo, Natasha Hale, Claire South

Field team Gill Aston, Lisa Bennett, Nancy Lee Boultbee, Fabienne Byrne, Michael

Clow, Laura Drummy, Amy Ekin, Lynda Enright, Amy Fairburn, Natalie

Harold, Sun Leong, Daniela Miloseski, Melanie Oddy, Hannah Pierce,

Jenny Paul, Sian Pulham, Hayley Saunders, Lisa Shuttleton, Sharon

Slater, Catie Stephenson, Nao Suzuki, Claire Thomson, Jessica Truong,

Karyn West, Carole Holywel, Gemma Whitman.

Work experience staff Hannah Pierce, Melissa Burford, Danica Keric

Staff Training Manual Dr Karen Martin, Stephanie McFaull

Food Coding Manual Margaret Miller, Stephanie McFaull

Physical activity coders Bree Shields (Coordinator), Natasha Hale, Dane Waters, Claire South,

Laura Drummy, Nancy Lee Boultbee, Hannah Pierce

Food coders Stephanie McFaull (Coordinator), Mark Miraudo, Karen West, Nicole

Steele, Dionne Marshall

Data entry Axis Data

Data merging Jonathon Kur

Statistics consultant Professor Max Bulsara, Notre Dame University

Data analysis Sarah French, Dr Karen Martin

PATF Evaluation and

Monitoring Working Group Rex Milligan, Steve Pratt, Geoffrey Jalleh

PATF Project Manager Jo Davies (previously Jennifer Riatti and Graeme Webb)

Funding Providers Healthway, Department of Education and Training, Department

of Health, Department of Planning and Infrastructure, Department

of Sport and Recreation.

Page iii


SUGGESTED CITATION

Martin, K., Rosenberg, M., Miller, M., French, S., McCormack, G., Bull, F., Giles-Corti, B., Pratt, S. Move and

Munch Final Report. Trends in physical activity, nutrition and body size in Western Australian children

and adolescents: the Child and Adolescent Physical Activity and Nutrition Survey (CAPANS) 2008.

Any enquiries regarding this publication should be directed to Physical Activity Taskforce Secretariat,

Department of Sport and Recreation, PO Box 329, Leederville, Western Australia, 6903.

© Government of Western Australia

There is no objection to the publication being copied in whole or in part provided there is due

acknowledge of any material quoted from the publication.

ISBN: 978-1-921648-08-3

This report is available at www.beactive.wa.gov.au

Published by the Western Australian Government

Page iv


MINISTER’S FOREWORD

Sufficient physical activity and a nutritious diet are vital for the growth and development of healthy

active children. With declining physical activity levels, changing recreation activity patterns and many

unhealthy food options, it is important we have an understanding of what our children do and eat,

to encourage healthy growth into adulthood.

To monitor the activity levels and dietary behaviours of Western Australian children, the 2008

Child and Adolescent Physical Activity and Nutrition Survey (CAPANS) was commissioned by the

Physical Activity Taskforce. This followed a previous survey from 2003, which alarmed authorities by

identifying one in four children as above a healthy weight.

Since the 2003 survey, national physical activity guidelines have been released on the amount

of physical activity that children and adolescents need for good health, as well as the maximum

amount of screen-based leisure they should engage in. CAPANS 2008 measures against these new

national guidelines, as well as provides comparisons to the previous survey results.

Of concern, CAPANS 2008 shows that more than half of Western Australian children are at risk of

health problems as adults because they are still not participating in enough healthy activities.

The key findings show the majority of children are not active enough and many are not eating

enough fruit and vegetables. This behaviour usually worsened into adolescence.

The research also shows the level of overweight and obesity has not changed since 2003. Therefore,

one in four Western Australian children remain above a healthy weight. While these levels remain

unacceptably high, we should be encouraged that efforts to encourage healthy behaviours in young

people appear to have had some positive effects.

There is also good news with significant increases in the proportion of secondary school students

actively commuting home from school. There are also positive nutrition findings, with increases in

consumption of healthier food choices, accompanied by decreases in consumption of unhealthier

food choices.

Under the guidance of the Taskforce, it is vital that research such as CAPANS continues to monitor

physical activity and nutrition amongst children and adolescents so that, the outcomes of policies

and programs can be monitored and our successes celebrated.

Terry Waldron MLA

Minister for Sport and Recreation

Page v


EXECUTIVE SUMMARY

INTRODUCTION

Optimising the health of Australian youth is a national priority, and the increasing evidence

suggesting children’s health behaviour transitions into adulthood1, 2 reinforces the importance

of investing in childhood health promotion programs. Addressing Australian children’s declining

physical activity participation, the quality of dietary intake and high levels of overweight and obesity

requires a multi-faceted and multi-sectoral approach.

Australian Physical Activity Recommendations suggest that children3 and adolescents4 participate in

a minimum of 60 minutes, and up to several hours, of moderate to vigorous intensity physical activity

every day, and that children accumulate no more than two hours screen time for entertainment

each day. The Dietary Guidelines for Children and Adolescents5 and the Australian Guide to Healthy

Eating6 provide guidance on the types and amounts of foods that should be included in the typical

daily diet to meet recommended nutrient intakes and to promote good health. Recent evidence7

suggests that a large proportion of Australian children and adolescents are not meeting these

recommendations.

In Western Australia, the first Child and Adolescent Physical Activity and Nutrition Survey (CAPANS)

commissioned by the Premier’s Physical Activity Taskforce was completed in 2003. A repeat study

was commissioned by the Physical Activity Taskforce and completed by a team of researchers from

Edith Cowan University and the University of Western Australia in 2008. This report builds on the

CAPANS 2008 Key Findings report released in December 2009.

METHODS

The target population was Western Australian children and adolescents in the primary school years

three, five, and seven (referred to throughout as ‘primary school children’), and secondary school

years eight, ten and 11 (referred to throughout as ‘secondary school children’). No year seven children

attending secondary school were sampled. The sample was structured to obtain proportional

representation according to Western Australia’s population figures.

The Australian Centre for Education Research selected the school samples in both years using

systematic random sampling from the total Western Australian government and non-government

funded school population of; primary metropolitan, primary non-metropolitan, secondary

metropolitan, and secondary non-metropolitan. In 2008, 46% of selected schools agreed to

participate in the study, compared with 60% of schools approached for the 2003 survey.

Data were collected during terms three and four of the Western Australian school year (i.e. from July

to December) in both the 2003 and 2008 surveys.

In 2008 an overall child response rate of 58.8% was achieved, with response rates of 79.5% for

primary school children and 46.2% for secondary school children. In 2003, the overall child

response rate was 55.8%, with response rates at primary and secondary schools of 58.8% and 52.1%

respectively.

Page vi


In 2008 and 2003, children could participate in one or more of the three survey components:

1) Physical Activity Questionnaire and pedometer record;

2) 24-hour Food Diary and Food Frequency Questionnaire; and/or

3) Anthropometric measurements (including height, weight, waist, umbilicus and hip measures).

Small participant numbers of children aged seven and 17 in selected year groups resulted in their

removal from the 2008 and 2003 samples.

Descriptive results were weighted to the Western Australian population by sex (when appropriate),

age and home neighbourhood socio-economic status (SES) derived from the Australian Socio-

Economic Index For Areas (SEIFA) with population data derived from 2006 Australian Census data.8

All statistical analyses of differences between proportions and means have been adjusted for sex,

age, home neighbourhood SES and school level clustering. Statistical significance was determined at

the level of 0.05.

RESULTS

Physical activity

Self-report overall physical activity

• In 2008, less than one-half (41.2%) of the primary school boys surveyed reported participating

in a daily 60 minutes or more physical activity (Australia’s Physical Activity Recommendations3)

on all of the last seven days. However, this was a significantly greater proportion than the

27.4% of primary school girls surveyed who participated in 60 minutes or more of daily

physical activity on all of the last seven days.

• Only one in ten (10.1%) of the secondary school girls surveyed reported doing 60 minutes

or more of daily physical activity on all of the last seven days (Australia’s Physical Activity

Recommendations4) in 2008. This was significantly less than the one-third (37.6 %) of

secondary school boys surveyed who reported participating in 60 minutes or more of daily

physical activity on all of the last seven days.

• Slightly more than one-third of primary school children surveyed recorded the recommended

pedometer step counts9 in both 2008 (37.7%) and 2003 (36.6%).

Sport, exercise, dance and active play

• Primary school boys surveyed reported jogging/running (77.7%) and movement-based video

games (70.6%) as their most common sport/exercise/dance and active play activities in 2008.

• The most common sport/exercise/dance and active play activities in 2008 for primary school

girls surveyed were jogging/running (75.6%) and playing with pets (74.7%).

• Basketball was the most commonly reported (50.5%) sport/exercise/dance activity and

movement-based video games the most prevalent (43.2%) active play activity in 2008 for

secondary school boys surveyed.

• In 2008, the most common sport/exercise/dance and active play activities for secondary

school girls surveyed were walking for exercise (52.7%) and playing with pets (46.5%).

Page vii


School physical education

• Around two-thirds of primary school children surveyed reported ‘quite often’ or ‘always’ being

very active during physical education in 2008 (boys: 61.6%, girls: 63.9%) and 2003 (boys: 70.0%,

girls: 70.6%). Although the proportions were lower in 2008 there were no significant differences

between survey years.

• Around three-quarters of secondary school boys surveyed reported being very active ‘quite

often’ or ‘always’ during physical education in 2008 (77.1%) and 2003 (71.8%).

• Significantly more secondary school girls surveyed reported being very active ‘quite often’ or

‘always’ in physical education in 2008 (66.0%) compared with 2003 (58.2%).

• Significantly fewer secondary school girls surveyed reported not participating in physical

education in 2008 (6.9%) compared with 2003 (14.5%).

School recess and lunch physical activity

• Just over three-quarters of primary school boys surveyed reported they ran around and played

‘quite a lot’ or ‘most of the time’ during recess in 2008 (79.7%) and 2003 (78.2%) and four out of

five reported running around and playing ‘quite a lot’ or ‘most of the time’ during lunch in 2008

(84.3%) and 2003 (81.6%). The differences in the proportions between survey years were not

significant.

• Around one-half of primary school girls ran around a played ‘quite a lot’ or ‘most of the time’

during recess in 2008 (49.9%) and 2003 (53.4%) and two-thirds reported running around and

playing ‘quite a lot’ or ‘most of the time’ during lunch in 2008 (61.4%) and 2003 (66.2%). The

differences in the proportions between survey years were not significant.

• The proportion of secondary school children who reported running around and playing ‘quite

a lot’ or ‘most of the time’ during recess (girls 5.7%; boys 38.5%) and lunch (girls 5.5%; boys

39.9%) in 2008 was much lower than the proportion of primary school children reporting this

level of activity during recess (girls 49.9%; boys 79.7%) and lunch (girls 5.7%; boys 38.5%).

• Significantly more secondary school boys reported running around and playing ‘quite a lot’ or

‘most of the time’ during recess and lunch in 2008 (recess: 38.5%, lunch: 39.9%) compared with

2003 (recess: 17.8%, lunch: 28.8%)

• Very small proportions of secondary school girls reported running around and playing ‘quite a

lot’ or ‘most of the time’ during recess and lunch in 2008 and 2003 (range 3.1% - 5.7%).

Active commuting

• In 2008, there were no significant differences to 2003 in the proportions of primary school boys

(31.8% vs. 34.0%) or girls (26.0% vs. 34.7%) who actively commuted to school on the day of

the survey. Similarly there were no significant differences in the proportion of primary school

children actively commuting home from school on the day prior to the survey (boys 41.9% vs.

40.8%; girls 34.5% vs. 38.6%)

• Amongst secondary school children, no significant differences between 2008 and 2003

were noted in the proportions of boys (57.9% vs. 46.7%) or girls (46.0% vs. 35.1%) actively

commuting to school on the day before the survey. However, a significantly higher proportion

of secondary school children actively commuted home from school on the day prior to the

survey in 2008 (boys: 63.2%, girls: 57.3%) compared with 2003 (boys: 50.0%, girls: 45.6%).

Page viii


• In 2008, just over one-half (boys: 51.8%, girls: 55.5%) of primary school children surveyed

reported actively commuting to school at least once in the last seven days.

• A significantly higher proportion of secondary school boys (60.7%) surveyed reported actively

commuting to school at least once in the past seven days, compared with secondary school

girls (47.9%).

• Less than one-half (boys: 45.5%, girls: 43.3%) of primary school children surveyed in 2008

reported actively commuting to friend’s houses in the last seven days.

• In 2008, significantly more secondary school boys than girls surveyed actively commuted to

sport venues (45.9% vs. 28.1% respectively) and skate ramps/parks/ovals/playgrounds (32.4%

vs. 17.8% respectively) at least once in the last seven days.

Sedentary activity

• In 2008, most primary school boys (70.9%) and girls (75.2%) surveyed reported participating in

more than two hours of electronic media activity on all of the last seven days.

• Amongst secondary school children in 2008, around four out of five secondary schools boys (78.7%)

and girls (83.0%) used electronic media for more than two hours on all of the last seven days.

• There were no significant differences in the proportions of boys and girls meeting Australian

Physical Activity Recommendations3, 4 in 2008 on electronic media use on all of the last seven days.

Nutrition

Energy from macronutrients

• There were no significant differences between 2008 and 2003 in mean total energy intakes

recorded in the 24-Hour Food Diary for primary school girls and boys and secondary school

boys. For secondary school girls, a 10% lower energy intake was observed in 2008 than 2003,

this difference was statistically significant.

• In 2008, approximately one-half (48.1% - 49.6%) of daily energy intake came from carbohydrates,

a third (32.7% - 33.9%) from fats and the remainder from protein (17.4% - 18.0%).

• In 2008, nearly one-half of the fat consumed by children was saturated fat, contributing

between 14.0% and 14.7% of energy intake.

• The proportions of energy from fat and saturated fat consumed by children were higher than

the maximum recommended levels (30% and 10% respectively), with no significant differences

between 2003 and 2008.

Micronutrient intakes

• In 2008, mean micronutrient intakes substantially exceeded the Estimated Average

Requirements (EARs) for all nutrients for all children with the exception of calcium and

magnesium amongst secondary school girls.

Proportion consuming food groups

• On the day of the 24-Hour Food Diary in 2008, more than nine in ten children reported

consuming cereal and cereal products (97.5% of primary school children and 94.0% of

secondary school children) and milk products and dishes (91.1% of primary school children

and 86.5% of secondary school children). Cereal-based products or dishes were consumed by

73.8% of primary school children and 70.9% of secondary school children.

Page ix


• In 2008, three-quarters of children reported consuming vegetable products and dishes (75.9%

of primary school children and 78.1% of secondary school children) and four in five consumed

meat, poultry and game products (81.0% of primary school children and 79.7% of secondary

school children).

• Three in five consumed fruit or fruit products (68.6% of primary school children and 62.7%

of secondary school), whereas one-quarter consumed snack foods (27.3% of primary

school children and 25.5% of secondary school children) and around two in five consumed

confectionary or other sugar products and dishes (35.6% of primary school children and 44.2%

of secondary school children) in 2008.

• The proportion of primary school children consuming confectionary and cereal bars in 2008

was significantly lower than in 2003 (35.6% vs. 48.3%). The proportion of secondary school

girls consuming sugar products and dishes was also significantly lower in 2008 compared with

2003 (33.2% vs. 56.1%).

Food habits over the last 12 months

Usual vegetable intakes

• In 2008, 42.1% of primary school boys and 43.1% of primary school girls reported meeting

dietary guidelines for vegetable consumption (3 serves per day). These proportions did not

differ significantly from those in 2003.

• In 2008, 28.1% of secondary school boys and 23.6% of secondary school girls reported meeting

dietary guidelines for vegetable consumption (4 serves per day). Amongst secondary school

girls this represents a significant higher proportion than the 2003 survey.

Usual fruit intakes

• In 2008, 62.9% of primary school boys and 70.2% of primary school girls usually met dietary

guidelines for fruit consumption (1 serve per day). These proportions were significantly higher

than in 2003.

• In 2008, 22.2% of secondary school boys and 28.3% of secondary school girls usually met

dietary guidelines for fruit consumption (3 serves per day).

• The proportion of secondary school girls usually meeting dietary guidelines for fruit

consumption (3 serves per day) was significantly greater in 2008 (28.3%) compared with 2003

(13.5%), however no difference was noted amongst secondary school boys.

Breakfast habits

• In 2008, 61.5% of secondary school girls reported consuming breakfast daily, compared to a

larger majority of primary school children (90.1% boys; 83.2% girls) and secondary school boys

(71.5%).

• The proportion of secondary school girls who consumed breakfast daily was significantly

higher in 2008 than 2003 (61.5% vs. 51.3% respectively), although no differences were

observed for primary school children or secondary school boys.

• In 2008, about half (range 48.3% - 60.5%) of all children prepared or helped to prepare their

breakfast most days of the week (five to seven days).

Page x


Lunch and snack habits

• In 2008, one-quarter of secondary school boys (24.3%) and girls (24.6%), reported usually

helping to prepare their lunch most days compared with a somewhat lower proportion of

primary school children (11.1% boys, 16.6% girls) with a further one-third of all children helping

some days.

• In 2008, approximately four in ten primary school children (43.2% boys, 39.4% girls) and one-

half of secondary school children (51.2% boys, 50.4% girls%) reported purchasing food or

drinks from the school canteen at least once per week, with secondary school children (19.8%

boys, 12.0% girls) being more likely than primary school children (4.7% boys, 5.9% girls) to

purchase on most days of the week.

• In 2008, about one-half of secondary school children (boys: 51.3% , girls: 55.9%) reported

making their own snack decisions, whereas for most primary school children (boys: 67.2%, girls:

70.5%), parents were also involved.

Evening meal habits

• In 2008, the majority of children had eaten their evening meal with family on most days of

the week, with the proportion higher for primary school boys (82.5%) and girls (84.2%) than

secondary boys (66.3%) and girls (68.4%).

• One-quarter of primary school boys (23.6%) watched television whilst eating dinner on

most days of the week in 2008, a result similar to 2003 (19.0%). One in eight primary school

girls (12.5%) watched television whilst eating dinner on most days of the week in 2008, a

significantly lower amount than 2003 (19.5%). Significantly lower proportions of secondary

school boys and girls indicated they watched television while eating dinner in 2008 than in

2003 (boys 16.1% vs. 30.1%; girls 20.0% vs. 31.5%).

• In 2008, up to 5% of children of all ages helped with dinner preparation most days, whereas

about one- third (primary: 38.3%, secondary: 43.4%) of boys and one-half (primary: 51.8%,

secondary: 53.0%) of girls helped on between one and four days per week.

Fast food

• In 2008, approximately one-third of primary school children (boys: 33.8%, girls: 34.9%) and

secondary school boys (33.7%) reported usually consuming fast food chain meals or snacks at

least once a week. These proportions were not significantly different between 2003 and 2008.

• The proportion of secondary school girls usually consuming fast food at least once a week was

significantly lower in 2008 (18.4%) compared with 2003 (34.6%).

Type of milk

• In 2008, at least 95% of children usually consumed milk in the last 12 months; however

secondary school girls (53.8%) were more likely to consume reduced fat or skimmed milk than

primary school children (42.3% boys, 41.8% girls) or secondary school boys (37.5%).

• The proportion consuming reduced fat or skimmed milk was higher in 2008 than 2003 for

primary school boys (42.3% vs. 34.5%) and girls (41.8% vs. 35.6%) and secondary school girls

(53.8% vs. 40.3%), however these differences were not statistically significant.

Page xi


Type of cereal

• At least 90% of children surveyed in 2003 and 2008 had eaten breakfast cereal at least once in

the previous 12 months.

• A wide range of cereal types were consumed, the most prevalent was plain wheat cereal,

consumed by one-third (34.0%) of children in 2008.

• The most substantial difference in the type of cereal consumed was a lower proportion

consuming highly sweetened cereals in 2008 compared with 2003 (17.2% vs. 22.0%

respectively).

Dietary supplements

• Two in five children usually consumed vitamin or mineral supplements over the previous

12 months. This proportion was significantly higher in 2008 than 2003 (44.5% vs. 37.4%

respectively).

• A higher proportion of girls consumed supplements more frequently; 19% of primary and

19.6% of secondary school girls consumed supplements five to seven times per week in 2008,

compared with 13.6% of primary and 13.4% of secondary school boys.

Food Frequency over the last 12 months

• Foods consumed more often in 2008 compared with 2003 were predominantly from the

healthier food categories, particularly different types of fruit, vegetables and wholegrain bread.

• Foods eaten less frequently in 2008 compared with 2003 were predominantly the less healthy

foods including baked good, white bread, meat pies/sausage rolls/other savoury pastries,

chocolate/chocolate bars, lollies/confectionary, potato chips/corn chips/similar snacks, fancy

sweet biscuits, ice cream, cordial, regular soft drink/flavoured mineral water and potato cooked

with fat (chips).

Body size

• The proportions of primary school boys and girls classified as overweight or obese were not

significantly different between 2008 (boys: 26.7%, girls: 18.7%) and 2003 (boys: 20.7%, girls:

26.0%).

• There was also no difference in the proportions of secondary school boys who were

overweight or obese between 2008 (15.9%) and 2003 (24.7%).

• However, the proportion of secondary school girls who were classified as overweight or obese

was significantly lower in 2008 (15.9%) compared with 2003 (23.1%).

• Notably, a significantly higher proportion of both primary and secondary school girls were

underweight in 2008 (primary: 9.9%, secondary: 9.4%) than in 2003 (primary: 4.2%, secondary:

5.5%). No significant differences in underweight proportions were evident for primary or

secondary school boys between 2008 (primary: 5.8%, secondary: 5.2%) and 2003 (primary:

3.8%, secondary: 3.6%).

Page xii


CONTENTS

CONTRIBUTION AND ACKNOWLEDGEMENTS ........................................................................................................ ii

SUGGESTED CITATION ..................................................................................................................................................... iii

MINISTERS FOREWARD ................................................................................................................................................... iv

EXECUTIVE SUMMARY ..................................................................................................................................................... v

TABLE OF CONTENTS ......................................................................................................................................................xii

LIST OF TABLES .................................................................................................................................................................xiii

LIST OF FIGURES ..............................................................................................................................................................xiv

CHAPTER 1: BACKGROUND ............................................................................................................................................1

CHAPTER 2 : METHODS ....................................................................................................................................................3

GENERAL PROCEDURES ..................................................................................................................................................4

DATA COLLECTION ............................................................................................................................................................4

Instruments ................................................................................................................................................................................................4

School visits ................................................................................................................................................................................................5

Data coding and cleaning .................................................................................................................................................................7

Data merging ............................................................................................................................................................................................8

Data treatment and analysis ............................................................................................................................................................8

CHAPTER 3: RESULTS ......................................................................................................................................................11

SAMPLE DEMOGRAPHICS .............................................................................................................................................11

PHYSICAL ACTIVITY ...............................................................................................................................................12

Self-report overall physical activity ...........................................................................................................................................12

Pedometer measured daily steps taken by children and adolescents...............................................................13

Physical activities reported by children and adolescents...........................................................................................14

School physical activity ....................................................................................................................................................................20

Active commuting ..............................................................................................................................................................................24

Inactivity and sedentary behaviour .........................................................................................................................................28

NUTRITION ...............................................................................................................................................................32

24- Hour Food Diary ...........................................................................................................................................................................32

Food Habits .............................................................................................................................................................................................45

Food Frequency ....................................................................................................................................................................................56

BODY SIZE .....................................................................................................................................................................81

CHAPTER 4: DISCUSSION ..........................................................................................................................................83

REFERENCES ..................................................................................................................................................................90

Page xiii


LIST OF TABLES

Table 1: Frequency of consumption conversion ...............................................................................................................9

Table 2: Weight adjustment due to clothing, 2003 and 2008. ...............................................................................10

Table 3: Participant demographics in the Child and Adolescent Physical Activity and Nutrition

Survey, 2003 and 2008 (unweighted). ................................................................................................................11

Table 4: Average daily step counts and proportion of children meeting recommended step

counts, 2003 and 2008: primary school children. .......................................................................................12

Table 5: Average daily step counts and proportion of children meeting recommended step

counts, 2003 and 2008: secondary school children. .................................................................................14

Table 6: Average minutes of daily by domain, 2008: secondary school children. .....................................20

Table 7: Frequency of being very active (or huffing and puffing for year three) during physical

education, 2003 and 2008: primary school children. ................................................................................21

Table 8: Frequency of being very active during physical education, 2003 and 2008: secondary

school children. ................................................................................................................................................................21

Table 9: Usual activity during recess, 2003 and 2008: primary school children. .........................................22

Table 10: Usual activity during recess, 2003 and 2008: secondary school children. ...................................23

Table 11: Usual activity during lunch, 2003 and 2008: primary school children. ..........................................23

Table 12: Usual activity during lunch, 2003 and 2008: secondary school children. ....................................23

Table 13: Response to active commuting barriers and facilitators: year five and seven children ......26

Table 14: Response to active transport barriers and facilitators: secondary school children ................26

Table 15: Frequency of intensity of sedentary activity behaviour, 2008: year three children. ..............30

Table 16: Mean daily minutes spent in sedentary activities, 2008: year five and seven children. ......31

Table 17: Mean daily minutes spent in sedentary activities, 2008: secondary school children. ..........31

Table 18: Mean 24 hour energy intake and proportion of energy from macronutrients, 2003 and

2008. ........................................................................................................................................................................................33

Table 19: Mean intake of macronutrients (grams), 2003 and 2008. ......................................................................34

Table 20: Mean 24 hour micronutrient intakes, 2003 and 2008. .............................................................................36

Table 21: Proportion of children consuming food from main food group, 2003 and 2008. ..................38

Table 22: Mean daily intake (grams per person) for consumers of main food groups, 2003 and

2008. ........................................................................................................................................................................................40

Table 23: Mean daily intake (grams per person) of food from main food groups (all participants),

2003 and 2008. ..................................................................................................................................................................42

Table 24: Mean proportion of daily energy (excluding dietary fibre) from food groups for all

participants regardless of consumption, 2003 and 2008. ......................................................................44

Table 25: Differences in 12 month frequency of food consumption, 2003 and 2008. ..............................78

Table 26: Proportions (%) of primary school children classified as underweight, healthy,

overweight and obese by sex and overall, 2003 and 2008. ..................................................................82

Table 27: Proportions (%) of secondary school children classified as underweight, healthy,

overweight and obese by sex and overall, 2003 and 2008. ..................................................................82

Page xiv


LIST OF FIGURES

Figure 1: Self-reported number of days participating in 60 minutes or more of physical activity

in the last seven days, 2008: primary school children. .............................................................................12

Figure 2: Self-reported number of days participating in 60 minutes or more of physical activity

in the last seven days, 2008: secondary school children ........................................................................13

Figure 3: Prevalence of physical activities undertaken in the last seven days, 2008: Year 5 and 7

primary school boys. .....................................................................................................................................................15

Figure 4: Prevalence of physical activities undertaken in the last seven days, 2008: Year 5 and 7

primary school girls. .......................................................................................................................................................16

Figure 5: Prevalence of physical activities undertaken in the last seven days, 2008: secondary

school boys. ........................................................................................................................................................................17

Figure 6: Prevalence of physical activities undertaken in the last seven days, 2008: secondary

school girls. ..........................................................................................................................................................................18

Figure 7: Proportion of children participating reporting at least one activity for each physical

activity domain in the last seven days, 2008. .................................................................................................19

Figure 8: Prevalence (%) of children active commuting to school on the previous school day,

2003 and 2008. ..................................................................................................................................................................24

Figure 9: Prevalence (%) of children active commuting home from school on the previous

school day, 2003 and 2008. .......................................................................................................................................27

Figure 10: Proportion of children reporting actively commuting to local destinations in the last

seven days, 2008: Year 5 and 7 children ............................................................................................................27

Figure 11: Proportion of children reporting actively commuting to local destinations in the last

seven days, 2008: secondary school children ................................................................................................28

Figure 12: Proportion of children meeting guidelines for electronic media use6,7 on each of the

last seven days .................................................................................................................................................................29

Figure 13: Proportion of children usually meeting recommended daily vegetable intake, 2003

and 2008. ..............................................................................................................................................................................46

Figure 14: Usual serves of vegetables per day, 2003 and 2008: primary school boys. ................................46

Figure 15: Usual serves of vegetables per day, 2003 and 2008: primary school girls. ..................................47

Figure 16: Usual serves of vegetables per day, 2003 and 2008: secondary school boys. ..........................48

Figure 17: Usual serves of vegetables per day: secondary school boys by location. ...................................48

Figure 18: Usual serves of vegetables per day, 2003 and 2008: secondary school girls. ............................49

Figure 19: Proportion of children usually meeting recommended daily fruit intake, 2003 and 2008. .........50

Figure 20: Usual daily serves of fruit, 2003 and 2008: primary school boys. ......................................................51

Figure 21: Usual daily serves of fruit, 2003 and 2008: primary school girls. ........................................................51

Figure 22: Usual daily serves of fruit, 2003 and 2008: secondary school boys. ................................................52

Figure 23: Usual daily serves of fruit, 2003 and 2008: secondary school girls. ..................................................52

Figure 24: Proportion of children who consume breakfast daily, 2003 and 2008. .........................................53

Figure 25: Frequency usually consume breakfast, 2003 and 2008: primary school boys. .........................54

Page xv


Figure 26: Frequency usually consume breakfast, 2003 and 2008: primary school girls............................54

Figure 27: Frequency usually consume breakfast, 2003 and 2008: secondary school boys. ...................55

Figure 28: Frequency usually consume breakfast, 2003 and 2008: secondary school girls. .....................55

Figure 29: Frequency of children reporting usually preparing or helping to prepare breakfast,

2003 and 2008: primary school boys. .................................................................................................................55

Figure 30: Frequency of children reporting usually preparing or helping to prepare breakfast,

2003 and 2008: primary school girls. ...................................................................................................................56

Figure 31: Frequency of children who usually prepare or helping to prepare breakfast, 2003

and 2008: secondary school boys. ........................................................................................................................57

Figure 32: Frequency of children who usually prepare or helping to prepare breakfast, 2003

and 2008: secondary school girls. .........................................................................................................................58

Figure 33: Frequency of children reporting usually preparing or helping to prepare lunch, 2008. ....58

Figure 34: Frequency of children reporting usually preparing or helping to prepare dinner, 2003

and 2008: primary school boys. ..............................................................................................................................59


and 2008: primary school girls. ...............................................................................................................................59


and 2008: secondary school boys. ........................................................................................................................60


and 2008: secondary school girls. .........................................................................................................................60

Figure 38: Frequency of purchasing food or drinks from the school canteen, 2008: primary

school children. ................................................................................................................................................................61

Figure 39: Frequency of purchasing food or drinks from the school canteen, 2008: secondary

school children. ................................................................................................................................................................62

Figure 40: Proportion of children eating evening meal with family five to seven days per week,

2003 and 2008. ..................................................................................................................................................................62

Figure 41: Proportion of children watching television while eating evening meal five to seven

evenings per week, 2003 and 2008. ....................................................................................................................63

Figure 42: Frequency children watch television while eating evening meal, 2003 and 2008:





secondary school boys. ...............................................................................................................................................65


secondary school girls. .................................................................................................................................................65

Figure 46: Who usually decides what children eat for meals: 2008. ........................................................................66

Figure 47: Who usually decides what children eat for snacks: 2008. ......................................................................67

Figure 48: Proportion of children consuming food or snacks from fast food chain at least once a

week, 2003 and 2008. ...................................................................................................................................................68

Page xvi


Figure 49: Proportion of children attending metropolitan and non-metropolitan schools

consuming food or snacks from fast food chain at least once a week, 2003 and 2008. ....68

Figure 50: Frequency children consume meals or snacks from fast food chain, 2003 and 2008:


Figure 51: Frequency children consume meals or snacks from fast food chain, 2003 and 2008:


Figure 52: Frequency children consume meals or snacks from fast food chain, 2008: primary

school children. ................................................................................................................................................................70

Figure 53: Type of milk usually consumed, 2003 and 2008: primary school boys. ........................................71

Figure 54: Type of milk usually consumed, 2003 and 2008: primary school girls. ..........................................71

Figure 55: Type of milk usually consumed, 2003 and 2008: secondary school boys. ..................................71

Figure 56: Type of milk usually consumed, 2003 and 2008: secondary school girls. ....................................72

Figure 57: Type of breakfast cereal usually consumed, 2003 and 2008. ...............................................................73

Figure 58: Proportion of children consuming dietary supplements, 2003 and 2008. .................................74

Figure 59: Frequency of vitamin and mineral supplements consumption, 2003 and 2008:









CHAPTER 1: BACKGROUND

Decreasing levels of physical activity participation, the poor quality of dietary intake and high

levels of overweight and obesity in Australian youth are of concern and require concerted multi-

sectoral efforts to improve. Both National7 and State10, 11 surveys have, in recent years, examined the

proportions of children who meet recommended physical activity, nutrient intake guidelines and

who are of a healthy weight.

The Australian Physical Activity Recommendations suggest that children3 and adolescents4

participate in 60 minutes, and up to several hours, of moderate to vigorous physical activity every

day and that children accumulate no more than two hours screen time for entertainment each day.

National survey data collected in 20077 found that only 32% of children aged 9-16 years met the

physical activity guidelines on all of the previous seven days and only 7% met the screen guidelines

on all of the previous seven days. Likewise, the 2007 national survey found low compliance of 9-16

year olds with the Dietary Guidelines for Children and Adolescents in Australia,5 especially low

consumption of fruit, vegetables, cereal foods and dairy foods, and high fat and sugar intakes. The

Australian Bureau of Statistics (ABS)12 found that approximately one-quarter of children aged 5-17

years nationally were overweight or obese, with 8% classified as obese. The ABS identified increases

between 1995 and 2008 in the proportion of boys who were obese and the proportion of girls who

were overweight.

The Premier’s Physical Activity Taskforce (the Taskforce) was established in 2001 following research

showing low physical activity levels in the Western Australian population. The Taskforce is a coalition

of senior representatives from the Departments of Education, Health, Planning, Sport and Recreation

and Transport, the Western Australian Local Government Association, Lotterywest and Healthway,

a leading academic in the field and a community representative. The purpose of the Taskforce is to

oversee the development and implementation of a whole of community physical activity plan for

Western Australia.

To achieve improved health for Western Australians, in 2001 a target was set to increase the

proportion of sufficiently physically active adults by 5% (from 58% to 63%) over 10 years. Research

examining this target remains a key role of the Taskforce through its Evaluation and Monitoring

Advisory Committee (EMAC). No target was set for West Australian children due to the absence of

adequate state level data.

The first Child and Adolescent Physical Activity and Nutrition Survey (CAPANS) in 2003 collected

information on children’s:

• participation in different types of physical activity;

• physical activity motivation factors;

• barriers to physical activity participation;

• pedometer measured daily step counts;

• body measurements including body mass index (BMI) determined overweight and obesity;

• information on key nutrient intake; and

• eating patterns.


The study made a number of recommendations including ongoing monitoring of child and

adolescent physical activity, nutrition and growth status. The CAPANS 2008 survey was undertaken

to make comparisons with the CAPANS 2003 research and to assist in the development of future

directions for physical activity and nutrition promotion.

While most questions in the CAPANS 2008 questionnaires remained the same as in CAPANS 2003,

changes in policy (such as the introduction of Australia’s Physical Activity Recommendations3, 4 in

2004) since the first study, and the need to optimise ease and timing of completion, led to some

questionnaire modification. Thus, not all 2008 data are comparable with the CAPANS 2003 data.

However, where possible, comparisons between data from the two surveys have been made.

This report details the findings of the CAPANS 2008 survey and provides comparisons with CAPANS

2003 data for physical activity, nutrition and body size.

CHAPTER 2: METHODS

This section describes the study design, sample and data collection procedures for the Child and

Adolescent Physical Activity and Nutrition Survey (CAPANS) 2008 survey and includes a summary

of methods reported for the CAPANS 2003 survey. Further study procedures for CAPANS 2008 are

available in the CAPANS 2008 Study Protocol. Further details of the CAPANS 2003 methods can be

found in the Physical Activity and Nutrition Levels in Western Australian Children and Adolescents

Report,13 Results of Western Australian Child and Adolescent Physical Activity and Nutrition Survey

2003; Physical Activity Technical Report14 and Nutrient Intakes in Western Australian Children and

Adolescents Report.15 The protocol used for 2008 data collection closely followed the methods

reported in the CAPANS 2003 survey; however some differences in child self-selection and data

collection may have occurred.

Ethics Approval

The University of Notre Dame Australia Ethics Committee approved the protocol for CAPANS 2003.

Approval was provided for the CAPANS 2008 survey by the Edith Cowan University Human Research

Ethics Committee.

School recruitment and response rates

The Physical Activity Taskforce coordinated the selection and recruitment of schools. The Australian

Council for Educational Research selected a random sample of government and non-government

schools using a two-stage stratified design with primary and secondary schools. The sampling

frame was divided into four strata; primary metropolitan, primary non-metropolitan, secondary

metropolitan, and secondary non-metropolitan.

Principals at randomly selected schools were mailed a letter from the Directors General of the

Departments of Sport and Recreation, and Education and Training inviting their school to participate

in the project. A School Information Sheet and School Consent Form were included with the letter.

Signed principal Consent Forms were returned to the Physical Activity Taskforce by facsimile or post.

In 2008, contact was made with 74 schools to achieve 34 participant schools, giving an overall school

response rate of 45.9%. This rate was lower than that achieved in 2003, when 36 schools agreed to

participate from a total of 60 schools approached, giving a school response rate of 60%.


Timing of Data Collection

CAPANS 2008 data were collected during Term 3 (22 July to 26 September) and Term 4 (14 October

to 18 December) during the 2008 Western Australian school year. This was comparable with the data

collection period for CAPANS 2003.

GENERAL PROCEDURES

Participating schools were contacted via a letter from the Research Team. To assist with

communication between the Research Team and the school, an individual teacher at each school

acted as a liaison. Suitable dates for data collection were coordinated through this person.

Staff training

A project coordinator, field coordinator, consent coordinator, four team leaders and 26 research

assistants were recruited to complete the 2008 data collection. Staff participated in a comprehensive

four-day training course in data collection techniques. This incorporated training in questionnaire

administration, food diary administration and checking, pedometer use, managing children, ethical

considerations and anthropometric measurement (height, weight and waist, hip and umbilicus

girth) using ISAK protocols.16

Teacher briefing session

At each school the consent coordinator, or a team leader, provided a briefing to the teachers of

selected classes about the study and its benefits. The teacher’s roles in the study were explained,

specifically to encourage children to participate in the study, collect consent forms, complete

pedometer step count records (primary schools only) and assist with collecting unreturned

pedometers. A Teacher Information Pack was sent to schools that declined a teacher briefing session.

Child recruitment

In primary schools, where possible, a number of random classrooms were selected to acquire

approximately 25 children from years 3, 5 and 7. All children in these classes were invited to

participate in the study. As random classroom recruitment was not possible in most secondary

schools, the principal, school liaison or fieldwork coordinator chose classes with appropriate class

timetabling to participate in the study.

The consent coordinator, or a team leader, provided a ten minute recruitment session to children

and distributed children’s Information Sheets and Consent Forms at each school (see Study Protocol

for further details). Children were informed about the study and their role in data collection if they

chose to participate. Correct use of the pedometer was demonstrated, and children’s questions were

answered. Children were provided a due date to return Consent Forms signed by their parents/

guardian. Multiple strategies were used to maximise participation and these are described in the

Study Protocol.

Participant response rates

Based on the total number of consent forms distributed in CAPANS 2008, an overall child response

rate of 58.8%, was achieved with response rates of 79.5% for primary school children and 46.2% for

secondary school children. The overall child response rate in CAPANS 2003 was 55.8%, with primary

and secondary school child response rates of 58.8% and 52.1% respectively.


DATA COLLECTION

Instruments

The survey instruments used in CAPANS 2003 were reviewed and modified for the CAPANS 2008

survey.

Demographic data

Demographic data for children in CAPANS 2008 were collected from a variety of data sources

including class lists, the Physical Activity Questionnaire, Food Frequency Questionnaire and the

child’s consent form. “Home neighbourhood” SEIFA (based on postcode) was used to represent

home socio-economic status (SES).

Physical activity instruments

Physical Activity Questionnaire

Three versions of the Physical Activity questionnaire were used; year three, year 5/7 and secondary

school. This questionnaire sought to establish the physical activity behaviour of children including

the types of physical activity in which children participated in over the past seven days, the time they

spent in these activities (for secondary school children) and the number of days children participated

in physical activity for 60 minutes or more.

Extensive consultation with experts in the physical activity research field led to several changes to

the Physical Activity Questionnaire for CAPANS 2008.

Questions on the year 5/7 and secondary school Physical Activity Questionnaire about the frequency

of physical activities and sedentary activities were rephrased; in the CAPANS 2003 version “usual”

physical activity participation in a typical week was used, whereas CAPANS 2008 asked about

physical activity participation during the “last seven days”. This change prevented direct comparison

of the 2008 and 2003 data for this question.

Two additional questions were included on the year three, year 5/7 and secondary school Physical

Activity Questionnaire in CAPANS 2008. These questions asked children to indicate the number

of days out of the last seven that they had been physically active for 60 or more minutes and the

number of days out of the last seven that the child had participated in screen-based activity (other

than for homework) for two hours or more. These questions were adapted from Prochaska’s single

physical activity question, which has been shown to be reliable for children with an average age of

12 years.17

Questions related to active transport (walking, cycling, scootering or skateboarding) to local

destinations18 as well as barriers to active commuting to school18 were added to the year 5/7 and

secondary school 2008 Physical Activity Questionnaires to obtain data on independent mobility.

Questions relating to physical activity motivators and barriers which displayed only small response

variability in CAPANS 2003 were removed from CAPANS 2008.

Pedometer and Pedometer Diary

Yamax Digiwalker (SW-700 or SW 200) pedometers were used to collect step count data. These are

valid and reliable objective instruments for measuring step counts.19 Elastic and a safety-pins were

provided to attach the pedometer to clothing, which assisted with reducing pedometer loss.


Nutrition instruments

24-Hour Food Diary

The food and nutrient intakes of children and adolescents were examined using a 24-Hour Food

Diary.20 This dietary assessment method requires participants to record the type, amount and source

of all foods, beverages and supplements consumed over a 24-hour period.

Food Frequency Questionnaire

The Food Frequency Questionnaire was designed to collect information about children’s and

adolescents’ usual pattern of eating over the previous 12 months. This instrument was based on the

1995 National Nutrition Survey Food Frequency Questionnaire7 with the addition of food items and

questions related to children. Section one asked about frequency of consumption per day, week

or month of 110 specific food items, four supplement items and eight alcoholic beverage items

(secondary school only) . This section collected only frequency information about food consumed;

no quantities were specified. The Food Frequency Questionnaire section two asked questions about

food and meal habits.21 Questions about school canteen use and food decision maker/s for the child

were added to this section in 2008.

Anthropometric measurements

Height, weight and waist girth measures taken from each child followed ISAK international

protocols.16 Calibration assessment of weight scales between each school visit using 30 kg weights

indicated that scales were measuring within 300 grams of the calibrated weight. Calibration

assessment of the stadiometers between each school field visit, using a calibrated one meter rule

(Supercraft Steel Rule R093076), indicated that all of the four stadiometers were measuring within

2mm of the calibrated length.

School visits

A minimum of three visits were made to each school. At least one team leader was in attendance for

each school visit.

School Visit 1

The team leader met with the school liaison and assisted with assembling children who had

provided consent to participate. Each child was provided with their individual survey pack labelled

with a unique identifier (ID). Depending on which study components the child had consented

to participate in, packs contained: Physical Activity Questionnaire; pedometer (with elastic and a

safety pin), Pedometer Diary; 24-hour Food Diary; measuring cups and spoons; Food Frequency

Questionnaire; a 2B pencil and an eraser.

The classroom was set up into four stations and children split into groups:

Station 1: Physical Activity Questionnaire

Children completed the Physical Activity Questionnaire as a group under the guidance of a research

assistant. Enlarged laminated copies of the questions were used to provide step-by-step instructions

to children for estimating time spent in physical activities and sedentary activities. The questionnaire

took approximately 20 minutes to complete.


Station 2: Pedometers and Pedometer Diaries

Children who agreed to participate in the physical activity component were provided with a

pedometer and instructed to wear it for between seven and ten days while awake, except when in

water. Children were shown how to correctly wear the pedometer by securing it over their right hip,

using the elastic and safety pin to attach it to clothing. Primary school children’s pedometers were

sealed with tape to avoid interference with data recording and reactivity. Each morning, primary

school children’s classroom teacher unsealed each child’s pedometer and recorded their step count

before resealing the pedometer. Secondary school children recorded their step counts into their

Pedometer Diary each night when removing the pedometer for sleep. Teachers and secondary

school children were requested to reset pedometers after recording step totals each day and asked

to note down if this was not done. Children were instructed to maintain a Pedometer Diary each day

to record any periods that their pedometer was not worn, and the activity undertaken during this

time.

Station 3: Food Diary and Food Frequency Questionnaire

A team of two research assistants presented the 24-hour Food Diary to children, and explained

how to record food consumed. Household food measuring cups and spoons were provided and a

demonstration of their use to estimate food quantities given. Children practiced recording foods

recently eaten and were provided with written instructions for their parents’ reference.

The Food Frequency Questionnaire was provided to primary school children for a parent or guardian

to complete. Secondary school children were asked to complete the questionnaire themselves and

to return it with their 24-hour Food Diary the next day.

Station 4: Anthropometric Measurements

Whilst children were completing the Physical Activity Questionnaire one child at a time was removed

for anthropometric measurement. Children were instructed to remove their shoes, socks, and any

other heavy clothing (e.g. jumpers). One research assistant took the measurements, while another

research assistant recoded measures. Every measurement was repeated twice, and if they differed by

more than 0.2 kg for weight, 5 mm for height or 5 mm for girth measures, a third measure was taken.

More information on anthropometric measurement is available in the CAPANS 2008 Study Protocol.

School Visit 2

The day after School Visit 1, a research team visited the school to collect the Food Frequency

Questionnaire, the 24-hour Food Diary and the measuring cups and spoons from children

participating in the nutrition component of the study. Children were taken out of class one at a

time and the 24-hour Food Diary checked by a research assistant for unclear or missing information.

Standard prompts and food measuring instruments were used to assist children to recall food items

not recorded. The interviewers scored the quality of the 24-hour Food Diary based on the amount of

information provided.

School Visit 3

On the ninth day after the commencement of the survey, a research team visited the school to

collect the pedometers and pedometer diaries and questionnaires or equipment that had not been

collected. Subsequent visits to the school assisted with further collection of missing equipment and

documents.


Data coding and cleaning

Physical Activity Questionnaire, Food Frequency Questionnaire and Pedometer Diary

Raw data from the Physical Activity Questionnaire, Food Frequency Questionnaire and Pedometer

Diary were cleaned and coded using questionnaire coding guides developed for the CAPANS

2008 questionnaires by the Project Manager. Axis Data entered the cleaned and coded 2008

Physical Activity Questionnaire, Food Frequency Questionnaire and Pedometer Diary data into

Microsoft Excel. Physical Activity and Food Frequency Questionnaire data were entered twice and

discrepancies corrected using the raw data.

Pedometer step counts

Pedometer step counts from the secondary school children’s Pedometer Diaries and primary school

teachers’ recording sheets were entered onto excel by Axis Data. A research assistant checked the

raw pedometer step counts (as recorded by teachers and secondary school children) against the

database of entered step counts and made corrections to the database where necessary.

Pedometer data from children who wore pedometers for four days or more were included in analysis.

Imputation of step counts for periods of physical activity recorded in the diary when the pedometer

was not worn followed the protocol used in CAPANS 2003. This was calculated as the product of

activity duration (minutes) by 120 steps,22 and these estimated step counts were added to the

recorded step count for that day. No imputation was performed for sedentary activities recorded in

the diary. A maximum of 180 minutes (21 600 steps) was imputed for surfing and beach activities.

For days on which the pedometer was not worn and, activity recorded in the diary for more than five

hours (such as beach swimming), a maximum of 240 minutes (28 800 steps) was recorded.

Pedometer step counts that consisted of two or more days combined data due to non-reset were

not included in analysis as it was not evident if the pedometer had been worn on every day of the

cumulative step count.

24- Hour Food Diary

The 24- Hour Food Diaries were examined and 230 were rejected due to poor quality. Foods

recorded for each child in the 24-hour Food Diary were coded for nutrient analysis using nutrition

analysis software Foodworks Professional Edition 2007,23 with reference to the AUSNUT 2007

nutrient composition database.24 Gram amounts of foods were either calculated by Foodworks from

household measures, determined from manufacturer’s information or by weighing the specified

quantity.

Food group codes, which include the same major and sub-food groups as those used in the 199525

and 2007 National Nutrition Surveys, were automatically derived from the 2003 survey data template.

The classification codes were obtained from Xyris Software (Australia) Pty Ltd during the 2003 survey

data analysis and imported into the Foodworks database after generating an Access file from the

Foodworks data.

If a suitable code could not be found in the existing database, a new food was created in Foodworks

using the ‘recipe’ facility and a similar food as a base. Nutrition composition data for new foods was

obtained from product labels or from the manufacturer and substituted for base food information in

the recipe.26 The food diaries were coded by four qualified nutritionists who received training from

the coding supervisor and were provided with written guidelines. Initially the coding supervisor re-


coded the coders work, then provided feedback to the coder to resolve discrepancies until their error

rate was less than five percent. The quality of coding was monitored throughout the coding process

by the coding supervisor. Further details are available from the CAPANS 2008 Dietary Coding Manual.

Data merging

Data from the excel text files were converted to dBase-IV format and, using the student ID as the

unique identifier, files were merged so that each record contained all information for each student

drawn from multiple sources. Templates were created in Microsoft Excel which specified which fields

to extract for each file created.

Data from the 2003 survey had already been merged into a single file, so the templates also specified

the appropriate column from the 2003 data file to match with the data from the 2008 survey where

applicable. Data were imported from Microsoft Excel into SPSS v17.27

Data treatment and analysis

Data were analysed using SPSS v17.27

Data from seven and 17 year olds were excluded due to small sample sizes.

School location was defined by the postcode; metropolitan locations were those with a postcode

including 6215 and below, other than 6041-6044 and non-metropolitan locations were all postcodes

above 6215, other than 6566 and 6588.

Population weighting

Comparative descriptive statistics between 2003 and 2008 were weighted to population

standardised age, home neighbourhood SES and sex, derived from 2006 Australian Census data.8

Population statistical weights were trimmed at the 95th percentile due to an anticipated loss of

precision from high weights.28

All statistical analyses to determine differences between sex or survey year were adjusted for age,

home neighbourhood SES, sex (when applicable) and school-level clustering. Statistical significance

was determined at the 0.05 level for all analyses.

Adjustment by school location was also included in nutrition comparisons due to observed

significant differences between metropolitan and non-metropolitan areas.

Physical Activity Questionnaire

Outliers for physical activity items were excluded for continuous data based on 95th percentile.

Differences between proportions between survey years and/or between sex were examined using

GENLIN models. Mixed models were created to examine differences between means across survey

years and/or sex. All models included age and home SES as well as survey year and sex (when

applicable) and were adjusted for school level clustering.

Pedometer data

Children with four or more days of pedometer data of between 4,000 and 40,000 daily step counts

were included in analysis. GENLIN mixed models for primary school boys and girls and secondary

school boys and girls were created to compare differences between the proportions of children

meeting step count recommendations29 between survey years. Separate mixed models were used


for primary school boys and girls and secondary school boys and girls to examine differences

between pedometer step count means between survey years. Models included age and home SES

as well as survey year. All models were adjusted for school level clustering.

Dietary records

Frequency distributions of nutrient and food group variables were examined to identify any unusual

or extreme values. Potential problems were checked against the original survey forms. Extreme high

values for nutrients were truncated to the 95th percentile and values for nutrients and food groups

were transformed using square root to adjust for skewness. Mixed models were created using SPSS

v17.0 to examine differences between means across survey years. Included in the models were age,

location and home SES as well as survey year and sex (when applicable). All models were adjusted

for school level clustering.

Estimation of energy intake and percentage contribution of macronutrients to total energy intake

used the following equations, based on the 2007 AUSNUT energy data equations,30 using an average

for carbohydrates:

Energy without dietary fibre:

• Energy without dietary fibre (kJ) = Protein (g)*17 + total carbohydrate (g) *16.5 + total fat

(g)*37 + alcohol (g)*29

Energy with dietary fibre

• Energy with dietary fibre (kJ) = Energy without dietary fibre (kJ) + dietary fibre (g)*8

Food frequency questionnaire

Food items in Section 1 of the Food Frequency Questionnaire marked with more than one frequency

by children were treated as missing. The nine frequency categories were converted to a frequency

of consumption relative to per day consumption as in Table 1 below. These values were then used

to calculate mean intakes of individual foods and to compare intakes between survey years and

primary and secondary school and sex. Mixed models were created using SPSS v17.0 to examine

differences between means across survey years. Models included age, location and home SES as well

as survey year and sex (when applicable). All models were adjusted for school level clustering.

Table 1: Frequency of consumption conversion

Frequency of consumption Conversion factor

Never 0

Less than once per month 0.033

1-3 times a month 0.066

Once a week 0.143

2-4 times a week 0.428

5-6 times a week 0.786

Once a day 1

2-3 times a day 2.5

4+ times a day 4


Frequency distributions and cross-tabulations of items in the food habits section of the Food

Frequency Questionnaire were examined for skewness. GENLIN models were generated to compare

differences between proportions between survey years, age group and sex. Models included

location and home SES and all models were adjusted for school level clustering.

Body size

The averages of the two closest weight, height and girth measures were calculated. Girth measures

taken over a single layer of clothing were reduced by 5mm.

Adjustments of child weight followed the CAPANS 2003 protocol and weights were reduced as listed

in Table 2.

Body mass index (BMI, weight in kilograms divided by height squared in metres) was calculated for

each child. Sex and age specific BMI thresholds31, 32 were used to categorise children as underweight,

healthy weight, overweight or obese. Overweight and obese proportions were combined for

statistical analysis.

Using SPSS v17.0, GENLIN models were created to compare differences between proportions of

primary school boys, primary school girls, secondary school boys and secondary school girls who

were underweight and proportions of children overweight or obese in 2003 and 2008. Models

included age and home SES as well as survey year and all models adjusted for school level clustering.

Table 2: Weight adjustment due to clothing, 2003 and 2008

ItemAdjustment

(kg)

Heavy belt -0.2

Heavy jeans or windcheater -0.4

Heavy jeans and belt -0.6

Heavy jeans, belt and windcheater -0.8


CHAPTER 3: RESULTS

SAMPLE DEMOGRAPHICS

Table 3 presents the unweighted 2003 and 2008 sample characteristics. The 2003 and 2008 samples

do not statistically significantly differ in the proportions of boys and girls. However, a significantly

higher proportion of survey participants were in year three in the 2008 survey (22.9%) compared

with the 2003 survey (16.5%). The proportion of children attending a metropolitan school was

significantly higher in 2008 (76.4%) compared with 2003 (72.6%).

Other differences in the 2008 sample included a significantly higher proportion of children who

resided in middle SES areas (43.6%) compared with 2003 (28.6%) and a significantly lower proportion

of children who resided in low SES areas (27.7%) compared with 2003 (39.8%).

A lower proportion of children in the 2008 sample were born in Australia (84.6%) compared with

children in the 2003 sample (88.5%) and the proportion of children who were Aboriginal and/or a

Torres Strait Islander (4.4%) in the 2008 survey sample was significantly higher than in 2003 (4.1%).

Table 3: Participant demographics in the Child and Adolescent Physical Activity and Nutrition Survey, 2003 and 2008 (unweighted).

Variable 2003

N=22272008

N=1827

n % n %

Gender

Boys 1109 49.8 897 49.1

Girls 1118 50.2 930 50.1

School year group#*

Year 3 367 16.5 416 22.9

Years 5 & 7 926 41.6 708 38.8

Years 8 , 10 & 11 934 41.9 703 38.5

School Location*

Metropolitan 1616 72.6 1396 76.4

Non-metropolitan 611 27.4 431 23.6

Home neighbourhood socio-economic status^*

Low 887 39.8 506 27.7

Medium 637 28.6 797 43.6

High 703 31.6 524 28.7

Country of birth*

Australia 1977 88.5 1469 80.8

UK 72 3.4 46 2.5

New Zealand 33 1.5 32 1.8

Other 121 5.4 178 8.4

Aboriginality*

Aboriginal or Torres Strait Islander 90 4.1 76 4.4

Raw data presented# Year groups were survey specific^ Tertiles created from sample distribution of SEIFA for home postcode * Statistically significant difference between 2003 and 2008; p<0.05


PHYSICAL ACTIVITY

Self-report overall physical activity

In CAPANS 2008, 95.8% of the children in the study completed the Physical Activity Questionnaire.

Children in all year groups were asked to report how many days they were physically active for 60 minutes

or more in the previous seven days, thus specifically addressing the national recommendations. The

results are presented for primary and secondary children in Figure 1 and Figure 2, respectively.

• Amongst primary school children in 2008, boys were significantly more likely to meet the Physical

Activity Recommendation3 on all of the last seven days (41.2%) compared with girls (27.4%) (Figure 1).

• In 2008, two-thirds of primary school boys (64.0%) and just over one-half of primary school

girls (56.8%) reported participating in 60 minutes or more of physical activity on at least five of

the previous seven days (Figure 1).

• A very small proportion of primary school boys (2.7%) and girls (2.3%) in 2008 reported not

participating in 60 minutes or more of physical activity on any of the last seven days (Figure 1).

Australia’s Physical Activity Recommendations for 12-18 year olds stipulate that adolescents should

also participate in 60 minutes, and up to several hours, of physical activity daily.4

• In 2008, a significantly higher proportion of secondary school boys (37.6%) compared with girls

(10.1%) achieved the recommendation on all of the previous seven days (Figure 2).

• Almost three-quarters of secondary school boys (71.6%) in 2008 reported participating in at

least 60 minutes of physical activity on at least five of the previous seven days (Figure 2).

• Just over one-third (39.2%) of secondary school girls in 2008 reported participating in 60

minutes of physical activity on at least five of the previous seven days (Figure 2).

• In 2008, a very small proportion of secondary school boys (1.5%) and girls (3.4%) reported not

participating in at least 60 minutes of physical activity on any of the previous seven days (Figure 2).

2.7%

13.3%

20.0% 22.8%

41.2%

2.3%

17.4%

23.5%

29.4% 27.4%

Boys (n=481)

Girls (n=442)

%

100%

80%

60%

40%

20%

0% 0 days 1-2 days 3-4 days 5-6 days 7 days^*

^ Recommended physical activity for 5-12 year olds6 * Significant difference between boys and girls after adjusting for age, SES and school clustering

Figure 1: Self-reported number of days participating in 60 minutes or more of physical activity in the last week: primary school children


^ Recommended physical activity for 12-18 year olds7

* Statistically significant difference between boys and girls after adjusting for age, SES and school clustering

Figure 2: Self-reported number of days participating in 60 minutes or more of physical activity in the last seven days: secondary school children

Pedometer measured daily steps taken by children and adolescents

Three-quarters (76.9%) of children in 2008 completed the pedometer component of the study

in 2008. Table 3 and Table 4 present average daily step counts and the proportion of primary and

secondary school children in the 2008 and 2003 surveys achieving pedometer-determined step

count recommendations.9

• The average daily step count for primary school boys was statistically greater in 2008 (13844

steps) than in 2003 (13 202 steps) (Table 4).

• Just over one-third of primary school children were at or above the recommended step

counts9 in both 2003 (36.6%) and 2008 (37.7%) (Table 4).

• No differences were identified in the proportion of primary school girls or boys achieving

above the recommended step counts9 between 2003 and 2008 (Table 4).

• Just over one-third (38.8%) of secondary school children met the recommended number of

daily steps9 in 2008 compared with 41.1% in 2003 (Table 5).

• No significant differences were observed between 2003 and 2008 for secondary school boys or girls

on average daily step count or the proportion meeting recommended9 daily step count (Table 5).

1.5% 6.1%

20.9%

34.0% 37.6%

3.4%

22.4%

34.9%

29.1%

10.1%

0 days 1-2 days 3-4 days 5-6 days 7 days^*

Boys (n=385)

Girls (n=392)

%

100%

80%

60%

40%

20%

0%


Physical activities reported by year 5 and 7 primary school, and secondary school children.

Children in year five and seven and secondary school were asked to indicate what types of moderate or

vigorous intensity physical activities they had undertaken in the last seven days, using a list of common

activities. Children could also specify other activities they had done which were not on the list. Figure 3

through Figure 6 present the prevalence of different types of physical activities undertaken by these boys

and girls. These activities are usually undertaken at moderate-intensity, except those marked with a hash

(#), which indicates a vigorous intensity activity. The physical activities were categorised into the following

four domains: “sport, exercise and dance”; “active play”; “school physical activity”; and “active transport”.

• Jogging/running (77.7%) and movement-based video games (70.6%) were the most common

sport/exercise/dance and active play activities reported by year 5 and 7 primary school boys (Figure 3).

• The most prevalent sport/exercise/dance and active play activities for year 5 and 7 primary

school girls were jogging/running (75.6%) and playing with pets (74.7%) (Figure 3).

• Basketball (50.5%) was the most commonly reported sport/exercise/dance activity by secondary school

boys and movement-based video games (43.2%) the most common active play activity (Figure 5).

• The most prevalent sport/exercise/dance and active play activities for secondary school girls

were walking for exercise (52.7%) and playing with pets (46.5%) (Figure 6).

Table 5: Average daily step counts and proportion of children meeting recommended step counts, 2003 and 2008: secondary school children

Variable 2003 2008

n mean (SD) n mean (SD)

Average daily steps

Boys 338 14319(±4352) 188 14433(±4134)

Girls 428 11709(±4060) 310 11368(±3541)

All 766 13052(±4409) 498 12764(±4113)

n % n %

Proportion (%) at or above recommended step counts#

Boys 338 39.9 188 41.2

Girls 428 42.3 310 36.8

All 766 41.1 498 38.8

# Recommended pedometer steps8

No statistically significant differences between 2003 and 2008 after adjusting for age, gender, SES

Table 4: Average daily step counts and proportion of children meeting recommended step counts, 2003 and 2008: primary school children

2003 2008

n mean (SD) n mean (SD)

Average daily steps

Boys* 551 13202(±4925) 398 13844(±4182)

Girls 505 11681(±4564) 414 12015(±3521)

All 1056 12502(±4820) 812 12943(±3975)

n % n %

Proportion (%) at or above recommended step counts#

Boys 551 34.8 398 31.7

Girls 505 38.8 414 43.9

All 1056 36.6 812 37.7

# Recommended pedometer steps8

* Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering


7.9%

21.6%

32.9%

56.8%

88.6%

6.4%

15.2%

16.1%

21.2%

33.8%

33.8%

39.3%

48.1%

49.7%

51.2%

53.4%

65.6%

66.0%

70.6%

3.1%

3.7%

4.0%

6.8%

7.1%

8.1%

16.7%

16.8%

23.4%

23.6%

24.9%

30.0%

30.8%

32.6%

33.5%

40.4%

40.7%

43.1%

43.2%

58.0%

59.6%

77.7%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

scooter/skateboard to school

ride bike to school#

walk to school

Active Transport

physical education class

sport class

School Physical Activity

other play activity

play in cubby house

roller-blading#

skipping rope#

skateboarding

walk the dog

4 square/down ball/king ball

bounce on trampoline

scooter

play on playground equipment

tag/chasey#

play with pets

bike riding#

movement-based video games

Active Play

horse riding

netball/nettaball#

aerobics#

other sport, exercise or dance

hockey#

calisthenics/gymnastics

rugby/touch rugby#

golf

martial arts#

dance

surfing/body boarding

athletics#

baseball/softball/teeball

tennis/table tennis#

bmx/motorbike riding

basketball#

Australian rules football#

cricket

swimming laps#

walk for exercise

soccer#

jogging/running#

Sport, Exercise and Dance

# Vigorous intensity physical activity9

Figure 3: Prevalence of physical activities undertaken in the last seven days, 2008: Year 5 and 7 primary school boys


1.0%

2.0%

17.6%

34.1%

58.5%

90.7%

5.1%

18.3%

18.6%

28.6%

30.2%

40.3%

47.2%

50.8%

54.5%

64.3%

65.7%

66.7%

67.0%

74.7%

3.4%

5.7%

6.7%

9.2%

9.4%

10.9%

11.1%

11.3%

11.3%

15.6%

22.1%

23.2%

23.6%

25.7%

27.7%

27.9%

28.4%

31.6%

50.9%

57.1%

69.7%

75.6%

other active transport



walk to school Active Transport


sport class School Physical Activity

other play activity

play in cubby house

roller-blading#

skipping rope#

skateboarding

walk the dog



scooter


tag/chasey#

play with pets

bike riding#


Active Play

horse riding

netball/nettaball#

aerobics#


hockey#


rugby/touch rugby#

martial arts#

dance


athletics#




golf

basketball#


cricket

swimming laps#

walk for exercise

soccer#

jogging/running#


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 4: Prevalence of physical activities undertaken in the last seven days, 2008: Year 5 and 7 primary school girls


2.4%

3.0%

13.6%

38.5%

66.9%

71.1%

0.9%

1.9%

4.8%

5.9%

9.6%

10.8%

10.9%

11.4%

13.3%

20.8%

26.4%

41.0%

41.9%

43.2%

0.7%

1.3%

2.2%

3.6%

3.9%

4.6%

4.6%

7.3%

7.8%

9.2%

16.6%

17.3%

20.1%

21.1%

21.5%

22.4%

23.3%

31.8%

34.6%

35.5%

49.0%

50.5%






sport class School Physical Activity

other play activity

play in cubby house

roller-blading#

skipping rope#

skateboarding

walk the dog



scooter


tag/chasey#

play with pets

bike riding#


Active Play

horse riding

netball/nettaball#

aerobics#


hockey#


rugby/touch rugby#

martial arts#

dance


athletics#




golf

basketball#


cricket

swimming laps#

walk for exercise

soccer#

jogging/running#


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 5: Prevalence of physical activities undertaken in the last seven days, 2008: secondary school boys


0.2%

4.0%

4.1%

41.6%

63.2%

69.7%

0.9%

3.4%

4.4%

5.0%

6.4%

6.4%

13.8%

18.9%

20.2%

21.3%

23.8%

25.9%

26.3%

46.5%

0.7%

1.9%

2.4%

2.7%

3.8%

4.3%

4.5%

5.0%

5.7%

5.9%

6.3%

8.9%

11.9%

16.1%

16.3%

19.2%

20.4%

22.4%

26.2%

41.0%

45.7%

52.7%





physical education

sport class

School Physical Activity

other play activity

play in cubby house

roller-blading#

skipping rope#

skateboarding

walk the dog



scooter


tag/chasey#

play with pets

bike riding#


Active Play

horse riding

netball/nettaball#

aerobics#


hockey#


rugby/touch rugby#

martial arts#

dance


athletics#




golf

basketball#


cricket

swimming laps#

walk for exercise

soccer#

jogging/running#


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Figure 6: Prevalence of physical activities undertaken in the last seven days, 2008: secondary school girls


Figure 7 presents the proportions of children reporting participating in at least one activity within

each of the four physical activity domains; “sport/exercise/dance”, “play activities”, “school physical

activity”, and “active transport” in the previous seven days.

• The majority of children surveyed participated in at least one session of sport/exercise/dance

in the last seven days (range 88.7% to 98.5%) (Figure 7).

• Most year five and seven primary school boys (98.8%) and girls (99.6%) participated in at least

one session of active play in the last seven days. Similarly most secondary school boys (86.8%)

and girls (89.1%) also participated in at least one session of active play (Figure 7).

• In the last seven days, less than half of year five and seven primary school boys (46.5%) and

girls (43.1%) reported one session of active transport. Just over half (50.9%) of secondary school

boys and 43.2% of secondary school girls reported at least one session of active transport

(Figure 8).

• The majority of year five and seven primary (boys: 93.1%, girls 93.3%) and secondary (boys:

85.5%, girls: 87.7%) school children participated in at least one session of school sport or

physical education (Figure 7).

Figure 7: Proportion of children participating reporting at least one activity for each physical activity domain in the last seven days, 2008

98.5% 98.8%

46.5%

93.1%

96.1% 99.6%

43.1%

93.3% 95.1%

86.8%

50.9%

85.5% 88.7% 89.1%

43.2%

87.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Sport/exercise/dance Active play Active transport School sport or PE

%

Activity type

Primary boys (n=489)

Primary girls (n=446)

Secondary boys (n=391)

Secondary girls (n=393)


Along with the types of activities in which they had participated, year five, seven and secondary

school children were also asked in 2008 to indicate how long in total (minutes) they had participated

in each activity (and in ‘other’ activities not listed). Minutes of each activity within each domain were

added together (along with ‘other’ activities classified in that domain such as rowing within sport/

exercise/dance). The “sport/exercise/dance”, “active play” and “active transport” totals were divided by

seven to provide an estimate of duration of daily physical activity. The school physical activity (school

sport and physical education) was divided by five to provide an estimate of school physical activity

for school days.

• Secondary school boys and girls spent most time in time sport/exercise/dance activities (68.3

and 50.1 minutes respectively), followed by active play (49.5 and 35.8 minutes respectively)

(Table 6).

• Participation in school sport and physical education averaged just over 30 minutes per school

day for both secondary school boys (37.6 minutes) and girls (34.1 minutes) (Table 6).

• Secondary school boys (9.1 minutes) and girls (9.1 minutes) reported, on average, just under 10

minutes of active transport each day (Table 6).

Table 6: Average minutes of daily by domain, 2008: secondary school children

Mins/dayMean (SD)

Physical activity domainsBoys

(n=388)

Girls

(n=393)

Sport, exercise and dance 68.3 (±36.3) 50.1 (±33.4)

Active play 49.5 (±33.1) 35.8 (±30.4)

School sport and PE^ 37.6 (±18.1) 34.1 (±16.8)

Active transport 9.1 (±7.4) 9.1 (±7.5)

^ Mins/day based on 5 day school week

School physical activity

Physical education

In both 2008 and 2003 children were asked about their physical activity during school physical

education. Year three children were asked how often they ‘huffed and puffed’ during physical

education and year five and seven and secondary school children were asked how often they were

‘very active’ during physical education. The response options were: do not do physical education, or

a frequency response option; hardly ever, sometimes, quite often, or always. The results are shown

Table 7 (primary school children) and Table 8 (secondary school children).

• Approximately two-thirds of primary school boys reported ‘quite often’ or ‘always’ being very

active during physical education in 2008 (61.6%), and although this is lower than in 2003

(70.0%), the difference was not significant (Table 7).

• In 2008, 63.9% of primary school girls reported ‘quite often’ or ‘always’ being very active during

physical education; again this was lower than in 2003 (70.6%) however, the difference was not

significant (Table 7).


• 77.1% of secondary school boys reported being very active ‘quite often’ or ‘always’ during

physical education in 2008, compared with 71.8% in 2003. This difference was not statistically

significant (Table 8).

• In 2008, significantly more secondary school girls (66.0%) reported being very active ‘quite

often’ or ‘always’ in physical education, compared with in 2003 (58.2%) (Table 8).

• There was no significant difference between 2008 and 2003 in the proportion of primary

school boys reporting not doing any physical education (4.3% vs. 3.9%); nor for primary

school girls approximately (2008: 2.0%, 2003: 2.3%) (Table 7); nor was there any difference for

secondary school boys (2008: 10.5%, 2003: 10.2%) (Table 8).

• There were significantly fewer secondary school girls reporting not doing physical education in

2008 (6.9%) compared with in 2003 (14.5%) (Table 8).

Table 7: Frequency of being very active (or huffing and puffing for year three) during physical education, 2003 and 2008: primary school children

Boys % Girls %

2003

(n=540)

2008

(n=551)

2003

(n=483)

2008

(n=511)

I don’t do physical education 3.9 4.3 2.3 2.0

Hardly ever 5.3 8.4 4.2 4.4

Sometimes 20.8 25.7 22.8 29.8

Quite often 36.4 29.9 40.0 38.6*1

Always 33.6 31.7 30.6 25.3*1

*1 Significantly different (p<0.05) when proportions in two categories combined and compared with all other categories combined.

Table 8: Frequency of being very active during physical education, 2003 and 2008: secondary school children

Boys % Girls %

2003

(n=531)

2008

(n=551)

2003

(n=483)

2008

(n=511)

I don’t do physical education 10.2 10.5 14.5 6.9*

Hardly ever 1.1 3.8 4.2 5.3

Sometimes 17.0 8.6 23.0 21.8

Quite often 41.8 41.8 34.3 46.0

Always 30.0 35.3 23.9 20.0

* Significantly different (p<0.05)


Recess and lunch activity

All year groups were asked in 2003 and 2008 what they usually did during recess and lunch and

provided with response options that ranged from ‘sat down’ to ‘ran and played most of the time’. The

proportions of primary school children responding to each category for recess activity for both 2003

and 2008 are shown in Table 9 and secondary school children are shown in Table 10. Usual activities

during lunch breaks are shown in Table 11 for primary school children and in Table 12 for secondary

school children for both 2003 and 2008.

Recess activity

• Just over three-quarters of primary school boys ran around and played ‘quite a lot’ or ‘most of

the time’ during recess in 2008 (79.7%) and 2003 (78.2%) (Table 9). There was no significant

difference between the survey years.

• Around one-half of primary school girls ran around a played ‘quite a lot’ or ‘most of the time’

during recess in 2008 (49.9%) and 2003 (53.4%) (Table 9).

• The proportion of secondary school children reporting running around and playing ‘quite a lot’

or ‘most of the time’ during recess was much lower than primary school children.

• Significantly more secondary school boys reported running around and playing ‘quite a lot’ or

‘most of the time’ during recess in 2008 (38.5%) compared with 2003 (17.8%) (Table 10).

• Fewer secondary school girls than primary school children or secondary school boys reported

running around and playing ‘quite a lot’ or ‘most of the time’ during recess. In 2008 only 5.7%

of secondary school girls reported this activity, which although somewhat higher than in 2003

(3.1%), the difference was not statistically significant (Table 10).

Table 9: Usual activity during recess, 2003 and 2008: primary school children

Boys % Girls %

2003

(n=537)

2008

(n=551)

2003

(n=483)

2008

(n=511)

Sat down 2.3 2.0 5.3 9.1

Stood around or walked around 7.6 8.0 18.6 16.7

Ran or played a little bit 11.8 10.2 22.8 24.3

Ran around and played quite a lot 23.0 18.9 26.7 20.9

Ran and played most of the time 55.2 60.8 26.7 29.0


Lunch time activity

• Around four in five primary school boys reported running around and playing ‘quite a lot’ or

‘most of the time’ during lunch, this was not significantly different between survey years (84.3%

in 2008 and 81.6% in 2003) (Table 11).

• Nearly two-thirds of primary school girls (61.4%) reported running around and playing ‘quite

a lot’ or ‘most of the time’ during lunch in 2008 compared with 66.2% in 2003; this was not a

significant difference (Table 11).

• Secondary school children reported running around and playing ‘quite a lot’ or ‘most of the

time’ during lunch, much less frequently than primary school children.

• In 2008, significantly more secondary school boys reported running around and playing ‘quite

a lot’ or ‘most of the time’ during lunch (39.9%) than in 2003 (28.8%) (Table 12).

Table 10: Usual activity during recess, 2003 and 2008: secondary school children

Boys % Girls %

2003

(n=530)

2008

(n=376)

2003

(n=530)

2008

(n=380)

Sat down 18.5 14.8 33.9 35.1



Ran around and played quite a lot 10.1 20.5*1 1.5 5.1

Ran and played most of the time 7.7 18.0*1 1.6 0.6


Table 11: Usual activity during lunch, 2003 and 2008: primary school children

Boys % Girls %

2003

(n=535)

2008

(n=548)

2003

(n=485)

2008

(n=511)

Sat down 2.8 1.6 2.2 3.8



Ran around and played quite a lot 24.6 23.6 32.1 27.5

Ran and played most of the time 57.0 60.7 34.1 33.9

Table 12: Usual activity during lunch, 2003 and 2008: secondary school children

Boys % Girls %

2003

(n=530)

2008

(n=373)

2003

(n=528)

2008

(n=377)

Sat down 11.8 14.6 24.6 23.6



Ran around and played quite a lot 17.4 23.3*1 3.6 4.5

Ran and played most of the time 11.4 16.6*1 1.0 1.0



Active commuting

Active commuting refers to walking, cycling, skateboarding or scootering to get from place to place.

This was examined in primary and secondary school children by asking children to report their mode

of transport to school and home from school on the previous day. Year five and seven and secondary

school children were asked about barriers to active commuting to school and any active commuting

to local destinations they had engaged in over the last seven days.

Active commuting between home and school

The proportions of primary and secondary school boys and girls reporting the use of an active transport

(walking, cycling, skateboarding or scootering part or the whole way to school) when travelling between

home and school on the previous day to the survey are presented in Figures 8 and 9.

• Almost one-third of primary school boys (31.8%) and one-quarter of primary school girls

(26.0%) reported active transport to school the previous day in 2008. This is slightly lower than

in 2003 (34.0% and 34.7%, respectively) however the difference between survey years was not

significant (Figure 8).

• Around three in five secondary school boys (57.9%) and just less than one-half of secondary

school girls (46.0%) reported using active transport to school on the previous day. This was

higher than reported in 2003 (46.7% boys, 35.1% girls) but not significantly so.

• A significantly higher proportion of secondary school children reported actively commuting

home from school on the previous day in 2008 (boys: 63.2%, girls: 57.3%) compared with 2003

(boys: 50.0%, girls: 45.6%) (Figure 9).

No statistically significant differences between 2003 and 2008 after adjusting for age, SES and school clusteringPrimary Boys 2003 n=544, 2008 n=525. Primary Girls 2003 n=489, 2008 n=496. Secondary Boys 2003 n=533, 2008 n=355. Secondary Girls 2003 n=538, 2008 n=379.

Figure 8: Prevalence (%) of children active commuting to school on the previous school day, 2003 and 2008

34.0% 34.7%

46.7%

35.1% 31.8%

26.0%

57.9%

46.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

%

Primary boys Primary girls Secondary boys Secondary girls

2003 (n=2103)

2008 (n=1941)


Active commuting to school barriers and facilitators

Year five and seven and secondary school children were asked to report their level of agreement

with statements on possible barriers and facilitators to active commuting to school in 2008. The

proportion of children agreeing and disagreeing with each statement are shown in Table 13 for year

five and seven children and in Table 14 for secondary school children.

• In 2008, the majority of year five and seven children reported that there were safe places to leave

their bike at school (87.0% boys, 88.8% girls); that they felt safe walking to school without an adult

(65.1% boys, 64.3% girls 64.3%); that walking to school was cool (64.3% boys, 71.6% girls); and that

they would have to cross a busy road to get to school (64.2% boys, 64.1% girls) (Table 13).

• However, amongst year five and seven children in 2008, significantly more girls than boys

reported that their friends thought it was cool to walk to school (57.6% vs. 48.0%); and that

they thought it was cool to walk to school (71.6% vs. 64.3%) (Table 13).

• Although just over one-half of year five and seven girls reported they felt safe walking to

school without an adult in 2008, significantly more year five and seven girls than boys reported

they felt safer being driven to school than walking (57.1% vs. 46.7%) (Table 13).

• The majority of secondary children surveyed reported they would feel safe walking to school

without an adult present (boys: 80.6%, girls 74.2%); and that there were safe places for them to

leave their bike at school (boys: 84.7%, girls 86.4%). Conversely many reported that they would

have to cross a busy road if they walked or rode to school (boys: 68.9%, girls 68.3%); and that

there was a lot of traffic outside their school (boys: 62.7%, girls: 69.1%) (Table 14).

40.8% 38.6%

50.0%

45.6% 41.9%

34.5%

63.2%

57.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

%

Primary boys Primary girls Secondary boys* Secondary girls*

2003 (n=2103)

2008 (n=1913)

* Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clusteringPrimary Boys 2003 n=544, 2008 n=525. Primary Girls 2003 n=489, 2008 n=496. Secondary Boys 2003 n=533, 2008 n=355. Secondary Girls 2003 n=538, 2008 n=379.

Figure 9: Prevalence (%) of children active commuting home from school on the previous school day, 2003 and 2008


• In 2008, significantly more secondary school boys than girls reported it would be easier for

them to walk to school than be driven (33.1% vs. 23.8%) (Table 14).

• Significantly more secondary school girls than boys reported that they felt safer being driven

to school than walking (47.7% vs. 35.4%) in 2008 (Table 14).

Independent mobility

Year five and seven and secondary school children in 2008 were asked to specify, from a list, local

destinations to which they had actively commuted (walked, cycled, skateboarded or scootered) at

least once in the last seven days. Figure 10 presents the results for year five and year seven children,

and Figure 11 presents the results for secondary school children.

• More than one-half of year five and seven primary school boys (51.8%) and girls (55.5%) in 2008

reported actively commuting to school at least once in the last seven days (Figure 10).

• In 2008, less than one-half of year five and seven primary school boys (45.5%) and girls (43.3%)

reported actively commuting to friend’s houses at least once in the last seven days (Figure 10).

Table 13: Response to active commuting barriers and facilitators: year five and seven children

Boys %(n=286)

Girls % (n=265)

Walking to school is easier for me than being driven 34.4 29.3*

It takes too much time to walk to school 40.1 40.5

I feel safer being driven to school than walking 46.7 57.1*

There is a lot of traffic outside my school 47.3 48.1

My friend thinks it’s cool to walk to school 48.0 57.6*

I have to cross a busy road if I walk or ride my bike to school 64.2 64.1

I think walking to school is cool 64.3 71.6*

I would feel safe walking to school without an adult present 65.1 64.3

I would feel safe crossing the road near my school 79.6 78.2

There are safe places for me to leave my bike at school 87.0 88.8

Table 14: Response to active transport barriers and facilitators: secondary school children

Boys %(n=387)

Girls %(n=390)

Walking to school is easier for me than being driven 33.1 23.8*

I feel safer being driven to school than walking 35.4 47.7*

My friend thinks it’s cool to walk to school 41.1 45.7

It takes too much time to walk to school 48.3 53.9

I think walking to school is cool 50.3 55.6

There is a lot of traffic outside my school 62.7 69.1

I have to cross a busy road if I walk or ride my bike to school 68.9 68.3

I would feel safe walking to school without an adult present 80.6 74.2

There are safe places for me to leave my bike at school 84.7 86.4

I would feel safe crossing the road near my school 86.1 83.8


• A significantly larger proportion of year five and seven primary school boys than girls actively

commuted to skate ramps/parks/ovals/playgrounds (40.8% vs. 28.6% respectively) or to sports

venues (30.6% vs. 18.7% respectively) at least once in the last seven days, compared with year

five and seven primary school girls in 2008 (Figure 10).

• Nearly two-thirds of secondary school boys (60.7%) reported actively commuting to school at

least once in the last seven days, compared with just less than one-half (47.9%) of secondary

school girls (Figure 11) in 2008, however this difference was not significant.

• In 2008, just over one-half of secondary school boys (53.7%) and girls (50.3%) reported actively

commuting to a friend’s house at least once in the last seven days and just over two in five to

the movies or shopping centre (45.2% vs. 44.4% respectively) (Figure 11).

• Significantly more secondary school boys than girls in 2008 actively commuted to sport

venues (45.9% vs. 28.1% respectively) or skate ramps/parks/ovals/playgrounds (32.4% vs. 17.8%

respectively) at least once in the last seven days (Figure 11).

* Significant difference between boys and girls after adjusting for age, SES and school clustering

Figure 10: Proportion of children reporting actively commuting to local destinations in the last seven days, 2008: Year 5 and 7 children

43.3%

18.7%

28.6%

15.4%

24.2%

8.0%

55.5%

11.2%

23.0%

35.3%

37.4%

45.5%

30.6%

40.8%

21.9%

26.8%

13.2%

51.8%

20.6%

22.9%

35.6%

0% 20% 40% 60% 80% 100%

Bike/walking tracks

Friend's houses

Sports venues*

Skate ramps/parks/ ovals/playgrounds*

Beach/waterways

Other open spaces

Public transport

School

Amusement parlour/arcade/dvd rental store

Local deli/takeaway/fastfood

Movies/shopping centre

Wa

lke

d, r

od

e, s

ka

ted

or

sco

ote

red

to

th

e d

est

ina

tio

n

31.5%

Boys (n=339)

Girls (n=335)


24.8%

50.3%

28.1%

17.8%

31.9%

24.7%

36.3%

47.9%

16.8%

33.5%

44.4%

28.7%

53.7%

45.9%

32.4%

24.2%

28.9%

39.7%

60.7%

18.9%

43.2%

45.2%

0% 20% 40% 60% 80% 100%

Bike/walking tracks

Friend's houses

Sports venues*

Skate ramps/parks/ ovals/playgrounds*

Beach/waterways

Other open spaces

Public transport

School

Amusement parlour/arcade/dvd rental store

Local deli/takeaway/fastfood

Movies/shopping centre

Wa

lke

d, r

od

e, s

ka

ted

or

sco

ote

red

to

th

e d

est

ina

tio

n

Boys (n=295)

Girls (n=322)

* Significant difference between boys and girls after adjusting for age, SES and school clustering

Figure 11: Proportion of children reporting actively commuting to local destinations in the last seven days, 2008: secondary school children

Inactivity and sedentary behaviour

Electronic media activity

Self-report use of electronic media was examined in both primary and secondary school children in

2008 by asking children to report the number of days on which they had participated in two hours

or less of electronic media activity (except for homework) in the last seven days. Australian Physical

Activity Recommendations specify that children3 and adolescents3 should not use electronic media for

recreation for more than two hours a day. The proportions of children meeting the recommendation

for electronic media use on all of the seven days prior to the survey are presented in Figure 12.

• Nearly three quarters of primary school boys (70.9%) and girls (75.2%) in 2008 reported participating

in more than two hours of electronic media on all of the last seven days (Figure 12).

• Amongst 2008 secondary school children, around 80% of secondary schools boys (78.7%) and girls

(83.0%) used electronic media for more than two hours on all of the last seven days (Figure 12).

• There were no significant differences between boys and girls meeting the electronic media use

recommendations in 2008.


Sedentary activity participation

Children were asked to indicate from a list provided which sedentary activities they had participated

in, and the frequency of these activities, over the last seven days. Year three had the following

response options: ‘never’, ‘a little bit’, ‘quite a lot’, or ‘a lot’, for both weekdays and weekends. The results

for year three children are displayed in Table 15. Years five and seven and secondary school children

were asked to specify how long (minutes) they had participated in each activity, in total, over the last

seven days. This was divided by seven to estimate daily minutes spent in each activity and the results

are displayed in Tables 16 and 17.

• Around 70% of year three boys reported ‘a lot’ or ‘quite a lot’ of television watching on

weekdays (71.2%) and weekends (70.3%) in 2008; this was lower in year three girls, with 55.8%

reporting ‘a lot’ or ‘quite a lot’ of television watching on weekdays and 46.7% reported this for

weekends. (Table 15).

• In 2008, just over half of the year three boys reported ‘a lot’ or ‘quite a lot’ of DVD or video

watching on weekdays (52.4%); this was higher on weekends (62.8%) (Table 15).

• Fewer than one-half of year three girls reported ‘a lot’ or ‘quite a lot’ of DVD or video watching

on weekdays in 2008 (43.0%); results were similar for weekends (42.6%) (Table 15).

• Year five and seven boys spent significantly more average time watching television (51.2

minutes) and using screens for recreation (108.6 minutes) than the girls (44.7 minutes and 84.5

minutes, respectively) in 2008 (Table 16).

• In 2008, secondary school boys spent significantly more average time watching television (55.2

minutes) than secondary school girls (39.1 minutes) (Table 17).

• Likewise, secondary school boys spent significantly more average time using screens for

recreation than secondary school girls (103.4 vs. 76.4 minutes) in 2008 (Table 17).

• All other sedentary activities were not tested for statistical difference between boys and girls.

No statistically significant difference between boys and girls after adjusting for age and SES

Figure 12: Proportion of children meeting guidelines for electronic media use6,7 on each of the last seven days

29.1% 24.8% 21.3% 17.0%

70.9% 75.2% 78.7% 83.0%

0%

20%

40%

60%

80%

100%

Primary girls (n=442)

Secondary boys (n=383)

Primary boys (n=483)

Secondary girls (n=392)

Meets guidelines Does not meet guidelines


Table 15: Frequency of intensity of sedentary activity behaviour, 2008: year three children

Weekday Weekend

Boys %

(n=197)

Girls %

(n=177)

Boys %

(n=197)

Girls %

(n=177)

Television

never 7.9 11.1 8.3 17.2

a little bit 20.9 33.1 21.4 36.1

quite a lot 41.0 31.1 36.9 29.1

a lot 30.2 24.7 33.4 17.6

DVDs/Videos#

never 20.5 36.9 13.8 34.6

a little bit 27.1 20.1 23.4 22.8

quite a lot 27.5 27.2 27.9 28.4

a lot 24.9 15.8 34.9 14.2

Handheld electronic devices

never 34.3 32.3 30.3 34.3

a little bit 15.2 23.3 16.6 23.0

quite a lot 19.9 19.9 16.9 23.9

a lot 30.6 24.6 36.2 18.7

Computer

never 39.7 38.7 45.3 47.4

a little bit 28.3 25.2 21.5 21.4

quite a lot 15.2 16.5 17.7 16.6

a lot 16.8 19.6 15.4 14.6

Study

never 32.3 28.0 62.9 61.0

a little bit 22.1 13.1 18.1 14.5

quite a lot 18.2 26.9 8.8 14.3

a lot 27.5 32.0 10.2 10.3

Reading

never 15.4 5.8 30.9 23.5

a little bit 20.2 23.1 32.3 28.0

quite a lot 22.3 22.5 11.6 15.4

a lot 42 48.7 25.2 33.0

Chat on phone

never 52.2 49.1 53.1 48.4

a little bit 24.8 22.6 24.9 26.9

quite a lot 10.5 13.8 10.4 11.9

a lot 12.6 14.5 11.6 12.8

Hobbies/crafts

never 39.5 37.2 44.8 42.5

a little bit 22.0 19.2 17.2 21.3

quite a lot 15.7 24.0 14.8 17.7

a lot 22.8 19.6 23.2 18.5

Listen to music

never 57.7 45.7 76.0 66

a little bit 14.8 10.7 10.4 12.9

quite a lot 11.7 19.9 7.0 8.8

a lot 15.8 23.7 6.6 12.3

Sedentary travel

never 39.5 37.2 44.8 42.5

a little bit 22.0 19.2 17.2 21.3

quite a lot 15.7 24.0 14.8 17.7

a lot 22.8 19.6 23.2 18.5

Church

never 73.9 81.5 70.2 72.3

a little bit 13.2 9.9 10.5 9.3

quite a lot 3.1 6.9 7.5 12.5

a lot 9.8 1.8 11.8 5.9

Child and Adolescent Physical Activity and Nutrition (CAPANS) Survey: 2008 Final ReportChild and Adolescent Physical Activity and Nutrition (CAPANS) Survey: 2008 Final Report

Table 16: Mean daily minutes spent in sedentary activities, 2008: year five and seven children

Mins/day, mean (SD)

Sedentary activityBoys

(n=573)Girls

(n=524)

Television 51.2 (±43.5)* 44.7 (±40.8)*

DVDs/Videos 27.6 (±29.0) 14.7 (±20.2)

Handheld electronic devices 10.4 (±16.8) 7.7 (±13.5)

Computer 18.3 (±30.1) 17.1 (±27.7)

Total screen time 108.6 (±84.7)* 84.5 (±72.2)*

Study 9.6 (±15.3) 13.2 (±18.2)

Reading 9.4 (±17.4) 13.9 (±18.3)

Chat on phone 2.4 (±6.4) 5.3 (±9.3)

‘Hangout’ 39.3 (±72.7) 52.2 (±78.3)

Hobbies and crafts 8.1 (±15.3) 9.2 (±15.1)

Listening to music 3.1 (±6.6) 4.5 (±7.6)

Sedentary travel 14.7 (±21.5) 17.2 (±23.8)

Church 2.2 (±5.4) 2.6 (±5.9)

Table 17: Mean daily minutes spent in sedentary activities, 2008: secondary school children

Mins/day, mean (SD)

Sedentary activityBoys

(n=284)Girls

(n=373)

Television 55.2 (±44.0)* 39.1 (±36.3)*

DVDs/Videos 15.8 (±22.1) 13.3 (±18.9)

Handheld electronic devices 8.8 (±14.7) 3.2 (±8.9)

Computer 25.5 (±30.4) 20.5 (±26.6)

Total screen time 103.4 (±69.0)* 76.4 (±53.6)*

Study 20.8 (±27.2) 29.3 (±29.4)

Reading 6.1 (±14.5) 10.5 (±17.0)

Chat on phone 4.1 (±9.0) 7.3 (±10.5)

‘Hangout’ 40.7 (±72.8) 50.2 (±70.9)

Hobbies and crafts 4.4 (±12.8) 5.2 (±12.1)

Listening to music 2.9 (±7.4) 3.5 (±7.4)

Sedentary travel 18.4 (±23.8) 20.7 (±22.8)

Church 2.0 (±5.7) 2.5 (±6.1)


NUTRITION

24- Hour Food Diary

Energy and proportion of energy from macronutrients

Energy and macronutrient intakes were derived from the 24-Hour Food Diaries. In 2008, 89.8% of

the participants completed a 24-Hour Food Diary. Twenty-four hour mean energy intake and mean

percent energy from macronutrients for children in 2003 and 2008 are presented in Table 18.

• Total energy intake varied with age and sex, with boys consuming more energy than girls of

the same age and secondary school boys consuming more energy than primary school boys

(Table 18).

• The mean 24 hour energy intake (kJ) of secondary school girls was significantly lower in 2008

(7,826 kJ) compared with 2003 (8,658kJ). There were no other significant differences in energy

intakes for primary school children or secondary school boys between 2003 and 2008 (Table 18).

• In 2008, the mean proportion of energy derived from carbohydrates was significantly lower in

2008 compared with 2003 for primary school boys (48.7% vs. 49.9%), secondary school boys

(48.1% vs. 49.8%) and secondary school girls (49.6% vs. 51.3%) school children. No significant

difference was noted amongst primary school girls (Table 18).

• The mean proportion of energy derived from sugars was lower in 2008 compared with 2003

amongst both primary (20.3% vs. 22.5%) and secondary (22.2% vs. 23.5%) school girls (Table 18).

• The mean proportion of energy derived from protein was significantly higher amongst primary

school girls (17.4% vs. 16.6%), secondary school boys (18.0% vs. 17.0%) and secondary school

girls (17.6% vs. 15.4%) compared with 2003 (Table 18).

• The mean proportion of energy derived from fats and saturated fats did not differ significantly

between 2003 and 2008 (Table 18).

• In comparison to secondary school boys, secondary school girls consumed a significantly

higher proportion of energy from sugar (22.2% vs. 20.9%) and a significantly lower proportion

of energy from protein (17.0% vs. 18.0%) (Table 18).

• Energy intake and the proportion of energy intake from protein were significantly greater in

metropolitan than non-metropolitan primary school boys (data not shown).

• Non-metropolitan secondary school children recorded a greater proportion of energy intake

from fat and saturated fat than metropolitan secondary school children in 2008. However the

proportion of energy from carbohydrate was lower amongst non-metropolitan school children

(data not shown).

• Primary school boys from the lowest SES tertile consumed a significantly higher proportion of

energy from fat and significantly less from carbohydrate than boys from the highest SES tertile

in 2008 (data not shown).

• Secondary school girls from the lowest SES tertile consumed a significantly lower proportion of

energy from protein and a significantly greater proportion of energy from sugar and saturated

fat compared with girls from the highest SES tertile in 2008 (data not shown).


Table 18: Mean 24 hour energy intake and proportion of energy from macronutrients, 2003 and 2008

Primary Secondary

2003 2008 2003 2008

Boys n=507 n=434 n=181 n=119

Energy (kJ)# 9049 9041 11203 11186

Mean % of energy from

Total Fats 32.9 33.7 33.2 33.9

Saturated Fats 14.4 14.6 14.4 14.1

Total Carbohydrates 49.9 48.7* 49.8 48.1*

Sugars 20.9 20.5 21.4 20.9

Total Protein 17.2 17.5 17.0 18.0*


Girls n=487 n=492 n=200 n=176

Energy (kJ)# 7885 8401 8658 7826*

Total Fats 33.3 33.5 33.3 32.7

Saturated Fats 14.9 14.7 14.4 14.0

Total Carbohydrates 50.1 49.0 51.3 49.6*

Sugars 22.5 20.3* 23.5 22.2*

Total Protein 16.6 17.4* 15.4 17.6*


All n=994 n=926 n=381 n=295

Energy (kJ)# 8494 8732 10011 9359

Total Fats 33.1 33.6 33.2 33.3

Saturated Fats 14.6 14.7 14.4 14.0

Total Carbohydrates 50.0 48.9* 50.5 49.0*

Sugars 21.7 20.4* 22.4 21.6*

Total Protein 16.9 17.5* 16.2 17.8*

Note - Alcohol contribution was less than 0.1% for all categories therefore not presented# Energy total excludes fermentable fibre* Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, gender, SES and school clustering

Macronutrient intakes

Mean daily intakes of macronutrients were derived from the 24-Hour Food Diary. Mean daily intakes

of macronutrients by primary and secondary school children in 2003 and 2008 are shown in Table 19.

• For all macronutrients (protein, carbohydrate, sugar, total fat, saturated fat and fibre) mean daily

intake was significantly higher for boys than girls in both 2008 and 2003 (Table 19).

• Amongst secondary school girls, mean intakes of carbohydrates and sugars were significantly

lower in 2008 compared with 2003 (carbohydrate, 230.3g vs. 262.6g; sugar, 108.3g vs. 122.2g)

(Table 19).

• For primary school children, mean intakes of protein and fibre were significantly higher in 2008

compared with 2003 (protein 87.1g vs. 82.2g; fibre 20.8g vs. 18.9g respectively) (Table 19).


Table 19: Mean intake of macronutrients (grams), 2003 and 2008

Primary Secondary

2003 2008 2003 2008

Boys n=506 n=431 n=308 n=222

Protein 87.8 90.6* 104.6 109.0*

Total Carbohydrates 263.2 260.6 320.5 308.2

Sugars (g) 115.9 113.2 146.8 141.3

Total Fats (g) 79.6 81.9 96.4 97.1

Saturated Fats (g) 35.6 36.0 42.5 42.2

Fibre (g) 19.6 21.3* 22.6 23.8

Girls n=492 n=429 n=319 n=331

Protein 76.0 83.4* 77.0 78.6


Sugars (g) 107.9 105.8 122.2 108.3*

Total Fats (g) 71.6 74.9 78.9 69.6

Saturated Fats (g) 32.2 33.0 34.5 30.2

Fibre (g) 18.1 20.2* 20.2 20.3

All n=998 n=860 n=627 n=553

Protein 82.2 87.1* 91.7 92.4


Sugars (g) 112.1 109.6 135.3 123.3*

Total Fats (g) 75.8 78.5 88.2 82.2

Saturated Fats (g) 34.0 34.6 38.8 35.7

Fibre (g) 18.9 20.8* 21.5 21.9

Note - Alcohol contribution was less than 0.1% for all categories therefore not presented# Energy total excludes fermentable fibre* Significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, sex, SES and school clustering

• After adjusting for differences in socio-economic status and survey year, mean daily intakes of

sugars, total fat, saturated fat and fibre of primary school children from non-metropolitan areas

were significantly higher than for those children from the Perth metropolitan area (data not

shown). Mean intake of these nutrients and total carbohydrate remained significantly higher

for non-metropolitan primary school boys.

• After adjusting for differences in location and survey year, mean daily intake of fibre amongst

secondary school girls of lower SES was significantly lower than for those from higher SES

tertiles (data not shown). No other significant differences in macronutrient intake were

observed between SES tertiles.


Micronutrients

Mean daily intakes of micronutrients by primary and secondary school boys and girls in 2003 and

2008 are shown in Table 20 with the Estimated Average Requirement (EAR) or Adequate Intake

(AI) as a reference point.33 The EAR is the daily nutrient level estimated to meet the requirements

of half of the healthy individuals in a particular life stage and sex group. The AI is an observed or

experimentally determined estimate when an EAR is not available.

• Primary school girls and boys and secondary school boys recorded significantly higher mean

vitamin A equivalent and vitamin C intakes in 2008 compared with 2003 (Table 20).

• Primary school girls and boys and secondary school girls recorded significantly higher mean

calcium intake in 2008 compared with 2003 (Table 20).

• Mean magnesium intake was significantly greater in 2008 compared with 2003 for both

primary school and secondary school boys and girls (Table 20).

• Primary school boys and girls recorded significantly higher mean niacin equivalent,

phosphorus and potassium intakes in 2008 compared with 2003 (Table 20).

• Primary school girls recorded significantly higher mean thiamin and riboflavin intakes in 2008

compared with 2003 (Table 20).

• Mean intakes substantially exceeded the EARs for almost all nutrients. The only exceptions to

this were amongst secondary school girls, who recorded lower consumption of calcium and

magnesium than the EARs (Table 20).

• Mean intakes of potassium were just under the AI for boys and just above for girls (Table 20).

After adjusting for differences in SES and survey year, there were no significant differences in mean

micronutrient intakes between metropolitan or non-metropolitan locations (data not shown) with

the following exceptions:

• Higher mean calcium and lower mean iron intakes were evident in non-metropolitan primary

school boys.

• Higher mean vitamin A equivalent intakes were evident in non-metropolitan primary school

girls.

• Higher mean vitamin A equivalent, thiamin and riboflavin intakes were evident in non-

metropolitan secondary school girls.

There were no significant differences in mean micronutrient intakes between SES tertiles (data not

shown) with the following exceptions:

• Significantly lower mean intakes in the lowest SES tertile of; calcium in primary school boys,

iron in secondary school boys, and vitamins A and C in primary school girls.


Table 20: Mean 24 hour micronutrient intakes, 2003 and 2008

Primary Secondary

EAR#

(9-13 yrs)

2003 2008 EAR#

(14-18 yrs)

2003 2008

Boys n=506 n=431 n=308 n=222

Vit A equivalents (ug) 445 902.4 1005.7* 630 960.9 1138.5*

Thiamin (mg) 0.7 1.9 1.9 1.0 2.2 2.4

Ribofl avin (mg) 0.8 2.6 2.4 1.1 2.9 3.0

Niacin equivalents (mg) 9 39.2 41.0* 12 46.6 49.5

Vitamin C (mg) 28 96.7 117.6* 28 109.2 141.0*

Calcium (mg) 800 965.8 1027.4* 1050 1099.8 1222.9

Phosphorous (mg) 1055 1501.6 1565.7* 1055 1797.1 1846.3

Magnesium (mg) 200 278.5 312.2* 340 327.3 368.0*

Iron (mg) 6 13.4 13.3 8 15.5 16.4

Zinc (mg) 5 11.9 12.2 11 14.3 14.8

Potassium@ 3000 2827.8 2918.9* 3600 3336.3 3506.0

Girls n=492 n=429 n=319 n=331

Vit A equivalents (ug) 420 810.0 962.4* 485 854.3 864.9

Thiamin (mg) 0.7 1.6 1.9* 0.9 1.6 1.6

Ribofl avin (mg) 0.8 2.0 2.4* 0.9 2.0 2.1

Niacin equivalents (mg) 9 33.5 38.2* 12 34.8 35.9

Vitamin C (mg) 28 101.5 125.5* 28 119.4 133.0

Calcium (mg) 800 829.4 975.8* 1050 813.7 936.8*

Phosphorous (mg) 1055 1309.1 1444.8* 1055 1359.9 1343.3

Magnesium (mg) 200 240.3 288.9* 340 264.1 292.0*

Iron (mg) 6 11.2 12.1 8 11.4 11.3

Zinc (mg) 5 10.2 11.2 6 10.3 10.4

Potassium@ 2500 2491.5 2717.6* 2600 2726.1 2787.9

Population weights applied* Significant difference between 2003 and 2008 after adjusting for age, home neighbourhood SES and school clustering# Estimated Average Requirement. The daily nutrient level estimated to meet the requirements of half of the healthy individuals in a particular life stage and

sex group.@ Adequate Intake. Observed or experimentally-determined estimates used when EAR is not available.


Food groups

Food group consumption is reported as the proportion consuming foods from each food group on

the day of survey (Table 21), the mean daily intake for those consuming foods from the food group

(Table 22) and the mean daily intake of foods from each food group for all participants (Table 23).

Significant differences in the proportion of children consuming some of the main categories of food

were observed between 2003 and 2008.

Details are as follows:

• The proportions of children consuming fruit products and dishes were significantly higher in

2008 compared with 2003. In 2008, 68.6% of primary school children consumed fruit products

and dishes compared with 56.7% in 2003; and this was similar for secondary school children

(62.7% vs. 54.0%) (Table 21).

• The proportions consuming meat, poultry and game products and dishes were significantly

higher in 2008 compared with 2003 for both primary (82.8% vs. 78.3%) and secondary school

boys (88.6 vs. 83.6%) (Table 21).

• The proportion of primary school girls consuming fish and seafood was significantly higher in

2008 (15.4%) compared with 2003 (10.5%) (Table 21).

• The proportion of primary school children consuming confectionary and cereal bars was

significantly lower in 2008 (35.6%) compared with 2003 (48.3%) (Table 21).

• The proportion of secondary school girls consuming sugar products and dishes was also

significantly lower in 2008 (33.2%) than in 2003 (56.1%) (Table 21).

• The proportion consuming fats and oils was lower in 2008 compared with 2003 amongst both

primary (42.2% vs. 49.0%) and secondary (41.0% vs. 49.2%) school children (Table 21).

• Milk products and dishes were consumed by a significantly smaller proportion of primary

and secondary school girls in 2008 compared with 2003 (primary: 91.5% vs. 92.8%; secondary:

84.1% vs. 88.9%) (Table 21).


Table 21: Proportion of children consuming food from main food group, 2003 and 2008

Primary Secondary

2003 2008 2003 2008

Boys n=506 n=431 n=308 n=222

Cereals & cereal products (e.g. breads, pasta, breakfast cereal) 97.2 98.1 93.8 97.6

Cereal-based products & dishes (e.g. biscuits, pastries, cakes) 71.0 71.1 71.7 72.1

Fruit products & dishes 51.4 63.0* 47.3 57.2*

Vegetable products & dishes 73.4 75.2 72.7 77.6

Fats & oils (e.g. butter, margarine, vegetable oils) 49.1 43.9* 46.8 42.8

Fish & seafood products & dishes 8.9 14.8 4.5 11.0

Egg products & dishes 8.2 9.1 7.8 11.0

Meat, poultry & game products &dishes 78.3 82.8* 83.8 88.6*

Milk products & dishes 93.2 90.7 89.3 89.3

Seed & nut products & dishes 16.4 14.3 8.8 14.8

Legume & pulse products & dishes 3.3 3.3 4.8 4.1

Snack foods (e.g. potato chips, corn chips, pretzels) 28.0 26.7 31.5 30.0

Sugar products & dishes (e.g. sugar, sweet spreads) 41.6 41.5 40.5 36.9

Confectionary & cereal bars (e.g. chocolate, fruit/cereal bars) 46.5 32.7* 43.5 41.4

Girls n=492 n=429 n=319 n=331



Fruit products & dishes 62.6 74.6* 61.9 67.3

Vegetable products & dishes 74.6 76.4* 84.1 78.6

Fats & oils (e.g. butter, margarine, vegetable oils) 49.0 40.3* 52.1 39.6*

Fish & seafood products & dishes 10.5 15.4* 12.2 11.9

Egg products & dishes 8.2 9.5 6.8 12.2*

Meat, poultry & game products &dishes 78.7 79.0 75.6 72.2

Milk products & dishes 92.8 91.5* 88.9 84.1*


Legume & pulse products & dishes 3.8 5.1 1.1 8.1*


Sugar products & dishes (e.g. sugar, sweet spreads) 43.1 42.4 56.1 33.2*


All children n=998 n=860 n=627 n=553





Fats & oils (e.g. butter, margarine, vegetable oils) 49.0 42.2* 49.2 41.0*

Fish & seafood products & dishes 9.7 15.1* 8.0 11.5



Milk products & dishes 93.2 91.1* 89.1 86.5




Sugar products & dishes (e.g. sugar, sweet spreads) 42.3 42.0 47.9 34.9*


* Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, gender, SES and school clustering


Significant differences in the mean daily intake from major food categories were observed between

2003 and 2008 (Table 22);

• Primary school boys consumed significantly larger amounts of sugar products and dishes in

2008 (42.3g) compared with 2003 (32.1g) (Table 22).

• Primary school girls in 2008 compared with 2003, on average consumed larger amounts of

egg products and dishes (80.4g vs. 56.7g), seed and nut products and dishes (31.2g vs. 20.7g),

snack foods (54.8g vs. 37.5g) and sugar products and dishes (51.2g vs. 32.8g). Conversely they

consumed smaller amounts of milk products and dishes (354.3g vs. 363.7g) (Table 22).

• Secondary school boys in 2008, compared with 2003, on average consumed smaller amounts

of cereal based products and dishes such as biscuits and cakes (219.7g vs. 260.7g) and legumes

and pulse products and dishes such as baked beans (112.1g vs. 203.4g). Conversely they

consumed larger amounts of egg products and dishes (112.1g vs. 82.9g), and seed and nut

products and dishes (37.3g vs. 19.4g) (Table 22).

• Secondary school girls in 2008, compared with 2003, consumed smaller amounts of cereal

based products and dishes such as biscuits and cakes (173.9g vs. 209.2g) and fats and oils

(9.2g vs. 11.3g). Conversely they consumed larger amounts of meat, poultry and game

products and dishes (177.1g vs. 159.6g) and sugar products and snacks (32.4g vs. 19.7g)

(Table 22).


Table 22: Mean daily intake (grams per person) for consumers of main food groups, 2003 and 2008

Primary Secondary

2003 2008 2003 2008

Boys


Cereal-based products & dishes (e.g. biscuits, pastries, cakes) 183.3 187.6 260.7 219.7*

Fruit products & dishes 204.8 214.9 254.3 250.0


Fats & oils (e.g. butter, margarine, vegetable oils) 11.7 11.6 12.8 13.4





Seed & nut products & dishes 18.5 34.8 19.4 37.3*



Sugar products & dishes (e.g. sugar, sweet spreads) 32.1 42.3* 31.2 36.4

Confectionary & cereal bars (e.g. chocolate, fruit/cereal bars) 39.4 39.0 47.1 51.3

Girls





Fats & oils (e.g. butter, margarine, vegetable oils) 9.7 10.6 11.3 9.2*


Egg products & dishes 56.7 80.4* 67.7 63.5

Meat, poultry & game products &dishes 166.1 170.4 159.6 177.1*


Seed & nut products & dishes 20.7 31.2* 30.0 35.8


Snack foods (e.g. potato chips, corn chips, pretzels) 37.5 54.8* 46.6 51.6

Sugar products & dishes (e.g. sugar, sweet spreads) 32.8 51.2* 19.7 32.4*

Confectionary & cereal bars (e.g. chocolate, fruit/cereal bars) 31.3 38.3 45.0 40.9*

All







Egg products & dishes 61.4 74.8* 76.3 84.5





Snack foods (e.g. potato chips, corn chips, pretzels) 42.1 53.5* 51.0 54.7

Sugar products & dishes (e.g. sugar, sweet spreads) 32.4 46.7* 24.9 34.3*



Table 21 indicates the proportion of the children who reported consuming each food group. Table

22 indicates the mean intake of those consuming the food group. By comparison, Table 23 provides

an estimate of population food group intake which includes individuals who did not consume foods

from the group. Table 23 therefore takes into account the proportion consuming the food group as

well as the amount consumed.

• For primary school children, the amount of fruit products consumed was significantly higher in

2008 (146.2g) compared with in 2003 (119.3g) (Table 23).

• Amongst boys the amount of seed and nut products and dishes consumed were significantly

higher in 2008 compared with 2003 (Primary school: 5.0g vs. 3.0g; Secondary school: 5.5g vs.

1.7g) (Table 23).

• The amount of confectionary and cereal bars consumed was significantly lower in 2008

compared with 2003 for primary school boys (12.8g vs. 18.3g) (Table 23).

• For primary school girls, consumption was significantly higher in 2008 compared with 2003

for sugar products and dishes (21.7g vs. 14.1g) and vegetable products and dishes (158.6g vs.

147.7g) (Table 23).

• Amongst secondary school boys, consumption of legume and pulse products and dishes was

significantly lower in 2008 (4.8g) compared with 2003 (9.7g) (Table 23).

• The amount of legumes and pulse products and dishes consumed was significantly higher in

2008 compared with 2003 for secondary school girls (16.1g vs. 1.6g). Conversely the amount of

cereal-based products and dishes such as biscuits and cakes was significantly lower (121.3g vs.

158.8g) (Table 23).


Table 23: Mean daily intake (grams per person) of food from main food groups (all participants), 2003 and 2008

Primary Secondary

2003 2008 2003 2008

Boys n=506 n=431 n=308 n=222










Seed & nut products & dishes 3.0 5.0* 1.7 5.5*



Sugar products & dishes (e.g. sugar, sweet spreads) 13.3 17.6 12.7 13.4


Girls n=492 n=429 n=319 n=331















All n=998 n=860 n=627 n=553















Includes all participants, Data weighted* significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location, (sex) and school clustering


The different food groups contribute different amounts of energy and nutrients to the diet. The

percentages of energy contributed by the major food groups for 2003 and 2008 are shown in Table 24.

• Cereal and cereal products and cereal-based products and dishes were the main source of

energy in the diet, contributing almost 40% of daily energy intake (Table 24).

• Meat, poultry and game products and dishes and milk products and dishes together

contributed about 30% of daily energy intake (Table 24).

• Snack foods, sugar products and dishes and confectionary together contributed to less than

10% of daily energy intake (Table 24).

After adjusting for sample differences, few significant differences in energy from food groups were

evident between the 2003 and 2008 samples.

• Cereal-based products and dishes contributed a significantly lower proportion of energy to the

diet of secondary school boys in 2008 than in 2003 (15.9% vs. 18.6%) (Table 24).

• Secondary school girls consumed significantly more energy in 2008 than 2003 from meat,

poultry and game dishes (14.3% vs. 11.5%) and legumes (1.0% vs. 0.1%). Conversely they

consumed less energy from cereal-based products and dishes (17.1% vs. 19.6%), vegetables

(6.5% vs. 8.6%) and fats and oils (1.7% vs. 2.0%) (Table 24).

After adjusting for SES, survey year, school clustering and age, some differences in energy from food

groups were evident between children from metropolitan and non-metropolitan school locations;

• Children from non-metropolitan areas consumed significantly more energy from fats and oils

than children from metropolitan areas (data not shown).

• Non-metropolitan primary school boys consumed significantly less energy from eggs and

significantly more from seed and nut products and dishes than boys from metropolitan areas

(data not shown).

• Non-metropolitan primary school girls consumed more energy from cereal based products

than metropolitan primary school girls (data not shown).

• Non-metropolitan secondary school boys consumed significantly more energy from fruit than

metropolitan secondary school boys with significantly less energy from meat, poultry and

game products and dishes (data not shown).

After adjusting for location, survey year, school clustering and age, some differences in energy from

food groups were evident between children from the lowest and highest SES tertiles;

• For primary school boys, the percentage of energy from meat, poultry and game was greater

in the lowest SES tertile, whereas energy from milk and milk products was lower (data not

shown).

• For secondary school boys, the percentage of energy from fruit was lower in lowest SES tertile.

• For secondary school girls the percentage of energy from seeds and nuts was greater in the

highest SES tertile.


Table 24: Mean proportion of daily energy (excluding dietary fibre) from food groups for all participants regardless of consumption, 2003 and 2008

Primary Secondary

2003 2008 2003 2008

Boys n=506 n=431 n=308 n=222






Fish & seafood products & dishes 1.1 1.5 .6 1.0

Egg products & dishes .4 .5 .5 .8



Seed & nut products & dishes .8 1.1 .4 1.1*

Legume & pulse products & dishes .2 .3 .3 .2




Girls n=492 n=429 n=319 n=331




Vegetable products & dishes 7.7 5.9 8.6 6.5*



Egg products & dishes .4 .6 .4 .8



Seed & nut products & dishes .7 .9 1.2 1.4

Legume & pulse products & dishes .3 .2 .1 1.0*




All n=998 n=860 n=627 n=553




Vegetable products & dishes 7.2 5.8* 8.2 6.4*



Egg products & dishes .4 .6 .4 .8*



Seed & nut products & dishes .8 1.0 .8 1.3

Legume & pulse products & dishes .2 .2 .2 .6




Includes all participants, Data weighted* significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location, (sex) and school clustering


Food Habits

Food habits data were collected in section two of the 12-month Food Frequency Questionnaire.

These included usual food consumption, breakfast and dinner habits, frequency of food purchase

at the school canteen and fast food outlets. The Food Frequency Questionnaire was completed by

82.7% of participants in 2008.

Usual Vegetable and Fruit Intake

Patterns of vegetable and fruit consumption are presented in Figures 13 through 23. Recommended

vegetable and fruit intakes are derived from the Australian Guide to Healthy Eating6 and the Dietary

Guidelines for Children and Adolescents in Australia.5

Vegetables

• In 2008, 42.1% of primary school boys and 43.1% of primary school girls reported meeting

dietary guidelines for vegetable consumption. This proportion did not differ significantly from

that in 2003 (33.3% for boys and 35.5% for girls) (Figure 13).

• Primary school children were significantly more likely to usually meet age-specific

recommended vegetable intake than secondary school children.

• In 2008, 23.6% of secondary school girls met the dietary guidelines for vegetable consumption.

This was significantly higher than the proportion in 2003 (18.0%) (Figure 13).

• While the proportion of secondary school boys meeting dietary guidelines for vegetable

consumption was 28.1% in 2008 and 18.1% in 2003, this difference was not statistically

significant (Figure 13).

• After adjusting for differences in SES and survey year, there were no significant differences

between proportions of primary or secondary school boys or girls from the metropolitan or

non-metropolitan locations usually meeting recommended vegetable intake (data not shown).

• Primary school boys in the lowest SES tertile were more likely to usually meet recommended

vegetable intake than those in the highest SES tertile. Otherwise, there were no significant

differences related to SES tertile in the proportion of primary or secondary children usually

meeting recommended vegetable intake (data not shown).

• Primary school boys in 2008 consumed significantly more serves of vegetables per day

compared with 2003 boys (Figure 14).

• No significant differences were observed in the serves of vegetables usually consumed per day

by location or SES for primary school boys (data not shown).

• There were no significant differences in serves of vegetables usually consumed per day by

primary school girls between 2003 and 2008 (Figure 15).

• There were no significant differences in serves of vegetables usually consumed per day by

primary school girls related to location or SES tertile (data not shown).


33.3% 35.5%

18.1% 18.0%

42.1% 43.1%

28.1%

23.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Primary boys Primary girls Secondary boys* Secondary girls*

2003 2008

3.1%

30.8% 32.6%

22.0%

2.9%

21.2%

33.9%

27.4%

7.3% 9.5%

4.2% 5.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Didn’t eat anyvegetables

1 serve orless/day

2 serves/day 3 serves/day 4 serves/day 5 or more serves/day

2003 (n=566) 2008 (n=436)*

Primary Boys 2003 n=583, 2008 n=444. Primary Girls 2003 n=549, 2008 n=459. Secondary Boys 2003 n=287, 2008 n=255. Secondary Girls 2003 n=299, 2008 n=354. Australian dietary guidelines for children and adolescents10 (3 serves for 8-11 yo, 4 serves for 12-18 yo)* Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering

Figure 13: Proportion of children usually meeting recommended daily vegetable intake, 2003 and 2008

* Significant difference (p < 0.05) between 2003 and 2008 after adjusting for location, SES, age and school clustering

Figure 14: Usual serves of vegetables per day, 2003 and 2008: primary school boys


• The proportion of secondary school boys consuming four serves of vegetables per day was

significantly higher in 2008 than 2003 (22.1% vs. 12.4%) (Figure 16).

• Usual vegetable serves consumed per day was significantly lower in metropolitan secondary

school boys compared with non-metropolitan boys (Figure 17).

• Secondary school girls in 2008 usually consumed significantly more serves of vegetables per

day compared with 2003 (Figure 18).

• There were no other significant differences related to location or SES tertile (data not shown).

No significant difference (p < 0.05) between 2003 and 2008 after adjusting for location, SES, age and school clustering

Figure 15: Usual serves of vegetables per day, 2003 and 2008: primary school girls

0.5%

23.7%

40.1%

22.2%

0.7%

26.5% 29.6%

26.0%

9.4% 13.3%

4.1% 3.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


2003 (n=565) 2008 (n=437)



Figure 16: Usual serves of vegetables per day, 2003 and 2008: secondary school boys


Figure 17: Usual serves of vegetables per day: secondary school boys by location

2.8%

21.4%

26.4%

31.4%

2.2%

21.6% 24.6% 23.6%

12.4%

22.1%

5.6% 5.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


2003 (n=279) 2008 (n=248)*

2.2%

24.3% 26.2% 25.0%

2.8%

15.2%

23.5%

31.3%

17.6% 18.4%

4.7% 8.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


Metro (n=360) Non metro (n=176)*


Fruit

• Primary school children were more likely to meet age-specific recommended fruit intake

compared with secondary school children (Figure 19).

• The proportions of primary school boys and girls, and secondary school girls usually meeting

recommended fruit intake were significantly higher in 2008 compared with 2003 (Figure 19).

• In 2008, 62.9% of primary school boys and 70.2% of primary school girls were meeting dietary

guidelines for fruit consumption; significantly higher than in 2003 (boys 52.4%; girls 63.6%)

(Figure 19).

• The proportion of secondary school girls usually meeting dietary guidelines for fruit

consumption was significantly greater in 2008 compared with 2003 (28.3% vs. 13.5%)

(Figure 19).

• The proportion of secondary school boys meeting dietary guidelines for fruit did not differ

between 2008 and 2003 (22.2% and 22.0% respectively) (Figure 19).

• There were no significant differences in the proportions usually meeting guidelines for fruit

intake related to SES or location.


Figure 18: Usual serves of vegetables per day, 2003 and 2008: secondary school girls

1.1%

23.6%

30.0% 27.3%

0.5%

17.9%

25.4%

32.4%

14.6% 14.5%

3.4%

9.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


2003 (n=279) 2008 (n=350)*


52.4%

63.6%

22.0%

13.5%

62.9%

70.2%

22.2%

28.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Primary boys* Primary girls* Secondary boys*

Secondary girls*

2003 2008

Primary Boys 2003 n=583, 2008 n=444. Primary Girls 2003 n=549, 2008 n=459. Secondary Boys 2003 n=287, 2008 n=255. Secondary Girls 2003 n=299, 2008 n=354. * Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering

Figure 19: Proportion of children usually meeting recommended daily fruit intake, 2003 and 2008

• A significantly higher proportion of primary school boys in 2008 usually consumed more

serves of fruit per day compared with 2003 (Figure 20). There were no significant differences

related to location or SES tertile (data not shown).

• A significantly higher proportion of primary school girls in 2008 usually consumed more serves

of fruit per day compared with 2003 (Figure 21).

• In 2008 a significantly higher proportion of primary school girls and secondary school children

in the highest SES tertile consumed fresh fruit more frequently than the lowest SES tertile (data

not shown).

• Primary school girls in 2008 usually consumed significantly more serves of fruit per day

compared with 2003 (Figure 21). There were no significant differences related to location or SES

tertile (data not shown).


* Significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location and school clustering

Figure 20: Usual daily serves of fruit, 2003 and 2008: primary school boys


Figure 21: Usual daily serves of fruit, 2003 and 2008: primary school girls

2.7%

45.0%

39.9%

9.1% 4.3%

32.9%

46.3%

11.1%

3.3% 5.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Didn’t eat anyfruit

1 serve orless/day

2 serves/day 3 serves/day 4 or more serves/day

2003 (n=565) 2008 (n=437)*

1.3%

35.0%

45.2%

14.7%

0.2%

29.6%

48.6%

18.5%

3.8% 3.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


2003 (n=538) 2008 (n=453)*


No significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location and school clustering

Figure 22: Usual daily serves of fruit, 2003 and 2008: secondary school boys


Figure 23: Usual daily serves of fruit, 2003 and 2008: secondary school girls

• Amongst secondary school boys there were no significant differences in usual daily serves of

fruit between survey years, (Figure 22), location or SES (data not shown).

• A significantly higher proportion of secondary school girls in 2008 usually consumed

significantly more serves of fruit per day compared with 2003 (Figure 23). There were no

significant differences related to location or SES tertile (data not shown).

1.3%

37.4% 37.7%

18.4%

2.4%

39.8% 35.9%

16.6%

3.4% 5.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


2003 (n=279) 2008 (n=249)

2.2%

40.7% 43.3%

10.1%

2.1%

26.7%

42.9%

21.1%

3.7% 7.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1 serve orless/day


2003 (n=298) 2008 (n=353)*


Primary Boys 2003 n=583, 2008 n=444. Primary Girls 2003 n=549, 2008 n=459. Secondary Boys 2003 n=287, 2008 n=255. Secondary Girls 2003 n=299, 2008 n=354. * Statistically significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering

Figure 24: Proportion of children who consume breakfast daily, 2003 and 2008

Breakfast Habits

Children were asked how often they consumed breakfast, the following results relate to 2008 data:

• The majority of children consumed breakfast daily – 90.1% of primary school boys, 83.2% of

primary school girls and 71.5% of secondary school boys. However, fewer secondary school

girls (61.5%) reported eating breakfast daily (Figure 24).

• The proportion of secondary school girls who consumed breakfast daily was significantly

higher in 2008 than 2003 (61.5% vs. 51.3% respectively).

• The proportions of primary school children and secondary school boys consuming breakfast

everyday did not differ significantly between 2008 and 2003.

• Amongst primary school girls, 77.7% of children in lowest SES tertile reported consuming

breakfast daily compared with 85% of girls in the highest SES (data not shown).

• Similarly, amongst secondary school boys, 55.9% from the lowest SES tertile reported

consuming breakfast daily compared with 77.5% of those in highest SES tertile (data not

shown).

Full details of usual frequency of breakfast consumption by age and sex are provided in Figures 24

through 28. These data are heavily skewed and therefore cannot be tested for differences between

year, age, location and SES tertiles.

85.8% 85.3%

71.3%

51.3%

90.1%

83.2%

71.5%

61.5%

0%

20%

40%

60%

80%

100%

Primary Boys Primary Girls Secondary Boys Secondary Girls*

2003

2008


Data not tested for differences between year, age, location and SES tertiles as data heavily skewed

Figure 26: Frequency usually consume breakfast, 2003 and 2008: primary school girls.


Figure 25: Frequency usually consume breakfast, 2003 and 2008: primary school boys

0.7% 1.3% 4.7%

7.5%

1.4% 3.8% 1.9% 2.8%

85.8% 90.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rarely never

irregularly

1-2 days/week 3-4 days/week 5-6 days/week Everyday

2003 (n=566)

2008 (n=438)

0.5% 3.1% 3.8%

6.9%

1.9% 1.7% 3.1%

10.1%

85.8% 83.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rarely neverirregularly


2003 (n=540) 2008 (n=453)



Figure 28: Frequency usually consume breakfast, 2003 and 2008: secondary school girls


Figure 27: Frequency usually consume breakfast, 2003 and 2008: secondary school boys

5.3% 4.7% 6.6%

11.9%

1.9% 4.6%

6.8%

15.1%

71.5% 71.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



2003 (n=276) 2008 (n=250)

12.3% 9.3% 10.1%

17.2%

6.7% 9.3%

6.3%

16.0%

51.1%

61.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


1-2 days/week 3-4 days/week 5-6 days/week Everyday*

2003 (n=298) 2008 (n=353)


Frequency of involvement in meal preparation

Secondary school children and parents of primary school children were asked about the usual

frequency with which children were involved in breakfast, lunch and dinner preparation. Responses

are reported by sex and survey year in Figures 29 through 32 for breakfast, Figure 33 for lunch and

Figures 34 through 37 for dinner.

• In both 2008 and 2003, about one-half (47.9% - 60.5%) of all children prepared or helped to

prepare their breakfast most days of the week (five to seven days).

• Secondary school girls’ frequency of involvement in breakfast preparation was significantly

higher in 2008 (Figure 32). This is potentially related to the significantly higher proportion in

2008 who regularly consumed breakfast (Figure 28).

• In 2008 and 2003 approximately one-quarter of secondary school children (24.3% boys, 24.6%

girls), and a smaller proportion of primary school children (11.1% boys, 16.6% girls) helped with

lunch preparation on most days (Figure 33).

• About a third of all children (31.2% - 40.1%) helped prepare lunch on between one and four

days per week.

• About 5% (4.0% - 5.3%) of children of all ages helped with dinner preparation most (5 – 7) days,

whereas about one-third (34.1%) to one-half (51.8%) helped some (1 – 4) days.

• In 2008, significantly higher proportions of primary school boys (38.3%) and girls (51.8%) helped

to prepare dinner some days than in 2003 (boys: 23.7%, girls: 36.7) (Figure 34 and Figure 35).


Figure 29: Frequency of children reporting usually preparing or helping to prepare breakfast, 2003 and 2008: primary school boys

27.4%

22.2% 24.7%

29.5%

47.9% 48.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rarely never irregularly 1-4 days/week 5-7 days/week

2003 (n=563) 2008 (n=438)



Figure 30: Frequency of children reporting usually preparing or helping to prepare breakfast, 2003 and 2008: primary school girls


Figure 31: Frequency of children who usually prepare or helping to prepare breakfast, 2003 and 2008: secondary school boys

25.2%

20.0% 21.5%

19.5%

53.3%

60.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=277) 2008 (n=249)

22.1% 19.8%

26.0% 30.1%

51.9% 50.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=537) 2008 (n=452)


Significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location and school clustering

Figure 32: Frequency of children who usually prepare or helping to prepare breakfast, 2003 and 2008: secondary school girls

Figure 33: Frequency of children reporting usually preparing or helping to prepare lunch, 2008

27.0%

21.2% 18.0%

20.9%

55.1% 57.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=297) 2008 (n=352)

53.3%

35.6%

11.1%

43.6% 39.7%

16.6%

44.6%

31.2%

24.3%

35.2%

40.1%

24.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%





Figure 34: Frequency of children reporting usually preparing or helping to prepare dinner, 2003 and 2008: primary school boys


Figure 35: Frequency of children reporting usually preparing or helping to prepare dinner, 2003 and 2008: primary school girls

74.1%

57.7%

23.7%

38.3%

2.2% 4.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=559) 2008 (n=437)

59.4%

44.1%

36.7%

51.8%

3.9% 4.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=530) 2008 (n=453)



Figure 36: Frequency of children reporting usually preparing or helping to prepare dinner, 2003 and 2008: secondary school boys


Figure 37: Frequency of children reporting usually preparing or helping to prepare dinner, 2003 and 2008: secondary school girls

58.1%

52.5%

34.1%

43.4%

7.8% 4.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=278) 2008 (n=248)

44.0% 41.6%

51.1% 53.0%

4.9% 5.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=295) 2008 (n=351)


Food purchasing habits at the school canteen

Data on the usual frequency of purchasing food and drinks from school canteen/kiosk (or deli/café

supplying food to children at school) were collected in 2008 only. The frequencies of purchasing

food and drink from school for primary and secondary school children are presented in Figure 38 and

Figure 39.

• In 2008, approximately two in five primary school children and one-half of secondary school

children purchased food or drinks from the school canteen at least once per week.

• Secondary school children were more likely to purchase from the school canteen on most days

of the week than primary school children.

• Significantly more secondary school boys purchased food or drink from the school canteen on

most days of the week (19.8%) than secondary school girls (12.0%) (Figure 39).

• In 2008 only about 5% of primary school children used the canteen on most days of the week

and there were no significant sex differences (Figure 38).

• There were no significant differences in frequency of canteen use by primary school children

related to SES or location in 2008 (data not shown).

• Metropolitan secondary school children were more likely to buy from the canteen than non-

metropolitan children; 51.6% of metropolitan secondary school students bought on 1-2 days

or 3-5 days vs. 40.3% of non-metropolitan secondary school children (data not shown).

2008 data: Question not included in 2003No significant differences between boys and girls after adjusting for age, SES and school clustering

Figure 38: Frequency of purchasing food or drinks from the school canteen, 2008: primary school children

2.2%

14.1%

40.5% 38.5%

3.7%

13.8%

43.1%

33.5%

4.7% 5.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

No Canteen Irregularly Rarely or never 1-2 days/week 3-5 days/week

Boys (n=438) Girls (n=453)


2008 data: Question not included in 2003* Significant difference between boys and girls after adjusting for age, SES and school clustering

Figure 39: Frequency of purchasing food or drinks from the school canteen, 2008: secondary school children

Primary school boys 2003 n=583, 2008 n=444. Primary school girls 2003 n=549, 2008 n=459. Secondary school boys 2003 n=287, 2008 n=255. Secondary school girls 2003 n=299, 2008 n=354. No significant differences between 2003 and 2008 after adjusting for age, SES, location and school clustering

Figure 40: Proportion of children eating evening meal with family five to seven days per week, 2003 and 2008

Evening Meal Habits

• In 2008, the majority of children reported eating their evening meal with their family on most

days of the week, although the proportions were lower in secondary school children (66.3%

boys, 68.4% girls) than primary school children(82.5% boys, 84.2% girls) (Figure 40) .

• There were no significant differences between age groups or year of survey (Figure 40) nor SES

or location (data not shown) after adjusting for differences between the samples.

1.7%

7.9%

39.3%

31.4%

0.3%

9.5%

39.8% 38.4%

19.8%

12.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

No Canteen Irregularly Rarely or never 1-2 days/week* 3-5 days/week

Boys (n=438) Girls (n=453)

87.3% 87.2%

72.0% 65.8%

82.5% 84.2%

66.3% 68.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 2008


• In 2008 fewer than one-quarter of children (12.5%-23.6%) watched television whilst eating

dinner on most days of the week (Figure 41).

• With the exception of primary school boys, the proportion of children watching television

while eating the evening meal on most days of the week was significantly lower in 2008

compared with 2003. In 2008, 16.1% of secondary school boys and 20.0% of secondary school

girls watched television while eating the evening meal on most days of the week, compared

with 30.1% of boys and 31.5% girls in 2003. The proportion of primary school girls watching

television while eating the evening meal on most days of the week was 12.5% in 2008

compared with 19.5% in 2003 (Figure 41).

• Primary school children in the lowest SES tertile were significantly more likely to eat in front of

television for five to seven evenings a week compared with children in the highest SES tertile.

There were no differences by SES tertile amongst secondary school boys and girls (data not

shown).

• Full details of usual frequency of children watching television while eating the evening meal by

age and sex are provided in Figures 42 through 44.

Primary school boys 2003 n=583, 2008 n=444. Primary school girls 2003 n=549, 2008 n=459. Secondary school boys 2003 n=287, 2008 n=255. Secondary school girls 2003 n=299, 2008 n=354. * Significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location and school clustering

Figure 41: Proportion of children watching television while eating evening meal five to seven evenings per week, 2003 and 2008

19.0% 19.5%

30.1% 31.5%

23.6%

12.5% 16.1%

20.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Primary boys Primary girls* Secondary boys* Secondary girls*

2003 2008



Figure 42: Frequency children watch television while eating evening meal, 2003 and 2008: primary school boys

Figure 43: Frequency children watch television while eating evening meal, 2003 and 2008: primary school girls

49.7%

38.0%

31.3%

38.4%

19.0%

23.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=559) 2008 (n=438)

48.3%

43.4%

32.1%

44.1%

19.5%

12.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=533) 2008 (n=454)


Figure 44: Frequency children watch television while eating evening meal, 2003 and 2008: secondary school boys

Figure 45: Frequency children watch television while eating evening meal, 2003 and 2008: secondary school girls

34.8% 33.9% 33.7%

46.2%

31.5%

20.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=297) 2008 (n=353)

37.0% 33.0% 32.9%

50.9%

30.1%

16.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=274) 2008 (n=249)


Meals and snacks

In 2008, secondary school children and parents of primary school children were asked who usually

decides what children eat for meals and snacks.

• For the majority (67.1%-73.5%) of all age and gender groups the parents together with children

decided what would be eaten for meals in 2008 (Figure 46).

• In the case of snacks, the parents together with the child were the main decision makers for

primary school boys (67.2%) and girls (70.5%) in 2008. However, for secondary school boys

(51.3%) and girls, at least half (55.9%) reported that the child was most likely to make snack

decisions alone (Figure 47).

Figure 46: Who usually decides what children eat for meals: 2008

2.4%

30.5%

67.1%

2.6%

28.6%

68.8%

5.1%

26.5%

68.4%

9.0%

17.5%

73.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Child alone Parent alone Both parent and child


Fast Food

Secondary school children and parents of primary school children were asked how often the child

eats meals or snacks from fast food chains (examples of common chains were listed).

• Approximately one-third of primary school children and secondary school boys (33.7% - 34.9%)

reported usually consuming fast food chain meals or snacks at least once a week (Figure 48).

This was not significantly different between survey year or SES tertile (SES data not shown).

• The proportion of secondary school girls usually consuming fast food at least once a week was

significantly lower in 2008 compared with 2003 (18.4% vs. 34.6%) (Figure 48).

• Secondary school girls from the middle and highest SES tertiles were significantly less likely

to consume fast food at least once a week than those from the lowest SES tertile (data not

shown).

Figure 47: Who usually decides what children eat for snacks: 2008

11.0%

21.8%

67.2%

9.4%

20.1%

70.5%

51.3%

10.8%

37.9%

55.9%

7.2%

36.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Child alone Parent alone Both parent and child


Primary school boys 2003 n=583, 2008 n=444. Primary school girls 2003 n=549, 2008 n=459. Secondary school boys 2003 n=287, 2008 n=255. Secondary school girls 2003 n=299, 2008 n=354. * Significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering

Figure 48: Proportion of children consuming food or snacks from fast food chain at least once a week, 2003 and 2008

• Primary school children and secondary school girls from non-metropolitan locations were

less likely to report consuming fast food at least once a week compared with metropolitan

children. This difference by location was significant for the entire sample when adjusted for

age, SES, year and school clustering (Figure 49).

• Additionally, a significant lower proportion of metropolitan children reported fast food

consumption more than once a week in 2008 compared with 2003 (Figure 49).

Metropolitan 2003 n=1167, 2008 n=1142. Non-metropolitan 2003 n=495, 2008 n=350. * Significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES, location and school clustering^ Significant difference (p<0.05) between metropolitan and non-metropolitan after adjusting for age, SES, year and school clustering

Figure 49: Proportion of children attending metropolitan and non-metropolitan schools consuming food or snacks from fast food chain at least once a week, 2003 and 2008

36.2% 36.1% 39.0%

34.6% 33.8% 34.9% 33.7%

18.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Primary boys Primary girls Secondary boys Secondary girls*

2003 2008

39.7%

26.4% 31.1%

26.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Metro Non-metro^

2003 2008*


No significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering

Figure 50: Frequency children consume meals or snacks from fast food chain, 2003 and 2008: secondary school boys

No significant difference (p < 0.05) between 2003 and 2008 after adjusting for age, SES and school clustering

Figure 51: Frequency children consume meals or snacks from fast food chain, 2003 and 2008: secondary school girls

7.2%

53.8%

28.6%

10.1% 7.1%

59.2%

26.4%

7.1%

0.3% 0.2% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Never Once a fortnightor less

Once a week 2-4 times a week 5-7 times a week

2003 (n=274) 2008 (n=248)

6.4%

59.0%

28.9%

4.5%

14.7%

67.0%

13.7%

4.4% 1.1% 0.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



2003 (n=295) 2008 (n=352)


No comparison to 2003

Figure 52: Frequency children consume meals or snacks from fast food chain, 2008: primary school children

Type of milk

• In 2008 and 2003, more than 95% of children completing the food frequency questionnaire

reported that they usually consumed milk.

• Around half of primary school boys (49.6%), primary school girls (51.9%) and secondary school

boys (55.1%) usually consumed whole milk in 2008 compared with 37.8% of secondary school

girls. Less than 10% consumed soy or other non-dairy milks and the remainder (37.5% - 53.8%)

usually consumed reduced fat or skimmed milk (Figures 53 through 56).

• Significantly higher proportions of primary school children and secondary school girls

consumed reduced fat or skimmed milk in 2008 than 2003; this difference was largest for

secondary school girls.

2.4%

62.4%

30.9%

4.2% 0.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



2008 (n=1679)


Figure 53: Type of milk usually consumed, 2003 and 2008: primary school boys

Figure 54: Type of milk usually consumed, 2003 and 2008: primary school girls

2.0%

58.8%

34.5%

4.7% 3.1%

49.6%

42.3%

5.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Don’t drink Whole Reduced fat/skim Soy/other

2003 (n=560) 2008 (n=435)

2.1%

57.4%

35.6%

4.9% 2.4%

51.9%

41.8%

3.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=529) 2008 (n=450)


Figure 55: Type of milk usually consumed, 2003 and 2008: secondary school boys

Figure 56: Type of milk usually consumed, 2003 and 2008: secondary school girls

3.5%

51.3%

35.4%

9.8%

0.7%

55.1%

37.5%

6.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=275) 2008 (n=245)

5.3%

43.7% 40.3%

10.6%

3.2%

37.8%

53.8%

5.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


2003 (n=295) 2008 (n=353)


Type of cereal

• Overall, at least 90% of children surveyed in 2003 and 2008 had eaten breakfast cereal in the

previous 12 months. A wide range of cereal types were consumed, with the most frequent

being plain wheat cereal (34.0%) (Figure 57).

• A significantly lower proportion of children in 2008 (17.2%) consumed highly sweetened

cereals compared with 2003 (22.0%) (Figure 57).

Dietary supplements

• Four out of ten children usually consumed vitamin or mineral supplements over the previous 12

months. This proportion was significantly higher in 2008 (44.5%) than 2003 (37.4%) (Figure 58).

• Approximately 12% of children consumed sports supplements, and between 3% and 4%

consumed weight control products; no significant difference was evident in the proportions

of those consuming sports supplements or weight control products between 2003 and 2008

(Figure 58).

• Vitamin or mineral supplement consumption was higher amongst secondary school children

(46.8% boys, 51.3% girls) than primary school children (41.4% boys, 38.6% girls) (Figures

58 through 62). Girls were more likely to be frequent consumers of vitamin and mineral

supplements, with one in five primary (19%) and secondary (19.6%) school girls consuming

them five times per week or more in 2008.

Plain Bran Cereals, Breakfast Bars and Liquid Breakfast were each consumed by less than 1.5% of the 2003 and 2008 samples.

Figure 57: Type of breakfast cereal usually consumed, 2003 and 2008

9.7% 9.4% 5.8% 7.6%

31.6% 34.0%

16.0% 14.5%

22.0%

17.2% 12.8% 13.6%

2.1% 3.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Don’t eat cereal

Porridge Plain wheatcereal

Plain corn/ricecereal

Cereals –added fruit

Cereals –added sugar

Other – Barsliquid, plain

bran

2003 (n=1598) 2008 (n=1439)



Figure 58: Proportion of children consuming dietary supplements, 2003 and 2008

Figure 59: Frequency of vitamin and mineral supplements consumption, 2003 and 2008: primary school boys

4.1% 2.9%

12.2% 11.6%

37.4%

44.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Weight control Sports Vitamin/Mineral*

2003 (n=1654) 2008 (n=1489)

66.9%

11.7% 9.2% 10.6%

58.6%

16.9%

8.8%

13.6%

1.6% 2.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Never Less than once a week

1-4 times a week 5-7 times a week More than oncea day

2003 (n=555) 2008 (n=433)


Figure 60: Frequency of vitamin and mineral supplements consumption, 2003 and 2008: primary school girls

Figure 61: Frequency of vitamin and mineral supplements consumption, 2003 and 2008: secondary school boys

69.1%

15.3%

5.1%

10.2%

61.4%

10.8% 7.5%

19.0%

0.3% 1.2% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



2003 (n=533) 2008 (n=452)

54.3%

25.2%

8.5% 9.8%

53.2%

20.7%

12.0% 13.4%

2.2% 0.7% 0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



2003 (n=273) 2008 (n=248)


Figure 62: Frequency of vitamin and mineral supplements consumption, 2003 and 2008: secondary school girls

Food Frequency

Table 25 presents a comparison of primary and secondary school boys’ and girls’ 12 month food

consumption frequency between 2003 and 2008. Secondary school children and primary school

parents were asked to report on average how often the child had eaten each food per day, per week or

per month, in the last 12 months. Food frequencies were converted to a common unit for comparison.

Significant differences between years of survey, SES and location are indicated by the symbols in Table 25.

Higher food frequency in 2008

• Sweet potato , other root vegetables (not potato) and avocado were consumed significantly

more frequently by all children in 2008 compared with 2003. (Table 25).

• Primary school children and secondary school girls consumed wholemeal or mixed grain

bread, stir fried vegetables, mixed vegetables in casseroles or stews, spinach/silverbeet,

broccoli, zucchini/eggplant/squash, capsicum, mushrooms, fresh fruit of all types, and berries

significantly more frequently in 2008 than 2003 (Table 25).

• Primary and secondary school girls reported significantly more frequent consumption in 2008

of carrots, lettuce and other salad greens, dried fruits, frozen fruit, fruit salad, mango/pawpaw,

melons, other fruit, compared with girls in 2003 (Table 25).

• Overall, secondary school girls reported significantly more frequent consumption of a wider

range of foods, 40 of the 110 food items, compared with 30 foods for primary school girls, 18

for primary school boys and only 3 for secondary school boys (Table 25).

• Increases in the proportion of children consuming foods were predominantly in the healthier

food categories, particularly fruit and vegetables (Table 25).

55.7%

17.2%

7.6%

17.9%

48.7%

19.8%

9.1%

19.6%

1.5% 2.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



2003 (n=293) 2008 (n=351)


Lower food frequency in 2008

• Six food items were consumed significantly less frequently by all children groups in 2008

compared with 2003. These items were white bread, meat pies/sausage rolls/other savoury

pastries, chocolate/chocolate bars, potato chips/corn chips/similar snacks, cordial, and regular

soft drink/flavoured mineral water (Table 25).

• Primary school children and secondary school girls reported significantly less frequent

consumption of potato cooked with fat and lollies/confectionary (Table 25).

• Primary school boys and secondary school children reported significantly less frequent

consumption of fancy sweet biscuits and ice cream (Table 25).

• Primary school children and secondary school boys reported significantly less frequent

consumption of English muffins/bagels/etc (Table 25).

• Secondary school children reported significantly less frequent consumption of all eight

alcoholic drinks listed, except wine coolers amongst secondary school girls (where frequency

of consumption was the same between survey years) (Table 25).

• Overall, secondary school girls reported significantly less frequent consumption of 17 of the

110 food items, compared with 14 foods for primary school girls, 17 for primary school boys

and 13 for secondary school boys (Table 25).

• Decreases in the proportion of children consuming certain foods between 2003 and 2008

were predominantly in the less healthy food categories including baked goods and snacks,

sugars, spread and dressings and non-milk drinks (Table 25).

Variations by SES

When frequency of consumption was considered by SES the following significant differences were

found;

• Frequency of consumption of regular soft drink/flavoured mineral waters was higher in the

lowest SES tertile compared with the highest SES tertile for all children (Table 25).

• Primary and secondary school boys from the lowest SES tertile consumed salami/luncheon

meats more frequently and avocado less often than boys from the highest SES tertile

(Table 25).

• Frequency of fresh fruit consumption was significantly higher in the highest SES than in the

lowest SES tertile for primary school girls and secondary school children (Table 25).

• Secondary school children from the higher SES tertile consumed dried fruit and tomato

products more frequently than those from the lowest SES tertile (Table 25).

• Primary school boys showed the most differences in food frequency related to SES. In addition

to the items already mentioned, primary school boys of the lowest SES tertile consumed more

mixed dishes with meat, vegetable soup, cauliflower, Brussels sprouts and similar greens, frozen

fruit, fruit salad, meat pies and other savoury pastries, potato chips and similar snacks, fruit juice

drinks and cordial when compared to primary school boys of the highest SES tertile (Table 25).


Variation by school location

When frequency of consumption was considered by school location the following significant

differences were found.

• Frequency of consumption of pumpkin was higher for non-metropolitan children, compared

with metropolitan children, as was consumption of Vegemite/Marmite/Promite (Table 25).

• Non-metropolitan children from three of the four age and sex groups more frequently

consumed potato cooked without fat, broccoli, oranges/citrus fruits and butter/margarine and

less frequently consumed chocolate/chocolate bars (Table 25).

• Non-metropolitan primary school children more frequently consumed green peas, savoury

biscuits, cakes/muffins/scones and plain sweet biscuits than their metropolitan counterparts.

• Conversely, non-metropolitan primary school children consumed soybeans/tofu, rice and

sports drinks less frequently than metropolitan children.

• Non-metropolitan secondary school children reported consumption of water and salad

significantly more frequently than their metropolitan counterparts (Table 25).

Table 25: Differences in 12 month frequency of food consumption, 2003 and 2008

Diff erence (see legend for symbol interpretation)

Primary

school boys

Primary

school girls

Secondary

school boys

Secondary

school girls

Meat, Chicken Fish, Eggs

Mince dishes (eg bolognaise sauce, rissoles, meatloaf ) = = = =

Mixed dishes with meat like beef, lamb,pork (eg stir-fry, casserole) =1 = = =

Mixed dishes with chicken, turkey, duck (eg stir-fry, casserole) = = = =

Roast, BBQ or steamed chicken, turkey, duck = = = +

Crumbed fried chicken, chicken nuggets = = = =3

Roast meat (eg beef, lamb, pork) = = = +

Steak or chops = = = +

Sausages, frankfurters = =4 = –1

Bacon =1 = = =

Ham 3 + = =

Salami, luncheon meats (eg polony, pressed chicken) =1 = =1 =

Liver including pate = = = =

Other offal (eg kidneys) – = = =

Canned fish (eg tuna, salmon, sardines) + =3 = =

Fish, fish fingers – steamed, baked, grilled = = = =

Fish, fish fingers – fried, battered, crumbed =4 = – =

Other seafood (eg prawns, oysters, calamari) = = =2 +

Eggs or egg dishes = = = =

Vegetarian meat substitutes

Soy-based meat substitutes (eg TVP, soy burger) =3 = = +

Nut-based meat substitutes (eg Nutolene™, Vegelinks™) = = = +

Beans and lentils

Soybean, tofu =3 =3 = +

Baked beans = = = =

Other beans/peas/lentils (eg kidney, borlotti, chickpeas, dhal) = + = =


Table 25: Differences in 12 month frequency of food consumption, 2003 and 2008 (continued)


Primary

school boys

Primary

school girls

Secondary

school boys

Secondary

school girls

Bread and Cereal Foods

White bread, toast or rolls –4 – – –

Wholemeal or mixed grain bread, toast, rolls + + = +

English muffin, bagel, crumpet, foccacia, flat bread – – – =

Dry or savoury biscuits, crispbread, crackers, rice cakes =4 +4 = =

Breakfast cereal = = =2 +

Rice including white or brown +3 +3 = =

Pasta including filled pasta, noodles, lasagne = =2 = =

Baked Goods and Snacks

Meat pie, sausage roll, other savoury pastries –1,3 – – –

Pizza =3 = – =

Hamburger with bun =3 = = –

Cakes, muffins, scones, pikelets =4 =4 = =

Sweet pies or sweet pastries – = = =

Other puddings and desserts –4 = = =3

Plain sweet biscuits –4 =2,4 = –

Fancy biscuits including jam/cream filled, chocolate, fruit & nut – = – –

Chocolate including chocolate bars (eg Mars bars™) –3 –3 –1,3 –

Other lollies, confectionery – – =3 –

Nuts = = = +

Potato chips, corn chips, Twisties™ etc –1,3 – – –

Vegetables (fresh, frozen, canned)

Green/ mixed salad (eg lettuce, tomato, cucumber, onion, etc) in

a sandwich

= = = +

Green/ mixed salad (eg lettuce, tomato, cucumber, onion, etc) as

a side salad

= = =4 +2,4

Stir-fried and mixed cooked vegetables + + = +

Mixed vegetables in a casserole or stew =4 + = +

Vegetable soup =1 = = =

Potato cooked without fat (eg boiled, mashed, dry baked) =4 =4 = =4

Potato cooked with fat (eg chips, French fries, gems, wedges, roast) – – = –

Carrots = =4 = =4

Pumpkin =4 =4 =4 =4

Sweet potatoes and other root vegetables + + + +

Green peas +4 +4 = =

Green beans = =4 =4 =

Silverbeet, spinach +3 + =2,4 +

Celery, asparagus or bean sprouts = = =2 +

Broccoli +4 +4 =2,4 +

Cauliflower =1 =4 = =1

Brussels sprouts, cabbage, coleslaw, Asian greens =1 = = =

Zucchini, eggplant, squash + + =2 +

Lettuce, rocket, endive, other raw salad greens = + =4 +2

Capsicum +3 + =2 +




Primary

school boys

Primary

school girls

Secondary

school boys

Secondary

school girls

Vegetables (fresh, frozen, canned) (continued)

Tomatoes including canned + + = =2

Tomato products (eg dried, paste, sauce) = = =2 =2

Avocado =2 + +2,4 +

Onion or leeks = = = =

Sweetcorn, corn on the cob = +4 = =

Mushrooms + + = +

Fruit

Fresh fruit-all types + +2 =2,4 +2

Dried fruit-all types (eg sultanas, prunes, apricots) =1 + =2,4 +2

Canned fruit-all types = + =4

Frozen fruit-all types =1 + = +

Fruit salad, mixed fruit =1,3 + = +

Apple, pear +4 = = +

Orange, mandarin, grapefruit = =4 =4 +4

Banana = + = =

Peach, nectarine, plum, apricot, cherries = = =4 +

Mango, paw-paw =3 + = +

Pineapple = = =4 +

Berries (eg strawberries, blueberries) +3 + = +

Melon (eg watermelon, rockmelon) =3 + =2,4 +

Other fruit (eg grapes, kiwi fruit) =3 + = +

Sugar, Spreads and Dressings

Sugar, syrup, honey =4 – = –

Jam, marmalade =4 – –4 =

Peanut butter, other nut spreads =4 = = =

Butter, dairy blends, margarine =4 –4 = –4

Vegemite™, Marmite™, Promite™ =4 =4 =4 =4

Oil and vinegar dressing = = – =

Mayonnaise, other creamy dressing = = = =

Dairy Foods

Flavoured milk/soy drink (eg milkshake, iced coffee, hot chocolate) –3 – = =

Milk/soy milk as a drink = =3 =3 =

Milk/soy milk on breakfast cereals = = =2 +

Milk/soy milk to top up hot drinks (eg milk in tea) = = = =

Cream or sour cream = = =4 =

Ice-cream – = – –

Yoghurt including plain, frozen, flavoured and fromage frais = + = =2

Cottage or ricotta cheese = = = =

Cheddar and all other cheeses N/A N/A = =




Primary

school boys

Primary

school girls

Secondary

school boys

Secondary

school girls

Non-milk drinks

Fruit juice (100%) =3 = + =

Fruit juice drinks (eg 35%) –1 = = =

Cordial –1 – – –

Low joule soft drinks (eg Diet Coke™) = = = –

Regular soft drink(eg Coke™, Sprite™), flavoured mineral water –1,3 –1,3 –1 –1,3

Electrolyte or sports drinks (eg Gatorade™) +3 =1,3 =1 +

Energy drinks (eg Red Bull™, V™, Red Eye™) = = = +

Water including unflavoured mineral water, soda water, tap water = = =4 =2,4

Coffee = – =4 –

Tea = = = =

Beer – low alcohol N/A N/A – –

Beer –- full strength N/A N/A – –

Red wine N/A N/A – –

White wine or champagne/sparkling wine N/A N/A – –

Wine cooler N/A N/A – =

Sherry or port N/A N/A – –

Pre-mixed drinks (eg Bacardi Breezer™) N/A N/A – –

Spirits or liqueurs N/A N/A – –

+ Significant greater proportion of participants consuming more frequently in 2008 compared with 2003 after adjusting for location, SES, age and school clustering– Significant lower proportion of participants consuming more frequently in 2008 compared with 2003 after adjusting for location, SES, age and school clustering1 Significant difference between SES after adjusting for year, location, age and school clustering. Lowest SES consume more frequently compared with highest SES.2 Significant difference between SES after adjusting for year, location, age and school clustering. Highest SES consume more frequently compared with lowest SES tertile.3 Significant difference between location after adjusting for year, SES, age and school clustering. Metropolitan children consume more frequently compared with non-

Metropolitan.4 Significant difference between location after adjusting for year, SES, age and school clustering. Non-metropolitan children consume more frequently compared with

Metropolitan.N/A denotes items not included in primary school questionnaire

BODY SIZE

In 2008, 90.8% of participants completed the anthropometric data collection. Table 26 displays the proportions

of primary school children classified as underweight, healthy weight, overweight and obese by sex.

• The proportion of primary school children classified as overweight or obese was similar in 2003

and 2008 (23.2% and 22.9% respectively) (Table 26).

• There were no significant differences in the proportions of primary school boys and girls

classified as overweight or obese in 2008 compared with 2003 (Table 26).

• A significantly higher proportion of primary school girls were underweight in 2008 (9.9%) than

in 2003 (4.2%). No significant difference in underweight proportions was evident for primary

school boys between 2003 and 2008 (Table 26).

Table 27 displays the proportions of secondary school children classified as underweight, healthy

weight, overweight and obese by age and sex.

• The proportion of secondary school girls who were classified as overweight or obese was

significantly lower in 2008 (15.9%) than in 2003 (23.1%) (Table 27).


Table 26: Proportions (%) of primary school children classified as underweight, healthy, overweight and obese by sex and overall, 2003 and 2008

2003 %n = 876

2008 %n = 961

Underweight

Boys 3.8 5.8

Girls 4.2 9.9*

All 4.0 7.8

Healthy#

Boys 75.5 67.6

Girls 69.8 71.4

All 72.8 69.4

Overweight

Boys 16.7 22.4

Girls 21.6 15.3

All 19.0 19.0

Obese

Boys 4.0 4.3

Girls 4.4 3.4

All 4.2 3.9

* Significant difference (p<0.05).

Table 27: Proportions (%) of secondary school children classified as underweight, healthy, overweight and obese by sex and overall, 2003 and 2008

2003 %n = 818

2008 %n = 747

Underweight

Boys 3.6 5.2

Girls 5.5 9.4*

All 4.5 7.4

Healthy#

Boys 71.7 78.9

Girls 71.4 74.6

All 71.6 76.6

Overweight

Boys 17.1 11.8

Girls 19.6 14.1*1

All 18.3 13.0

Obese

Boys 7.6 4.1

Girls 3.5 1.8*1

All 5.6 2.9

* Significant difference (p<0.05).*1 Significant difference (p<0.05) with proportions in two categories combined then compared with all other categories combined.

• Although the proportion of secondary school boys who were overweight or obese appears

lower in 2008 (15.9%) than 2003 (24.7%), the difference was not statistically significant.

• The proportion of underweight secondary school girls was significantly higher in 2008 (9.4%)

than in 2003 (5.5%).

• No significant difference in underweight proportions was evident for secondary school boys

between 2003 and 2008 (Table 27).


CHAPTER 4: DISCUSSION

The Child and Adolescent Physical Activity and Nutrition Survey (CAPANS) 2008 measured physical

activity participation, nutrient intake and body size of 1,887 children across primary and secondary

schools in Western Australia. The survey was a repeat of the CAPANS 2003 survey which involved

2,227 primary and secondary school children across the state. The prevalence of children’s and

adolescent’s engagement in physical activity, food habits and body size are discussed below with

reference to the CAPANS 2003 survey and other previous research.

Physical activity

Self-report physical activity

Australia’s Physical Activity Recommendations suggest that children3 and adolescents3 participate

in 60 minutes, and up to several hours, of moderate to vigorous physical activity every day.

CAPANS 2008 found that 41% of year three, five and seven primary school boys met the physical

activity recommendation on all of the previous seven days as did 27% of year three, five and seven

primary school girls. Although direct comparison is difficult given differences in age groups, survey

methodology and questionnaires, these results are slightly lower than the Australian National Survey

which found that 45% of boys and 33% of girls aged 9-13 years met the recommendation.7

In Western Australia, 38% of year eight, ten and 11 secondary school boys and only 10% of secondary

school girls reported participating in 60 minutes or more of physical activity on all of the last seven

days. These results are different to the Australian National Survey which found that 25% of

14 -16 year old boys met the recommendation, as did 13% of girls. Significantly more boys than

girls participating in CAPANS 2008 met the physical activity recommendations on each of the last

seven days.

The Western Australian CAPANS 2008 results are different again from those in the New South

Wales survey34 which found three-quarters of children aged 11-16 met the physical activity

recommendations. In part this difference could be attributable to the different survey instrument

used in the NSW survey; the Adolescent Physical Activity Recall Questionnaire.35 The importance

of the choice of survey instrument is highlighted by findings from the recent Queensland state

survey11 which found, compared with other previous Australian studies, lower proportions of

children participating in recommended levels of physical activity (12% of year five boys, 10 % of year

five girls, 12.5% year ten boys and 5% year ten girls). Children in the Queensland study were asked

the number of days on which they had engaged in physical activity or active play that raised their

heart rate or caused them to huff and puff for a total of 60 minutes or more, which is a measure of

‘vigorous‘ physical activity. This is different to the wording used in CAPANS 2008 and in other surveys.

For example, CAPANS 2008 did not stipulate an increase in heart rate or mention ‘huffing and puffing’.

The CAPANS 2008 results suggest that the minority of children are meeting the national physical

activity recommendations of 60 minutes of physical activity on all of the previous seven days.

However, very few children (less than 4%) did not participate in 60 minutes or more physical activity

on at least one of the previous seven days, suggesting that few children are completely sedentary.


This measure of meeting the national guidelines is a new item included in CAPANS 2008 and has

been shown to be reliable only for children aged around 12 years. Furthermore, it relies on child self-

report and their ability to recall their behaviour, which is known to have some measurement error,

Thus these results should be interpreted with some caution. Furthermore, direct comparison with

other state and national survey findings is difficult due to the known differences in methodologies,

instruments and age group classifications. Nevertheless, the results suggest that a significant

proportion of young Western Australians may not be participating in sufficient physical activity to

benefit their health.

Pedometer steps

Measuring physical activity using objective instruments, such as pedometers, is seen as the major

advance in the field of monitoring of physical activity. The use of objective instruments provides

a measure of physical activity that is not influenced by student recall. Pedometers were used to

measure physical activity in both CAPANS 2003 and 2008. Results of both surveys showed about

one-third of primary school boys met, or were above, recommended step counts of 15 000 steps.29

The pedometer results from CAPANS 2008 suggest a slightly greater proportion of Western Australian

primary school boys in year three, five and seven (31.7%) achieved recommended levels of physical

activity compared with the Australian National Survey, in which only 24% of boys aged 9-13 met or

were above the same recommended step count. In 2008, approximately 40% of Western Australian

primary school girls from year three, five and seven met, or were above, the recommended step

count of 12 000 steps, compared with one-third of girls aged 9-13 in the Australian National Survey.7

The proportion of Year 8, 10 and 11 secondary school children meeting physical activity

recommended step count thresholds also did not change between 2003 and 2008, with around

40% of both boys and girls meeting the recommendation. This is a much higher proportion than the

results reported in the Australian National Survey7 where only 13% of 14-16 year old boys and 16% of

14-16 year old girls met the recommendation.

When the CAPANS 2008 data are considered as continuous data (rather than looking at the proportion

meeting a threshold), there appeared to be a significant increase in the average daily steps for primary

school boys in 2008 compared with 2003. However, given that the proportion of primary school boys

meeting the recommended threshold in 2003 and 2008 were similar, it is likely that the increase in

mean number of steps is a result of already active boys participating in more physical activity, rather

than an overall increase in the number of steps taken by all primary school boys.

The pedometer results from CAPANS 2008 suggest that Western Australian children and adolescents

maintained similar physical activity participation between 2003 and 2008.

Sport, exercise and dance

Movement-based video games were the most popular form of active play for primary (70.6%) and

secondary (43.2%) school boys. These games are a new phenomenon and do not appear in other

surveys, prohibiting any comparison across recent years or other datasets. “Playing with pets” was the

most popular form of active play for primary (74.7%) and secondary school (46.5%) girls. “Jogging/

running” was the most prevalent form of “sport/exercise/dance” in primary school children and

second in secondary school children. However, it is unclear whether children reported jogging/

running that was part of another activity, such as basketball or soccer.


School physical activity

The majority of children reported that they are ‘quite often’ or ‘always’ very active during physical

education and this appears to have remained consistent between 2003 and 2008 for primary and

secondary school boys. However, there appears to have been a drop since 2003 in the proportion of

primary school girls reporting ‘quite often’ or ‘always’ being very active during physical education (71%

vs. 64% respectively). The opposite was seen for secondary school girls in a higher proportion reported

‘quite often’ or ‘always’ being very active during physical education in 2008 (66%) than 2003 (58%).

Very few (less than 4%) primary school children reported not participating in physical education

in both 2003 and 2008. However, nearly one in ten secondary school children report not doing

any physical education, although this was significantly lower in 2008 for secondary school girls

(7%) than in 2003 (14.5%). This reduction may be attributable to the 2006 Federal Government

initiative specifying that all children up to year ten, in government-funded schools, were expected to

participate in a minimum of two hours of physical activity during school hours per week.36

Just over three-quarters of primary school boys reported running around and playing ‘quite a lot’ or

‘most of the time’ during recess in both 2003 and 2008. This contrasts with primary school girls; only

50% reported running around and playing ‘quite a lot’ or ‘most of the time’ during recess in both 2008

and 2003. The proportion being more active at lunch time is higher than recess, with around four out

of five primary school boys and two-thirds of primary school girls reporting this in both 2003 and 2008.

Encouragingly, a significantly higher proportion of secondary school boys reported running

around and playing ‘quite a lot’ or ‘most of the time’ at lunchtime 2008 (38.5%) compared with 2003

(18%). However, only between 3% and 6% of secondary school girls reported running around and

playing ‘quite a lot’ or ‘most of the time’ during both recess and lunch in both 2008 and 2003. With

girls participating in significantly less physical activity than boys, recess and lunch time are ideal

opportunities in which girls’ physical activity participation could be increased.

The results suggest that schools are supporting children’s engagement in physical education during

school time.

Active commuting

Just over one-half of primary school children reported actively commuting to school at least once in

the last seven days in 2008, suggesting that there are opportunities for active commuting to occur

for at least one-half the primary school children.

However, there were no significant differences in the proportions of children who actively

commuted to school in 2008 compared with 2003. A significantly higher proportion of secondary

school children actively commuted home from school on the day before the survey in 2008

compared with 2003.

Other than to school, less than one-half of year five and seven students reported actively commuting

to any other local destination in the last week. Significantly more boys actively commuted to skate

ramps/parks/ovals/playgrounds and sports venues than girls.


Sedentary activity

Only a minority (17.0%-29.1%) of all children appeared to meet the recommendation for electronic

media activity use on all of the last seven days when reporting number of days of less than two

hours of screen time participation. The proportions meeting the guidelines in CAPANS 2008 were

higher than the 6-7% meeting the guidelines in the 2007 National survey.7 Although there was

no significant differences in the proportions of boys and girls meeting electronic screen time

recommendations, boys reported higher electronic media use than girls and there were differences

in specific screen use activity observed.

When asked in CAPANS 2008 how frequently they watched television, 70% of year three boys and

three out of five year three girls reported ‘a lot’ or ‘quite a lot’ of television watching on weekdays.

However, year three girls appeared to watch less television on the weekends than weekdays, with

less than 50% reporting ‘a lot’ or ‘quite a lot’ of television watching on weekends. Year five and seven

boys spent significantly more time watching television than the girls (51 minutes vs. 45 minutes per

day respectively). Secondary school boys spent nearly an hour on average watching television, which

was significantly more average time than secondary school girls who reported around 40 minutes.

When total screen time was considered, year five and seven boys spent significantly more average

time using screens for recreation than girls (109 minutes vs. 84.5 minutes per day respectively).

Likewise, secondary school boys spent significantly more average time using screens for recreation

than secondary school girls (103 minutes vs. 76 minutes per day respectively).

Nutrition

Food patterns

The Australian Guide to Healthy Eating6 provides guidance on the types and amounts of foods that

should be included in the typical daily diet to meet recommended nutrient intakes33 and to promote

good health5. On the day of the CAPANS 2008 24-Hour Food Diary at least eight in ten children

reported consuming foods from the recommended cereal and cereal products, milk and milk

products, meat, poultry, eggs and fish and vegetable and legume product food groups. The results

suggest that five or six in ten children consumed at least the recommended amounts of fruit or fruit

products on the day of the dietary diary. However, the results also show that about three to four in

ten consumed non-essential snack foods, confectionary or other sugar products and dishes.

Data from both the dietary diary and the food frequency questionnaire suggest an increase in the

proportion of children consuming fruit since 2003. However, 30% of Western Australian girls and

40% of boys were found to eat no fruit on the day of the 2008 survey, with 70% to 80% of secondary

school children not usually eating the minimum recommended amount of fruit. These results

are consistent with dietary survey results from NSW in 2004,34 Queensland in 200611 and the 2007

National Nutrition and Physical Activity survey26 which showed that a high proportion of children

of secondary school age were not eating the recommended amount of fruit. The differences in the

proportions of primary versus secondary school children meeting recommendations can partly be

explained by the increase from one to three in the recommended pieces of fruit per day between

the younger and older age groups.


Most children consumed vegetables on the day of the survey (CAPANS 2008), with the mean

amounts of between 200-220g eaten by those consuming vegetables, marginally below the

minimum recommended 225-375g (three to five serves per day). CAPANS 2008 food frequency data

show that about 25% of secondary school children and 40% of primary school children say they

usually achieve recommended daily vegetable intakes, with only secondary school girls showing an

increased proportion meeting recommended daily vegetable intake since 2003. The 2004 SPANS34

study also found that 15-25% of year 10 children were eating four serves of vegetables per day and

mean intakes of the vegetable food group in the National survey26 and the Queensland Survey11

were similar to the results found in CAPANS 2008.

Dairy foods were also consumed by most children on the day of the CAPANS 2008 survey, although

the proportion of secondary school girls consuming dairy foods was 4% lower in 2008 than in 2003,

and the mean amounts consumed, especially by girls (350g) were less than the recommended

amount of two to three serves (500-750g milk equivalents) per day. Whilst significantly higher

amounts of dairy food consumption were seen in 2008 compared with 2003, the mean calcium

(937mg) and magnesium (292mg) intakes of secondary school girls were less than the respective

EARs, suggesting risk of inadequate intake by a large proportion of this age group. The 2007 National

survey7 also reported high risk of inadequate calcium and magnesium intakes by secondary school

aged girls.

Nutritional quality of food choices

Evidence from CAPANS 2008 suggests that the nutritional quality of food choices has improved since

2003, especially for secondary school girls.

The food frequency questionnaire was used to assess differences in consumption of 110 food items

between 2003 and 2008. Higher frequencies of food consumption were predominantly in the

healthier food categories, particularly different types of fruit, vegetables and wholegrain bread. Foods

eaten less frequently in 2008, when compared with 2003, were predominantly the less healthy foods

and included baked goods, white bread, meat pies/sausage rolls/other savoury pastries, chocolate/

chocolate bars, lollies/confectionary, potato chips/corn chips/similar snacks, fancy sweet biscuits,

ice-cream, cordial, regular soft drink/flavoured mineral water and potato cooked with fat (chips).

Overall, secondary school girls reported more significant differences between 2003 and 2008 in

consumption than secondary school boys and primary school children.

The Dietary Guidelines for Children and Adolescents in Australia5 recommend that children over

two years of age consume reduced fat milk. The proportion of children consuming reduced fat or

skimmed milk was higher by between 6% and 13% in 2008 than in 2003 for primary school children

and secondary school girls, however not secondary school boys, with the differences in proportions

greatest for secondary school girls. Over one-half (53.8%) of secondary school girls usually

consumed reduced fat/ skimmed milk in 2008 compared with about 40% of the other groups. These

proportions were double those reported for children in Queensland11 and NSW34 and represents a

five-fold increase since 1995.25


Despite the reported changes in usual consumption of foods between CAPANS 2003 and 2008, the

distribution of energy from macronutrients found in the 24 Hour Dietary Diaries was not significantly

different between 2008 and 2003 CAPANS surveys. Whilst total energy intake varied with age and

sex, the proportion of energy contributed by macronutrients was consistent between groups with

approximately one-half (48.1%-51.3%) of daily energy intake from carbohydrates, a third (32.7%-

33.9%) from fats and the remainder from protein (16.2%-18.0%). This distribution of energy was

similar to that observed in the 2006 Queensland survey11 although energy from fat was higher than

found in the National survey26 (31%) and the level (30%) recommended by the NHMRC Dietary

Guidelines for Children and Adolescents in Australia.5 Saturated fat intake was approximately

one-half of total fat intake; and at 14.0% - 14.7% of energy intake, was substantially above the

maximum 10% recommended.

Nearly one-half of the carbohydrate consumed was derived from sugars, contributing 20%-22% of

energy intake. Whilst there are no specific recommendations for sugar intake (intrinsic or added),

the Dietary Guidelines for Children and Adolescents in Australia state that an intake of 15%-20% of

energy from sugars is not incompatible with a healthy diet for most Australians. Although in the

CAPANS 2008 sample sugar intake was at the upper end of this range, the trend across surveys

appears to be towards a decrease in intake. These results are promising compared with previous

findings where total sugars intakes of 25%-26% of energy intake were reported for children 8-15

years in the 199537, 38, 6 national dietary survey, 22%-23% for Queensland children11 in 2006 and

23%-24% for 9-16 year olds in the 2007 National survey26. In part, the 2008 CAPANS findings are

supported by the self-reported usual frequency of consumption of many sweetened foods including

sugary breakfast cereals, cordials, soft drinks, sweet biscuits and confectionary being lower in the

2008 CAPANS compared with 2003, and the mean contribution of sugars to energy intake decreased

by 1% for all children.

There appeared to be a 10% reduction in the overall energy intake of secondary school girls in

2008 when compared with 2003, however no significant differences in mean total energy intake

for primary school children or secondary school boys was noted. This reduction may be due to

increased under-reporting of intake in food diaries, as the mean daily energy intake of secondary

school girls (7826kJ) was less than the mean for primary school girls (8401kJ) in this survey.

Significant under-reporting of energy intake by secondary school age girls has been noted in other

Australian surveys11, 26 with between 30% and 50% of 13-16 year old girls in the 2007 National survey

reporting energy intakes less than the lower bound of estimated energy requirements.26 Selective

under-reporting of unhealthy foods may be an explanation for the apparent improvement of dietary

patterns of secondary school girls relative to the other children, and needs further investigation.


Body size

The proportion of primary school children and secondary school boys classified as overweight or

obese did not change significantly between 2003 and 2008 and remains around 23%. The results of

this study suggest that the previously increasing prevalence of children classified as overweight and

obese may have stabilised amongst children in Western Australia between 2003 and 2008. Similar

findings on stabilisation of the proportion of overweight and obese children were observed in a

meta-analysis of other Australian studies,39 indicating that nationally approximately 23% of children

are overweight or obese.

The 2008 results suggest that some population groups more than others may be responding to

concerns about growing levels of obesity. For example, in the 2008 CAPANS study, the proportion

of secondary school girls classified as overweight or obese appeared to have significantly decreased

in 2008 (16%) compared with 2003 (23%). No other Australian study appears to have identified such

a reduction in the proportion of overweight and obesity in any sub-group, and chance cannot be

ruled out for this finding. Moreover, in the CAPANS 2008 study, the proportion of both primary and

secondary school girls who were underweight significantly increased compared with girls in 2003.

Additionally the proportion of underweight girls in the CAPANS 2008, was somewhat higher than

the 5% - 6% of children classified as underweight in the 2007 National Survey.7

The interpretation of findings in changes in body size between the 2008 and 2003 CAPANS surveys

requires some caution for a number of reasons. Children at secondary schools in 2008 were not

randomly selected (rather the principal or school liaison selected the classes based on convenience).

Moreover, participation in the surveys was voluntary. We cannot be sure that children did not

self-select their participation in the survey based on their weight status. Data on ‘school type’ (i.e.

government/private funding) and school year group were not available for 2003 and it is possible

that the response rates by school type may have differed between 2003 and 2008. In addition,

a higher proportion of schools from medium to high socioeconomic areas participated in 2008,

compared with 2003.

Despite sampling limitations, it is evident that there are still just under one quarter of children

who are overweight or obese and concerted efforts to reduce this must be continued. Likewise,

the proportion of children classified as underweight is of concern and future research to better

understand this potential problem is warranted.


REFERENCES

1. Hancox R, Milne B, Poulton R. Association between child and adolescent television viewing and

adult health: a longitudinal birth cohort study. The Lancet. 2004;364(9430):257-262.

2. Franks P, Hanson R, Knowler W, Sievers M, Bennett P, Looker H. Childhood obesity, other

cardiovascular risk factors, and premature death. New England Journal of Medicine.

2010;362(6):485.

3. Commonwealth of Australia. Australia’s Physical Activity Recommendations for 5-12 Year Olds.

2004; Department of Health and Ageing.

4. Commonwealth of Australia. Australia’s Physical Activity Recommendations for 12-18 Year Olds.

2004; Department of Health and Ageing.

5. National Health and Medical Research Council. Food for Health. Dietary Guidelines for Children

and Adolescents in Australia. 2003; Canberra: Commonwealth of Australia.

6. Smith A, Kellett E, Schmerlaib Y. Australian Guide to Healthy Eating. 1998; Canberra: Department

of Health and Family Services.

7. Australian Government Department of Health and Ageing. Australian National Children’s

Nutrition and Physical Activity Survey- Main Findings. 2008: Barton, ACT.

8. Australian Bureau of Statistics. 2006 Census Data. 2006.

9. Tudor-Locke C, Kasse C, Williams J, Reis J. Pedometer-assessed steps taken in 30 minutes of self-selected

moderate intensity walking. 2002; Poster presentation Southwest ACSM,(Las Vegas, NV.).

10. Booth M, Oakley AD, Denney-Wilson E, Hardey L, Yang B, Dobbind T. NSW Schools physical

activity and nutrition survey (SPANS) 2004 Summary Report. 2004; NSW Department of Health.

11. Abbott R, Macdonald D, Mackinnon L, et al. Healthy Kids Queensland Survey 2006-Full Report.

2007; Brisbane: Queensland Health.

12. ABS Australian Social Trends. Children who are overweight or obese. 2009.

13. Hands B, Parker H, Glasson C, Brinkman S, Read H. Physical Activity and Nutrition Levels in Western

Australian Children and Adolescents: Report. 2004; Perth: Western Australia: Western Australian

Government.

14. Hands B, Parker H, Glasson C, S B, Read H. Results of Western Australian Child and Adolescent

Physical Activity and Nutrition Survey 2003 (CAPANS). Physical Activity Technical Report. 2004; Perth:

Western Australia: Western Australian Government.

15. Glasson C, Read H, Hands B, Parker H, Brinkman S, Miller M. Food and Nutrient Intakes in Western

Australian Children and Adolescents: Report. 2004. Perth, Western Australia

16. International Society for the Advancement of Kinanthropometry (ISAK). International Standards

for Anthropometric Assessment 2001; Underdale, SA, Australia.

17. Prochaska JJ, Sallis JF, Long B. A physical activity screening measure for use with adolescents in

primary care. Archives Pediatric Adolescent Medicine. 2001;155:554-559.

18. Wood G, Giles-Corti B, Pikora T, Bulsara M, McCormack G, Timperio A. The Travel, Environment

and Kids Project: Preliminary Findings Report. 2010;Centre for the Built Environment and Health,

School of Population Health: The University of Western Australia.

19. Schneider P, Crouter S, Bassett D. Pedometer measures of free-living physical activity:

comparison of 13 models. Medicine & Science in Sports & Exercise. 2004;36(2):331.


20. Department of Community Services and Health. National dietary survey of schoolchildren (aged

10-15 years): No.1 Foods consumed. 1985; Canberra: Commonwealth of Australia.

21. Marks GC, Webb K, Rutishauser IHE, Riley M Monitoring Food Habits in the Australian Population

Using Short Questions. 2001; Canberra: Commonwealth Department of Health and Aged Care.

22. Tudor-Locke C, Kasse C, Williams J, Reis J. Pedometer-assessed steps taken in 30 minutes of self-

selected moderate intensity walking. 2002;Poster presentation Southwest ACSM, Las Vegas, NV..

23. Foodworks Professional Edition. (Xyris software, www.xyris.com.au). 2007.

24. Food Standards Australia New Zealand.

http://www.foodstandards.gov.au/consumerinformation/ausnut2007. 2007

25. Australian Bureau of Statistics. National Nutrition Survey: Foods Eaten, Australia 1995. 1999;

Commonwealth Department of Health and Aged Care: ABS cat. no. 4804.4800.

26. Australian Government Department of Health and Ageing. 2007 Australian National Children’s

Nutrition and Physical Activity Survey - User Guide. 2008: Commonwealth of Australia.

27. SPSS for Windows, [computer program]. Version 17.0. 2008; Chicago, Il: SPSS Inc.;.

28. Little R, Lewitzky S, Heeringa S, Lepkowski J, Kessler R. Assessment of weighting methodology

for the National Comorbidity Survey. American Journal of Epidemiology. 1997;146(5):439.

29. Tudor-Locke C, Pangrazi R, Corbin C, et al. BMI-referenced standards for recommended

pedometer-determined steps/day in children. Preventive Medicine. 2004;38(6):857-864.

30. Food Standards Australia and New Zealand. Australian Food Supplement and Nutrient Database

2007 for Estimation of Population Nutrient Intakes: Explanatory Notes. 2008;

http://www.foodstandards.gov.au/_srcfiles/AUSNUT%202007%20-%20Explanatory%20Notes.

pdf(AUSNUT 2007).

31. Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in

children and adolescents: international survey. British Medical Journal. 2007; doi: 10.1136/

bmj.39238.399444.55 .

32. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight

and obesity worldwide: international survey. British Medical Journal. 2000;320(7244):1240 - 1243.

33. National Health and Medical Research Council. Nutrient reference values for Australia and New

Zealand, Including Recommended Dietary Intakes. 2006; Canberra: Commonwealth of Australia.

34. Booth M, Oakley AD, Denney-Wilson E, Hardey L, Yang B, Dobbind T. NSW Schools Physical Activity

and Nutrition Survey (SPANS) 2004 Summary Report. 2004; NSW, Department of Health.

35. Booth M, Okely A, Chey T, Bauman A. The reliability and validity of the adolescent Physical

Activity Recall Questionnaire. Medicine & Science in Sports & Exercise. 2002;34(12):1986.

36. Commonwealth of Australia. Active School Curriculum. 2006; Department of Health and Ageing.

37. Australian Bureau of Statistics. National Nutrition Survey: Nutrient Intakes and Physical

Measurements, Australia. 1998; Canberra: ABS cat. no. 4805.4800.

38. Cobiac L, Record S, Leppard P, Syrette J, Flight I Sugars in the Australian diet: results from the

1995 National Nutrition Survey. Australian Journal of Nutrition and Dietetics. 2003;60(3):152-173.

39. Olds T, Ferrar K, Tomkinson G, Maher C. Childhood obesity: the end of the epidemic? Health.

2005;29:339-342.


Notes

Physical Activity Taskforce

The Physical Activity Taskforce was established

in 2001 to oversee the development and

delivery of a whole of government and whole

of community approach to increasing physical

activity levels in Western Australians. It comprises

government, non-government, academic and

local government agencies.

There is no objection to this publication being copied in whole or in part provided there is due acknowledgement of any material quoted from the publication and after informing the Physical Activity Taskforce Secretariat.© Government of Western Australia 2010

Physical Activity Taskforce Secretariat

PO Box 329, Leederville WA 6903

T 08 9492 9630 F 08 9492 9711

W www.beactive.wa.gov.au

Contact us for more information:

No single agency or organisation will be able to increase physical activity levels on its own.

ISBN: 978-1-921648-08-3

move and munch - physical activity taskforce capans 2008 reprot.pdf · child and adolescent...

Documents