Gender impact on children's knowledge and perceptions regarding cardiovascular disease risk factors: A school-based survey in Greece.

Background: Cardiovascular disease (CVD) risk factors are adopted during childhood and adolescence. Health literacy at these ages remains the cornerstone of a healthy adult life. The aim of the study was to examine the role of gender regarding CVD risk factors' awareness and to develop an evaluation tool for the assessment of CVD risk factors' knowledge and perception among children.

Methods: During the school years 2014-2015 and 2015-2016, 1728 students aged 10-12 years (5th and 6th grade), from 5 Greek cities (including Athens metropolitan area), were enrolled; nearly 45% were boys (participation rate varied from 95% to 100% from school to school). Students and their parents completed an anonymous questionnaire; students' somatometric characteristics were also recorded. Schools were randomly selected. Linear regression models were applied to evaluate the impact of children's gender on knowledge and perceptions about CVD risk factors.

Results: Significant higher percentage of correct answers, among girls compared to boys, was revealed regarding the weekly consumption of legumes, the breakfast weekly consumption, and the effects of soft drinks on health (all < 0.05). As far as CVD risk factors' knowledge, significantly higher percentage of girls than boys also answered that high blood pressure and television viewing are bad for health and particularly for heart-related problems (all < 0.05). Girls had a significantly higher mean score of 0.304 than boys, after adjusting for several confounders ( = 0.029).

Conclusion: Health education programs should take into account gender differences in children's perception and attitudes toward CVD risk factors, in order to increase awareness of children and eventually reduce CVD risk during adulthood.