Sexual and urban vs. Rural differences in dietary habits and physical activity of school-age children in the Municipality of Jagodina, Serbia

The purpose of this research was to assess the differences between the sexes when it comes to dietary habits and physical activity of elementary school students from urban and rural environments in Serbia, as well as to analyse the differences among children of the same sex depending on their place of residence. The cross-sectional study was conducted in elementary schools on the territory of the Municipality of Jagodina in the Pomoravlje District in the period from March to May 2025. The data were collected using an anonymous structured questionnaire that encompassed dietary and physical activity habits. Descriptive methods and χ² test (p<0.05) were used for statistical analysis. The research encompassed 978 students, aged 11 to 14 (12.42 ± 1.03), including 483 (49.0%) girls and 495 (51.0%) boys, of which 810 students came from urban environments, while 168 were from rural environments. In urban environments, the majority of dietary habits showed no significant difference between the sexes (p>0.05). Significant differences were observed in meat consumption (p = 0.002), soft drink consumption (p = 0.004), as well as in self-assessment of healthy nutrition (p = 0.001), with boys showing more meat and soft drink consumption, while girls were more likely to report healthier habits. A difference in physical activity was also observed (p<0.001), with boys participating more in organised sports. In rural environments, there were no significant differences in diet between the sexes (p>0.05), with the only significant difference observed in physical activity (p = 0.006), again more prevalently in boys. Significant differences were found between girls from urban and rural environments in the habit of eating breakfast (p = 0.005), consumption of fruit (p = 0.002), nutrition self-assessment (p = 0.008), and physical activity (p<0.001), with girls from urban environments showing more favourable habits. Among boys, the only difference was observed in the habit of consuming breakfast (p = 0.001), while the other parameters showed no significant differences, including the parameter of physical activity (p = 0.22). Dietary and physical activity habits were mostly equally distributed, but there were some significant differences between the sexes and children with different places of residence. Girls reported healthier habits, while boys were more physically active; the differences were more pronounced between girls, depending on whether they lived in urban or rural environments. The observed differences indicate the need for a targeted, gender-sensitive, and context adapted interventions, aimed at improving dietary and physical activity habits among school-age children in urban and rural environments.