الفهرس 
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Abstract
Summary
The internet has become the most rapidly grown medium of today’s modern life. But negative effects of internet use are the growing concern among health care providers and educators. Adolescence is a critical stage in the human life due to numerous physiological, psychological and occupational changes. These changes affect the nutritional demands and eating behavior. Healthy eating habits are fundamental to prevent diseases in adulthood. According to literature, uncontrolled use of internet is correlated to changes in the dietary behavior, diet quality, sleep pattern, physical activities and overall daily routine of students (Kamran et al., 2018).
This study aimed to assess the consequences of internet addiction on lifestyle and dietary behavior of adolescents in Assiut city. It was conducted at four public governmental secondary schools in Assiut City. The selected schools represented all directions in Assiut City. These include; El- Gamaa Al Mowhada Secondary School (for girls), Fossol El-Walidya Secondary School (for girls), Gamal Farghaly Sultan Secondary School (for boys), and Nasser El-Askarya Secondary School (for boys).
A correlational descriptive research design was used. A representative sample of 400 adolescents was recruited as a study subjects. The researcher followed a stratified sampling technique. A list of all governmental secondary schools was obtained from the directorate of education in Assiut city. One school was selected randomly from each direction in Assiut City. from each school, two classes for each grade (first and second) were chosen randomly. Each class included about (20-30) students. Data were collected during the period from the beginning of January 2018 to the end of May 2018 (5 months). Four tools were utilized to collect the data: Socioeconomic scale, life style pattern questionnaire, internet addiction test, and dietary behavior and diet quality questionnaire.
Main results of this study were:
• More than one-third of studied adolescents (36.75%) had control over internet use, while 40.75% of students had occasional to frequent problem due to internet use, and less than one-quarter of them (22.5%) had significant problem from internet use.
• Three-quarters (75%) of studied adolescents had bad quality of diet, while one-fourth (25%) of them had good quality with the mean score of diet quality 28.14±4.21.
• Males were significantly more likely to have a significant problem due to internet use than females (67.75% vs. 32.2%) The difference was statistically significant (p<0.001**). While there was no statistically significant difference between level of internet addiction and adolescents’ age (p=0.521).
• There was a statistical significant difference between levels of internet addiction and life style of the studied adolescents (p<0.001**) as regard bedtime, sleep disturbance, and tobacco use. Adolescents who had occasional to frequent problem and significant problem due to internet use complained of irregular bedtime (58.4% and 31.5% respectively). While 59% and 32% respectively were suffered from sleep disturbance.
• There were statistical significant differences between internet addiction and dietary behavior of adolescents (p < 0.001**).
• Majority of studied adolescents who had significant problem due to internet use their dietary habits had been changed to have big meal sizes and had a worse appetite, irregular and fast eating than adolescents who had control over internet use.
• A higher prevalence of skipping meal was found between adolescents who had significant problem due to internet use (87.7% skipping breakfast and 67.75% skipping dinner).
• Adolescents who had significant problem due to internet use snacked frequently, often snack more than three times per day (66.7% vs. 9.5% for studied adolescents who had control over internet use) while 69.9% of adolescents who had occasional to frequent problem due to internet usage snacked 1-2 times per day.
• Fast food was the favorite snack of 64.4% of adolescents who had significant problem due to internet use versus 8.2% of adolescents who had control over internet use. Items of snacking pattern were significantly different among adolescents based on levels of internet addiction (p<0.001**).
• The difference between internet addiction and diet quality of studied adolescents was statistically significant (p = 0.001**). The mean of consuming varied and regular diet of studied adolescents who had control over internet use was more than their counterparts (the mean was 6.8±1.3).
• Studied adolescents who had occasional to frequent problem and significant problem due to internet use were consumed the four food groups that should be consumed in limited amounts such as (fried and fatty food, salt, ice cream, cake, and drinking soda) with a mean of 14.27±2.87 and 17.16±1.41 respectively more than studied adolescents who had control over internet use. Statistical significant difference was found between diet quality and internet addiction (p=0.001**).
• Tolerance & neglecting daily routine had a higher mean score (9.43±0.65) in adolescents who had significant problem due to internet use. There was a statistical significant difference between levels of internet addiction and their domains (Interference with family relationship, salience and withdrawal, over indulgence in online relationship, and tolerance & neglecting daily routine) (p <0.001**).
Conclusion
Studied adolescents who had significant problem from internet use complained of irregular bedtime, sleep disturbance, used tobacco, eat big meals, had loss of an appetite, skipped meals, increase frequency of snacking, and had bad quality of their diet more than their counterparts who had control over internet use.
Recommendations:
Raising adolescents’ awareness about adverse effects of internet addiction on their development such as poor dietary behavior; through mass media and health education program in the schools and family-centered care.
• Implementing an educational program about how to prevent IA in adolescents.
• Health care professionals especially the pediatric nurse should educate the adolescent students what a balanced diet and optimum physical activity to remain healthy and maintain growth.