effect of breakfast skipping on nutritional …...skipping was also prevalent in lower...

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EFFECT OF BREAKFAST SKIPPING ON NUTRITIONAL STATUS AND SCHOOL PERFORMANCE OF 10-16 YEARS OLD CHILDREN

OF UDUPI DISTRICT

Meenakshi Garg*, Vidya Rajesh** and Pawan Kumar***

ABSTRACT

Insight into breakfast consumption of children and adolescents is of public health concern, for several reasons as it has been associated with positive outcomes for diet quality, micronutrient intake, BMI status and lifestyle factors. Studies suggest that eating a breakfast which contains sufficiently balanced nutrients has a beneficial impact on both student health – in terms of nutrient intake height-to-weight ratio and early physical development– and cognitive skills such as focused attention and memory recall. Skipping breakfast or consuming an inadequate breakfast contributes to dietary inadequacies that are seldom compensated for at other meals. Present study aims at studying the effect of breakfast skipping on the nutritional status and cognition of school going children. An exploratory cross sectional study was undertaken to assess and compare the nutritional status of school going children eating breakfast and those skipping it. The total sample size was 195 school going students aged 10-16 years old. Chi-square test and t-test were used for statistical analysis using SPSS software.

According to the results of the current study, the prevalence of breakfast skipping among school going children of age 10-16 years old is 23.50% in selected areas of Udupi district. More number of breakfast skippers were found to be overweight

*Assistant Professor, Selection Grade and HOD, Department of Allied Hospitality Studies, Manipal University, Manipal-576104, Karnataka, India, E-mail: [email protected]. **Dietitian, Kasturba Hospital, Manipal, Karnatak, India. *** Professor, Department of Community Medicine, KMC, Manipal, Karnataka, India.

Health and Population - Perspectives and Issues 37 (3 & 4), 98-117, 2014

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than breakfast non-skippers (p =0.992). The intakes of cereals (p<0.01), milk (p<0.001), vegetables (p<0.05), and fruits (p<0.05) were significantly less in breakfast skippers. However intakes of fat (p<0.05) and miscellaneous foods (p<0.05) like junk food that are high in saturated fat were significantly high in breakfast skippers than breakfast non-skippers. A significant difference was also seen in a no. of parameters like memory (p<0.001), concentration (p<0.001), grades obtained (p<0.001), attendance (p<0.001) etc between breakfast skippers and breakfast non-skippers. The study indicates that skipping breakfast affects both the nutritional status as well as the school performance of the students. The study strongly favours breakfast plays an important role for adequate nutrition of school children and has a major impact on cognition.

Key words: Breakfast skipping, Cognition, BMI, Nutritional status, Food groups.

Skipping breakfast has become the norm in modern day India because of changes in family lifestyle. When this happens largely among children, it can result in their suboptimal growth and development – a factor important to the future human resource development of the country1. Breakfast is regarded by many as “the most important meal of the day”, because an adequate food intake at the beginning of the day helps to ensure that nutrient needs by the body for the reminder of the day are likely to be met. The problem children face when attempting morning school work on an empty stomach appears to be at least partly due to low blood glucose2. Breakfast has been suggested to positively effect learning in children in terms of behaviour, cognitive, and school performance. To maintain this higher metabolic rate, a continuous supply of energy derived from glucose is needed; hence breakfast consumption may be vital in providing adequate energy for the morning. Children who habitually consume breakfast are more likely to have favorable nutrient intakes including higher intake of dietary fiber, total carbohydrate and lower total fat and cholesterol3. Increased consumption of bakery items, snacking between meals, family meals, skipping breakfast (in older children), were found to be related to waist circumference4. Skipping breakfast or consuming an inadequate breakfast contributes to dietary inadequacies that are seldom compensated for at other meals. Contribution of breakfast to a person’s health status over time is particularly relevant for children whose daily dietary intake barely meets the requirements5. If the transitory

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metabolic changes due to skipping were to occur frequently, they would be likely to have a cumulative adverse effect that may place a child’s progress at risk. On average twenty percent of children skip breakfast on a regular basis. Research has shown that participation in a school breakfast programme significantly increased student’s academic performance and significantly reduced absenteeism and tardiness6.

Very less published work is available on the prevalence of breakfast skipping in school going children in India. Also very few studies regarding comparison of nutritional status of school going children skipping and having breakfast has been done in Manipal and Udupi. It is also of great concern that very few studies have considered nutritional parameters like the quality of diet, as most of them have concentrated on cognitive functions with regards to breakfast skipping. Thus, to explore the topic in depth the study was undertaken.

METHODOLOGY

The study was an exploratory, cross sectional study. It was carried out in several schools of Udupi district. Data was collected from selected samples, tabulated and analyzed over a period of 4 months. The estimated sample size was 195 school children from 3 selected schools. Inclusion criteria: School children of Age: 10-16 years. Tools used were interview schedule, Kuppuswamy scale (2007) and SPSS Package Version 16.0. Demographic profiles, anthropometric measurement like current weight, height, body mass index (BMI) were collected and analyzed using WHO criteria. The data collected was coded using statistical analysis tool. Chi-square and t-tests were used for the statistical testing.

FINDINGS AND DISCUSSION

According to the findings of the current study, the prevalence of breakfast skipping among school going children aged 10-16 years old is 23.50 per cent in selected areas of Udupi district. Other studies have reported that 20 per cent of the children and 31.5 per cent of adolescents were breakfast skippers7 and 78 per cent of children usually had breakfast, but 22 per cent reported skipping breakfast. Habits of skipping breakfast were observed among 41 per cent of subjects in a study of lifestyle of adolescent girls in Chandigarh8. Around 20–30 per cent of the children and adolescents skip breakfast in the developed world3.

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TABLE 1

SOCIO DEMOGRAPHIC CHARACTERISTICS

Parameters

Breakfast /Skippers

N=46

Breakfast Non-Skippers

N=149

Chi-SquareValue P-Value

Age (yrs) 10 to 14 6(13.2%) 45(30.2%)9.625* <0.05

>14 to <16 40(86.8%) 104(69.8%)

GenderMale 33(71.7%) 92(61.7%)

9.425* <0.05Female 13(28.3%) 57(38.3%)

ClassEighth 14(30.4%) 51(34.2%)

0.910NS 0.634Ninth 18(39.1%) 47(31.5%)Tenth 14(30.4%) 51(34.2%)

Socio

E c o n o m i c -Status

Higher 0 (0%) 30(20.1%)

14.332** <0.01Upper middle 9(19.6%) 33(22.1%)Lower middle 12(26.1%) 21(14.1%)Upper lower 18(39.1%) 53(35.6%)Lower 7(15.2%) 12(8.1%)

Family typeNuclear 18(93.1%) 79(53%)

2.721NS 0.100Joint 28(60.9%) 70(47%)

**indicates significance at 1 per cent level * significance at 5 per cent level NS: Not Significant

FIGURE 1

PREVALENCE OF BREAKFAST SKIPPING

23.58%

76.41%

PREVALENCE OF BREAKFAST SKIPPING

BREAKFAST SKIPPERSBREAKFAST NON-SKIPPERS

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The above table depicts results of chi square test applied on various parameters .Children aged >14yrs (p<0.05), more number of males (p <0.05), class ninth children (p=0.634) , with socio economic status of upper lower / middle class (p<0.01) and children of nuclear family (p=0.100) skipped breakfast.. This would be because at the age of around 14yrs, children tend to become more conscious about their health and start trying new methods and steps to lose weight, look attractive, etc. One of the methods for the same is skipping of breakfast. Also children at this age like to spend more time with friends and classmates than family, thus come early to school skipping breakfast. The findings of the current study is supported by a study which resulted, the results of the logistic regression analysis showed that breakfast-skipping was more frequent, older children9. More number of male students (71.7%) was found to have skipped breakfast than females. The same was observed in case of students having breakfast regularly, i.e. more no. of male students (61.7%) had breakfast regularly than females (38.3%). The findings of the current study is supported by a study which resulted, breakfast consumption was most frequent among boys. Students from higher socio-economic class are more pampered and have numerous options available for meals i.e. can afford to skip meals and then later compensate for the same by eating outside, unlike students of lower socio-economic group. Breakfast skipping was also prevalent in lower socio-economic class this may be because of the unavailability of food because of poor economic conditions. The finding of the current study is supported by a study which resulted, breakfast skipping appears to be a more prevalent behavior among low-income and minority school children10. A highly significant significance was seen between socio-economic status and breakfast skipping.

TABLE 2

PERCEPTION OF CHILDREN REGARDING IMPORTANCE OF BREAKFAST AND HEALTH CONSCIOUSNESS

Parameters

Breakfast Skippers

N=46


N=149


Health

Consciousness

Yes 20 (43.47%) 27(18.1%)

31.435** 0.000No 9 (19.56%) 32(21.5%)

Moder-ately 17(36.95%) 90(60.4%)

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Parameters

Breakfast Skippers

N=46


N=149


Do You Feel Any Difference In Your Efficiency To Wo r k / C o n c e n -trate If You Don’t Consume Break-fast?

Yes 25 (54.5%) 122 (81.9%)

13.777** 0.000No 21 (45.5%) 27(18.1%)

Is It Important To Have Meals Regu-larly?

Yes 29(63.1%) 133(89.3%)

13.740** 0.000No 17(36.9%) 16(10.7%)

Does Breakfast Influence Body F u n c ti o n i n g , Physical/Mental?

Yes 22(47.8%) 133(89.3%)

15.583** 0.000No 24(52.2%) 16(10.7%)

Do You Feel Weak Or Tired While At-tending School Without Having Breakfast?

Yes 24(52.2%) 133(89.3%)

18.181** 0.000No 22(47.8%) 16(10.7%)

Does Skipping Breakfast Affect Memory?

Yes 30(65.2%) 125(83.9%) 15.044** 0.001

No 16(34.8%) 24(16.10%)

Does Skipping Breakfast Affect School Atten-dance?

Yes 27(58.7%) 116(77.9%) 4.811* 0.028

No 19(41.3%) 33(22.1%)

Does Skipping Breakfast Affect Concentration?

Yes 29(63.1%) 131(87.9%) 11.601** 0.001

No 17(36.9%) 18(12.1%)

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Parameters

Breakfast Skippers

N=46


N=149


Does Skipping Breakfast Affect Physical Activity?

Yes 18(39.1%) 132(88.6%) 14.892** 0.001

No 28(60.9%) 17(11.4%)

Do You Aspire To Have Breakfast Daily?

Yes 24(52.2%) 149(100%) 36.520** 0.001

No 22(47.8%) 0

** Significant at 1 per cent *significant at 5 per cent NS: not significant

The above table depicts an association between breakfast skipping and health consciousness of the students. A highly statistical significance was seen between breakfast skipping and health consciousness. At this age teens tend to be more self conscious about the way they look, thus choosing skipping breakfast as one of the means to lose weight. They perceived themselves to be overweight in spite of having normal weight and carried on weight loss practices8. More of the students were found to be moderately conscious about their health. The above also shows the perception of students about the importance of meals, particularly breakfast. More number of breakfast non-skippers feel that it is important to have meals regularly, it does influence the body functioning (physical /mental), they do feel weak or tired while attending school without having breakfast, it does affect memory, attendance concentration and physical activity. Less number of breakfast skippers felt the same. Skipping breakfast impairs attention and short-term memory. Moreover, the impairment increases over time. Most of the breakfast skippers aspired to have breakfast daily, as they knew there are some benefits of having breakfast regularly.

Table 3 shows the pattern of meal skipping among breakfast skippers and non-skippers. Mid-morning meal was never skipped by any of the breakfast skippers while in case of breakfast non-skippers it was never skipped by (14.09%) and everyday by (85.90%). This is possibly because breakfast skippers tend to become hungrier by mid-morning than breakfast non-skippers. As breakfast skippers are devoid of energy (food) after dinner till the time of any mid-morning break. Therefore breakfast skippers never skip midmorning meal, unlike breakfast non-skippers.

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TABLE 3

COMPARISON OF SKIPPING MEALS BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

Para

met

ers

Freq

uenc

y

Brea

kfas

t Ski

pper

s

N=4

6

Brea

kfas

t N

on-

Skip

pers

N=1

49

Chi-S

quar

e

P-Va

lue

Skip mid-m o r n i n g meal/school tiffin

Never 46(100%) 21(14.09%)

19.50** <0.001Everyday 0 128(85.90%)

Skip Lunch Never 46(100%) 149(100%)0.567 NS 0.451

Everyday 0 0

Skip evening supper

Never 41(89.1%) 138(92.6%)0.423 NS 0.473

Everyday 5(10.9%) 11(7.4%)**Significant at 1 per cent NS: not significant

Evening supper was never skipped by (89.1%) of the breakfast skippers, while it was never skipped by (92.6%) of breakfast non-skippers. After school i.e. after attending all the classes, playing games, walking back to home etc. students tend to become very hungry and tried, therefore there is a instant need of energy (food). Therefore, a larger percentage of students never skipped evening supper. Lunch was never skipped by any of the breakfast skippers and non-skippers. By lunch time students tend to get hungry and it is often assumed to the important meal, students sit together for lunch, as they share Tiffin, socialize, discuss etc. Most of the students receive lunch from school free of cost as a part of Mid-Day Meal Programme. Therefore no student skipped lunch. It was observed that breakfast skippers had higher intakes of energy, protein as compared to breakfast non-skippers, this is a result of consumption of food items high on fat, sugar, sodium mostly junk food for mid morning and evening meals. About two-third of the subjects (60.9%) were consuming three meals a day followed by 29.7% two meals a day. Six of the subjects (4.7%) consumed one meal in a day and same percentage consumed 4 meals in a day8.

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TABLE 4

COMPARISON OF REASONS FOR SKIPPING MEALS BY BREAKFAST SKIPPERS AND NON-SKIPPERS

Parameter Frequency Breakfast Skippers N=46

Breakfast

Non-Skippers

N=149

Chi-Suare P-Value

Reasons for s k i p p i n g meal

Lack of time 14(30.4%) 59(39.6%)

5.019 NS 0.170

Loss of ap-petite 13(28.3%) 46(30.6%)

No variety of food 11(23.9%) 32(21.5%)

Not avail-able 8(17.4%) 12(8.1%)

NS: Not Significant

Most common reason for skipping breakfast among breakfast skippers and non-skippers was lack of time. Breakfasts being the first meal of the day i.e. posts dinner, most of the students tend to be hungry, but due to lack of time as they may get up late, may get let for the school bus. In an attempt to not miss school, students skip breakfast as they do not consider it an important meal, as most of the students are unaware of the importance of meals, especially breakfast. Different reasons for skipping breakfast as, for example, single parents might be too busy to prepare breakfast, while older girls may be dieting in order to lose weight9. Adolescents perceived themselves to be overweight as compared to their actual weight status and half of the girls belonging to all weight categories adopted weight loss measures like exercising, skipping meal, starving, binge eating and diet pills8.

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TABLE 5

COMPARISON OF EATING OUTSIDE BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

Parameter Breakfast Skippers N=46


N=149Chi-Suare P-Value

Eat outside/canteen

Mostly 37(80.4%) 1(0.75%)

14.362** <0.001S o m e -times 9(19.6%) 106(71.1%)

Rarely 0 34(22.8%)Never 0 8(5.4%)


Eating outside/canteen was found mostly, more by breakfast skippers than breakfast non-skippers. The frequency of eating outside was less in case of breakfast non-skippers. As breakfast skippers tend to get hungry during break time, they eat outside/from canteen, to suffice the hunger.

TABLE 6

COMPARISON OF POCKET MONEY RECEIVED BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

ParameterBreakfast Skippers

N=46

Breakfast

Non-Skippers

N=149

Chi-Square P-Value

Pocket money received

Mostly 26(56.5%) 45(30.2%)

15.265** 0.002S o m e -times 20(43.5%) 78(52.0%)

Rarely 0 26(17.5%)

Pocket money was received mostly, more by breakfast skippers than non skippers. Breakfast skipping is largely seen in higher socio economic class. In case if both parents are working, due to lack of time, breakfast is not prepared at all, or may be monotonous. To compensate for the loss of food, parents tend to give money to the kids, so that they can purchase some food items and eat.

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TABLE 7

COMPARISON OF MEMORY AND CONCENTRATION PROBLEMS FACED BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

Parameters

B r e a k f a s t Skippers

N=46


N=149

Chi-Square P-Value

Memory problemsYes 35 (76.1%) 74 (49.7%)

14.779** <0.001No 11 (23.9%) 75 (51.3%)

Do you feel any dif-ference in your effi-ciency to work/con-centrate if you don’t consume breakfast?

Yes 25 (54.4%) 122 (81.9%)

13.777** <0.001No 21(45.6%) 27(18.1%)

** significant at 1 per cent *significant at 5 per cent NS: not significant

A difference was seen in the no. of students with memory problems. Memory problem was found to exist more in case of breakfast skippers than breakfast non-skippers. A series of 8 questions regarding cognition were asked in the questionnaire such as, are you experiencing increased difficulty at learning new tasks, do you frequently forget material you have just read, are you forgetting people’s names or work given to you. As per the answers given, children were scored and categorized. According to the scores obtained children were assessed for memory problems. Breakfast skippers are less attentive and concentrate less in class, as because of an empty stomach they find it difficult to listen to the classes but would rather think of food items.

The above table shows an association between breakfast skipping and efficiency to work/ concentrate. More number of breakfast skippers felt a difference in their efficiency to work/concentrate without having breakfast, than breakfast consumers. A highly statistical significance was seen between breakfast skipping and efficiency to work/concentrate. Studies generally demonstrate that eating breakfast has a positive effect on children’s cognitive performance, particularly in the domains of memory and attention. Short term changes in cognitive function

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during lessons (e.g., memory and attention) may therefore translate, with habitual breakfast consumption, to meaningful changes in school performance by an increased ability to attend to and remember information during lessons3.

The dietary micronutrient deficiencies associated with children’s skipping breakfast may carry additional adverse consequences for cognitive function10. At the very least, breakfast consumption improves school attendance and enhances equality the students’ diets. Regular habit of eating breakfast as opposed to irregular consumption or skipping breakfast altogether had beneficial influence on attention-concentration, memory and school achievement5.

TABLE 8

COMPARISON OF GRADES OBTAINED BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

ParametersBreakfast Skippers N=46


N=149

Chi-SquareValue

Significance Value

GRADESA+ - 6(4.0%)

26.583 ** <0.001A 17(37.0%) 109(73.2%)

B 25(54.34%) 32(16.41%)

C 4(8.69%) 2(1.02%)


None of the breakfast skippers scored A+ grade, while a few of breakfast non-skippers. More number of breakfast non-skippers scored A grade than breakfast skippers. More number of breakfast skippers scored C grade than breakfast non skippers. Breakfast skippers tend to attend school in empty stomach, thus pay less attention in the classes. If they follow the same pattern during exams, breakfast skippers will not score well in exams as they will be less attentive and also their concentration power will be less, therefore they score less grades than breakfast non-skippers. None of the breakfast skippers scored A+ grade, while a few of breakfast non-skippers. More number of breakfast non-skippers scored a grade than breakfast skippers. More number of breakfast skippers scored C grade than breakfast non-skippers. A highly statistical significance was seen between breakfast skipping and attendance. Children may be particularly vulnerable to the nutritional effects of breakfast on brain activity and associated cognitive,

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behavioral, and academic outcomes. In a large sample of adolescents aged 15–16 years, that those who never ate breakfast were twice as likely to have lower self-reported school grades compared with those who consumed breakfast every day (7 days/week). This finding was consistent in boys and girls3.

More number of hours was spent in studying at home by breakfast non skippers than skippers. Completing homework was always more by breakfast non skippers than breakfast skippers. As breakfast non-skippers tend to have more concentration and attention span, they spent more time in studying at home. As breakfast non-skippers, are more attentive in class, they tend to always complete homework in time. Breakfast skippers being less attentive, tend to be forgetful and thus the percentage of completion of homework on time is comparatively less. The increase in on-task behaviour following breakfast may indicate that children who eat breakfast are more able to concentrate, pay attention and are more alert at school. This is supported by evidence that demonstrates positive effects of breakfast on cognitive performance including attention and memory11. Number of hours spent in watching TV or surfing was found more in breakfast skippers than breakfast non skippers. As breakfast skippers spent less time in studying or completing homework, they invest more time in watching TV/surfing net or playing games. There were very few subjects involved in vigorous activities and most of them were engaged in indoor activities like doing household chores, watching TV and listening to music for as long as seven hours a day8.

TABLE 9

COMPARISON OF NO. OF HOURS STUDYING AND WATCHING TV/SURFING NET BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

ParametersBreakfast Skippers

N=46

B r e a k f a s t Non-Skippers

N=149

Chi-Square P-Value

No. of hours studying at home

>3 5(10.9%) 19(12.8%)

10.532* 0.0142-3 23(50.0%) 98(65.8%)

2-1 18(39.1%) 32(21.5%)

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TABLE 10

COMPARISON OF HOMEWORK COMPLETION BY BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

PARAMETERS BreakfastSkippers N=46

BreakfastNon-Skippers N=149

Chi-Suare P-Value

Complete homework on time

Always 3 (6.5%) 82 (55.0%)

96.842** 0.000Mostly 18 (39.1%) 64 (43.0%)

Some time 24 (52.2%) 0

Rarely 1 (2.2%) 3 (2.0%)

TABLE 11

COMPARISON OF ATTENDANCE OF BREAKFAST SKIPPERS AND BREAKFAST NON-SKIPPERS

Breakfast S k i p p e r s N=46

Breakfast Non-SkippersN=149

Chi-SquareValue

S i g n i fi c a n c e Value

ATTENDANCE 75-100% 9(19.6%) 68(45.6%) 13.055** p=0.001

74.9-50% 32(69.56%) 80(40.3%)

49.9-25% 5(10.86%) 1(0.67%)


The above table depicts an association between breakfast skipping and percentage of attendance in school. A highly statistical significance was seen between breakfast skipping and attendance. Breakfast skippers had less school attendance than breakfast non skippers. Attendance of breakfast skippers was found to be better than breakfast non-skippers, as breakfast skippers tend to miss the micronutrients as a part of breakfast food items, thus owing lower immunity. They are more vulnerable to suffer from infections, fever etc. Also breakfast non-

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skippers are more susceptible to diseases like diarrhea as outside food is poor in hygiene and constipation as a lack of fiber in diet. These factors lead to a decreased percentage of attendance. Iron, vitamins (foliate, thiamine, riboflavin, niacin, vitaminB6, and vitamin B12) and Vitamin D– 60 per cent higher in children who regularly eat breakfast as compared with breakfast skippers3.

The mean intake of food group servings was compared between breakfast skippers and non-skippers. It was seen that in case of cereals, pulse, milk, fish/meat/poultry, green leafy vegetables, roots, other vegetables and fruits, the no. of servings were higher for breakfast non-skippers as compared to breakfast skippers. While in case of food groups like sugar, fat and miscellaneous foods, the no. of servings were higher for breakfast skippers when compared to breakfast non-skippers. A significant difference was seen between the mean no. of servings in case of cereals, milk, GLV, fruit, fat, and miscellaneous foods.The energy and protein composition of breakfasts eaten by the children indicated that those who did not skip breakfast met one-quarter to one third of their total daily energy and protein requirements1. Cereals and vegetables were consumed in adequate quantity. Dietary habits of adolescents consisted of consumption of large amount of junk food items and inadequate consumption of pulses and fruits. There were few subjects who were eating fruits, milk/milk products regularly8. Some evidence suggested that quality of habitual breakfast, in terms of providing a greater variety of food groups and adequate energy, was positively related to school performance. Some evidence suggested that increased quality of habitual breakfasting terms of providing a greater variety of food groups (3–4) and adequate energy (>20–25% of total estimated energy needs) is positively related to school performance3.

TABLE 12

COMPARISON OF MEANS OF FOOD GROUPS (SERVINGS) CONSUMPTIONBETWEEN BREAKFAST SKIPPERS AND NON-SKIPPERS

Food Group (Serving)

Breakfast Skippers

(Mean±Sd)


(Mean±Sd)

T-Value P-Value

Cereal 7.46±2.60 8.617±2.48 2.688** <0.01Pulse 1.37±0.57 1.54±0.53 1.781NS 0.076Milk 2.600±0.96 3.436±1.04 4.77** <0.001Fish/meat/poul-try

0.73±0.4800 0.76±0.54 0.328NS 0.743

GLV 0.462±1.2 0.673±2.1 0.299* <0.05Roots 0.733±0.26 0.766±0.25 0.216NS 0.829

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Other veg 0.766±0.24 0.789±0.244 0.803NS 0.423Fruit 0.305±2.34 0.739±2.13 0.709* <0.05Sugar 3.82±0.89 3.69±0.87 0.856NS 0.393Fat 6.17±2.15 5.11±1.23 2.523* <0.05Miscellaneous 2.04±1.08 0.95±0.25 0.565* <0.05


TABLE 13

BMI OF THE STUDENTS

ParametersBreakfast Skippers

N=46

BreakfastNon-Skippers

N=149

Chi-Square Value P-Value

BMI

U n d e r w e i g h t (<18.50kg/m2) 12 (26.1%)

39

(26.2%)

0.106NS 0.992Normal( 18.50-24.90 kg/m2) 24 (52.2%)

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69.1%)

Overweight(25.00-29.00kg/m2) 10 (21.7%) 7 (4.7%)

NS: Not Significant

In the current study, more numbers of breakfast non-skippers (69.1%) were found to have BMI in normal range than breakfast skippers (52.2%) whereas more number of breakfast skippers (21.73%) were found to be overweight than breakfast non-skippers (4.7%). This may possibly be a result of more consumption of junk food i.e. high in saturated fat, by breakfast skippers. As breakfast skippers tend to eat outside food during break hours and most of the food items available are high in saturated fat for instance, samosa pav, vadapav, veg and non-veg puffs, deep fried chips etc. leading to overweight and obesity. 2.9% of the sample reported never eating regularly and while 17.2 per cent reported daily consumption of junk food. Young people who reported eating irregularly and consuming junk food daily were at a significantly greater risk of poorer mental (OR 5.41, 95% confidence interval 4.03–7.25 and 2.75, 95% confidence interval 1.99–3.78) and physical health (OR 4.56, 95% confidence interval 3.56–5.85 and 2.00, 95% confidence interval 1.63–2.47)12. For children skipping breakfast, fast food comes handy in school. A positive correlation of increased fast food consumption, skipped breakfasts and increased

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body mass index was found among adolescents13.The finding of the current study is supported by many studies which resulted, the most important risk factor for overweight and obesity was skipping breakfast. Breakfast skipping was associated with being overweight11. A prospective study also found that skipping breakfast was associated with weight gain14.

FIGURE 2

COMPARISON OF FREQUENCY OF MISCELLANEOUS FOOD CONSUMPTIONBREAKFAST SKIPPERS AND NON-SKIPPERS

Tea ,coffee 28%

Magi 0%

Ice creams 0%

Chocolates 33%

Indian (samosa,puff

,pakora, pavbhaji)

4% Candies

0%

Cakes 0%

Pastries 0%

Plain biscuits 7%

Cream biscuits 0%

Chips/lays/kurkure/chakkuli

14%

Bournvita ,horlicks

14%

5-6 times/week

Tea ,coffee 0%

Magi 0%

Ice creams 0% Chocolates

12%

Indian (samosa,puff,

pakora,pavbhaj) 56% Candies

0%

Cakes 0%

Bread 0%

Pastries 0%

Plain biscuits 0%

Cream biscuits 0%

Chips/lays/ kurkure/ chakkuli

32%

Bournvita,horlicks 0%

5-6 times /week

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BREAKFAST SKIPPERS

The above pie charts show a significant difference in the type and amount of food items consumed by children. Breakfast skippers consumed more amounts of junk food stuffs for instance Samosa, pakora, etc as compared to breakfast skippers. In case of breakfast non skippers consumption of healthy proprietary drinks, biscuit was observed. Junk and fast food was also consumed but by lesser number of students. Junk food and fast foods are high in Trans-fat and saturated fat, thus leading to a higher BMI in children, if consumed in higher amounts. Such dietary practices may lead to childhood obesity and co-morbidities in adulthood. Lifestyle choices have an impact throughout life and it can be measured by health behaviour, leisure-time activities and social relations8.

TABLE 14

COMPARISON OF FOOD GROUP CONSUMPTION WITH RDA

Food Group Breakfast Rda (Servings)

Mean Values T-Value P-Value

CEREAL Skipper 8 7.46±2.60 12.106** <0.001Non-skipper 8.617±2.48 11.023** <0.01

PULSE Skipper 1 1.377 4.403** <0.001Non-skipper 1.543 12.316** <0.001

MILK Skipper 5 2.600 16.719** <0.001Non-skipper 3.436 18.209** <0.001

FISH/MEAT/POULTRY

Skipper 1 0.7685 5.03NS 0.532Non-skipper 0.731 4.02NS 0.245

GLV Skipper 1 0.462 7.220** <0.001Non-skipper 0.673 13.903** <0.001

ROOTS Skipper 1 0.733 7.408** <0.001Non-skipper 0.766 11.653** <0.001

OTHER VEG Skipper 1 0.7668 6.24NS 0.532Non-skipper 0.7337 5.02NS 0.654

FRUIT Skipper 1 0.305 6.133** <0.001Non-skipper 0.739 12.562** <0.001

FAT Skipper 5 6.17 1.430NS 0.214Non-skipper 5.11 1.637NS 0.145


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On comparison of food group consumption with RDA of both breakfast skippers and non-skippers, it was found that most of the RDA values were not met by either of the groups of students. But it was found that more breakfast non-skippers had a higher mean value, i.e. more closer to the RDA as compared to breakfast skippers. Fat and pulse RDA were exceeding in case of breakfast non-skippers than breakfast skippers, because of high consumption of outside food rich in trans-fat. A significant difference was seen between cereal, pulse, milk, GLV, roots and tubers, and fruit consumption as compared to the RDA values, indicating that the students are consuming lesser than the required amounts. A previous study of breakfast eating patterns of Indian school children reported that breakfast eaters showed deficient intakes of iron, b-carotene and niacin, whereas breakfast skippers had distinctly lower values than breakfast eaters1.

CONCLUSION

According to the findings of the current study, the prevalence of breakfast skipping among school going children of age 10-16 years old is 23.50 per cent in selected areas of Udupi district. Breakfast skipping affects a number of parameters like memory, concentration, grades obtained, attendance, etc. along with lesser intake of nutritious food items like cereal, milk, vegetables, fruits and in turn increases consumption of miscellaneous foods like junk food that are high in saturated fat. Thus, skipping breakfast affects both the nutritional status and the school performance of the students. There were certain limitations like; weight for age of the students could have been considered as one of the anthropometric parameter, in order to assess the nutritional status. The type of residence of the students, i.e. hostel/home was considered, as it would have affected the breakfast skipping pattern. If in future a study is done on the same topic; a detailed 24 hour recall can be used to calculate the nutrient content of the diets. Equal number of girls and boys can be taken for better comparison. A comparative study between the pattern of breakfast skipping between students of government and private school can be done. As school going children and adolescents are the foundations for lifestyle adaptation in the coming years, there is a need on the part of parents, teachers and health professionals to motivate them towards healthy lifestyle by healthy eating practices. This can give rise to future healthy generation.

REFERENCES

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effect of breakfast skipping on nutritional …...skipping was also prevalent in lower...

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