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doi: 10.4103/0970-258X.255771
PMID: 31044773

Breakfast-eating habits of school-going adolescents in Kochi, Kerala, India

Ann John Kurien, Anjali Rejiv, Anusree Premarajan, BA Renjini, PS Rakesh
 Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita University, Coimbatore, Tamil Nadu, India

Corresponding Author:
P S Rakesh
Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita University, Coimbatore, Tamil Nadu
rakeshrenjini@gmail. com
How to cite this article:
Kurien AJ, Rejiv A, Premarajan A, Renjini B A, Rakesh P S. Breakfast-eating habits of school-going adolescents in Kochi, Kerala, India. Natl Med J India 2018;31:188
Copyright: (C)2018 The National Medical Journal of India

Breakfast is generally considered as the important meal of the day. It has many benefits for the quality of diet and cognitive and academic performance of adolescents and schoolchildren.[1],[2],[3] A systematic review found that young adults skipped breakfast more frequently than other main meals and rates of skipping breakfast ranged from 14% to 88.5%.[4] Many studies have shown that adolescents who do not skip their breakfast are less likely to be overweight or obese as compared to those who skip breakfast.[5],[7] However, a systematic review suggested that several longitudinal studies and randomized controlled trials failed to establish the inverse association between regular breakfast consumption and excess body weight.[8],[9] In view of the increase in the number of overweight schoolchildren in Kochi, Kerala,[10] we were curious whether there was an association between skipping breakfast and obesity, as it is a potentially modifiable risk factor.

We studied 373 school-going adolescents in the age group of 13¯15 years from three government-aided schools to determine the frequency of skipping breakfast and its association with body mass index (BMI) in Kochi. Along with the medical examination at schools, a structured questionnaire was administered to students of standards VIII and IX. The questionnaire included details of sociodemographic profile, questions regarding their usual breakfast habits, reasons for skipping breakfast and anthropometric measurements. The summary statistics are presented as frequencies and percentages. Chi-square test was used to test differences between proportions, and independent sample t-test was used to test differences between continuous variables.

Among the participants, 59.7% were men. In the study, 137 (36.7%; 95% CI 31.8%–41.6% reported going to school without having breakfast in the past 30 days and 38 (10.2%; 95% CI 7.1%– 13.3%) of schoolchildren reported that they skipped breakfast for three or more days in a usual week. On the day of the study, 32 (8.6%) had not had breakfast. The reasons for skipping breakfast reported in order of frequency (n=38) were lack of time (20), conscious about body image (10), not hungry in the morning (4), don’t like breakfast foods (2) and others (2). Sex (odds ratio [OR] 1.04, 95% CI 0.47– 2.29; p=0.547) or residential status (OR 0.88, 95% CI 0.37–2.10; p=0.49) were not associated with skipping breakfast. The mean (SD) BMI of school-going adolescents who reported skipping breakfast more than three times a week and less than that were 18.64 (3.56) and 18.75 (7.40), respectively (mean difference 0.10, SE of difference 1.21 [95% CI –2.29 to 2.49]; p=0.712).

The habit of skipping breakfast among school-going adolescents in our study was less than what has been reported from Andhra Pradesh (50%) and comparable with the results from Delhi (30%) and Hyderabad (34%).[3],[7] However, we could not find any association between skipping breakfast and BMI. This is in contrast to many cross-sectional studies, but consistent with the findings of systematic reviews.[8],[9] The association between skipping breakfast and obesity status could be due to many confounders such as physical activity and dietary energy intake or due to reverse causality bias. It is also possible that associations between breakfast consumption and BMI may not be consistent across different regions of the world in children with diverse cultural and socioeconomic backgrounds.

Our study highlights that skipping breakfast is a problem among school-going adolescents in Kochi. However, we did not find any association between BMI and skipping breakfast in our study.

Hoyland A, Dye L, Lawton CL. A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 2009;22:220-43.
[Google Scholar]
Nicklas TA, Myers L, Reger C, Beech B, Berenson GS. Impact of breakfast consumption on nutritional adequacy of the diets of young adults in Bogalusa, Louisiana: Ethnic and gender contrasts. J Am Diet Assoc 1998;98:1432¯8.
[Google Scholar]
Gajre NS, Fernandez S, Balakrishna N, Vazir S. Breakfast eating habit and its influence on attention-concentration, immediate memory and school achievement. Indian Pediatr 2008;45:824-8.
[Google Scholar]
Pendergast FJ, Livingstone KM, Worsley A, McNaughton SA. Correlates of meal skipping in young adults: A systematic review. Int J BehavNutrPhys Act 2016;13:125.
[Google Scholar]
de la Hunty A, Gibson S, Ashwell M. Does regular breakfast cereal consumption help children and adolescents stay slimmer? A systematic review and meta-analysis. Obes Facts 2013;6:70-85.
[Google Scholar]
Szajewska H, Ruszczynski M. Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Crit Rev Food SciNutr 2010;50:113-19.
[Google Scholar]
Arora M, Nazar GP, Gupta VK, Perry CL, Reddy KS, Stigler MH, et al. Association of breakfast intake with obesity, dietary and physical activity behavior among urban school-aged adolescents in Delhi, India: Results of a cross-sectional study. BMCPublic Health 2012;12:881.
[Google Scholar]
Mesas AE, Muñoz-Pareja M, López-García E, Rodríguez-Artalejo F. Selected eating behaviours and excess body weight: A systematic review. Obes Rev 2012;13:106-35.
[Google Scholar]
Brown MM, Milanes JE, Allison DB, Brown AB. Eating compared to skipping breakfast has no discernible benefit for obesity-related anthropometrics: Systematic review and meta-analysis of randomized controlled trials. FASEB J 2017;31 Suppl 1:lb363.
[Google Scholar]
10 Raj M, Sundaram KR, Paul M, Sudhakar A, Kumar RK. Dynamics of growth and weight transitions in a pediatric cohort from India. Nutr J 2009;8:55.
[Google Scholar]

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