Irregular breakfast eating and health status among adolescents in Taiwan

BMC Public Health Irregular breakfast eating and health status among adolescents in Taiwan Rea-Jeng Yang 2 Edward K Wang 1 Yeu-Sheng Hsieh 0 Mei-Yen Chen 3 0 Department of Agricultural Extension, National Taiwan University , Taipei , Taiwan 1 Neurology Department, Tao-Yuan Veteran Hospital , Tao- Yuan , Taiwan 2 Nursing Department, National Taipei College of Nursing , Taipei , Taiwan 3 Nursing Department, Chang Gung Institute of Technology , Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan , Taiwan Background: Regular breakfast eating (RBE) is an important contributor to a healthy lifestyle and health status. The aims of the present study were to evaluate the relationships among irregular breakfast eating (IRBE), health status, and health promoting behavior (HPB) for Taiwanese adolescents. Methods: A cross-sectional, descriptive design was used to investigate a cluster sample of 1609 (7th -12th grade) adolescents located in the metropolitan Tao-Yuan area during the 2005 academic year. The main variables comprised breakfast eating pattern, body weight, and health promoting behaviors. Data were collected by a self-administered questionnaire. Results: A total of 1609 participants were studied, 64.1% in junior high school and 35.9% in high school, boys (47.1%) and girls (52.9%) ranging in age from 12-20 years. Of the total participant population, 28.8% were overweight and nearly one quarter (23.6%) reported eating breakfast irregularly during schooldays. The findings indicated that adolescents with RBE had a lower risk of overweight (OR for IRBE vs. RBE = 1.51, 95% CI: 1.12, 2.04), and that the odds of becoming overweight were 51% greater for IRBE than for RBE even after controlling for demographical and HPB variables. IRBE also was a strong indicator for HPB. However, the profile of the high-risk IRBE group was predominantly junior high schoolchildren and/or children living without both parents. Conclusion: This study provides valuable information about irregular breakfast eating among adolescents, which is associated with being overweight and with a low frequency of health promoting behavior. School and family health promotion strategies should be used to encourage all adolescents to eat breakfast regularly. - Background Regular breakfast eating (RBE) has been identified as an important factor in nutrition, especially during growth. Eating breakfast regularly is also an important contributor to a healthy lifestyle and health status. Several studies [14] have revealed that smoking, frequent alcohol used, and infrequent exercise were significantly associated with adolescent breakfast skipping. Moreover, many studies have shown significant relationships between skipping breakfast and depressive symptoms, stress, catching cold, chronic disease [5], and high body mass index (BMI) in adolescents [1,6-13]. Notably, Chen et al. [14] found that irregular breakfast eating (IRBE) had a significant negative association with quality of life among Japanese schoolchildren. Some studies [4,15] have shown that earlier menarche or dysmenorrheal is more common in girls with IRBE than in girls with RBE. RBE has been shown to contribute significantly to children's daily nutrient intake and nutritional well-being and to affect the adequacy of their total daily intake [4,16]. IRBE or lack of breakfast has been implicated as a contributor to poor school performances: e.g. lower attendance rate; lower scores on math, English, social study and science; impaired short-term memory, problem solving skills and mental performance; and lower class rank [1721]. Over the past decade, public health institutions around the world have placed increased emphasis on the importance of healthy lifestyles. Previous studies have shown that healthy lifestyles decrease susceptibility to disease and increase longevity [22]. Some studies on Taiwanese schoolchildren [23,24] have shown that the level of health status perception decreases with educational level, from elementary to college. Those students with a higher educational background exhibited the least health-promoting lifestyles; however, students with better health perceptions were found to exhibit better health-promoting behaviors [24]. The results of Chen et al. [23] also revealed that overweight adolescents had fewer health promoting behaviors than those who were not overweight. These findings strongly suggest that public health professionals need to take heed of what is happening to youth in Taiwan. Research has revealed that breakfast is the most important meal of the day. The aims of the present study were to evaluate the relationships among IRBE, health status, and health promoting behavior for Taiwanese adolescents. We hypothesized that IRBE is strongly related to being overweight and to negative health behaviors. We tested four hypotheses, focusing on Taiwanese adolescents, while controlling for the effects of potential confounders. The hypotheses were as follows. Hypothesis 1: there is a si (...truncated)