Document Type : original article
Assistant Professor of Nursing, Patient Safety Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
Professor of Nursing, Maternal and Child Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
PhD Candidate in Nursing, Department of Nursing, Urmia University of Medical Sciences, Urmia, Iran
Assisstant Professor, Non Communicable Disease Research Center, Ilam University of Medical Sciences, Ilam, Iran
Background: Childhood weight status is one of the important predictors of health status later in life. Some previous studies have postulated a relationship between the pattern of breakfast intake and weight status, but this relationship has not yet been clearly confirmed. This study aimed to assess the status of regularity in intake of breakfast and snacks and its relationship with weight status in elementary school students.
Method: This study was done with a descriptive-analytic design. 362 362 children (Males: 192, Females: 170 child) were selected from elementary schools of Urmia by the use of stratified cluster sampling. A dietary 24-hour recall form was used for the assessment of intakes. Data about breakfast, snacks, height, weight, and waist circumferences were collected. Children's Physical Activity Questionnaire (PAQ-C) was used to assess the participants’ physical activity level. Data were analyzed using the descriptive and inferential statistics in SPSS software.
Results: Mean student age, weight and BMI were 10.57±1.17 years, 37.44±11.30 kg and 18.4±3.39, respectively. 53.2% of girls had a regular breakfast and 55% regular snack intake. Among the boys, 46.8% had regular breakfast and 45% regular snack intake. Results showed a significant relationship between BMI and snacks consumption (p = 0.02). There was a significant relationship between the frequency of irregular breakfast intake and weight (P=0.01), but the relationship was not significant for the body mass index (P = 0.11). 58.1% of the students in the irregular breakfast group and 64.4% of those in the irregular snacks group were lean.
Conclusions: Regular intake of snacks was correlated with higher weight status and maintaining desirable BMI. Irregular breakfast intake was related to lower weight. Most students with irregular breakfast and snack intake were underweight and thin.
- Raj M, Kumar RK. Obesity in children & adolescents. The Indian journal of medical research. 2010; 132(5):598.
- Update on the Commission on Ending Childhood Obesity: report by the Director-General. Geneva [Internet]. 2015.
- Esfarjani F HA, Rostaee R, et al. Evaluation of prevalence of obesity and lifestyle in overweight primary school children of Tehran. Second Health Child Seminar; Jahad Daneshgahi2009.
- Haeri F, Shariatpanahi SP, Kafeshani M. Prevalence of Obesity in the First Grade Primary School Children in Mehriz, Iran, based on Different References of Body Mass Index. Journal of Health System Research. 2022; 17(4):0-.
- Abrams P, Katz LEL. Metabolic effects of obesity causing disease in childhood. Current Opinion in Endocrinology, Diabetes and Obesity. 2011; 18(1):23-7.
- Moore GF, Tapper K, Murphy S, Lynch R, Raisanen L, Pimm C, Moore L. Associations between deprivation, attitudes towards eating breakfast and breakfast eating behaviours in 9–11-year-olds. Public health nutrition. 2007; 10(6):582-9.
- Adair LS, Gordon‐Larsen P, Du S, Zhang B, Popkin BM. The emergence of cardiometabolic disease risk in Chinese children and adults: consequences of changes in diet, physical activity and obesity. Obesity reviews. 2014; 15:49-59.
- WHO. Global school-based student health survey (GSHS). WHO CHP. 2009.
- Saeidlou SN, Babaei F, Ayremlou P. Children malnutrition in northwestern, central and southern regions of Iran: does geographic location matter? Global journal of health science. 2014; 6(4):36.
- Llewellyn A, Simmonds M, Owen C, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta‐analysis. Obesity reviews. 2016; 17(1):56-67.
- Reinehr T. Lifestyle intervention in childhood obesity: changes and challenges. Nature Reviews Endocrinology. 2013; 9(10):607.
- Gill T. Managing and preventing obesity: Behavioral factors and dietary interventions: Elsevier; 2014.
- Murakami K, Livingstone MBE. Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003–2012. British Journal of Nutrition. 2016; 115(10):1819-29.
- Zerati M PP, Razaviyr S, Dastgiri S. Prevalence of Junk food consumption among male and female students in schools of Tabriz. Congress of nutrition; Tabriz2008.
- Taii N DS, Saki R. Survey of nutritional habits in school children in Khorramabad city. Congress of nutrition; Tabriz, Iran 2008.
- Committee DGA. Report of the dietary guidelines advisory committee on the dietary guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. Agricultural Research Service. 2010.
- Bruening M, Afuso K, Mason M. Associations of eating two breakfasts with childhood overweight status, sociodemographics, and parental factors among preschool students. Health Education & Behavior. 2016; 43(6):665-73.
- DELVARIAN ZM, KHOSRAVI A, TAGHAVI N, BOLBOL HN, SADEGHIAN F, KHATIBI MR. Nutritional Evaluation of Adolescent Middle School Girls in Shahroud. 2012.
- Hoyland A, McWilliams K, Duff R, Walton J. Breakfast consumption in UK schoolchildren and provision of school breakfast clubs. Nutrition Bulletin. 2012; 37(3):232-40.
- O'Neil CE, Nicklas TA, Fulgoni III VL. Nutrient Intake, Diet Quality, and Weight Measures in Breakfast Patterns Consumed by Children Compared with Breakfast Skippers: NHANES 2001–2008. AIMS public health. 2015; 2(3):441.
- Lawman HG, Polonsky HM, Vander Veur SS, Abel ML, Sherman S, Bauer KW, Sanders T, Fisher JO, Bailey-Davis L, Ng J, Wye GV, Foster GD. Breakfast patterns among low-income, ethnically-diverse 4 th-6 th grade children in an urban area. BMC public health. 2014; 14(1):604.
- Brown AW, Bohan Brown MM, Allison DB. Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. The American journal of clinical nutrition. 2013; 98(5):1298-308.
- Antonogeorgos G, Panagiotakos D, Papadimitriou A, Priftis K, Andricopoulos M, Nicolaidou P. Breakfast consumption and meal frequency interaction with childhood obesity. Pediatric obesity. 2012; 7(1):65-72.
- Wang L, Zhou B, Zhao Z, Yang L, Zhang M, Jiang Y, Li Y, Zhou M, Wang L, Huang Z, Zhang X, Zhao L, Yu D, Li C, Ezzati M, Chen Z, Wu J, Ding G, Li X. Body-mass index and obesity in urban and rural China: Findings from consecutive nationally representative surveys during 2004–18. The Lancet. 2021; 398(10294):53-63.
- WHO. www.who.int/entity/mediacentre/factsheets/fs311/en/ who Report. 208.
- Rodig NM, Roem J, Schneider MF, Seo-Mayer PW, Reidy KJ, Kaskel FJ, Kogon AJ, Furth SL, Warady BA. Longitudinal outcomes of body mass index in overweight and obese children with chronic kidney disease. Pediatric Nephrology. 2021; 36(7):1851-60.
- Moore JB, Hanes Jr JC, Barbeau P, Gutin B, Treviño RP, Yin Z. Validation of the Physical Activity Questionnaire for Older Children in children of different races. Pediatric Exercise Science. 2007; 19(1):6-19.
- Janz KF, Lituchy EM, Wenthe P, Levy SM. Measuring activity in children and adolescents using self-report: PAQ-C and PAQ-A. Medicine and science in sports and exercise. 2008; 40(4):767-72.
- Jeans MR, Asigbee FM, Landry MJ, Vand Yousefi S, Ghaddar R, Leidy HJ, Davis JN. Breakfast consumption in low-income hispanic elementary school-aged children: associations with anthropometric, metabolic, and dietary parameters. Nutrients. 2020; 12(7):2038.
- Rahimi T, Dehdari T, Ariaeian N, Gohari M. Survey of breakfast consumption status and its predictors among Qom students based on the Pender's health promotion model constructs. Iranian Journal of Nutrition Sciences & Food Technology. 2012; 7(2):75-84.
- Doostan F, Hosseini Nasab A, Kamyab S. Assessment of Dietary Behaviour and its Relationship with Body Mass Index among Junior High School Girls in Kerman during 2012-2013. Journal of Health and Development. 2016; 5(4):285-96.
- Hanson T, Austin G, Lee-Bayha J. Student health risks, resilience and academic performance in California. California Healthy Kids Survey Factsheet. 2003; 1.
- Ahadi Z, Qorbani M, Kelishadi R, Ardalan G, Motlagh ME, Asayesh H, Zeynali M, Chinian M, Larijani B, Shafiee G, Heshmat R. Association between breakfast intake with anthropometric measurements, blood pressure and food consumption behaviors among Iranian children and adolescents: the CASPIAN-IV study. Public Health. 2015; 129(6):740-7.
- Smetanina N, Albaviciute E, Babinska V, Kalinauskiene L, Albertsson-Wikland K, Petrauskiene A, Verkauskiene R. Prevalence of overweight/obesity in relation to dietary habits and lifestyle among 7–17 years old children and adolescents in Lithuania. BMC Public Health. 2015; 15(1):1001.
- Shakeri M, Mojtahedi Y, Moradkhani M. Obesity among female adolescents of Tehran schools. Journal of Payavard Salamat. 2013; 6(5):403-11.
- Blondin S, Anzman‐Frasca S, Django H, Economos C. Breakfast consumption and adiposity among children and adolescents: an updated review of the literature. Pediatric obesity. 2016; 11(5):333-48.
- Maffeis C, Grezzana, Perrone L, Del Giudice EM, Saggese G, Tatò L. Could the savory taste of snacks be a further risk factor for overweight in children? Journal of pediatric gastroenterology and nutrition. 2008; 46(4):429-37.
- Solhi M, Jazayeri S, Amiri F. Snack consumption status and obesity in secondary school male students. Rahavard Salamat Journal. 2016; 2(3):27-37.