The intake and quality of breakfast consumption among adolescents attending public secondary schools in Potchefstroom
Regular breakfast consumption among adolescents has been linked to decreased risk of obesity and chronic diseases, improved cognition and improved nutrient intake in adolescents. Despite this, research has indicated that adolescent breakfast consumption is declining globally. Adolescents are at particularly high-risk for health compromising behaviours such as increased fast food consumption, increased sedentary levels and frequent breakfast skipping. Research shows that lifestyle and behaviour habits which are entrenched during adolescence are likely to remain throughout adulthood. The reported prevalence of breakfast skipping among different adolescent population groups in South Africa ranges from 13 to 36%. However, little is known about breakfast behaviour among adolescents in the South African context. Studying breakfast behaviour and the mechanism by which breakfast influences positive health outcomes creates an understanding of the magnitude of the problem to be addressed and guides effective recommendations for public health guidelines. The aim of the present study was to determine the proportion and quality of breakfast intake among adolescents attending public secondary schools in Potchefstroom and its surrounding areas in the Northwest Province, and to determine the effect of breakfast intake and quality on overall diet quality and other lifestyle behaviours. A cross sectional quantitative study design was used. Adolescents in grades nine to eleven (n = 254) were randomly selected from seven public secondary schools across quintiles in Potchefstroom and its surrounding areas in the Northwest Province of South Africa. A basic self-administered demographic questionnaire was used. A single 24-hour recall using the four-stage multiple pass method was conducted to obtain information on breakfast and dietary intake for the day. A self-administered questionnaire was used to select the type of breakfast usually consumed by the adolescents. Height and weight were measured by a level one anthropomotrist. Dietary data was analysed using the Medical Research Council Food Composition Tables. Breakfast quality was measured through the allocation of a breakfast quality score and the Diet Quality Index Revised (DQI-R) was used to assess the quality of the overall diet. Associations between breakfast intake and categorical characteristics were assessed by either the Chi-squared Test or Fisher’s Exact Test. Spearman correlations were used to assess the associations between breakfast quality score and continuous variables. The threshold for statistical significance was set at 0.05. The Goldberg cut-off was applied to exclude over- and under-reporters. Information was collected for 244 adolescents with a mean age of 17.5 years (± 2.3). The proportion of breakfast intake and skipping was 81% and 19% respectively. The mean breakfast quality score was 3.1 out of a possible score of 5, indicating moderate breakfast quality which incorporates one of the Australian Guide to Healthy Eating (AGHE) food groups. Breakfast intake was influenced by race, and breakfast quality was influenced by participation in physical activity. Breakfast eaters and skippers showed no significant difference in diet quality score. Breakfast quality score was marginally associated with calcium intake (p<0.0001; r=0.418), phosphorous intake (p<0.0001; r=0.378) and total diversity score (p<0.0001; r=0.369). The foods most frequently consumed at breakfast were bread, milk, ready-to-eat cereal (RTEC) and maize porridge. In conclusion, breakfast skipping proportion was consistent with published South African data. The quality of the breakfast consumed among adolescents in the present study was moderate. Cultural and socio-environmental factors may influence breakfast intake and breakfast quality among adolescents. Breakfast intake did not influence diet quality, but the intake of certain foods at breakfast improved the mean scores for components of the DQI-R and improved the intake of key nutrients. It is recommended that the governmental departments responsible for the Integrated School Health Policy (ISHP) incorporate breakfast messaging into the nutrition education component of the ISHP. Facilitators involved in implementing the ISHP, such as School-based support teams, teachers and healthcare professionals are encouraged to continue the promotion of breakfast intake among adolescents.
- Health Sciences