Breakfast Intake and its Association with Body Mass Index among Pre-schoolers in Taska Permata Keluarga Kuala Nerus, Terengganu
In Malaysia, breakfast is the most frequently skipped meal. Skipping breakfast has been associated with an increased risk of childhood obesity. However, this relationship has not been investigated widely among preschoolers in Malaysia. Hence, this cross-sectional study aimed to determine the association between breakfast intake and Body Mass Index (BMI) among preschoolers in Taska Permata Keluarga (TPK), Kuala Nerus. A total of 131 Malays preschoolers aged four to six years old were recruited from nine TPK using convenience sampling method. Information on sociodemographic, breakfast intake pattern and anthropometric measurements (weight and height) were obtained. Respondents consisted of 74 (56.5%) boys and 57 (43.5%) girls. Anthropometric results showed that 8.4% preschoolers were overweight and obese. Among the preschoolers, 22.1% of them were breakfast skippers. In terms of gender breakdown, 20.3% boys and 24.6% girls skipped breakfast. There was a significant association between breakfast intake and BMI status among preschoolers (p = 0.003). This indicated that preschoolers that skipped breakfast were associated with overweight or obese compared to those who consumed breakfast daily. Breakfast consumption is a marker of a healthy lifestyle which can reduce the risk of childhood obesity. This habit should be inculcated during this critical period of life in which parents play a vital role in promoting breakfast consumption among preschoolers.
Affenito, S. G., Thompson, D. R., Barton, B. A., Franko, D. L., Daniels, S. R., Obarzanek, E., … Striegel-Moore, R. H. (2005). Breakfast consumption by African-American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index. Journal of the American Dietetic Association, 105(6), 938–945.
Affinita, A., Catalani, L., Cecchetto, G., De Lorenzo, G., Dilillo, D., Donegani, G., Zuccotti, G. (2013). Breakfast: a multidisciplinary approach. Italian Journal of Pediatrics, 39(1), 44.
Ahadi, Z., Qorbani, M., Kelishadi, R., Ardalan, G., Motlagh, M. E., Asayesh, H., … Heshmat, R. (2015). Association between breakfast intake with anthropometric measurements, blood pressure and food consumption behaviors among Iranian children and adolescents: the CASPIAN-IV study. Public Health, 129(6), 740–7.
Alexy, U., Wicher, M., Kersting, M., Belanger-Ducharme, F., Tremblay, A., Jéquier, E., … Manning, C. K. (2010). Breakfast trends in children and adolescents: frequency and quality. Public Health Nutrition, 13(11), 1795–1802.
American Dietetic Association (2008). Position of the American Dietetic Association: Nutrition guidance for healthy children ages 2 to 11 years. Journal of American Dietetic Association 108(6). 1038-1047.
Aziz, M. F. A., & Devi, M. N. (2012). Nutritional status and eating practices among children aged 4-6 years old in selected urban and rural kindergarten in Selangor, Malaysia. Asian Journal of Clinical Nutrition, 4(4), 116-131.
Bellisle, F., Rolland-Cachera, M. F., Deheeger, M., & Guilloud-Bataille, M. (1988). Obesity and food intake in children: evidence for a role of metabolic and/or behavioral daily rhythms. Appetite, 11(2), 111–8.
Biddle, S. J., Gorely, T., Marshall, S. J., Murdey, I., & Cameron, N. (2004). Physical activity and sedentary behaviours in youth: issues and controversies. The Journal of the Royal Society for the Promotion of Health, 124(1), 29–33.
Cardona Cano, S., Tiemeier, H., Van Hoeken, D., Tharner, A., Jaddoe, V. W. V., Hofman, A., … Hoek, H. W. (2015). Trajectories of picky eating during childhood: A general population study. International Journal of Eating Disorders, 48(6), 570–579.
Cheng, T. S., Tse, L. A., Yu, I. T.-S., & Griffiths, S. (2008). Children’s perceptions of parental attitude affecting breakfast skipping in primary sixth-grade students. Journal of School Health, 78(4), 203–208.
Chong, K. H., Wu, S. K., Noor Hafizah, Y., Bragt, M. C. E., & Poh, B. K. (2016). Eating habits of Malaysian children: Findings of the South East Asian Nutrition Surveys (SEANUTS). Asia-Pacific Journal of Public Health, 28(5, Suppl), 59S–73S.
Deshmukh-Taskar, P. R., Nicklas, T. A., O’Neil, C. E., Keast, D. R., Radcliffe, J. D., & Cho, S. (2010). The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: The National Health and Nutrition Examination Survey 1999-2006. Journal of the American Dietetic Association, 110(6), 869–878.
Deshmukh-Taskar, P. R., Radcliffe, J. D., Liu, Y., & Nicklas, T. A. (2010). Do breakfast skipping and breakfast type affect energy intake, nutrient intake, nutrient adequacy, and diet quality in young adults? NHANES 1999-2002. Journal of the American College of Nutrition, 29(4), 407–18.
Drummond, S., Crombie, N., & Kirk, T. (1996). A critique of the effects of snacking on body weight status. European Journal of Clinical Nutrition, 50(12), 779–83.
Dubois, L., Girard, M., Potvin Kent, M., Farmer, A., & Tatone-Tokuda, F. (2009). Breakfast skipping is associated with differences in meal patterns, macronutrient intakes and overweight among pre-school children. Public Health Nutrition, 12(1), 19–28.
Fabritius, K., & Rasmussen, M. (2008). Breakfast habits and overweight in Danish schoolchildren. The role of socioeconomic positions. Ugeskrift for Laeger, 170(34), 2559–63.
Falciglia, G. A., Couch, S. C., Gribble, L. S., Pabst, S. M., & Frank, R. (2000). Food neophobia in childhood affects dietary variety. Journal of the American Dietetic Association, 100(12), 1474–1481.
Fisher, J. O., Birch, L. L., Moore, L. L., Gillman, M. W., Garrahie, E. J., Singer, M. R., … Brace, L. (1995). Fat preferences and fat consumption of 3- to 5-year-old children are related to parental adiposity. Journal of the American Dietetic Association, 95(7), 759–764.
Fleig, D., & Randler, C. (2009). Association between chronotype and diet in adolescents based on food logs. Eating Behaviors, 10(2), 115–118.
Garg, M., Rajesh, V., & Kumar, P. (2014). Effect of breakfast skipping on nutritional status and school performance of 10-16 years old children of Udupi district, Health and Population-Perspectives and Issues, 37(3&4), 98–117.
Giovannini, M., Verduci, E., Scaglioni, S., Salvatici, E., Bonza, M., Riva, E., & Agostoni, C. (2008). Breakfast: a good habit, not a repetitive custom. The Journal of International Medical Research, 36, 613–624.
Gleason, P. M., & Dodd, A. H. (2009). School breakfast program but not school lunch program participation is associated with lower body mass index. Journal of the American Dietetic Association, 109(2), S118–S128.
Horikawa, C., Kodama, S., Yachi, Y., Heianza, Y., Hirasawa, R., Ibe, Y., … Sone, H. (2011). Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: A meta-analysis. Preventive Medicine, 53(4–5), 260–267.
Hoyland, A., Dye, L., & Lawton, C. L. (2009). A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutrition Research Reviews, 22(2), 220–43.
Huang, C.-J., Hu, H.-T., Fan, Y.-C., Liao, Y.-M., & Tsai, P.-S. (2010). Associations of breakfast skipping with obesity and health-related quality of life: evidence from a national survey in Taiwan. International Journal of Obesity, 34(4), 720–725.
Institute for Public Health (IPH) (2016). National Institutes of Health, Ministry of Health Malaysia. 2016. National Health and Morbidity Survey (NHMS) 2016: Maternal and Child Health. Vol. II: Findings, pp 272
Ismail M.N., Poh B.K., Norimah A. K., Ruzita A.T., Nik MazlanMamat (2009). Nutritional status and dietary habits of primary school children in Peninsular Malaysia (2001-2002).UniversitiKebangsaan Malaysia.
Keast, D. R., Nicklas, T. A., & O’Neil, C. E. (2010). Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999-2004. American Journal of Clinical Nutrition, 92(2), 428–435.
Keski-Rahkonen, A., Kaprio, J., Rissanen, A., Virkkunen, M., & Rose, R. J. (2003). Breakfast skipping and health-compromising behaviors in adolescents and adults. European Journal of Clinical Nutrition, 57(7), 842–853.
Kontogianni, M. D., Farmaki, A.-E., Vidra, N., Sofrona, S., Magkanari, F., & Yannakoulia, M. (2010). Associations between lifestyle patterns and body mass index in a sample of Greek children and adolescents. Journal of the American Dietetic Association, 110(2), 215–221.
Lee, R.D &Nieman, D.C. (2013). Nutritional Assessment. 6th edi. McGraw HillLew, T.S.Y. (2006). Prevalence and factors influence overweight and obesity mong preschoolers (4-6 years old) in Bangi and Kajang (dissertation). UniversitiKebangsaan Malaysia, Kuala Lumpur.
Lioret, S., Volatier, J.-L., Lafay, L., Touvier, M., & Maire, B. (2009). Is food portion size a risk factor of childhood overweight? European Journal of Clinical Nutrition, 63(3), 382–391.
Miech, R. A., Kumanyika, S. K., Stettler, N., Link, B. G., Phelan, J. C., & Chang, V. W. (2006). Trends in the association of poverty with overweight among US adolescents, 1971-2004. Journal of the American Medical Association, 295(20), 2385.
Mohd Nasir, M. T., Norimah, A. K., Hazizi, A. S., Nurliyana, A. R., Loh, S. H., & Suraya, I. (2012). Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia. Appetite, 58(2), 525–530.
Mota, J., Fidalgo, F., Silva, R., Ribeiro, J. C., Santos, R., Carvalho, J., & Santos, M. P. (2008). Relationships between physical activity, obesity and meal frequency in adolescents. Annals of Human Biology, 35(1), 1–10.
Moy, F. M., Johari, S., Ismail, Y., Mahad, R., Tie, F. H., & Wan Ismail, W. A. (2009). Breakfast skipping and its associated factors among undergraduates in a public university in Kuala Lumpur. Malaysian Journal of Nutrition, 15(2), 165–74.
Moy, F. M., Ying, G. C., & Kassim, S. Z. M. (2006). Eating patterns of school children and adolescents in Kuala Lumpur. Malaysian Journal of Nutrition, 12(1), 1–10.
Nicklas, T. A., McQuarrie, A., Fastnaught, C., & O’Neil, C. E. (2002). Efficiency of breakfast consumption patterns of ninth graders. Journal of the American Dietetic Association, 102(2), 226–233.
Niemeier, H. M., Raynor, H. A., Lloyd-Richardson, E. E., Rogers, M. L., & Wing, R. R. (2006). Fast food consumption and breakfast skipping: Predictors of weight gain from adolescence to adulthood in a nationally representative sample. Journal of Adolescent Health, 39(6), 842–849.
Norimah, A. K., Mohd Nasir M.T., Hazizi, A.S., Suraya.S., Loh, H., Nurlinyana, A.R. (2014). Association of body weight status and socio-demographic factors with food habits among preschool children in Peninsular Malaysia. Malaysian Journal of Nutrition, 20(3), 303-315.
Nurul-Fadhilah, A., Teo, P. S., Huybrechts, I., & Foo, L. H. (2013). Infrequent breakfast consumption is associated with higher body adiposity and abdominal obesity in malaysian school-aged adolescents. PLoS ONE, 8(3), 1–6.
Obesity and overweight. (2018). Retrieved from World Health Organization: http://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
Pang, M.Y.M., Poh, B.K., Tham, B.L.K., Chee, W.S.S. & Tee, E.S. (2003). Assessment of knowledge, attitudes and practices on nutrition of preschool children in Klang Valley. Malaysian Journal of Nutrition, 9(2) (Suppl): S48
Papoutsou, S., Briassoulis, G., Hadjigeorgiou, C., Savva, S. C., Solea, T., Hebestreit, A., … Tornaritis, M. (2014). The combination of daily breakfast consumption and optimal breakfast choices in childhood is an important public health message. International Journal of Food Sciences and Nutrition, 65(3), 273–9.
Pérez-Morales, M. E., Bacardí-Gascón, M., & Jiménez-Cruz, A. (2012). Childhood overweight and obesity prevention interventions among Hispanic children in the United States: systematic review. Nutrición Hospitalaria, 27(5), 1415–21.
Poh, B. K., Ng, B. K., Siti Haslinda, M. D., Nik Shanita, S., Wong, J. E., Budin, S. B., … Norimah, A. K. (2013). Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia). British Journal of Nutrition, 110(S3), S21–S35.
Poh, B. K., Tham, K. B., Wong, S., Chee, W. S., & Tee, E. (2012). Nutritional status, dietary intake patterns and nutrition knowledge of children aged 5-6 years attending kindergartens in the Klang Valley, Malaysia. Mal J Nutr, 18(2), 231–242.
Preschool – Ministy of Education Malaysia. (2016). Retrieved Jun 17, 2016,from:http://www.moe.gov.my/index.php/en/sekolah/prasekolah?highlight=WyJwcmFzZWtvbGFoIl0=
Ruhaya, H., Jaafar, N., Jamaluddin, M., Rashid Ismail, A., Mastura Ismail, N., Chek Badariah, T., … Zaitun Mohamed, S. (2012). Nutritional status and early childhood caries among preschool children in Pasir Mas, Kelantan, Malaysia, Archives of Orofacial Science, 7(2), 56–62.
Szajewska, H., & Ruszczyński, M. (2010). Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Critical Reviews in Food Science and Nutrition, 50(2), 113–119.
Timlin, M. T., Pereira, M. A., Story, M., & Neumark-Sztainer, D. (2008). Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating Among Teens). Pediatrics, 121(3), e638–e645.
Tin, S. P. P., Ho, S. Y., Mak, K. H., Wan, K. L., & Lam, T. H. (2011). Lifestyle and socioeconomic correlates of breakfast skipping in Hong Kong primary 4 schoolchildren. Preventive Medicine, 52(3), 250–253.
UNICEF Malaysia - Press - Overcoming childhood obesity and malnutrition in Malaysia. (2016). Retrieved Jun 16, 2016, from: https://www.unicef.org/malaysia/media_double burden - malnutrition - obesity - children - Malaysia .htm#.WCLy59V97IW
Utter, J., Scragg, R., Mhurchu, C. N., & Schaaf, D. (2007). At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. Journal of the American Dietetic Association, 107(4), 570–576.
World Health Organization.(2006). WHO Child Growth Standards. Geneva: WHO. Retrieved Jun 16, 2016,from: http://www.who.int/childgrowth
World Health Organization.(2007). Growth Chart for Children 5–19 years. Geneva: WHO. RetrievedJun 16, 2016, from: http://www.who.int/growthref/en/
World Health Organization. (2009). WHO AnthroPlus for Personal Computers Manual: Software for Assessing Growth of the World’s Children and Adolescents. Geneva: WHO
World Health Organization. (2010). WHO Anthro for Personal Computers Manual: Software for Assessing Growth and Development of the World’s Children. Geneva: WHO.