Skipping Breakfast and Eating Breakfast Away From Home Were Prospectively Associated With Emotional and Behavioral Problems in 115,217 Chinese Adolescents

Overview

Journal J Epidemiol

Specialty Public Health

Date 2021 Jun 21

PMID 34148915

Citations 8

Authors

Wei-Jie Gong

Daniel Yee-Tak Fong

Man-Ping Wang

Tai-Hing Lam

Thomas Wai-Hung Chung

Sai-Yin Ho

Affiliations

Soon will be listed here.

Abstract

Background: Breakfast is deemed the most important meal of the day. We examined the prospective associations of breakfast habits with emotional/behavioral problems in adolescents and potential effect modification.

Methods: 115,217 Primary 6 students (United States Grade 6; mean age, 11.9; standard deviation [SD], 0.59 years) who attended the Student Health Service of Department of Health in Hong Kong in 2004/05, 2006/07, 2008/09 were followed till Secondary 6 (United States Grade 12). Emotional/behavioral problems were biennially examined using Youth Self-Report since Secondary 2 (United States Grade 8). Lifestyles were biennially examined using standardized questionnaires since Primary 6. Prospective associations of breakfast habit with emotional/behavioral problems and potential effect modification were examined using generalized estimating equations.

Results: Compared with eating breakfast at home, eating breakfast away from home was significantly associated with total emotional/behavioral problems and seven syndromes, including withdrawal, somatic complaints, anxiety/depression, thought problems, attention problems, delinquent behaviors, and aggressive behaviors (adjusted odds ratios [AORs] 1.22-2.04), while skipping breakfast showed stronger associations with the above problems and social problems (AORs 1.34-2.29). Stronger associations were observed in younger students for total and attention problems (P < 0.03) and in those with lower weight status for delinquent behaviors (P = 0.005).

Conclusion: Eating breakfast away from home and especially skipping breakfast were prospectively associated with adolescent emotional/behavioral problems. The associations weakened with increasing age for total emotional/behavioral and attention problems, and weakened with higher weight status for delinquent behaviors, highlighting the vulnerability of younger and underweight children. If the associations are causal, increasing home breakfast may reduce adolescent emotional/behavioral problems and benefit psychosocial health.

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References

Wang W, Du X, Guo Y, Li W, Teopiz K, Shi J . The associations between sleep situations and mental health among Chinese adolescents: A longitudinal study. Sleep Med. 2021; 82:71-77. DOI: 10.1016/j.sleep.2021.03.009. View

Wallinius M, Delfin C, Billstedt E, Nilsson T, Anckarsater H, Hofvander B . Offenders in emerging adulthood: School maladjustment, childhood adversities, and prediction of aggressive antisocial behaviors. Law Hum Behav. 2016; 40(5):551-63. DOI: 10.1037/lhb0000202. View

Fanjiang G, Kleinman R . Nutrition and performance in children. Curr Opin Clin Nutr Metab Care. 2007; 10(3):342-7. DOI: 10.1097/MCO.0b013e3280523a9e. View

Tajik E, Latiffah A, Awang H, Siti NurAsyura A, Chin Y, Azrin Shah A . Unhealthy diet practice and symptoms of stress and depression among adolescents in Pasir Gudang, Malaysia. Obes Res Clin Pract. 2015; 10(2):114-23. DOI: 10.1016/j.orcp.2015.06.001. View

Kessler R, Berglund P, Demler O, Jin R, Merikangas K, Walters E . Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005; 62(6):593-602. DOI: 10.1001/archpsyc.62.6.593. View

Keski-Rahkonen A, Kaprio J, Rissanen A, Virkkunen M, Rose R . Breakfast skipping and health-compromising behaviors in adolescents and adults. Eur J Clin Nutr. 2003; 57(7):842-53. DOI: 10.1038/sj.ejcn.1601618. View

Fayet-Moore F, Kim J, Sritharan N, Petocz P . Impact of Breakfast Skipping and Breakfast Choice on the Nutrient Intake and Body Mass Index of Australian Children. Nutrients. 2016; 8(8). PMC: 4997400. DOI: 10.3390/nu8080487. View

Hariri A, Holmes A . Genetics of emotional regulation: the role of the serotonin transporter in neural function. Trends Cogn Sci. 2006; 10(4):182-91. DOI: 10.1016/j.tics.2006.02.011. View

Lakens D . Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013; 4:863. PMC: 3840331. DOI: 10.3389/fpsyg.2013.00863. View

10.

Brassai L, Piko B, Steger M . Meaning in life: is it a protective factor for adolescents' psychological health?. Int J Behav Med. 2010; 18(1):44-51. DOI: 10.1007/s12529-010-9089-6. View

11.

Ryder A, Yang J, Zhu X, Yao S, Yi J, Heine S . The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America?. J Abnorm Psychol. 2008; 117(2):300-313. DOI: 10.1037/0021-843X.117.2.300. View

12.

Eby G, Eby K . Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006; 67(2):362-70. DOI: 10.1016/j.mehy.2006.01.047. View

13.

Leung P, Kwong S, Tang C, Ho T, Hung S, Lee C . Test-retest reliability and criterion validity of the Chinese version of CBCL, TRF, and YSR. J Child Psychol Psychiatry. 2006; 47(9):970-3. DOI: 10.1111/j.1469-7610.2005.01570.x. View

14.

Cohen J . A power primer. Psychol Bull. 2009; 112(1):155-9. DOI: 10.1037//0033-2909.112.1.155. View

15.

Nas A, Mirza N, Hagele F, Kahlhofer J, Keller J, Rising R . Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk. Am J Clin Nutr. 2017; 105(6):1351-1361. DOI: 10.3945/ajcn.116.151332. View

16.

Adolphus K, Lawton C, Champ C, Dye L . The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review. Adv Nutr. 2016; 7(3):590S-612S. PMC: 4863264. DOI: 10.3945/an.115.010256. View

17.

Lien L . Is breakfast consumption related to mental distress and academic performance in adolescents?. Public Health Nutr. 2007; 10(4):422-8. DOI: 10.1017/S1368980007258550. View

18.

Gong Q, Li H, Zhang X, Zhang T, Cui J, Xu G . Associations between sleep duration and physical activity and dietary behaviors in Chinese adolescents: results from the Youth Behavioral Risk Factor Surveys of 2015. Sleep Med. 2017; 37:168-173. DOI: 10.1016/j.sleep.2017.06.024. View

19.

Leung B, Wiens K, Kaplan B . Does prenatal micronutrient supplementation improve children's mental development? A systematic review. BMC Pregnancy Childbirth. 2011; 11:12. PMC: 3039633. DOI: 10.1186/1471-2393-11-12. View

20.

Hoyland A, Dye L, Lawton C . A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev. 2009; 22(2):220-43. DOI: 10.1017/S0954422409990175. View