Abstract
BackgroundIn developed countries, regular breakfast consumption is inversely associated with excess weight and directly associated with better dietary and improved physical activity behaviors. Our objective was to describe the frequency of breakfast consumption among school-going adolescents in Delhi and evaluate its association with overweight and obesity as well as other dietary, physical activity, and sedentary behaviors.MethodsDesign: Cross-sectional study. Setting: Eight schools (Private and Government) of Delhi in the year 2006. Participants: 1814 students from 8th and 10th grades; response rate was 87.2%; 55% were 8th graders, 60% were boys and 52% attended Private schools. Main outcome measures: Body mass index, self-reported breakfast consumption, diet and physical activity related behaviors, and psychosocial factors. Data analysis: Mixed effects regression models were employed, adjusting for age, gender, grade level and school type (SES).ResultsSignificantly more Government school (lower SES) students consumed breakfast daily as compared to Private school (higher SES) students (73.8% vs. 66.3%; p<0.01). More 8th graders consumed breakfast daily vs.10th graders (72.3% vs. 67.0%; p<0.05). A dose–response relationship was observed such that overall prevalence of overweight and obesity among adolescents who consumed breakfast daily (14.6%) was significantly lower vs. those who only sometimes (15.2%) or never (22.9%) consumed breakfast (p<0.05 for trend). This relationship was statistically significant for boys (15.4 % vs. 16.5% vs. 26.0; p<0.05 for trend) but not for girls. Intake of dairy products, fruits and vegetables was 5.5 (95% CI 2.4-12.5), 1.7 (95% CI 1.1-2.5) and 2.2 (95% CI 1.3-3.5) times higher among those who consumed breakfast daily vs. those who never consumed breakfast. Breakfast consumption was associated with greater physical activity vs. those who never consumed breakfast. Positive values and beliefs about healthy eating; body image satisfaction; and positive peer and parental influence were positively associated with daily breakfast consumption, while depression was negatively associated.ConclusionDaily breakfast consumption is associated with less overweight and obesity and with healthier dietary- and physical activity-related behaviors among urban Indian students. Although prospective studies should confirm the present results, intervention programs to prevent or treat childhood obesity in India should consider emphasizing regular breakfast consumption.
Highlights
In developed countries, regular breakfast consumption is inversely associated with excess weight and directly associated with better dietary and improved physical activity behaviors
Breakfast consumption was significantly lower among older students as compared to younger students (Chi-square statistic=12.09; P=0.027), higher among Government schools than Private schools (Chi-square statistic=14.26; P=0.002), and higher among 8th graders than 10th graders (Chi-square statistic=7.97; P=0.019)
It was observed that the prevalence of overweight and obesity was lowest overall among those students who consumed breakfast daily (14.6%), higher among those who consumed breakfast sometimes (15.2%) and highest among never breakfast consumers (22.9%) (F-test statistic=3.25; P=0.039 for trend)
Summary
Regular breakfast consumption is inversely associated with excess weight and directly associated with better dietary and improved physical activity behaviors. Our objective was to describe the frequency of breakfast consumption among school-going adolescents in Delhi and evaluate its association with overweight and obesity as well as other dietary, physical activity, and sedentary behaviors. It is estimated that 30% of obesity begins in childhood [1], and about 50-80% of obese children become obese adults [2] This epidemic is well-described in the developed world, far fewer studies have been conducted in developing countries, like India, where the prevalence is escalating [3]. In higher SES classes in India, the prevalence of overweight and obesity among school-aged youth is on par with the prevalence in many countries of the developed world [4]. The need for preventive interventions is great and this should be driven by etiologic research, which is lacking in this context at present
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