Hyun-Suk Kim; Ui-Suk Lee; Seon-Hyeong Kim; Youn-Soo Cha

doi:10.4163/jnh.2019.52.2.217

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Kim, Lee, Kim, and Cha: Evaluation of dietary habits according to breakfast consumption in Korean adolescents: based on the 6th Korea National Health and Nutrition Examination Survey, 2013~2015∗

Research Article

J Nutr Health 2019;52(2):217-226.

Published online: 19 January 2019

DOI: https://doi.org/10.4163/jnh.2019.52.2.217

Evaluation of dietary habits according to breakfast consumption in Korean adolescents: based on the 6^th Korea National Health and Nutrition Examination Survey, 2013~2015^∗

Hyun-Suk Kim^1,², Ui-Suk Lee^1,², Seon-Hyeong Kim^1,², Youn-Soo Cha^2,^3,^†

¹Department of Nutrition, Chonbuk National University Hospital, Jeonju, Jeonbuk 54907, Korea

²Department of Food Science and Human Nutrition, Chonbuk National University, Jeonju, Jeonbuk 54895, Korea

³Department of Obesity Research Center, Chonbuk National University, Jeonju, Jeonbuk 54895, Korea

^†To whom correspondence should be addressed. tel: +82-63-270-3822 e-mail: cha8@jbnu.ac.kr

^∗ This work was carried out with the support of 'Cooperative Research Program for Agriculture Science & Technology Development (Project No.PJ0133722019)' Rural Development Administration, Republic of Korea.

Received 8 February 2019 Revised 6 March 2019 Accepted 14 March 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

This study examined the nutrient intake and dietary habits based on breakfast consumption in Korean adolescents.

Methods:

The data of the 2013~2015 Korea National Health and Nutrition Examination Survey (KNHANES) were used in this study. The analysis included 1,281 adolescents aged 12 to 18 years. The subjects were divided into two groups (EBF: eating breakfast, n=911; SBF: skipping breakfast, n=370).

Results:

The EBF group was significantly younger than the SBF group. In addition, the EBF group had a significantly lower frequency of skipping dinner than the SBF group. The EBF group consumed significantly higher levels of most nutrients except for vitamin A than the SBF group. The percent of nutrient intake under the EAR (estimated average requirements) in the EBF group were also significantly lower than that in the SBF group. Moreover, the NAR (nutrient adequacy ratio) and MAR (mean adequacy ratio) of the EBF group were significantly higher than those of the SBP group. The intake of cereal, sugars and sweeteners, vegetables, and eggs in the EBF group was significantly higher than that in the SBF group.

Conclusion:

The habit of skipping breakfast in adolescents leads to a decrease in the total nutrient intake and imbalanced dietary habits. Breakfast consumption in adolescence is very important. Therefore, more studies will be needed to develop nutrition education systematically in Korean adolescents.

Keywords: adolescents, eating breakfast, nutrient intake, food intake, dietary habit

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Table 1.

General characteristics of the subjects

Variables	EBF (n = 911)¹⁾	SBF (n = 370)²⁾	Total (n = 1,281)	p-value
Age (yrs)	14.90 ± 0.07³⁾	15.45 ± 0.11	15.07 ± 0.06	0.0001^∗∗∗4)
Sex (n (%))
Boys	489 (53.6)	181 (48.3)	670 (52.0)	0.142⁵⁾
Girls	422 (46.4)	189 (51.7)	611 (48.0)	(χ² = 3.041)
Family income level (n (%))
Low	73 (8.5)	60 (17.6)	133 (11.3)	0.002∗∗
Middle low	243 (28.2)	100 (26.2)	343 (27.6)	(χ² = 22.692)
Middle high	312 (34.1)	123 (31.3)	435 (33.2)
High	283 (29.2)	87 (24.9)	370 (27.9)
Height (cm)	164.9 ± 0.34	164.3 ± 0.46	164.7 ± 0.28	0.286
Weight (kg)	58.6 ± 0.47	58.9 ± 0.77	58.7 ± 0.42	0.795
BMI (kg/m²)	21.4 ± 0.14	21.7 ± 0.24	21.5 ± 0.12	0.334
Normal (%)	78.9	78.1	78.6	0.224
Overweight (%)	10.3	8.1	9.6	(χ² = 3.503)
Obesity (%)	10.9	13.9	11.8
Waist circumference (cm)	71.6 ± 0.36	72.1 ± 0.63	71.8 ± 0.32	0.479

¹⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

²⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

³⁾ Age-adjusted mean ± SE (except age and sex)

⁴⁾ Different between two groups at α = 0.05 by ANCOVA test adjusted for complex

⁵⁾ Different between two groups at α = 0.05 by Rao-Scott chi = square test

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

Table 2.

Dietary habits of the subjects

Variables	EBF (n = 911)¹⁾	SBF (n = 370)²⁾	Total (n = 1,281)	p-value³⁾
Frequency of eating-out
≥ 2 time/d	142 (17.2)⁴⁾	63 (18.9)	205 (17.7)	0.015^∗
1 time/d	268 (19.1)	126 (33.9)	394 (30.6)	(χ² = 21.605)
5 ~ 6 time/w	470 (49.6)	154 (38.4)	624 (46.1)
3 ~ 4 time/w	11 (1.7)	12 (3.2)	23 (2.2)
1 ~ 2 time/w	13 (1.7)	9 (3.6)	22 (2.3)
1 ~ 3 time/m	6 (0.7)	5 (1.4)	11 (0.9)
None (< 1 time/m)	1 (0.1)	1 (0.7)	2 (0.3)
Skipping lunch
Yes	86 (10.9)	37 (11.1)	123 (10.9)	0.905
No	825 (89.1)	333 (1.9)	1,158 (89.1)
Skipping dinner
Yes	52 (5.9)	44 (12.1)	96 (7.9)	0.001^∗∗∗
No	859 (94.1)	326 (87.9)	1,185 (92.1)

¹⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

²⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

³⁾ Different between two groups at α = 0.05 by Rao-Scott chi = square test

⁴⁾ 4) n (%)

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

Table 3.

Daily food intakes from each food group of the subjects

Variables	EBF (n = 911)¹⁾	SBF (n = 370)²⁾	Total (n = 1,281)	p-value³⁾
Total food (g)	1,544.72 ± 27.32⁴⁾	1,275.67 ± 40.32	1,460.97 ± 22.76	0.0001^∗∗∗
Cereals (g)	361.46 ± 7.22	284.82 ± 9.16	337.82 ± 5.79	0.0001^∗∗∗
Potato and starches (g)	70.88 ± 4.97	59.36 ± 7.20	67.72 ± 4.17	0.185
Sugars and sweetners (g)	19.44 ± 1.34	18.89 ± 2.16	19.28 ± 1.14	0.029^∗
Pulses (g)	51.18 ± 4.68	46.13 ± 7.86	49.90 ± 4.27	0.554
Nuts and seeds (g)	4.34 ± 0.69	3.27 ± 0.77	4.05 ± 0.56	0.289
Vegetables (g)	238.12 ± 9.87	172.64 ± 8.84	218.23 ± 7.49	0.0001^∗∗∗
Fungi and mushrooms (g)	15.67 ± 1.90	12.20 ± 1.83	14.64 ± 1.50	0.171
Fruits (g)	246.35 ± 13.95	233.25 ± 22.94	242.86 ± 12.24	0.618
Meats (g)	172.99 ± 7.94	171.45 ± 11.20	172.54 ± 6.34	0.913
Eggs (g)	49.45 ± 2.10	38.64 ± 3.35	46.52 ± 1.77	0.007^∗∗
Fish and shellfishes (g)	79.29 ± 5.54	71.20 ± 7.74	77.13 ± 4.67	0.384
Seaweeds (g)	25.22 ± 3.85	33.79 ± 10.33	27.21 ± 3.72	0.445
Milks (g)	256.82 ± 9.10	240.66 ± 16.23	252.39 ± 8.18	0.367
Oils and fat (g)	9.92 ± 0.43	10.10 ± 0.82	9.97 ± 0.38	0.849
Beverages (g)	350.90 ± 18.61	384.28 ± 30.66	361.81 ± 16.52	0.343
Seasoning (g)	38.38 ± 1.69	32.52 ± 2.76	36.60 ± 1.46	0.070
Prepared and processed food (g)	183.19 ± 38.83	83.41 ± 25.43	147.93 ± 31.09	0.109
Other (g)	8.14 ± 2.43	9.06 ± 7.74	8.33 ± 2.66	0.911

¹⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

²⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

³⁾ Different between two groups at α = 0.05 by ANCOVA test adjusted for complex sampling design

⁴⁾ Age-adjusted mean ± SE

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

Table 4.

Daily nutrient intakes of the subjects

Variables	EBF (n = 911)¹⁾	SBF (n = 370)²⁾	Total (n = 1,281)	p-value³⁾
Energy (kcal)	2,343.94 ± 38.20⁴⁾	1,935.57 ± 54.42	2,216.82 ± 31.11	0.0001^∗∗∗
Protein (g)	84.17 ± 1.93	68.46 ± 2.48	79.28 ± 1.49	0.0001^∗∗∗
Fat (g)	62.85 ± 1.48	56.95 ± 2.30	61.01 ± 1.27	0.030^∗
Carbohydrate (g)	351.66 ± 5.65	277.89 ± 7.52	328.69 ± 4.53	0.0001^∗∗∗
Fiber (g)	20.07 ± 0.46	15.24 ± 0.56	18.57 ± 0.37	0.0001^∗∗∗
Cholesterol (mg)	330.86 ± 10.51	255.66 ± 12.79	307.45 ± 8.26	0.0001^∗∗∗
Vitamin A (ugRE)	713.43 ± 34.40	660.31 ± 93.17	696.90 ± 36.59	0.598
Vitamin B₁ (mg)	2.18 ± 0.05	1.75 ± 0.07	2.04 ± 0.04	0.0001^∗∗∗
Viamin. B₂ (mg)	1.54 ± 0.03	1.25 ± 0.05	1.45 ± 0.03	0.0001^∗∗∗
Niacin (mg)	17.35 ± 0.41	13.79 ± 0.52	16.24 ± 0.33	0.0001^∗∗∗
Vitamin C (mg)	77.57 ± 3.16	60.11 ± 4.73	72.13 ± 2.67	0.002^∗∗
Calcium (mg)	525.06 ± 13.06	410.85 ± 18.41	489.51 ± 11.61	0.0001^∗∗∗
Phosphorus (mg)	1,194.23 ± 21.72	920.94 ± 28.32	1,109.17 ± 17.47	0.0001^∗∗∗
Sodium (mg)	3,738.07 ± 90.25	3,050.37 ± 129.72	3,524.01 ± 74.56	0.0001^∗∗∗
Potassium (mg)	2,840.63 ± 54.77	2,223.06 ± 78.38	2,648.40 ± 45.40	0.0001^∗∗∗
Iron (mg)	17.73 ± 0.81	13.44 ± 0.64	16.39 ± 0.62	0.0001^∗∗∗
Energy distribution
% Carbohydrate	60.99 ± 0.39	58.60 ± 0.68	60.25 ± 0.35	0.002^∗∗
% Protein	14.23 ± 0.16	13.99 ± 0.28	14.16 ± 0.14	0.455
% Fat	23.41 ± 0.30	25.64 ± 0.52	24.11 ± 0.28	0.0001^∗∗∗

¹⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

²⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

³⁾ Different between two groups at α = 0.05 by ANCOVA test adjusted for complex sampling design

⁴⁾ Age-adjusted mean ± SE

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

Table 5.

The percent of the subjects consumed under EAR1) of the subjects

Variables	EBF (n = 911)²⁾	SBF (n = 370)³⁾	Total (n = 1,281)	p-value⁴⁾
Energy⁵⁾	548 (58.6)⁶⁾	280 (77.7)	828 (64.6)	0.0001^∗∗
				(χ² = 45.876)
Protein	107 (12.3)	109 (30.4)	216 (17.9)	0.0001^∗∗∗
				(χ² = 57.298)
Vitamin A	484 (53.0)	240 (64.6)	724 (56.6)	0.001^∗∗
				(χ² = 15.149)
Vitamin B₁	69 (7.7)	90 (26.6)	159 (13.6)	0.0001^∗∗∗
				(χ² = 77.022)
Vitamin B₂	339 (37.0)	194 (55.5)	533 (42.7)	0.0001^∗∗
				(χ² = 38.375)
Niacin	274 (29.3)	183 (50.2)	457 (35.8)	0.0001^∗∗∗
				(χ² = 51.494)
Vitamin C	8 (1.1)	15 (5.1)	23 (2.4)	0.0001^∗∗∗
				(χ² = 16.913)
Calcium	710 (77.0)	318 (87.3)	1028 (80.2)	0.0001^∗∗∗
				(χ² = 19.660)
Phosphorus	372 (41.3)	238 (66.3)	610 (49.1)	0.0001^∗∗∗
				(χ² = 69.400)
Iron	259 (27.1)	188 (53.1)	447 (35.2)	0.0001^∗∗∗
				(χ² = 79.708)

¹⁾ Estimated average requirement

²⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

³⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

⁴⁾ Different between two groups at α = 0.05 by Rao-Scott chi = square test

⁵⁾ Estimated energy requirement

⁶⁾ n (%)

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

Table 6.

NAR¹⁾ and MAR²⁾ of the subjects

Variables	EBF (n = 911)³⁾	SBF (n = 370)⁴⁾	Total (n = 1,281)	p-value⁵⁾
Protein⁶⁾	1.44 ± 0.03	1.18 ± 0.04	1.36 ± 0.02	0.0001^∗∗∗
Vitamin A	0.98 ± 0.05	0.93 ± 0.14	0.96 ± 0.05	0.751
Vitamin B₁	1.73 ± 0.04	1.39 ± 0.05	1.62 ± 0.03	0.0001^∗∗∗
Vitamin B₂	1.06 ± 0.02	0.87 ± 0.03	1.00 ± 0.02	0.0001^∗∗∗
Niacin	1.11 ± 0.02	0.88 ± 0.03	1.04 ± 0.02	0.0001^∗∗∗
Vitamin C	0.77 ± 0.03	0.60 ± 0.05	0.72 ± 0.03	0.002^∗∗
Calcium	0.61 ± 0.01	0.48 ± 0.02	0.57 ± 0.01	0.0001^∗∗∗
Phosphorus	1.12 ± 0.02	0.85 ± 0.03	1.03 ± 0.02	0.0001^∗∗∗
Iron	1.27 ± 0.06	0.96 ± 0.05	1.17 ± 0.04	0.0001^∗∗∗
MAR	1.12 ± 0.02	0.91 ± 0.03	1.05 ± 0.02	0.0001^∗∗∗

¹⁾ Nutrient adequacy ratio

²⁾ Mean adequacy ratio

³⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

⁴⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

⁵⁾ Different between two groups at α = 0.05 by ANCOVA test adjusted for complex sampling design

⁶⁾ Age-adjusted mean ± SE

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

Table 7.

INQ¹⁾ of the subjects

Variables	EBF (n = 911)²⁾	SBF (n = 370)³⁾	Total (n = 1,281)	p-value⁴⁾
Protein⁵⁾	1.45 ± 0.02	1.43 ± 0.03	1.44 ± 0.01	0.339
Vitamin A	1.03 ± 0.05	1.08 ± 0.15	1.05 ± 0.06	0.756
Vitamin B₁	1.76 ± 0.02	1.70 ± 0.04	1.74 ± 0.02	0.188
Vitamin B₂	1.09 ± 0.02	1.05 ± 0.02	1.08 ± 0.02	0.134
Niacin	1.12 ± 0.02	1.09 ± 0.03	1.11 ± 0.01	0.272
Vitamin C	0.82 ± 0.03	0.76 ± 0.06	0.80 ± 0.03	0.327
Calcium	0.64 ± 0.01	0.59 ± 0.02	0.63 ± 0.01	0.060
Phosphorus	1.16 ± 0.01	1.08 ± 0.02	1.14 ± 0.01	0.0001^∗∗∗
Iron	1.24 ± 0.05	1.13 ± 0.05	1.21 ± 0.04	0.109

¹⁾ Index nutritional quality

²⁾ EBF (Eating breakfast) group: subjects who were eating breakfast in survey one day ago

³⁾ SBF (Skipping breakfast) group: subjects who were skipping breakfast in survey one day ago

⁴⁾ Different between two groups at α = 0.05 by ANCOVA test adjusted for complex sampling design

⁵⁾ Age-adjusted mean ± SE

^∗ p < 0.05,

^∗∗ p < 0.01,

^∗∗∗ p < 0.001

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