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Product Category: Projects

Product Code: 00007930

No of Pages: 130

No of Chapters: 5

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The study aimed to assess breakfast habit and its relationship with nutritional status of 376 randomly selected adolescents, aged 10-19 years in Ihiala Local Government Area of Anambra State. In this cross-sectional study, data were obtained on the students’ personal information, dietary habit, usual breakfast eating habit, nutrition knowledge and foods eaten at breakfast using a structured questionnaire. Weights and heights were measured obtained by direct measurements following standard procedures. The body mass index (BMI), calculated as weight/height (kg/m2), was used in assessing the nutritional status of the students. Data obtained were analyzed using descriptive statistics (such as frequency and percentages) and cross tabulation. Chi square test were used to determine the relationship between nutritional status and breakfast consumption. From the result, 50.8% were between the ages of 12-15 years, 73.4% live with their parents, 31.1% skipped breakfast, 22.6% consumed rice and stew at breakfast. About 60.4% ate breakfast at home, 36.7% ate breakfast between 6am-7am daily. Some (45.5%) had average knowledge of nutrition. Mean height-for-age was significantly higher in males (p=0.006), while females had higher mean MUAC (0.011). Non-breakfast eaters had higher height-for-age (-0.97) compared to breakfast eaters. Nutrition education on the importance of breakfast consumption should be carried out in other secondary schools in Nigeria.











INTRODUCTION 1                                                                                          

1.1 Statement of Problem 6

1.2 Objectives 8

1.2.1  General objective 8

1.2.2 Specific objectives 8

1.3 Significance of the Study 9



2.1 Definition of Breakfast Skipping 10

2.2 Importance of Breakfast 11

2.2.1 Effect of breakfast eating habit on adolescents 12

2.2.2 Determinants of breakfast eating habit by adolescents 14

2.1.3 Characteristics of a healthy breakfast 16

2.2 Breakfast Skipping 17

2.2.2 The correlates of breakfast skipping 19

Effect of breakfast skipping 22

Breakfast habits and nutritional benefits 24

Factors influencing breakfast skipping 24

2.2.6 Nutritional benefits of breakfast 26

2. 3      Nutritional problems of adolescents                                                   27

2.3.1 Adolescents 28

2.3.2 Nutritional status of adolescents 30

2.3.2 Energy and protein requirements 32

Mineral and micronutrient requirements 34

    Obesity in Adolescents 36

2.5       Criteria to define obesity in adolescent 38

2.5.1    Anthropometric measurement 39

Height measurement 39                   

Weight measurement 40

Mid-upper arm circumference 40




3.1 Study Design 42

3.2 Area of the Study 42

3.3 Population of the Study 43

3.4 Sample Size Determination 43

3.4.1  Sampling Procedure   44

3.5     Preliminary Visits 45

3.5.1  Training of research assistants 46

3.6     Data Collection 46

3.6.1  Questionnaire validation 46

3.6.2 Anthropometry measurement 47

3.6.3  Dietary assessment 48

3.7     Data Analysis 48

3.8     Statistical Analysis 50



4.1 Personal Information of the adolescents                                            51                        

4.2 Socio-demographic characteristics of their parents 53

4.3 Dietary Habit of the adolescents 60

4.4 Prevalence of breakfast skipping among the adolescents                   71                    

4.5 Usual breakfast eating habits of Adolescent  74                      

4.6 Types of foods consumed and frequency of consumption  76

4.7 Nutritional knowledge of the adolescents  78

4.8 Nutritional status using anthropometric indices of the adolescent  80

4.9        Relationship between anthropometric status of male and female  81                   

4.10 Relationship between anthropometric status breakfast and

non-breakfast eaters      86



5.1 Conclusion  89

5.2 Recommendation  90

REFERENCES                                                                                   91                        APPENDIX I                                                                                                   109                        APPENDIX II


Table 4.1a: Personal Information of the Adolescents                                 53                           

Table 4.2: Socio-demographic characteristics of the adolescents              54                       

Table 4.2b: Socio-demographic characteristics of their parents                  56                         

Table 4.3a: Dietary habit of the adolescents                                                  61                         

Table 4.3b: Dietary habit of the adolescents                                                 65                     

Table 4.3c: Dietary habit of the adolescents                                                 68                 

Table 4.4: Prevalence of breakfast skipping among the adolescents           71                

Table 4.5a:      Usual breakfast habits of breakfast eaters                                   73                

Table 4.5b:      Usual breakfast habits of breakfast eaters                                   75                 

Table 4.6: Types of foods commonly consumed for breakfast over

 a week period       77        

Table 4.7:        Nutritional knowledge of the male and female adolescents         79   

Table 4.8:        Nutritional knowledge of breakfast and non-breakfast eaters      80   

Table 4.9a: Mean Anthropometry of the male and female adolescents            82      

Table 4.9b:      Mean Anthropometry of the breakfast and non-breakfast eaters  84       

Table 4.9c: Relationship between anthropometric status of male and female 86                   

Table 4.10:      Relationship between anthropometric status of breakfast and

non-breakfast eaters                                                                       88                        






Breakfast is crucial to all humans since it is considered the most important meal of the day (Marika, 2003). It contributes at least 25% of the daily nutritional requirement of an individual. This is because studies have identified that there is a possible role of breakfast consumption in maintaining normal weight status in children and adolescent (Turconi et al., 2015). Breakfast consumption is also associated with other health lifestyle factors. Studies reported that regular breakfast consumption among adolescent is positively associated with intake of most vitamins and minerals, while those skipping breakfast were more likely to be frequent consumers of unhealthy snack foods (Utter et al., 2007). The consumption of breakfast is associated with lower risk of weight gain (Cho et al., 2003). Research has shown that adolescents who regularly skipped breakfast had 4.5 times risk of developing obesity than those who consumed breakfast regularly (Mota et al., 2008).  

However, contradictory findings have also been reported on the association of breakfast skipping to body mass index (BMI) (Williams, 2007) or to overweight/obesity (Mota et al., 2008).  The relationship between breakfast habit and body weight is not well-established. Some believe that breakfast omission results in weight loss (Rampersaud, 2009). However, breakfast skipping has become increasingly common in parallel with escalation of childhood obesity (Williams et al., 2016). As breakfast habit is alterable, understanding its effect on body weight has important implication for weight control (Szajawska et al., 2010). Many cross-sectional studies have linked breakfast skipping to higher bodyweight among young children and adolescents (Deshmukh-Taskar et al., 2010), but prospective studies are scarce and provide inconsistent results (Timlin et al., 2008). In a study on the intake and quality of breakfast consumption in adolescents attending public secondary schools in the North West province 0f South Africa, the reported prevalence of breakfast skipping in different adolescent population groups in South Africa ranged from 13-36% (Feeley et al., 2012).

The need for adequate nutrition can therefore not be over emphasized since it is important for children to reach their maximum growth, development and health potential (Fugas et al., 2013). Skipping breakfast and unhealthy food consumption may lead to micro nutrient deficiencies and poor nutritional status for adolescents (Hallstrom et al., 2013). The consequences of poor nutritional status at early stage of life may be so serious that it can result in depression, lack of self esteem, unconsciousness, anxiety, poor cognition and academic achievements and in extreme condition premature death among children and adolescents (Hoyland et al., 2012).

World Health Organization (WHO) identifies adolescence as the period in human growth and development that occurs after childhood and before adulthood, from ages 10-19 years (WHO 2000).  Eating behaviours, such as consuming breakfast has been associated with intakes of nutrients as well as body weight (Obbagy et al., 2011). Furthermore, research has linked the consumption of breakfast with adolescent’s mental and physical health (O’Sullivan et al., 2008).

Types of breakfast food consumed in Africa and other countries differ. For example in Ghana porridge is sometimes eaten at home, but many buy their breakfast from street vendors (Gibson, 2003).  Omelettes, and a very sweet dense bread known as sugar bread are also popular in Ghana (Gibson, 2003).  In central Uganda, a typical breakfast would be tea (made with milk and ginger),served with a combination of green cooking bananas in a stew with beef or in a vegetable sauce, while in Nigeria porridge made from corn, made with evaporated milk is common amongst the south western Yoruba people (Gibson, 2003). For those in southwest a popular breakfast food is ‘garri’, which is made of root and cassava and soaked overnight then sweetened with sugar and eaten with cereal.

In a study on the relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents, the result showed that 20% 0f children and 31.5% of adolescents were breakfast skippers (National Health and Nutrition Examination Survey (NHANES), 1999 -2006).

Anthropometry is the measurement of certain parameters of the human body and it is frequently used to assess nutritional status as well as growth and development of school aged children and adolescents (Shetty and James, 1994). It is also the most frequently used tool in public health evaluation and clinical settings; and involves measurements viz: skin fold thickness, circumferences or various height and weight based indices such as weight-for-height and BMI (Himes, 1991; WHO, 1995). The BMI has been recommended and used to screen for overweight, obesity and thinness among adults and adolescents (Gorstein, 1989; Garrow and Webster, 1985), but it does not differentiate between fat and lean tissue mass. An alternative technique that is simple, inexpensive and non invasive is the measurement of subcutaneous fat thickness or skinfold at selected sites (Popkin et al., 2001). Skin fold thickness measured at various sites on the body provides an estimate of the thickness of subcutaneous fat (Onimawo and Cole, 2000). Anthropometry can thus be used to evaluate either individual or population in order to determine the prevalence of over nutrition and under nutrition. The method involves the use of body weight and height scales, skin fold-calipers, head and arm circumference tapes (Onimawo and Cole, 2000). The method has also been used by various authors to determine body composition of various groups (Onimawo and Cole 2000). Even though the association between breakfast habit and obesity has been studied in developed countries, few or no research has been conducted in developing countries and the study area.  It is therefore necessary to conduct a study on adolescents to ascertain the magnitude of the problem.



Adolescents have been considered to have the lowest mortality among different age groups and have therefore received low priority in terms of nutritional status assessment (Woodruff, 2000). However, because of rapid growth in stature, muscle mass and fat mass during the peak of the adolescent growth spurt, the requirements for some nutrients is as high or higher in adolescents than in any other age group (WHO, 2000). The 2420 kcal required per day by adolescents is the highest energy requirement of any age group (Woodruff, 2000). Skipping breakfast and unhealthy food consumption may lead to micro-nutrient deficiencies and poor nutritional status (Acham et al., 2012).

Skipping breakfast also plays an important role in obesity (Utter et al., 2007). In addition, children and adolescents who habitually skip breakfast are at higher risk for skipping other meals, snacking, being less physically active and being overweight and obese (Rampersaud et al., 2005).  Convenience food that are mostly consumed by adolescent/school going children are high in salt, saturated fats and low in essential micro-nutrients for  children undergoing growth spurts (Grimes et al., 2013).  A large body of research supports breakfast’s key role in helping adults and children meet nutrition recommendation (IFIC, 2012). Many studies have shown association between hunger, poor dietary intake, stunting, underweight and poor school performance after controlling for socio-economic conditions (Grantham-McGregor, 2005). Breakfast is also widely promoted to improve cognitive function and academic performance, leading to the provision of breakfast initiatives by public health bodies (Hoyland et al., 2009). There are indications in some countries that breakfast consumption among adults is declining (Akinyele et al., 1997), especially among young adults and children.  Lack of time available to eat breakfast before school may be a factor in breakfast omission since it was discovered that children were likely to eat substantial breakfast during holidays than on school days (Rampersaud et al., 2005). This study therefore aimed to assess breakfast habits of adolescents in relation to their nutritional status.






1.2.1 General objective

The general objective is to describe the breakfast habit and its relationship with nutritional status of adolescences in Ihiala Local Government Area of Anambra state.

1.2.2 Specific objectives

The specific objectives of the study are to:

i. Identify the proportion of adolescents who eat and do not eat breakfast.

ii. Assess the usual breakfast eating habits of the adolescents.

iii. Evaluate the differences in anthropometric status of breakfast and non breakfast eaters.

iv. Examine the nutritional knowledge of breakfast and non breakfast eaters.

v. Examine the relationship in anthropometric status of breakfast and non breakfast eaters.



The findings of this study will guide parents, caregivers and education ministries to develop new policy framework or adjust existing policy framework to meet the current food and health situations in our secondary schools and adolescences. This study will give knowledge of the nutritional status of the adolescents in the study area which will form base data or information for nutritionists, public health workers, policy makers of food nutrition and health. It will also help stakeholder in nutrition to draw up an appropriate intervention programmes for the adolescents.

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