BACKGROUND: Changes in socioeconomic inequalities in health behaviours following the COVID-19 pandemic remain unknown, particularly among Japanese school-aged adolescents. Therefore, in this study, we examined changes in socioeconomic inequalities in school-aged adolescents' health behaviours, including physical activity (PA), screen time (ST), sleep duration, breakfast consumption, and bowel movement frequency, before and after the pandemic. METHODS: This three-wave repeated cross-sectional study utilised data from the 2019, 2021, and 2023 National Sports-Life Survey of Children and Young People in Japan, analysing data from 766, 725, and 604 participants aged 12-18 years, respectively. Favourable health behaviours were defined as moderate-to-vigorous PA of ≥60 min/day, ST <2 h/day, sleep duration of 8-10 h, daily breakfast consumption, and bowel movements at least every 3 days. Absolute and relative socioeconomic inequalities were quantified using the slope index of inequality (SII) and the relative index of inequality (RII). Temporal changes were analysed using quadratic trend analyses, employing interaction terms between socioeconomic status and survey year. RESULTS: Significant quadratic trends indicated that socioeconomic inequalities in breakfast consumption decreased substantially from 2019 (SII: 20.7%, RII: 5.09) to 2021 (SII: -0.1%, RII: 0.95) but resurged in 2023 (SII: 16.2%, RII: 3.70). This resurgence may have been primarily driven by changes among those in the moderately low-income (poverty level II) and higher-income groups, which had a breakfast consumption rate of 81.0, 87.0, and 76.4% in 2019, 2021, and 2023, and 88.7, 82.1, and 87.5%, respectively. Among low-income households, adherence to PA recommendations significantly declined from 18.6% to 5.3%, and ST adherence worsened over the study period. No significant inequalities or trends were observed for sleep duration or bowel movement frequency across survey years. CONCLUSIONS Socioeconomic disparities in breakfast consumption among Japanese school-aged adolescents resurfaced after initially narrowing during the pandemic, likely driven by changes in moderately low-income and higher-income groups. Among low-income households, adherence to PA and ST guidelines declined over time. However, at the population level, socioeconomic inequalities in PA did not exhibit a consistent trend of widening or narrowing. This study highlights the need for sustained public health initiatives to address these socioeconomic disparities.
Adolescent ; Child ; Female ; Humans ; Male ; Breakfast ; COVID-19/psychology* ; Cross-Sectional Studies ; Exercise ; Health Behavior ; Japan/epidemiology* ; Screen Time ; Sleep ; Socioeconomic Factors ; East Asian People

OBJECTIVES: This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior.METHODS: The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR).RESULTS: The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R²=0.200) and perceived sensitivity (β=0.373, R²=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children.CONCLUSIONS: In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.
Anemia ; Body Mass Index ; Breakfast ; Child ; Diet ; Eating ; Education ; Ethics Committees, Research ; Female ; Growth Disorders ; Humans ; Indonesia ; Intention ; Malnutrition ; Mothers ; Obesity ; Overweight

OBJECTIVES: College is an important time for students to establish their identity as an independent subjects and develop a foundation to maintain a healthy adulthood. However, after female students become college students, their eating habits are likely to become more irregular and they may experience various health problems because of excessive weight control. Therefore, this study was conducted to investigate the dietary behaviors and blood clinical indices of female college students by residence types. METHODS: A total of 374 subjects were classified as home group, self-boarding group or boarding group according to residence type. Dietary habits, frequency of food intake, and eating attitudes were examined through questionnaires and anthropometric measurements and blood clinical indices were analyzed. RESULTS: The meal most frequently skipped by female college students was breakfast, and the frequency of skipping breakfast was significantly lower in the home group than other groups. Most college students recognized that their eating habits had worsened since becoming college students, with the self-boarding group in particular feeling that their eating habits changed negatively. The consumption frequencies of protein foods, fruits, dairy products, seaweed, and fatty meats were significantly lower in the self-boarding group than other groups. The home group ate food cut into smaller pieces, while the self-boarding group tried new and rich foods. Residence types did not affect blood clinical indices. CONCLUSIONS: The self-boarding group had inadequate dietary habits compared to the home group. Although residence type did not affect the blood clinical indices, the students still had poor dietary habits. Therefore, proper nutrition education is needed to improve the nutritional status of college students, especially those that self-board.
Breakfast ; Dairy Products ; Eating ; Education ; Female ; Food Habits ; Fruit ; Humans ; Meals ; Meat ; Nutritional Status ; Seaweed ; Seoul

OBJECTIVES: This study examines the intake of food and nutrients of children according to the employment and working hours of their mothers. METHODS: The married women in the source data from the 6th National Health and Nutrition Survey were classified into full-time working mothers, part-time working mothers and housewives according to the working type and the data on their children from 3 to 18 years old were analyzed using SAS 9.4. RESULTS: The group from 3 to 5 years old was the smallest group with 682 children (20.2%), followed by the group from 6 to 11 years with 1,345 children (39.8%) and the group from 12 to 18 years old with 1,355 children (40.1%). The lowest rates for having no breakfast and dinner were observed in the group with housewives (p<0.05). The calcium and phosphorous intakes were the highest in the group with housewives at 61.9% and 126.8%, respectively, and the lowest in the group with full-time working mothers at 54.7% and 115.3%, respectively (p<0.05). The group with full-time working mothers had the highest rate in the calcium and iron intake less than the dietary reference intake at 74.9% and 30.0%, respectively. It indicated that the group with full-time working mothers did not have sufficient nutrients as compared to the other two groups. Moreover, the group with the part-time working mothers showed the high vitamin A intake ratio of 41.4% (p<0.05). CONCLUSIONS: This study found evidence of a negative association between mother's employment status and children's diet quality. The employment and economic activity of married women will continuously increase in the future. Therefore, a national nutrition policy is required to provide quality nutrition care for children in the households.
Breakfast ; Calcium ; Child ; Diet ; Eating ; Employment ; Family Characteristics ; Female ; Humans ; Iron ; Korea ; Meals ; Mothers ; Nutrition Policy ; Nutrition Surveys ; Nutritional Status ; Obesity ; Recommended Dietary Allowances ; Vitamin A

BACKGROUND: Energy drinks (EDs), functional beverages with high concentrations of caffeine, can cause health risks. This study examined the frequency of ED consumption and related factors in Korean adolescents. METHODS: Data from the 10th-13th Korea Youth Risk Behavior Web-based Survey was used, and a total of 137,101 boys and 130,806 girls were included in the final analyses. Differences in ED consumption and associated factors were analyzed using the Rao-Scott chi-square test and a multivariate logistic regression analysis, reflecting of the complex sample design. RESULTS: In total, 17.3% boys and 12.9% girls consumed EDs more than once a week (P<0.001). In particular, 24.2% of all high-school students in the 12th grade consumed more than three EDs a week. After adjusting for confounding factors, a multivariate logistic regression analysis indicated that higher ED consumption was significantly associated with a higher soda, sweet-drink, and fast food intake; skipping breakfast; a lower vegetable intake; depression; suicidal thoughts; sleep deprivation; and increased smoking and alcohol drinking. CONCLUSIONS: ED consumption is associated with undesirable dietary-, lifestyle-, and mental health-related behaviors, suggesting the need for appropriate nutrition education in adolescents.
Adolescent ; Alcohol Drinking ; Beverages ; Breakfast ; Caffeine ; Depression ; Education ; Energy Drinks ; Fast Foods ; Female ; Food Habits ; Humans ; Korea ; Life Style ; Logistic Models ; Mental Health ; Risk-Taking ; Sleep Deprivation ; Smoke ; Smoking ; Vegetables

OBJECTIVES: This study investigated dietary and lifestyle factors associated with the weight status among Korean adolescents in multicultural families.METHODS: This cross-sectional study analyzed 1,751 multicultural families' adolescents who participated in the 2017–2018 Korea Youth Risk Behavior Surveys. Information on dietary and lifestyle factors was self-reported using a web-based questionnaire and this information included breakfast and foods consumption, perceived health status, alcohol drinking, smoking, physical activity, and weight control efforts. Body mass index (BMI) was calculated based on the self-reported height and body weight (kg/m²). Weight status was assessed according to the 2017 Korean National Growth Chart: underweight (weight-for-age <5(th) percentiles), overweight (85(th)≤ BMI-for-age <95(th) percentiles), and obese (BMI-for-age ≥95(th) percentiles). Multiple logistic regression analysis was performed to examine the dietary and lifestyle factors associated with weight status after adjustment for covariates.RESULTS: Among Korean adolescents from multicultural families, the prevalence of overweight/obesity was 20.9%, whereas about 7% of adolescents were underweight. The weight status did not show differences according to gender, school level, area of residence, and household income. Compared to adolescents who did not have breakfast during the previous week, those who had breakfast 3–4 days/week and ≥5 days/week had a 42% (p=0.021) and a 37% (p=0.009) lower prevalence of overweight/obesity, respectively. The adolescents who frequently consumed carbonated soft drinks (≥5 times/week) showed an odds ratio (OR) of 1.69 (95% CI=1.01–2.83) for overweight/obesity relative to those adolescents who did not consume carbonated soft drinks. The OR of being underweight for adolescents who ate fast food ≥3 times/week was 1.97 (95% CI=1.04–3.71) compared to those adolescents who had not eaten fast food during the previous week.CONCLUSIONS: Dietary and lifestyle factors were associated with overweight/obesity as well as underweight among Korean adolescents in multicultural families. Our findings could be used to design and provide nutrition interventions for this specific population.
Adolescent ; Alcohol Drinking ; Body Mass Index ; Body Weight ; Breakfast ; Carbon ; Carbonated Beverages ; Cross-Sectional Studies ; Family Characteristics ; Fast Foods ; Growth Charts ; Humans ; Korea ; Life Style ; Logistic Models ; Motor Activity ; Odds Ratio ; Overweight ; Prevalence ; Risk-Taking ; Smoke ; Smoking ; Thinness

BACKGROUND: Eating breakfast is important for optimal growth and development in adolescence, and is associated with academic achievement as well as nutrition and health status. This study aimed to investigate the relationship between breakfast consumption frequency and high school students' academic achievement.METHODS: We used data from the 2017 Korea Youth's Risk Behavior Web-Based Study, conducted by the Korean Center for Disease Control (64,991 students). The relationship between academic achievement and breakfast consumption frequency was examined using logistic regression.RESULTS: Students who consumed breakfast frequently exhibited higher academic achievement as compared to their counterparts. There was a significant correlation between awareness of appropriate eating habits and breakfast consumption frequency. Further, students who had not received any education about eating habits exhibited low academic achievement.CONCLUSION: To improve the academic achievement of students, they should be motivated to eat breakfast every day. Additionally, appropriate education about eating habits need to be implemented at schools and at home to increase students' breakfast consumption frequency.
Adolescent ; Breakfast ; Centers for Disease Control and Prevention (U.S.) ; Eating ; Education ; Feeding Behavior ; Growth and Development ; Humans ; Korea ; Logistic Models ; Risk-Taking

BACKGROUND: Recently, the number of one-person households has increased, and the prevalence of type 2 diabetes mellitus has risen in Korea. Major complications of diabetes, such as stroke and myocardial infarction are major causes of death. Therefore, we conducted this study to test the hypothesis that the risk factors and prevalence of type 2 diabetes mellitus differ between one-person and multi-person households.METHODS: This retrospective study analyzed data of 3,691 adults over 19 years old from the 7th (2016) Korea National Health and Nutrition Examination Survey. Data were analyzed by composite sampling for age, family history, waist circumference, body mass index, hypertension, high-density lipoprotein cholesterol, triglycerides, smoking, alcohol consumption, physical activity, and consumption of breakfast. Multivariate logistic regression analysis was performed by household-type in order to estimate the relative risk of factors associated with diabetes.RESULTS: Hypertension was a significant risk factor for diabetes in both groups. Among other diabetic risk factors, individuals in one-person households were more likely to skip breakfast and less likely to engage in physical activity than those in multi-person households.CONCLUSION: One-person households have a high risk of hypertension, skipping breakfast, and poor physical activity. It is important to consider the role of one-person households when studying the management and treatment of disease.
Adult ; Alcohol Drinking ; Body Mass Index ; Breakfast ; Cause of Death ; Cholesterol ; Diabetes Mellitus, Type 2 ; Family Characteristics ; Humans ; Hypertension ; Korea ; Lipoproteins ; Logistic Models ; Motor Activity ; Myocardial Infarction ; Nutrition Surveys ; Prevalence ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Triglycerides ; Waist Circumference

OBJECTIVES: Young athletes require adequate nutrition to maintain their athletic performance, growth and health. This study examined the status and needs of nutrition management and meal services for student athletes among the athlete's parents. METHODS: The subjects were parents of elementary, middle, and high school athletes (n=323) from 18 schools participating mainly in the Sports Food Truck. The questionnaire included general characteristics, status and needs on nutrition management and meal service for student athletes, and satisfaction with the Food Truck. The survey was done during 2018. The data were analyzed according to the school groups using a χ2-test or ANOVA. RESULTS: Approximately 45% of subjects had difficulty in the nutrition management of athletes, and 87.1% had not received nutrition education. Approximately 74% wanted nutrition education held for athletes, and mainly wanted topics on nutrition management for health and eating for athletic performance. The preferred methods were lectures and cooking activity. The responses on the necessity of nutrition education for athletes, desired education topics, and desired times for education differed significantly according to the school groups (p < 0.05). Most subjects also wanted nutrition information mainly through SNS. In the athlete's meal, breakfast and snacks were highlighted as the meal to supplement. Approximately 90.3% responded that providing a meal service is necessary. The subjects preferred snacks before/after exercise and dinner if a meal service was provided. They preferred Korean food, followed by snacks, and a dish meal. As the meal type, the subjects wanted the Food Truck and packed meal. The responses on necessity of a meal service (p < 0.05), preferred food (p < 0.001), and meal type (p < 0.001) in the meal service differed significantly according to the school groups. Approximately 43% were satisfied with the Food Truck and 50.8% responded as average. They made suggestions for the Food Truck in terms of foods, operations and frequency. CONCLUSIONS: Based on the study results, nutrition education and meal service may support nutrition for student athletes considering the needs of the parents according to the school groups.
Athletes ; Athletic Performance ; Breakfast ; Cooking ; Eating ; Education ; Humans ; Lectures ; Meals ; Motor Vehicles ; Needs Assessment ; Parents ; Snacks ; Sports

OBJECTIVES: This study was performed to compare the dietary life of single- and non single-person households in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A nationally representative sample of 20,421 19-64-year-olds who had 24-hour recall data was taken from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES). Single- and non single-persons were compared for nutrient intake, dietary behaviors, food consumption patterns, nutrition education and confirm nutrition label. RESULTS: The dietary intakes of dietary fiber and iron were lower in single-person households than in non single-person households. The lower the level of education and income, the lower the nutrient intake of single-person households. In the case of those aged 19 to 29, the breakfast skipping rate was higher in single-person households than in non single-person households. The higher the education level, the higher the breakfast skipping rate and the eating out frequency in the single-person households. In the food intake survey, the frequency of healthy food intake in single-person households was much lower than that of non single-person households. The confirmation rate of nutrition labeling was lower in single-person households than in non single-person households. CONCLUSIONS: This study shows that single-person households have poorer health-nutritional behaviors than multi-person households. Therefore, a nutrition education program based on the data of this study needs to be developed for health promotion of single-person households.
Breakfast ; Dietary Fiber ; Eating ; Education ; Family Characteristics ; Food Labeling ; Health Promotion ; Iron ; Korea ; Nutrition Surveys