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: This study investigated physical activity (PA) participation based on demographic, physical, and psychological variables in Korean adults.METHODS: Participants were divided into four groups (combined, aerobic only, resistance only, and neither) based on meeting the PA guidelines using moderate and vigorous PA time and resistance exercise frequency from the Korea National Health and Nutrition Examination Survey 2017. The association between meeting the PA guidelines and demographic, medical, fitness, lifestyle, and psychological variables were analyzed using complex samples crosstabs and a general linear model.RESULTS: Of the 5,820 Korean adults, 66.0% did not meet any of the guidelines. Among demographic factors, sex, age, marital status, income, education level, occupation, and employment status were associated with meeting the PA guidelines. Chronic disease prevalence, weight, waist circumference, body mass index, diastolic blood pressure, glucose, high-density lipoprotein and triglyceride levels, hand-grip strength, resting heart rate, and family history of chronic disease in the medical and fitness variables; frequency of drinking and eating breakfast, total calorie, water, protein, and fat intake in the lifestyle variables; and perceived stress, depression, suicidal thoughts, and quality of life in the psychological variables were associated with meeting PA guidelines.CONCLUSIONS: Most Korean adults participate in insufficient PA. Moreover, individuals who are socially underprivileged, have low-income or poor physical and mental health conditions participated in relatively less PA. Our findings suggest that government and individual efforts are required to increase PA and resolve health inequality in Korean adults.
Adult ; Blood Pressure ; Body Mass Index ; Breakfast ; Chronic Disease ; Demography ; Depression ; Drinking ; Eating ; Education ; Employment ; Glucose ; Health Equity ; Heart Rate ; Humans ; Korea ; Life Style ; Linear Models ; Lipoproteins ; Marital Status ; Mental Health ; Motor Activity ; Nutrition Surveys ; Occupations ; Prevalence ; Quality of Life ; Socioeconomic Factors ; Triglycerides ; Waist Circumference ; Water

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

BACKGROUND: Bisphosphonate (BP) is an effective drug for the prevention and treatment of osteoporosis. However, gastrointestinal distress caused by BP is a well-known side effect for low compliance. The aim of our study was to compare the 1-year persistence, compliance and T-scores between the aperitif medication group and the postprandial medication group. METHODS: Three hundred patients were included in this study to determine their persistence and compliance with the prescribed daily BP (Maxmarvil®, alendronate 5 mg and calcitriol 0.5 µg; YuYu Pharm) following distal radius fractures. Patients in Group 1 (aperitif medication) were asked to adhere to the general guidelines for BPs before breakfast. Patients in Group 2 (postprandial medication) were recommended medication after breakfast. We compared the persistence and compliance of this daily BP therapy using the medication possession ratio (MPR) and T-scores between the 2 groups after 1 year. RESULTS: Bone mineral density in hip and lumbar spine was improved significantly in 2 groups (P < 0.001). Significant differences existed between 2 groups, including 73 of 150 patients (48.7%) in Group 1, and 111 of 150 patients (73.3%) in Group 2 for 1-year persistence (P=0.001). The mean MPR is 0.66 in Group 1 (range, 0.50–0.86) and 0.71 in Group 2 (range, 0.54–0.87). A significant difference was detected between the 2 groups (P=0.002). CONCLUSIONS: Postprandial administration improved persistence and compliance with daily BP therapy, resulting in better clinical outcomes.
Alendronate ; Bone Density ; Breakfast ; Calcitriol ; Compliance ; Hip ; Humans ; Osteoporosis ; Radius Fractures ; Spine

PURPOSE: This study examined the relationship of the nutrition of rice and the positive evaluation of the rice-based meal with the food consumption habits, physical and emotional health status, and learning efficacy of 601 middle and high school students in Jeonju area. METHODS: The participants were divided into two groups using cluster analysis in that the participants belonging to the upper groups had a center score of 46.86 (n = 348), while the people belonging to the lower group had a center score of 36.89 (n = 253). Statistical differences were tested for all the relationships between the physical and emotional healths symptoms and learning efficacy between the groups at the α = 0.05 level. RESULTS: Significant differences in the physical self-evaluated symptoms were observed in all five items in each cluster (p < 0.05). In the case of the emotional health status, nine out of 10 items showed significant differences between the groups. Similarly, significant differences in all five items in learning efficacy questionnaire were noted (p < 0.05). Positive attitudes of the parents toward having breakfast also showed significant differences among the groups. CONCLUSION: The nutrition of rice and a positive evaluation of the rice-based meals significantly affect the physical and emotional health status and learning efficacy of juveniles. These findings can be used as baseline information for promoting nutrition education, particularly rice-based breakfast.
Adolescent ; Breakfast ; Education ; Food Habits ; Humans ; Jeollabuk-do ; Learning ; Meals ; Parents

PURPOSE: This study was conducted to identify the dietary life and nutritional status of Korean elementary school students according to breakfast frequency and to clarify the relationship between breakfast frequency of elementary school students and parental dietary and social environmental factors. METHODS: This study used data from the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES VI). The subjects were 1,325 elementary school students aged 6 to 11 years old. Subjects were categorized into two groups: a skipping breakfast group (ate breakfast 0 ~ 4 times per week), eating breakfast group (ate breakfast 5 ~ 7 times per week) by sex and grade (lower grade: 1st ~ 3rd/upper grade: 4 th ~ 6 th). RESULTS: Among upper grade boys and girls, the skipping breakfast group had a higher rate of childhood obesity than the eating breakfast group. In lower grade boys, the mothers of the skipping breakfast group had higher rates of economic activity and eating breakfast alone without family members than the mothers of the eating breakfast group. For lower grade boys and girls and upper grade boys, the skipping breakfast group had a higher rate of parents who did not eat breakfast than the eating breakfast group. The energy intake of the breakfast consumed by all subjects was less than 25% of the Estimated Energy Requirements (EER). Moreover, for upper grade boys and girls, the skipping breakfast group had a higher rate of subjects whose daily intake was below the Estimated Average Requirement (EAR) for iron than the eating breakfast group. CONCLUSION: Breakfast frequency of elementary school students was related to childhood obesity. The frequency of eating breakfast among elementary school students was related to the dietary life factors of parents such as breakfast frequency and dietary condition. Intake for breakfast was less than 25% of the EER, while the skipping breakfast group had a higher rate of subjects whose daily intake was below the EAR for iron than the eating breakfast group. Therefore, it is necessary to consider diverse forms of policy support such as opening nutrition education programs for parents and practicing morning meals at school for elementary school students to provide regular and balanced breakfasts.
Breakfast ; Ear ; Eating ; Education ; Energy Intake ; Female ; Humans ; Iron ; Korea ; Mothers ; Nutrition Surveys ; Nutritional Status ; Parents ; Pediatric Obesity ; Social Environment

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.
Adolescent ; Breakfast ; Carbohydrates ; Ear ; Eating ; Edible Grain ; Education ; Eggs ; Food Habits ; Humans ; Korea ; Meals ; Nutrition Surveys ; Ovum ; Sweetening Agents ; Vegetables ; Vitamin A