Evaluation of Associated Factors with Children's Breakfast Attitudes and Self- Efficacy for Healthy Eating

Yıl 2023, , 977 - 985, 26.09.2023

Betül Kocaadam Bozkurt , Osman Bozkurt

https://doi.org/10.37989/gumussagbil.1228467

Öz

This study aimed to evaluate the breakfast attitude and healthy eating self-efficacy status of children and the factors affecting them (such as gender, BMI, and mindful eating). The study included 505 children (47.9% boys, 52.1% girls) with a mean age of 9.7±0.77 years. Data were obtained using the survey and a face-to-face interview method. The questionnaire includes general information, anthropometric measurements, Breakfast Attitudes Questionnaire (BAQ), Self-Efficacy for Healthy Eating Questionnaire (SEHE), and Mindful Eating Questionnaire for Children (MEQ-C). While 46.9% of children have normal BMI, 42.2% are overweight or obese. 39.6% of children reported skipping at least one main meal or snack. Of those who skipped meals, 19.0% skipped breakfast, and 60.5% skipped at least one of the snacks. The BAQ score was higher in girls (p=0.003); lower in overweight/obese children (p<0.05). Those who did not skip breakfast had higher SEHE scores (p=0.020). When the factors affecting the scores obtained from BAQ were evaluated with multiple linear regression analysis, child BMI, Mindless eating score affected BAQ score negatively, father education duration, mother and father BMI, Awareness, and SEHE scores affected BAQ score positively. Awareness and BAQ scores were found to affect SEHE positively. Our findings indicate that breakfast attitudes are related to healthy eating self-efficacy, mindful eating, and BMI in children and may also be related to parents' educational status and BMI. These results show that it is very important to provide education by nutritionists in order to improve children's breakfast attitudes, healthy eating self-efficacy and mindful eating skills.

Anahtar Kelimeler

Breakfast attitude, Childhood, Healthy eating self-efficacy, Mindful eating.

Çocukların Kahvaltı Tutumları ve Sağlıklı Beslenme Öz Yeterliliği ile İlişkili Faktörlerin Değerlendirilmesi

Öz

Bu çalışmanın amacı, çocukların kahvaltı tutumu ile sağlıklı beslenme öz-yeterlik durumlarını ve bunları etkileyen faktörleri (cinsiyet, BKİ, yeme farkındalığı gibi) değerlendirmektir. Çalışmaya yaş ortalaması 9,7±0,77 olan 505 çocuk (%47,9 erkek, %52,1 kız) dahil edilmiştir. Veriler anket aracılığıyla yüz yüze görüşme yöntemi kullanılarak elde edilmiştir. Anket içeriğinde genel bilgiler, antropometrik ölçümler, Kahvaltı Tutumu Ölçeği (KTÖ), Sağlıklı Beslenme için Öz-Yeterlilik Ölçeği (SBÖY) ve Çocuklar için Yeme Farkındalığı Ölçeği (YFÖ-Ç) yer almaktadır. Çocukların %46,9'unun BKİ değerleri normal aralıktadır, %42,2'si fazla kilolu veya obezdir. Çocukların %39,6'sı en az bir ana öğünü veya ara öğünü atladığını bildirmiştir. Öğün atlayanların %19,0'ı kahvaltıyı, %60,5'i ara öğünlerden en az birini atladığı saptanmıştır. KTÖ puanı, kızlarda daha yüksekken (p=0,003); fazla kilolu/obez çocuklarda daha düşüktür (p<0.05). Kahvaltıyı atlamayanların SBÖY puanları daha yüksek bulunmuştur (p=0,020). KTÖ'dan alınan puanları etkileyen faktörler çoklu doğrusal regresyon analizi ile değerlendirildiğinde, çocuğun BKİ değeri ve Bilinçsiz yeme skoru negatif; baba eğitim süresi, anne ve baba BKİ, Farkındalık ve SBÖY skorları pozitif yönde etkilemiştir. Farkındalık ve KTÖ ölçek skorlarının, SBÖY'yi pozitif yönde etkilediği bulunmuştur. Sonuçlarımız, çocuklarda kahvaltı tutumlarının sağlıklı beslenme öz yeterliliği, yeme farkındalığı ve BKİ ile ilişkili olduğunu ve ayrıca ebeveynlerin eğitim durumu ve BKİ değerleri ile ilişkili olabileceğini göstermektedir. Bu sonuçlar, çocukların kahvaltı tutumlarını, sağlıklı beslenme öz yeterliklerini ve yeme farkındalığı becerilerini geliştirmek için beslenme uzmanları tarafından erken dönemde eğitim verilmesinin çok önemli olduğunu göstermektedir.

Anahtar Kelimeler

Kahvaltı Tutumu, Çocukluk Dönemi, Sağlıklı Beslenme Öz Yeterliliği, Yeme Farkındalığı

Kaynakça

• 1. World Health Organisation Consideration of the evidence on childhood obesity for the Commission on Ending Childhood Obesity: report of the ad hoc working group on science and evidence for ending childhood obesity. Geneva, Switzerland: World Health Organization (2016).
• 2. World Health Organization European Regional Obesity Report 2022. Copenhagen: WHO Regional Office for Europe; 2022. Licence: CC BY-NC-SA 3.0 IGO.
• 3. Türkiye Çocukluk Çağı (7–8 Yaş) Şişmanlık Araştırması (COSITUR), 2013 Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu, Milli Eğitim Bakanlığı, Hacettepe Üniversitesi, Sağlık Bakanlığı Yayın No: 920, Ankara 2014.
• 4. Turkey Childhood (Primary School 2nd Grade Students) Obesity Survey - COSI-TUR 2016 Ministry of Health, General Directorate of Public Health, Ministry of National Education, World Health Organization European Regional Ofce, Ministry of Health Publication No: 1125, Ankara, 2019.
• 5. Rose-Jacobs, R, Black, M.M, Casey, P.H, Cook, J.T, Cutts, D.B, Chilton, M, Heeren, T, Levenson, S.M, Meyers, A.F. and Frank, D.A. (2008). Household food insecurity: associations with at-risk infant and toddler development. Pediatrics, 121 (1), 65-72.
• 6. Kawafheh, M.M, Hamdan, F.R, Abozeid, S.E.S. and Nawafleh, H. (2014). The effect of health education programs for parents about breakfast on students' breakfast and their academic achievement in the north of Jordan. International Journal of Advanced Nursing Studies, 3 (2), 84.
• 7. Koca, T, Akcam, M, Serdaroglu, F. and Dereci, S. (2017). Breakfast habits, dairy product consumption, physical activity, and their associations with body mass index in children aged 6–18. European Journal of Pediatrics, 176 (9), 1251-1257.
• 8. Muturi, N.W, Kidd, T, Khan, T, Kattelmann, K, Zies, S, Lindshield, E. and Adhikari, K. (2016). An examination of factors associated with self-efficacy for food choice and healthy eating among low-income adolescents in three US states. Frontiers in Communication, 1, 6. https://doi.org/10.3389/fcomm.2016.00006
• 9. Ames, G.E, Heckman, M.G, Grothe, K.B. and Clark, M.M. (2012). Eating self-efficacy: development of a short-form WEL. Eating Behaviors, 13 (4), 375-378.
• 10. ALBashtawy, M. (2017). Breakfast eating habits among schoolchildren. Journal of Pediatric Nursing, 36, 118-123.
• 11. Nakade, M, Akimitsu, O, Wada, K, Krejci, M, Noji, T, Taniwaki, N, Takeuchi, H. and Harada, T. (2012). Can breakfast tryptophan and vitamin B6 intake and morning exposure to sunlight promote morning-typology in young children aged 2 to 6 years?. Journal of Physiological Anthropology, 31 (1), 1-10.
• 12. Wüenstel, J.W, Kowalkowska, J, Wądołowska, L, Słowińska, M.A, Niedźwiedzka, E. and Kurp, L. (2015). Habitual eating of breakfast, consumption frequency of selected food and overweight prevalence in adolescents from various age groups. Developmental Period Medicine, 19 (2), 193-201.
• 13. Moschonis, G, Tsoutsoulopoulou, K, Efstathopoulou, E, Tsirigoti, L, Lambrinou, C.P, Georgiou, A, Filippou, C, Lidoriki, I, Reppas, K, Androutsos, O, Lionis, C, Chrousos, G.P. and Manios, Y. (2015). Conceptual framework of a simplified multi-dimensional model presenting the environmental and personal determinants of cardiometabolic risk behaviors in childhood. Expert Review of Cardiovascular Therapy, 13 (6), 673-692.
• 14. Horikawa, C, Kodama, S, Yachi, Y, Heianza, Y, Hirasawa, R, Ibe, Y, Saito, K, Shimano, H, Yamada, N. and Sone, H. (2011). Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: a meta-analysis. Preventive Medicine, 53 (4-5), 260-267.
• 15. Ardeshirlarijani, E, Namazi, N, Jabbari, M, Zeinali, M, Gerami, H, Jalili, R.B, Larihani, B. and Azadbakht, L. (2019). The link between breakfast skipping and overweigh/obesity in children and adolescents: A meta-analysis of observational studies. Journal of Diabetes & Metabolic Disorders, 18 (2), 657-664.
• 16. Moschonis, G, Kalliora, A.C, Costarelli, V, Papandreou, C, Koutoukidis, D, Lionis, C, Chrousos, G.P. and Manios, Y. (2014). Identification of lifestyle patterns associated with obesity and fat mass in children: the Healthy Growth Study. Public Health Nutrition, 17 (3), 614-624.
• 17. Kocaadam-Bozkurt, B, Köksal, E. and Özalp Ateş, F.S. (2022). Mindful Eating Questionnaire for Children: Validation and Reliability in Turkish Children. Mindfulness, 13, 1469–1478
• 18. Özkan, N. ve Bilici, S. (2018). Yeme Davranişinda Yeni Yaklaşimlar: Sezgisel Yeme ve Yeme Farkindaliği. Gazi Sağlık Bilimleri Dergisi, 3(2), 16-24.
• 19. Bektaş, İ, Bektaş, M, Demir, D, Demir, Ş, Ayar, D. and Kudubeş, A.A. (2020). Psychometric Properties of the Turkish Version of the ‘Nine to Eleven-Year-Olds’ Attitudes Towards Breakfast Questionnaire. The Journal of Pediatric Research, 7 (4), 342-349.
• 20. Kabasakal, E, Arslan, U.E, Üner, S, Ünlü Konşuk, H, Bilir, N, Yardım, M.S, Araz, Ö, Huang, T. ve Özcebe, H. (2020). Çocuklar İçin Sağlıklı Yeme Öz-Yeterlik Ölçeğinin Türkçe Geçerlik ve Güvenirlik Çalışması. Türkiye Çocuk Hastalıkları Dergisi, 15: 72-77
• 21. Tapper, K, Murphy, S, Lynch, R, Clark, R, Moore, G.F. and Moore, L. (2008). Development of a scale to measure 9–11-year-olds' attitudes towards breakfast. European Journal of Clinical Nutrition, 62 (4), 511-518.
• 22. Story, M, Sherwood, N.E, Himes, J.H, Davis, M, Jacobs, D.R, Cartwright, Y, Smyth, M. and Rochon, J. (2003). An after-school obesity prevention program for African-American girls: the Minnesota GEMS pilot study. Ethnicity and Disease, 13 (1; SUPP/1), S1-54.
• 23. Framson, C, Kristal, A.R, Schenk, J.M, Littman, A.J, Zeliadt, S. and Benitez, D. (2009). Development and validation of the mindful eating questionnaire. Journal of the American Dietetic Association, 109 (8), 1439-1444.
• 24. Hart, S.R, Pierson, S, Goto, K. and Giampaoli, J. (2018). Development and initial validation evidence for a mindful eating questionnaire for children. Appetite, 129, 178-185.
• 25. Lohman, T.G, Roche, A.F. and Martorell, R. (1988). Anthropometric standardization reference manual: Human Kinetics. Champaign, IL.
• 26. Onis, M.D, Onyango, A.W, Borghi, E, Siyam, A, Nishida, C. and Siekmann, J. (2007). Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization, 85 (9), 660-667.
• 27. World Health Organisation. (2006). Global database on Body Mass Index: BMI Classification. Geneva: World Health Organization.
• 28. Skelton, J.A, Irby, M.B, Grzywacz, J.G. and Miller, G. (2011). Etiologies of obesity in children: nature and nurture. Pediatric Clinics, 58 (6), 1333-1354.
• 29. Antonogeorgos, G, Panagiotakos, D.B, Papadimitriou, A, Priftis, K.N, Anthracopoulos, M. and Nicolaidou, P. (2012). Breakfast consumption and meal frequency interaction with childhood obesity. Pediatric Obesity, 7 (1), 65-72.
• 30. Vanelli, M, Iovane, B, Bernardini, A, Chiari, G, Errico, M. K, Gelmetti, C, Corchia, M, Ruggerini, A, Volta, E. and Rossetti, S. (2005). Breakfast habits of 1,202 northern Italian children admitted to a summer sport school. Breakfast skipping is associated with overweight and obesity. Acta Biomed, 76 (2), 79-85.
• 31. Gross, S.M, Bronner, Y, Welch, C, Dewberry-Moore, N. and Paige, D.M. (2004). Breakfast and lunch meal skipping patterns among fourth-grade children from selected public schools in urban, suburban, and rural Maryland. Journal of the American Dietetic Association, 104 (3), 420-423.
• 32. Panagiotakos, D.B, Antonogeorgos, G, Papadimitriou, A, Anthracopoulos, M.B, Papadopoulos, M, Konstantinidou, M, Fretzayas, A. and Priftis, K.N. (2008). Breakfast cereal is associated with a lower prevalence of obesity among 10–12-year-old children: the PANACEA study. Nutrition, Metabolism and Cardiovascular Diseases, 18 (9), 606-612.
• 33. Arora, M, Nazar, G.P, Gupta, V.K, Perry, C.L, Reddy, K.S. and Stigler, M.H. (2012). Association of breakfast intake with obesity, dietary and physical activity behavior among urban school-aged adolescents in Delhi, India: results of a cross-sectional study. BMC Public Health, 12 (1), 1-12.
• 34. Ricotti, R, Caputo, M, Monzani, A, Pigni, S, Antoniotti, V, Bellone, S. and Prodam, F. (2021). Breakfast skipping, weight, cardiometabolic risk, and nutrition quality in children and adolescents: A systematic review of randomized controlled and intervention longitudinal trials. Nutrients, 13 (10), 3331.
• 35. Fernández-Alvira, J.M, De Bourdeaudhuij, I, Singh, A.S, Vik, F.N, Manios, Y, Kovacs, E, Jan, N, Brug, J. and Moreno, L.A. (2013). Clustering of energy balance-related behaviors and parental education in European children: the ENERGY-project. International Journal of Behavioral Nutrition and Physical Activity, 10 (1), 1-10.
• 36. Al Yazeedi, B, Berry, D.C, Crandell, J. and Waly, M. (2021). Family influence on children's nutrition and physical activity patterns in Oman. Journal of Pediatric Nursing, 56, e42-e48.