Daily breakfast consumption with quality food choices contribute to a healthy lifestyle and should be encouraged in Malaysian children

Daily Breakfast Consumption with Quality Food Choices Contribute to a Healthy Lifestyle and Should Be Encouraged in Malaysian Children 1Malaysia, like many developing countries, experiences the coexistence of the dual burden of malnutrition. While overnutrition is more prevalent than undernutrition, poor dietary habits such as irregular consumption of main meals (e.g. breakfast), frequent consumption of snacks and fast food, and low consumption of fruits and vegetables have led to deficiencies in essential micronutrients. Alexandra Prabaharan, a certified nutritionist with the American Fitness Professionals and Associates (AFPA), explains that often, visible warning signs or external physical manifestations become only apparent at a severe stage of micronutrient deficiency.

This is an important issue to address as more than 30% of Malaysian children between the ages of 6 months and 12 years, did not meet the Malaysian recommended nutrient intake (RNI) for energy, calcium and vitamin D, with almost 50% of children exhibiting vitamin D insufficiency.1 A smaller proportion of children also had low status levels of hemoglobin, serum ferritin and vitamin A.1 Thus, although the diet of most Malaysian children is sufficient in calories, there is an inadequacy of certain nutrients which are required for healthy mental and physical development. In this way, inadequate intake of dietary iron results in low circulating iron stores in the body which can be measured as low ferritin status levels. The consequence is reduced hemoglobin synthesis, which can result in anemia.

Strategies to improve the nutritional status of Malaysian children should include implementing nutritional education for children and their guardians. It is shown that maternal nutritional knowledge is positively correlated with children’s vegetable intake and inversely correlated with the bad eating habit of snack consumption in between meals.2 Therefore, healthy dietary habits with optimal food choices should be promoted to influence the development of a child’s eating habits. This may contribute to an improved nutritional profile in the long term.

The old adage “breakfast is the most important meal of the day”, is not without basis. Besides providing energy for the day ahead, studies have also shown that regular consumption of breakfast provides some additional benefits. A study found that breakfast consumption is positively associated with nutrient adequacy in children and adolescents.3 The prevalence of nutrient inadequacy for vitamin D and A, calcium, iron, magnesium, phosphorus and zinc was higher when breakfast was omitted compared with breakfast consumers. Similar results were found in another study which showed that children and adolescents are more likely to reach a higher mean adequacy ratio for micronutrients when breakfast is consumed.4

In addition to these nutritional benefits, eating breakfast regularly may be of interest for overweight people. A study found that frequent breakfast consumption is associated with a reduction in body weight, adiposity and abdominal obesity.5 And indeed, a systematic review and meta-analysis revealed children and adolescents who regularly consumed breakfast had a reduced likelihood of being overweight compared to those with irregular breakfast habits.6

Apart from this, having healthy and regular eating habits, such as eating breakfast every morning, may not only be positive for your figure, but may also help you live a healthy lifestyle and achieve your goals in life. A multi-national study correlated breakfast consumption with lifestyle factors in schoolchildren and found that having breakfast on a regular basis is positively associated with healthy lifestyle behaviors such as being physically active and consuming fruits and vegetables.7 In contrast, it was negatively associated with unhealthy lifestyle behaviors in most countries including smoking, watching television for more than two hours per day and consumption of soft drinks.7 This 41 country study reveals that daily breakfast consumption can serve as an indicator to identify children at risk for unhealthy lifestyle behaviors.

Evidence from another systematic review on the effects of regular and healthy breakfast on academic performance links breakfast habits with children’s performance in school. Breakfast frequency and quality positively correlates with better grades or achievement test scores.8 In addition, data from school breakfast programs suggest benefits towards mathematic grades and arithmetic test scores in undernourished children and/or children from deprived or low socio-economic status backgrounds8. Thus, the effects of frequent and healthy breakfast should not be underestimated and one should consider starting the day with a healthy meal.

Some children in Malaysia should take this to heart as a recent study revealed that breakfast is the most commonly missed main meal among Malaysian children. Only 22% of schoolchildren in Kuala Lumpur consumed breakfast on a regular basis, with common choices of breakfast being bread, biscuits and ready-to-eat cereals.9 Healthy dietary habits like frequent breakfast consumption with quality food choices should be promoted among Malaysian children as it appears associated with positive outcomes for diet quality, micronutrient intake, weight status, lifestyle factors and cognitive performance.

References

  1. Poh BK, Ng BK, Siti Haslinda MD, et al. Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia). Br J Nutr. 2013;110:S21-S35.
  2. Poh BK, Tham KBL, Wong SN, Chee WSS, Tee ES. Nutritional status, dietary intake patterns and nutrition knowledge of children aged 5-6 years attending kindergartens in the Klang Valley, Malaysia. Malays J Nutr. 2012;18:231-242.
  3. Barr SI, DiFrancesco L, Fulgoni VL. Breakfast consumption is positively associated with nutrient adequacy in Canadian children and adolescents. Br J Nutr. 2014;112:1373-1383.
  4. Deshmukh-Taskar PR, Nicklas T a., O'Neil CE, Keast DR, Radcliffe JD, Cho S. The Relationship of Breakfast Skipping and Type of Breakfast Consumption with Nutrient Intake and Weight Status in Children and Adolescents: The National Health and Nutrition Examination Survey 1999-2006. J Am Diet Assoc. 2010;110:869-878.
  5. Nurul-Fadhilah A, Teo PS, Huybrechts I, Foo LH. Infrequent Breakfast Consumption Is Associated with Higher Body Adiposity and Abdominal Obesity in Malaysian School-Aged Adolescents. PLoS One. 2013;8:1-6.
  6. De La Hunty A, Gibson S, Ashwell M. Does regular breakfast cereal consumption help children and adolescents stay slimmer? A systematic review and meta-analysis. Obes Facts. 2013;6:70-85.
  7. Vereecken C, Dupuy M, Rasmussen M, et al. Breakfast Consumption and Its Socio-Demographic and Lifestyle Correlates in Schoolchildren in 41 Countries Participating in the HBSC Study. Int J Public Health. 2009;54:180-190.
  8. Adolphus K, Lawton CL, Dye L. The effects of breakfast on behavior and academic performance in children and adolescents. Front Hum Neurosci. 2013;7:425.
  9. Koo HC, Jalil SNA, Abd Talib R. Breakfast eating pattern and ready-to-eat cereals consumption among schoolchildren in Kuala Lumpur. Malaysian J Med Sci. 2015;22:32-39.