Effects of Skipping Breakfast on Nutrition Status, Fatigue Level, and Attention Level among Middle School Students in Gyunggi Province, Korea

아침 결식이 경기지역 남녀 중학생의 영양섭취상태, 피로자각도 및 주의집중력에 미치는 영향

  • 임경숙 (수원대학교 식품영양학과)
  • Received : 2014.10.10
  • Accepted : 2014.10.15
  • Published : 2014.10.31


Eating breakfast provides crucial nutrition for brain function and helps promote overall health. It is especially critical in growing adolescents, as it is known to form good eating habits and better study habits. This study investigated the effects of skipping breakfast on nutritional state, fatigue level, and attention level. A cross-sectional study was conducted in 2010 on total of 828 adolescents composed of 414 boys and 414 girls. Students who ate breakfast never to twice per week were placed in the breakfast-skipper group while students who ate breakfast more than five times per week were included in the breakfast-eater group. Students performed a self-reported questionnaire on food behaviors, amount of food consumption, fatigue level, attention deficient hyperactivity disease (ADHD) level by Conners-Wells' Adolescent Self-Report Scales, depression scale, and self-esteem level. Statistical analysis was conducted using the SAS program (version 9.1). A total of 135 boys (32.6%) and 138 girls (33.3%) were included in the breakfast-skipper group, whereas 241 boys (58.2%) and 223 girls (53.9%) were included in the breakfast-eater group. The breakfast-skipper group showed irregular food behaviors and lacked nutrients. Specifically, energy (p< .001), protein (p< .001), dietary fiber (p< .001), calcium (p< .01), vitamin A (p< .01), thiamin (p< .05), niacin (p< .001) levels in boy breakfast-skippers were statistically lower compared to boy breakfast-eaters. Intakes of all nutrients except fat in girl breakfast-skippers were statistically lower than in girl breakfast-eaters. Girl breakfast-skippers (41.3%) showed significantly higher fatigue risks compared to girl breakfast-eaters (21.5%). Low attention level was also observed only in girls in the breakfast-skipping group. Moreover, students in the breakfast-skipper group showed higher scores for depression and low self-esteem (p< .001). In conclusion, skipping breakfast has effects on young adolescents' nutrition, manifesting as high fatigue level and low attention level, especially in girls.


Supported by : 농림수산식품부


  1. Adolphus K, Lawton CL, Dye L, 2013. The effects of breakfast on behavior and academic performance in children and adolescents. Front Hum. Neurosci., 7:425(1-28)
  2. Arora M1, Nazar GP, Gupta VK, Perry CL, Reddy KS, Stigler MH, 2012. Association of breakfast intake with obesity, dietary and physical activity behavior among urban school-aged adolescents in Delhi, India: results of a crosssectional study. BMC Public Health, 12:881(1-12)
  3. Bahn GH, Shin MS, Cho SC, Hong KE, 2001. A preliminary study for the development of the assessment scale for ADHD in adolescents: Reliability and validity for CASS(S). Korean J. Child & Adol. Psychiatr., 12(2):218-224
  4. Basch CE, 2011. Breakfast and the Achievement Gap Among Urban Minority Youth. J. Sch. Health., 81(10):635-640
  5. CAN Pro 3.0 (Computer-Aided Nutrition Analysis Program, Pro 3.0), 2006. The Korean Nutrition Society, Seoul.
  6. Choe JS, Chun HK, Chung GJ, Nam HJ, 2003. Relations between the dietary habit and academic achievement, subjective health judgement, physical status of high school students. J. Korean Soc. Food Sci. Nutr., 24(4):624-635
  7. Conner CK, 1997. Conners Rating Scales. Revised Technical Manual. Multi-Health Systems, New York, pp 213-215
  8. Conner SL, GUstafson JR, Artaud-Wild SM, Classick-kohn CJ, Conner WE. 1989. The cholesterol-saturated fat index for coronary prevention; background, use and comprehensive table of foods. J. Am. Diet. Assoc., 89(6):807-816
  9. Deshmukh-Taskar PR, Nicklas TA, O'Neil CE, Keast DR, Radcliffe JD, Cho S, 2010. 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., 110(6):869-878
  10. Gacek M, 2013. Dietary habits and locus of control assessed in middle-school pupils from the Malopolska region of Poland. Rocz Panstw Zakl Hig., 64(2):129-134
  11. Harris WS, Held SJ, Dujovne CA. 1995. Comparison of two scoring systems used to monitor diets in outpatient clinical trials. J. Cardiovasc. risk, 2(4):359-365
  12. Hong S, Bae HC, Kim HS, Park EC, 2014. Variation in mealskipping rates of Korean adolescents according to socioeconomic status: results of the Korea Youth Risk Behavior Web-based Survey. J. Prev. Med. Public Health, 47(3):158-168
  13. Jackson LW, 2013. The most important meal of the day: why children skip breakfast and what can be done about it. Pediatr. Ann., 42(9):184-187
  14. Jeon BJ, 1974. Self-esteem. A test of its measurability. Yonsei Journal, 11(1):107-129
  15. Jones JF, Nisenbaum R, Solomon L, Reyes M, Reeves WC, 2004. Chronic fatigue syndrome and other fatiguing illnesses in adolescents: a population-based study. J. Adolesc. Health, 35(1):34-40
  16. Kim HY, Frongillo EA, Han SS, Oh SY, Kim WK, Jang YA, Won HS, Lee HS, Kim SH, 2003. Academic performance of Korean children is associated with dietary behaviours and physical status. Asia Pac. J. Clin. Nutr., 12(2):186-192
  17. Kim JA, Kim IK, 2012. A study on self-regulated learning, attentional control, and fatigue related to breakfast characteristics of university students. J. Korean Public Health Nurs., 26(3):465-477
  18. Kim JS, Lee SA, Kim MS, 2006. Effects of stretching on fatigue and concentration in high school students. J. Korean Acad. Child Health Nurs., 12(2):196-203
  19. Kral TVE, Whiteford LM, Heo MS, Faith MS, 2011. Effects of eating breakfast compared with skipping breakfast on ratings of appetite and intake at subsequent meals in 8- to 10-y-old children. Am. J. Clin. Nutr., 93(2):284-291
  20. Lee HS, 2013. Effect of Self-differentiation and Self-esteem on School Adjustment among Adolescents. J. Korea Contents Assoc., 13(1):333-341
  21. Lee SY, Kim YJ, 2000, Factors associated with fatigue in middle-aged male workers. J. Korean Acad. Fam. Med., 21(10):1277-1287
  22. Merten MJ, Williams AL, Shriver LH, 2009. Breakfast consumption in adolescence and young adulthood: parental presence, community context, and obesity. J. Am. Diet. Assoc., 109(8):1384-1391
  23. Nicklas TA, Bao W, Webber LS, Berenson GS, 1993. Breakfast consumption affects adequacy of total daily intake in children. J. Am. Diet. Assoc., 93(8):886-891
  24. Pereira MA, Erickson E, McKee P, Schrankler K, Raatz SK, Lytle LA, Pellegrini AD, 2011. Breakfast frequency and quality may affect glycemia and appetite in adults and children. J. Nutr., 141(1):163-168
  25. Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD, 2005. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J. Am. Diet. Assoc, 105(5):743-760
  26. Report of the National Health and Nutrition Survey 2012, Ministry of Health & Welfare, The Korea Centers of Disease Control and Prevention.
  27. Robins RW, Widaman KF, Conger RD, 2013. Is Low Self-Esteem a Risk Factor for Depression? Findings from a Longitudinal Study of Mexican-Origin Youth. Dev. Psychol., 50(2):622-633
  28. Rosenberg, M, 1965. Society and adolescent self-image. Princeton : Princeton University Press, pp 135-138
  29. Shin SC, Kim MK, Yun KS, Kim JH, Lee MS, Moon SJ, Lee MJ, Lee HY, Yoo KJ, 1991. The center for epidemiologic studies-depression scale: its use in Korea. J. Korean Neuropsychiatr Assoc., 30(4):752-767
  30. Stea TH, Torstveit MK, 2014. Association of lifestyle habits and academic achievement in Norwegian adolescents: a cross-sectional study. BMC Public Health, 14(1):829(1-8)
  31. The Korean Centers for Disease Control and Prevention & the Korean Pediatric Society, 2007. Body Growth Standard Value of Korean Pediatrics and Juveniles in 2007, Seoul
  32. The Korean Nutrition Society, 2010. Dietary Reference Intakes for Koreans 2010. The Korean Nutrition Society, Seoul, pp xxiv-xxvii
  33. The Korean Society for the Study of Obesity, 2012. Obesity and Treatment Guidelines 2012. Korean Society for the Study of Obesity, Seoul, pp 141-148
  34. Timlin MT, Pereira MA, 2007. Breakfast frequency and quality in the etiology of adult obesity and chronic diseases. Nutr. Rev., 65(6 Pt 1):268-281
  35. Yeoh YJ, Yoon JH, Shim JE, 2009. Relation of breakfast intake to diet quality in korean school-aged children: Analysis of the data from the 2001 national health and nutrition survey. Korean J. Comm. Nutr., 14(1):1-11
  36. Yi BS, 2004. A Comparative study on dietary life and recognition of diet related factors in elementary, middle and high school students. J. Korean Diet. Assoc., 10(3):364-374
  37. Yi BS, Yang IS, 2006. An exploratory study for identifying factors related to breakkfast in elementary, middle and high school students. Korean J. Comm. Nutr., 11(1):25-38
  38. Yoon NJ, Shin NN, 2014. The effects of children's perceptions of parental expectations, self-esteem, and achievement motivation on school happiness. Korean J. Child. Studies, 35(3):157-176
  39. Yorra ML, 2014. Self-efficacy and self-esteem in third-year pharmacy students. Am. J. Pharm. Educ., 78(7):134-138

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