Background
Methods
Study design and setting
Participants
Measures
Anthropometric measures
Behavioral-psychosocial (BP) survey
Breakfast consumption
Other behavioral factors
Variable | Question |
---|---|
Dietary Behaviors
| |
Eat dairy products (yes/no) | Do you eat dairy foods (such as paneer [cottage cheese], butter etc.)? |
Eat fruits (≥1 times/day) | In the past one year, how many times did you eat fruits (not counting fruit juice)? |
Eat vegetables (≥2 times/day) | In the past one year, how many times did you eat vegetables (not counting carrots, potatoes or salad)? |
Eat fried food (≥2 times/day) | In the past one year, how many times did you eat fried foods (such as samosa, pakoda, vada etc.)? |
Drink soft-drinks (≥2 times/day) | How often do you drink soft drinks (such as Pepsi, Coca Cola, Mirinda, Sprite, 7Up, Limca etc.)? |
Physical Activity
| |
Do mild exercise (≥1/2 hour/day) | In a usual week, how many hours do you spend doing mild exercise (little effort). Examples: walking slowly (to school, friends’ house, etc.), bowling, golf, yoga |
Do moderate exercise (≥1/2 hour/day) | In a usual week, how many hours do you spend doing moderate exercise (not exhausting). Examples: walking quickly, cricket, gymnastics, slow cycling, volleyball, dancing, table-tennis, skipping, badminton |
Do strenuous exercise (≥1/2 hour/day) | In a usual week, how many hours do you spend doing strenuous exercise (heart beats rapidly). Examples: cycling fast, aerobic exercise, jogging, swimming, laps, skating, tennis, soccer/football, basketball, throwball, kabaddi, kho kho, pitthu [a local game involving running] |
Sedentary Behaviors
| |
Watch TV, Weekday (≥2 hours/day) | On an average weekday (Monday-Friday), during your free time, how many hours do you spend watching TV and videos? |
Watch TV, Weekend (≥2 hours/day) | On an average weekend day (Saturday or Sunday), how many hours do you spend watching TV and videos? |
Use Computer, Weekday (≥2 hours/day) | On an average weekday (Monday-Friday), during your free time, how many hours do you spend using a computer for net surfing, e-mailing, chatting, playing games, watching movies, etc.? |
Use Computer, Weekend (≥2 hours/day) | On an average weekend day (Saturday or Sunday), how many hours do you spend using a computer for net surfing, e-mailing, chatting, playing games, watching movies, etc.? |
Study School, Weekday (≥2 hours/day) | On an average weekday (Monday-Friday), during your free time, how many hours do you spend reading, studying and doing academic work, including tuitions? |
Study School, Weekend (≥2 hours/day) | On an average weekend day (Saturday or Sunday), how many hours do you spend reading, studying and doing academic work, including tuitions? |
Psychosocial risk factors
Psychosocial factor | Items | Cronbach’s Alpha | Example of question |
---|---|---|---|
Values | 7 | 0.77 | How important is being healthy for you? |
Beliefs | 5 | 0.84 | How strongly do you agree with the statement that “The type of food I eat affects my health”? |
Satisfaction with body image | 5 | 0.84 | How satisfied are you with your weight? |
Depression | 7 | 0.82 | In the past one year how often have you been bothered about worrying too much? |
Eating more than usual | 7 | 0.77 | Do you think you eat more than usual when you are studying for your exams? |
peer’s influence | 6 | 0.89 | Many of my friends care about eating healthy food? |
Parents’ influence | 6 | 0.92 | My parents encourage me for eating healthy food? |
Data analysis
Results
Breakfast consumption and demographic variables
Demographic profile | N (%) | Breakfast % | Chi-sqaure value | p-value | ||
---|---|---|---|---|---|---|
Never (n=129) | Intermediate (n=417) | Daily (n=1268) | ||||
Gender
| ||||||
Boys | 1094 (60.3) | 7.3 | 22.2 | 70.5 | 1.01 | 0.604 |
Girls | 720 (39.7) | 6.8 | 24.2 | 69.0 | ||
Age
| ||||||
<=13 | 418 (23.1) | 6.7 | 19.6 | 73.7 | 12.09 | 0.027 |
14 | 418 (23.1) | 4.6 | 23.9 | 71.5 | ||
15 | 443 (24.4) | 7.2 | 22.4 | 70.4 | ||
16 and above | 534 (29.5) | 9.4 | 25.5 | 65.2 | ||
School
| ||||||
Private | 944 (52.0) | 7.8 | 25.9 | 66.3 | 14.26 | 0.002 |
Government | 870 (48.0) | 6.3 | 19.4 | 73.8 | ||
Grade
| ||||||
8th
| 995 (54.9) | 5.8 | 21.9 | 72.3 | 7.97 | 0.019 |
10th
| 819 (45.2) | 8.7 | 24.3 | 67.0 |
Breakfast consumption and excess weight
Breakfast | N (%) | Overweight and Obese† % (95% CI) | ||||
---|---|---|---|---|---|---|
Overall | School Type | Gender | ||||
Private | Government | Boys | Girls | |||
Never | 129 | 22.9 | 37.8 | 7.3 | 26.0 | 18.5 |
(7.1) | (15.5-30.2) | (24.6-50.9) | (2.1-12.6) | (16.5-35.6) | (8.3-28.8) | |
Sometimes | 417 | 15.2 | 27.6 | 2.9 | 16.5 | 14.4 |
(23.0) | (9.9-20.6) | (17.6-37.7) | (0.0-6.0) | (9.4-23.6) | (7.9-20.8) | |
Daily | 1268 | 14.6 | 25.6 | 4.0 | 15.4 | 14.3 |
(69.9) | (10.0-19.2) | (16.5-34.7) | (2.3-5.7) | (9.4-21.5) | (9.3-19.3) | |
F test value | 3.25 | 2.45 | 1.07 | 3.16 | 0.35 | |
P value | 0.039 | 0.087 | 0.345 | 0.043 | 0.702 |
Breakfast consumption and other dietary, physical activity, and sedentary behaviors
Dietary Behaviours | Breakfast | Overall | School Type | Gender | |||
---|---|---|---|---|---|---|---|
Private | Government | Boys | Girls | ||||
Unadjusted OR | Adjusted OR† | OR‡ | OR‡ | OR§ | OR§ | ||
(95% CI) | (95% CI) | (95% CI) | (95% CI) | ||||
Eat dairy products (yes/no) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.9 | 2.2 | 1.3 |
4.9
| 1.2 |
4.6
| |
(0.8-4.4) | (0.9-5.2) | (0.4-4.1) |
(1.2-19.3)
| (0.4-3.9) |
(1.2-17.3)
| ||
Daily |
4.8
|
5.5
|
3.4
|
9.3
|
3.5
|
7.9
| |
(2.1-10.8)
|
(2.4-12.5)
|
(1.0-11.1)
|
(2.9-3.2)
|
(1.1-11.4)
|
(2.4-26.6)
| ||
Eat fruits (≥1 times/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 0.8 | 0.8 | 1.0 | 0.6 | 0.6 | 1.2 | |
(0.5-1.3) | (0.5-1.2) | (0.6-1.8) | (0.3-1.1) | (0.3-1.0) | (0.6-2.5) | ||
Daily |
1.7
|
1.7
|
2.3
| 1.0 | 1.3 |
2.2
| |
(1.1-2.4)
|
(1.1-2.5)
|
(1.3-3.9)
| (0.6-1.7) | (0.8-1.1) |
(1.2-4.2)
| ||
Eat vegetables (≥2 times/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.5 | 1.5 | 1.6 | 1.2 | 1.4 | 1.6 | |
(0.9-2.6) | (0.9-2.5) | (0.8-3.0) | (0.5-3.1) | (0.7-2.7) | (0.7-3.7) | ||
Daily |
2.2
|
2.2
|
2.2
| 2.0 |
2.1
|
2.2
| |
(1.3-3.5)
|
(1.3-3.5)
|
(1.2-4.1)
| (0.9-4.5) |
(1.1-3.9)
|
(1.0-4.8)
| ||
Eat fried foods (≥1 times/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 0.8 | 0.8 | 1.1 | 0.7 | 0.8 | 0.9 | |
(0.5-1.2) | (0.5-1.3) | (0.5-2.2) | (0.4-1.3) | (0.5-1.4) | (0.4-1.8) | ||
Daily | 0.8 | 0.8 | 1.0 | 0.7 | 0.9 | 0.6 | |
(0.5-1.2) | (0.5-1.2) | (0.5-2.0) | (0.4-1.2) | (0.5-1.5) | (0.3-1.2) | ||
Soft drink consumption (≥2 times/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes |
0.6
| 0.6 | 0.7 | 0.6 | 0.6 | 0.6 | |
(0.4-0.9)
| (0.4-1.0) | (0.4-1.3) | (0.3-1.1) | (0.4-1.1) | (0.3-1.3) | ||
Daily |
0.7
| 0.7 | 0.7 | 0.7 | 0.7 | 0.6 | |
(0.4-1.0)
| (0.5-1.1) | (0.4-1.3) | (0.4-1.2) | (0.4-1.2) | (0.3-1.2) | ||
Physical Activity
| |||||||
Strenuous (≥ ½ hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes |
1.9
|
1.9
|
1.9
| 2.0 |
2.0
| 1.7 | |
(1.2-2.9)
|
(1.2-3.0)
|
(1.1-3.3)
| (1.0-4.0) |
(1.1-3.5)
| (0.8-3.4) | ||
Daily |
1.7
|
1.7
|
1.8
| 1.7 |
1.7
| 1.7 | |
(1.2-2.5)
|
(1.2-2.6)
|
(1.1-3.0)
| (0.9-3.1) |
(1.0-2.8)
| (0.9-3.3) | ||
Moderate (≥ ½ hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes |
2.8
|
2.8
|
2.4
|
3.2
|
3.9
| 1.8 | |
(1.8-4.5)
|
(1.7-4.5)
|
(1.2-4.9)
|
(1.6-6.4)
|
(2.0-7.6)
| (0.8-3.9) | ||
Daily |
2.6
|
2.7
|
2.9
|
2.4
|
2.8
|
2.4
| |
(1.7-3.9)
|
(1.7-4.1)
|
(1.5-5.4)
|
(1.3-4.4)
|
(1.6-4.8)
|
(1.2-5.0)
| ||
Mild (≥ ½ hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes |
2.4
|
2.6
|
2.1
|
3.1
|
3.7
| 1.5 | |
(1.6-3.8)
|
(1.6-4.0)
|
(1.1-3.9)
|
(1.6-5.9)
|
(2.1-6.7)
| (0.7-3.0) | ||
Daily |
2.7
|
2.9
|
2.8
|
3.01
|
4.6
| 1.5 | |
(1.9-4.0)
|
(1.9-4.4)
|
(1.6-5.0)
|
(1.68-5.39)
|
(2.8-7.7)
| (0.8-3.0) | ||
Sedentary Activity
| |||||||
Watch TV, weekday (≥2 hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.0 | 1.0 | 1.1 | 1.0 | 0.8 | 1.5 | |
(0.7-1.5) | (0.7-1.5) | (0.6-1.8) | (0.5-1.8) | (0.5-1.3) | (0.8-2.9) | ||
Daily | 0.8 | 0.8 | 0.8 | 0.7 | 0.7 | 0.9 | |
(0.6-1.1) | (0.6-1.2) | (0.5-1.4) | (0.4-1.3) | (0.5-1.2) | (0.5-1.7) | ||
Watch TV, weekend (≥2 hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.7 | 1.7 | 2.1 | 1.3 | 1.8 | 1.5 | |
(1.1-2.5) | (1.1-2.5) | (1.2-1.5) | (0.7-2.5) | (1.1-3.1) | (0.8-2.8) | ||
Daily | 1.3 | 1.3 | 1.4 | 1.2 | 1.5 | 1.0 | |
(0.9-1.8) | (0.9-1.8) | (0.9-2.4) | (0.7-2.0) | (0.9-2.5) | (0.6-1.9) | ||
Use computer, weekday (≥2 hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 0.9 | 1.0 | 1.0 | 0.9 | 0.8 | 1.4 | |
(0.6-1.4) | (0.6-1.5) | (0.6-1.9) | (0.4-1.7) | (0.8-4.2) | (0.6-3.2) | ||
Daily | 0.8 | 0.9 | 0.8 | 1.1 | 0.8 | 1.3 | |
(0.5-1.2) | (0.6-1.3) | (0.4-1.3) | (0.6-2.0) | (0.7-3.1) | (0.6-2.7) | ||
Use computer, weekend (≥2 hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.1 | 1.1 | 0.9 | 0.8 | 0.8 | 1.9 | |
(0.7-1.6) | (0.7-1.7) | (0.5-1.9) | (0.4-1.4) | (0.5-1.4) | (0.8-4.2) | ||
Daily | 1.0 | 1.0 | 1.2 | 0.7 | 0.9 | 1.4 | |
(0.7-1.5) | (0.7-1.6) | (0.7-2.3) | (0.4-1.2) | (0.6-1.5) | (0.7-3.1) | ||
Study school, weekday (≥ 2 hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.2 | 1.2 | 1.4 | 0.9 | 1.2 | 1.1 | |
(0.8-1.8) | (0.8-1.8) | (0.8-2.4) | (0.5-1.9) | (0.7-2.0) | (0.5-2.2) | ||
Daily |
1.6
|
1.5
|
1.8
| 1.2 | 1.4 | 1.6 | |
(1.1-2.4)
|
(1.0-2.2)
|
(1.0-3.0)
| (0.7-2.3) | (0.9-2.3) | (0.8-3.2) | ||
Study school, weekend (≥ 2 hr/day) | Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Sometimes | 1.4 | 1.4 | 1.5 | 1.1 | 1.3 | 1.4 | |
(0.9-2.0) | (0.9-2.0) | (0.9-2.7) | (0.6-2.1) | (0.7-2.2) | (0.7-2.7) | ||
Daily |
2.3
|
2.3
|
2.5
|
2.0
|
2.0
|
2.7
| |
(1.6-3.3)
|
(1.5-3.3)
|
(1.5-4.2)
|
(1.1-2.6)
|
(1.2-3.2)
|
(1.4-5.0)
|
Psychosocial factors and breakfast consumption
Psychosocial factors‡ | Overall | School Type | Gender | ||
---|---|---|---|---|---|
Private | Government | Boys | Girls | ||
Estimate† (SE) | Estimate† (SE) | Estimate† (SE) | Estimate† (SE) | Estimate† (SE) | |
Values
| 0.09**
| 0.07 | 0.11*
| 0.09*
| 0.10 |
(0.03) | (0.05) | (0.05) | (0.04) | (0.06) | |
Belief
| 0.08**
| 0.06 | 0.11*
| 0.14**
| −0.02 |
(0.03) | (0.04) | (0.05) | (0.04) | (0.06) | |
Body Image Satisfaction
| 0.07*
| 0.02 | 0.11*
| 0.05 | 0.09 |
(0.03) | (0.05) | (0.04) | (0.04) | (0.05) | |
Depression
| −0.08**
| −0.10*
| −0.06 | −0.05 | −0.14**
|
(0.03) | (0.05) | (0.04) | (0.04) | (0.05) | |
Eating more than usual
| −0.01 | 0.00 | −0.01 | −0.00 | −0.01 |
(0.03) | (0.05) | (0.05) | (0.04) | (0.05) | |
Peer’s influence
| 0.12**
| 0.13**
| 0.10*
| 0.10**
| 0.01*
|
(0.32) | (0.05) | (0.05) | (0.04) | (0.06) | |
Parents’ Influence
| 0.17**
| 0.17**
| 0.17**
| 0.17**
| 0.19**
|
(0.03) | (0.05) | (0.05) | (0.04) | (0.06) |