Dietary habits in relation to breakfast consumption among adolescent males in New Zealand

Background: Adolescence is a vulnerable period of life whereby dietary habits are still being formed. These habits include regular breakfast consumption, which has been linked to several health benefits, including a lower body mass index and overall better diet quality. Previous literature identified that breakfast is a meal commonly skipped by adolescents. Breakfast consumption and associated dietary habits of adolescents have not been examined in New Zealand since the Adult Nutrition Survey 08/09, thus it is necessary to provide up to date data on this. Objective: To assess the dietary habits of male adolescents, aged 15-18 years, in New Zealand. In particular, this thesis will investigate associations between breakfast consumption patterns and weight status and overall diet quality of these adolescents. Design: The SuNDiAL (Survey of Nutrition, Dietary Assessment and Lifestyles) project is a nationwide, cross-sectional study focusing on male adolescents between the ages of 15-18 years in New Zealand. Six schools were recruited throughout New Zealand, with a total of 135 participants completing enrolment. Of these participants, 122 completed a dietary habits questionnaire, which was used to determine frequency of breakfast intake as well as food group intakes. Dietary data was also obtained through two 24-hour dietary recalls which was used to calculate energy, macronutrients and fibre intake via FoodWorks. Height and weight were measured and the World Health Organisation growth charts were used to determine Z-scores. Socioeconomic status was defined based on the 2018 New Zealand Deprivation Index, categorising the participants into low, medium or high deprivation categories depending on their corresponding scores. The prioritised ethnicity method was used to allocate participants into one of the following ethnic groups: Māori, Pacific, Asian, New Zealand European and Others. Results: The current study found that 57.4% of participants consumed breakfast every day, while 9.8% reported not usually consuming breakfast. Of those consuming breakfast regularly (≥5 days a week), 69% were of a healthy weight status, compared to 63% of those who never/rarely consumed breakfast. There were a higher percentage of participants in the high deprivation category consuming breakfast never/rarely compared to that of regular breakfast eaters. Regular breakfast eaters had higher mean energy intakes (10343 kJ/day (95% CI: 9749-10937)), along with mean fibre intakes (25.7 g/day (95% CI: 24-28)), and a higher percentage of energy from carbohydrates (44% of energy from carbohydrates), compared to those consuming breakfast never/rarely. Forty-eight percent and 21% of regular breakfast eaters met the MOH guidelines for servings of fruits and vegetables, respectively, compared to 25% and 10% respectively, for those never/rarely consuming breakfast. Conclusion: This study indicates that, in New Zealand adolescent boys, regular breakfast consumption promotes healthier overall eating habits and is associated with a healthy weight status. The results of this study also identify areas that need improvement in terms of the breakfast consumption and associated dietary habits in New Zealand male adolescents. More specifically, those in high deprivation areas were more likely to skip breakfast. Further research, with a larger and more representative population, is required to validate the findings of this study