The intake and quality of breakfast consumption in adolescents attending public secondary schools in the North West province, South Africa

Objectives: The objectives of the study were to determine the proportion and quality of breakfast intake in adolescents, and to determine the effect of breakfast intake and quality on overall diet quality.Design: A cross-sectional quantitative study design was used.Setting: The setting was seven public secondary schools in Potchefstroom and the surrounding areas in North West province.Subjects: The subjects were randomly selected adolescents in grades 9-11 (n = 244).Outcome measures: A self-administered demographic questionnaire was completed by the adolescents. Single 24-hour recall, using the four-stage multiple-pass method, was conducted to obtain information on breakfast and dietary intake for the day. Breakfast quality was measured by applying a breakfast quality score. The Diet Quality Index Revised was used to assess the quality of the overall diet. Spearman’s rank correlation coefficient was employed to assess an association between the continuous variables. The chi-square or Fisher’s exact test was utilised to assess an association between the categorical variables.Results: The proportion of breakfast intake and skipping was 81% and 19%, respectively. The mean breakfast quality score was moderate (3.1). No significant difference was shown in the diet quality score for the breakfast eaters and skippers. The breakfast quality score was marginally associated with calcium intake (p-value < 0.0001, r = 0.418), phosphorous intake (p-value < 0.0001, r = 0.378) and total diversity score (p-value < 0.0001, r = 0.369).Conclusion: The proportion of breakfast skipping, moderate quality of the breakfast consumed and trend of improved nutrient intake with improved breakfast quality highlights the need for breakfast education and intervention as part of the Integrated School Health Policy.Keywords: adolescent, breakfast, breakfast quality, diet quality, adolescenc