Perspectives in Practice
Association between Unhealthful Eating Patterns and Unfavorable Overall School Performance in Children MING-LING FU, PhD; LIEYUEH CHENG, PhD; SU-HAO TU, PhD; WEN-HARN PAN, PhD with unfavorable overall school performance were more likely to eat sweets and fried foods, and were less likely to eat foods rich in protein, vitamins, and minerals. A potential relationship between eating patterns and unfavorable overall school performance is supported by a positive relationship between frequency of food intake and food preferences in our study. J Am Diet Assoc. 2007;107:1935-1943. ABSTRACT The objective of this article is to evaluate the relationship between children’s unhealthful eating patterns and overall school performance. The Nutrition and Health survey in Taiwan Elementary School Children, 2001-2002, was carried out by using a multistaged complex sampling design. A total of 2,222 elementary school children who had complete data on demographics, anthropometrics, diet and lifestyle, and overall school performance were included in the analyses. Differences in characteristics between children with favorable and unfavorable overall performance were compared using t test and 2 test. Using factor analysis, food frequency of 22 food groups was grouped into ﬁve factors, which were used to construct dietary patterns. The association between dietary patterns and unfavorable overall performance was assessed by multiple logistic regression after adjustment for known risk factors. Prevalence of unfavorable overall performance in Taiwanese elementary school children was 7.1%. Unfavorable overall school performance was positively associated with unhealthful eating patterns, which included high intake of low-quality foods (eg, sweets and fried foods) and low intake of dairy products and highly nutrient-dense foods (eg, vegetables, fruit, meat, ﬁsh, and eggs). Children with a greater number of unhealthful eating patterns were more at risk for unfavorable overall performance in school. The study shows that children M.-L. Fu is a lecturer, Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan, ROC. L. Cheng is a professor, Department of Special Education, National Taipei University of Education, Taipei, Taiwan, ROC. S.-H. Tu is associate research fellow, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan, ROC. W.-H. Pan is a research fellow, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, ROC and a professor at both the Institute of Microbiology and Biochemistry and the Institute of Epidemiology, National Taiwan University, Taipei, Taiwan, ROC. Address correspondence to: Wen-Harn Pan, PhD, Institute of Biomedical Sciences, Academia Sinica, No 128, Sec 2, Academia Rd, Nan-Kang, Taipei 115, Taiwan, ROC. E-mail: firstname.lastname@example.org Copyright © 2007 by the American Dietetic Association. 0002-8223/07/10711-0003$32.00/0 doi: 10.1016/j.jada.2007.08.010
aiwan has undergone enormous social and economic change in recent times, leading to adoption of a fastfood culture and development of altered eating patterns. The increased participation of women in the workforce has led to increases in children eating out (1,2). Commercial advertising has pushed heavily the consumption of foods and snacks low in micronutrients and minerals, which has also inﬂuenced children’s food choices. Research on the relationship between nutrition and school performance has been carried out in four major areas (3,4): the effects of iodine or zinc supplementation in nutrientdeﬁcient children; the relationship between anemia, iron supplementation, and learning; the effects of insufﬁcient food intake; and the importance of breakfast.
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With regard to the effects of nutrient deﬁciencies and supplementation, children with iodine or zinc deﬁciency were found to have marked improvement in intelligence quotient (IQ) and cognitive ability after...
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November 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
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