Topics: Nutrition, Food, Nutrient density Pages: 20 (6878 words) Published: September 10, 2013
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: 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...

References: 1. Department of Health. Report of Nutrition and Health Survey in Taiwan, NAHSIT, 1993-1996. Taipei, Taiwan: Department of Health; 1998. 2. Department of Health. Report of the Elementary School Children’s Nutrition and Health survey in Taiwan, 2001-2002. Taipei, Taiwan: Department of Health; 2006. 3. Taras H. Nutrition and student performance at school. J Sch Health. 2005;75:199-213. 4. Currie J. Health disparities and gaps in school readiness. Future Child. 2005;15:117-138. 5. Bautista A, Barker PA, Dunn JT, Sanchez M, Kaiser DL. The effects of oral iodized oil on intelligence, thyroid status, and somatic growth in school-age children from an area of endemic goiter. Am J Clin Nutr. 1982;35:127-134. 6. Sandstead HH, Penland JG, Alcock NW, Dayal HH, Chen XC, Li JS, Zhao F, Yang JJ. Effects of repletion with zinc and other micronutrients on neuropsychologic performance and growth of Chinese children. Am J Clin Nutr. 1998;68(suppl):470S-475S. 7. Walker SP, Grantham-McGregor SM, Himes JH, Williams S, Duff EM. School performance in adolescent Jamaican girls: Associations with health, social and behavioural characteristics, and risk factors for dropout. J Adolesc. 1998;21:109-122. 8. Otero GA, Aguirre DM, Porcayo R, Fernandez T. Psychological and electroencephalographic study in school children with iron deficiency. Int J Neurosci. 1999;99:113-121. 9. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics. 2001;107:1381-1386. 10. Samadpour K, Sheikholeslam R, Abdollahi Z, Salehi FM. The effect of weekly dose of iron supplementation for 16 and 20 week on the iron status of adolescent girls in Iran. Asia Pac J Clin Nutr. 2004;13:S135. 11. Seshadri S, Gopaldas T. Impact of iron supplementation on cognitive functions in preschool and school-aged children: The Indian experience. Am J Clin Nutr. 1989;50:675-684, discussion 685-676. 12. Crombie IK, Todman J, McNeill G, Florey CD, Menzies I, Kennedy RA. Effect of vitamin and mineral supplementation on verbal and non-verbal reasoning of schoolchildren. Lancet. 1990;335:744-747. 13. Schoenthaler SJ, Bier ID, Young K, Nichols D, Jansenns S. The effect of vitamin- mineral supplementation on the intelligence of American schoolchildren: A randomized, double-blind placebo-controlled trial. J Altern Complement Med. 2000;6:19-29. 14. Sungthong R, Mo-suwan L, Chongsuvivatwong V. Effects of haemoglobin and serum ferritin on cognitive function in school children. Asia Pac J Clin Nutr. 2002;11:117-122. 15. Ivanovic D, Vasquez M, Aguayo M, Ballester D, Marambio M, Zacarias I. Nutrition and education. III. Educational achievement and food habits of Chilean elementary and high school graduates. Arch Latinoam Nutr. 1992;42:9-14. 16. Alaimo K, Olson CM, Frongillo EA Jr. Food insufficiency and American school-aged children’s cognitive, academic, and psychosocial development. Pediatrics. 2001;108:44-53. 17. Kleinman RE, Murphy JM, Little M, Pagano M, Wehler CA, Regal K, Jellinek MS. Hunger in children in the United States: Potential behavioral and emotional correlates. Pediatrics. 1998;101:E3. 18. Murphy JM, Wehler CA, Pagano ME, Little M, Kleinman RE, Jellinek MS. Relationship between hunger and psychosocial functioning in low-income American children. J Am Acad Child Adolesc Psychiatry. 1998;37:163-170. 19. Powell C, Grantham-McGregor S, Elston M. An evaluation of giving the Jamaican government school meal to a class of children. Hum Nutr Clin Nutr. 1983;37:381-388. 20. Meyers AF, Sampson AE, Weitzman M, Rogers BL, Kayne H. School Breakfast Program and school performance. Am J Dis Child. 1989; 143:1234-1239. 21. Murphy JM, Pagano ME, Nachmani J, Sperling P, Kane S, Kleinman RE. The relationship of school breakfast to psychosocial and academic functioning: Cross-sectional and longitudinal observations in an inner-city school sample. Arch Pediatr Adolesc Med. 1998;152:899-907. 22. Lopez I, de Andraca I, Perales CG, Heresi E, Castillo M, Colombo M. Breakfast omission and cognitive performance of normal, wasted and stunted schoolchildren. Eur J Clin Nutr. 1993;47:533-542.
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November 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION
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