ARTICLES
RELATIONSHIP BETWEEN SKIPPING BREAKFAST, ACADEMIC PERFORMANCE
AND BMI AMONG NURSING STUDENTS
* **
Mrs. Kirandeep Kaur & Dr. C.P Sharma
*Ph.D. Scholar, Himalayan University, Itanagar, Arunachal Pradesh, India.
**Research Supervisor, Himalayan University, Itanagar, Arunachal Pradesh, India.
DOI: http://doi.org/10.47211/trr.2019.v05i02.007
th th th
Received 28 October 2019, Accepted 5 December 2019, Published 20 December 2019
ABSTRACT
The existing study performed was to find the relationship between skipping breakfast, academic performance
and BMI among 60 nursing students in selected college of Nursing, Bathinda. Objectives under this study were:
to assess the skipping breakfast habits among nursing students by using skipping breakfast assessment sheet,
assess the academic performance of nursing students by using academic performance sheet, assess the BMI of
nursing students, find the relation between skipping breakfast, academic performance and BMI among nursing
students, find out the association between skipping breakfast with their selected socio-demographic variables.
st nd
A descriptive research design was adopted for the study. Population for the study taken was GNM 1 , 2 and
rd
3 year students. The study results found that maximum 42 (70%) students were skipping breakfast and 18
(30%) students were not breakfast skippers. Most of 41(68.33%) students were having common reason for
skipping breakfast was lack of time. There was a significant association between skipping breakfast with grade
and BMI. There was a significant association of skipping breakfast with educational status of mother, area of
residence and type of family at p-0.05.
Key words: Skipping breakfast, Academic performance, BMI, Nursing Students.
ABOUT AUTHORS
Author Mrs. Kirandeep Kaur, M.Sc (N) Child Health Nursing is Ph.D. Research Scholar in Himalayan University,
Arunachal Pradesh, India.
Author Dr. C. P Sharma M.Sc (N) Medical Surgical Nursing is Research Supervisor in Himalayan University,
Arunachal Pradesh, India.
40
Page
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
INTRODUCTION
Breakfast is taken as an important dietary source of nutrients which provides energy during the day as
1
necessary. In students, the eating of breakfast is proportional to many definite outcomes like maintenance of
2
body weight and regular attending of classes. In addition to, all kind of positive effects like enthusiasm, energy
level, interest, mental alertness, happiness and determination rises crossly in the morning to noon time and is
3
much more raised in habitual breakfast eaters. It also increases the ability to focus and lessen the level of
4
failures in attention and cognition during the day especially in the case of multitasked work.
5
Young adults are those who aged 18-30 years have a bit of maximum rates of meal skipping as compared to
6
other age groups as said by Australian Bureau of Statistics. Data from the American National Health and
Nutrition Examination Survey (NHANES) 2011-12 proposed that 33% of young adults do not consume breakfast
7
on daily basis.
Researchers didn’t know exactly what the link between two is, but they believed that there can be many
factors behind it. For one, skipping breakfast can cause overeating rest for the day, which may lead to weight
gain and may increase the risk of heart disease. However, it is also possible that skipping breakfast can have
8
adverse effects in the body like reduce insulin sensitivity.
The prevalence of skipping breakfast has increased in age group of < 25 years and it will decline with the
9
increase in age.
When you skip your breakfast 12 things will happen to your body which includes greater risk of having heart
disease, more likely to acquire diabetes, may increase weight, metabolism may slow down, may get stupid, get
irritable, lose the energy, breath go down, cortisol level may raise, can develop chronic inflammation, have
10
more cravings rest for the day and period may get worse.
BMI provides a simple numeric measure which allows health professionals to discuss weight problems more
objectively with their patients. BMI was designed to be used as a simple means of classifying average
11
sedentary (physically inactive) populations, with an average body composition.
2
For young adults, the current value recommendations are as follows: Person having BMI lower than 18.5kg/m
2 2
suggests underweight, BMI with 18.5-25 kg/m indicates normal weight, BMI from 25-30kg/m indicates
2 12
overweight and more than 30kg/m suggests obese.
PROBLEM STATEMENT
A study to assess the relationship between skipping breakfast, academic performance and BMI among nursing
students in selected college of nursing, Bathinda.
OBJECTIVES
1. To assess the skipping breakfast habits among nursing students by using skipping breakfast assessment
sheet.
2. To assess the academic performance of nursing students by using academic performance sheet.
3. To assess the BMI of nursing students.
4. To find the relation between skipping breakfast, academic performance and BMI among nursing students.
5. To find out the association between skipping breakfast with their selected socio-demographic variables.
MATERIALS AND METHOD
Research approach: Quantitative research approach was adopted for this study.
Research design: The research design used for this study was descriptive research design.
Research setting: The study was conducted in college of nursing, Adesh University, Bathinda.
st nd rd
Population: Population for the study taken was GNM 1 , 2 and 3 year students.
Sample size: Total sample size was 60 students.
Sampling technique: Sample was selected by using non-probability purposive sampling technique.
CRITERIA FOR SAMPLE SELECTION
Inclusive criteria:
1. Male and female Nursing students aged 18 to 23 were asked to participate in the study.
2. Students who are willing to participate in the study.
3. Students who are available and cooperative at the time of data collection.
41
Exclusive criteria:
1. Students who are on leave and sick during the time of data collection.
Page
2. Students with any hormonal problems.
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
DEVELOPMENT OF TOOL
Section A: includes Socio-demographic variables such as Age (in years), Gender, Class, Monthly Family income,
Educational status of father, educational status of mother, area of residence and type of staying.
Section B: includes skipping breakfast assessment sheet which contains 7 questions which was used to assess
skipping breakfast habits.
Section C: includes academic performance assessment sheet. It was divided into 2 parts:
1. Class assessment level which was used to assess the student’s academic performance in the class which
contains 27 questions and every question is rated on three point Likert scale. Answers of the students were
recorded, scored, and then summed together. It was categorized into three levels as follows: - (1) indicates
low, (2) indicates moderate, (3) indicates high class level.
2. GPA (Grade Point Average): this section aimed to assess GPA of the nursing students, which included the
following score average:
Grade Score
A 90% ≤ 100%
B 75 %< 90%
C 60 %< 75%
D 50 %< 60%
E <50%
Section D: Body mass index (BMI) measurement: this part aimed to assess the nursing students BMI according
to classification of WHO.
2
Classification Category (kg/m )
Underweight Lower than 18.5
Normal weight 18.5-24.9
Overweight 25-29.9
Obese More than 30
Method of data collection: A tool prepared after review of literature, collection of experts view. After
development of tool, it was given to GNM students in the class. Appropriate time was given to the students to
fill up the tool. Tool reliability was checked with cronbach’s alpha test was 0.80.
Statistical analysis: Data was analyzed by using SPSS software package version 20.0. Data was analysed by
frequency and percentage distribution. Chi-square test was used to study the association between two
variables.
Section I
TABLE-I
Frequency and Percentage distribution of socio-demographic variables of GNM students.
N=60
S.No. Socio-demographic variables f %
1. Age (in years)
a) 18-19 30 50
b) 20-21 22 36.67
c) 21-23 08 13.33
2. Gender
a) Male 17 28.33
b) Female 43 71.67
3. Class
a) GNM 1ts Year 25 41.67
nd
b) GNM 2 Year 15 25
rd
c) GNM 3 Year 20 33.33
42
Page
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
4. Family Income (in months)
a) 10,001-20,000 10 16.67
b) 20,001-30,000 22 36.67
c) ≥30,001 28 46.67
5. Educational status of father
a) No formal education 12 20
b) High school 04 6.67
c) Senior Secondary 20 33.33
d) Graduation and above 24 40
6. Educational status of mother
a) No formal education 28 46.67
b) High school 04 6.67
c) Senior Secondary 18 30
d) Graduation and above 10 16.67
7. Area of residence
a) Rural 34 56.67
b) Urban 26 43.33
8. Type of staying
a) Day-scholar 32 53.33
b) Hosteller 28 46.67
Majority of 30 (50%) students were from 18-19 years age group, maximum 43 (71.67%) students were
st
females, 25 (41.67%) students were from GNM 1 year class, 28 (46.67%) students family monthly income was
≥20,001, 24 (40%) students father were graduate and above, 28 (46.67%) mothers were having no formal
education, 34 (56.67%) students belongs to rural area, 32 (53.33%) students were day scholars.
RESULTS:
Section II
Assess the frequency distribution of skipping breakfast habits among nursing students by using skipping
breakfast assessment sheet.
Table II N=60
Items n %
Students skipping breakfast
Skip( 4 times or more per week) 42 70
Not skip(less than 4times per week) 18 30
No. %
*
Reasons for skipping breakfast meal
Haven't time 41 68.33
Not hungry 26 43.33
Fear of increase weight 10 16.67
Don't like breakfast foods 9 15
Students family skip breakfast 8 13.33
Students friends skip breakfast 7 11.67
Breakfast not available 10 16.67
Lack of appetite 12 20
*
Effect of skipping breakfast meal on students
Feel hungry 35 58.33
A headache 38 63.33
Stomachache 13 21.67
Feel tired 17 28.33
Not have energy 19 31.67
Feel grumpy 2 3.33
43
Have trouble paying 4 6.67
Decrease attention in class 15 25
Page
*
Benefits of eating breakfast
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
Increase energy 43 71.67
Wakes up 14 23.33
Increase attention 20 33.33
Gaining good grades 7 11.67
Have a better mood 10 16.67
Improve health 20 33.33
Helps in try new foods 5 8.33
Increase activity 10 16.67
Students favorite food
Fast food 38 63.33
Traditional food 22 36.67
How often do students take tea or coffee per a day?
Never 5 8.33
1-2 times 17 28.33
3 - 4 times 34 56.67
5- 6 times 4 6.67
Above 0 0
How often do students drink/ soft drinks per day?
Never 8 13.33
1-2 times 10 16.67
3 - 4 times 36 60
5- 6 times 6 10
Above 0 0
* Students response more than one time.
Table 2 depicted frequency distribution of skipping breakfast habits among nursing students. More than
two-third 42 (70%) students were skipping breakfast and 18 (30%) students were not skipping their
breakfast. Regarding reasons for skipping breakfast meal, it was found that about two third 41(68.33%)
were not having enough time to eat, followed by 26 (43.33%) were skipping breakfast because they were
not feeling hungry. Regarding effect of skipping breakfast meal found that about two-third 38 (63.33%)
were having headache followed to this 35(58.33%) were feeling hungry. Regarding benefits of eating
breakfast most of 43 (71.67%) eating breakfast increases energy. In addition to students favourite food 38
(63.33%) students had fast foods. Regarding how often do students take tea or coffee/day, more than half
34 (56.67%) were taking tea/coffee 3-4 times a day. Regarding how often do students take soft drink per
day 36 (60%) were drinking 3-4 times a day.
Skip
30
Not skip
70
44
Fig 1: Pie diagram showed skipping breakfast habits among nursing students
Page
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
Assess academic performance of nursing students by using academic performance sheet.
Table 3 N-60
Academic performance level n %
Class assessment level
Low 22 36.67
Moderate 30 50
High 8 13.33
Grade point average
A 3 5
B 21 35
C 31 51.67
D 2 3.33
E 3 5
Table 3 displayed frequency distribution regarding academic performance of nursing students.It was
revealed that half of 30 (50%) students had moderate academic performance in class while assessing class
assessment level, More than half 31 (51.67%) students were under grade-C (60 - <75%)
Assess the BMI of nursing students.
Table-4 N-60
2
BMI Category (kg/m ) n %
Underweight Lower than 18.5 6 10
Normal weight 18.5-24.9 22 36.67
Overweight 25-29.9 25 41.67
Obese More than 30 6 10
Table 4 revealed that near to half 25 (41.67%) were overweight, followed by one third 22 (36.67%) were
having normal weight.
Find the relation between skipping breakfast, academic performance and BMI among nursing students.
Table-5 N-60
Academic performance Student skipping breakfast df χ2 p-value
level Skip breakfast Not skip
(42) breakfast
(18)
n % n %
Class assessment level
Low (22) 19 45.23 3 16.67 2 10.5195 0.0051
Moderate (30) 21 50 9 50 S
High (8) 2 4.76 6 33.33
Grade point average
A (3) 0 0 3 16.67
B (21) 16 38.09 5 27.77 4 9.6013 0.0476
C (31) 21 50 10 55.56 S
D (2) 2 4.76 0 0
E (3) 3 7.14 0 0
Student skipping breakfast
Skip breakfast Not skip
BMI (42) breakfast df χ2 p-value
(18)
n % N %
Underweight (≤18.5) 13 30.95 4 22.22
Normal weight (18.5-24.9) 12 28.57 12 66.67 3 8.5294 0.0361
Overweight (25-29.9) 14 33.33 2 11.11 S
45
Obese (≥30) 3 7.14 0 0
Page
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
Table 5 displayed that there was statistical significant relationship between skipping breakfast and
academic performance at p-0.05. In addition to, there was statistical significant relationship between
skipping breakfast and BMI at p-0.05.
Association between skipping breakfast with their selected socio-demographic variables.
Table-6 N-60
Socio-demographic Students Skipping breakfast df χ2 p-value
variables Skip Not skip
breakfast (42) breakfast (18)
n % n %
Age (in years) 0.9271 0.6290
a) 18-19 20 47.61 10 55.55 NS
2
b) 20-21 17 40.47 5 27.77
c) 21-23 5 11.90 3 16.67
Gender 6.5703 0.0103
a) Male 16 38.09 1 5.55 1 S
b) Female 26 61.90 17 94.44
Class 0.1270 0.9385
a) GNM 1ts Year 18 42.85 7 38.89 NS
nd
b) GNM 2 Year 10 23.80 5 27.78 2
rd
c) GNM 3 Year 14 33.33 6 33.33
Family Income (in months) 1.0915 0.5793
a) 10,001-20,000 NS
b) 20,001-30,000 6 14.28 4 22.22 2
c) ≥30,001 17 40.47 5 27.78
19 45.23 9 50
Educational status of 3.8095 0.2827
father NS
a) No formal education 7 16.67 5 27.78
b) High school
3
c) Senior Secondary 3 7.14 1 5.56
d) Graduation and above 12 28.57 8 44.44
20 47.61 4 22.22
Educational status of 8.2993 0.0401
mother S
a) No formal education 19 45.23 9 50
b) High school
3
c) Senior Secondary 1 2.38 3 16.67
d) Graduation and above 12 28.57 6 33.33
0 0 0 0
Area of residence 4.6671 0.0306
a) Rural 20 47.61 14 77.78 S
1
b) Urban 22 52.38 4 22.22
Type of staying 4.1327 0.0420
a) Day-scholar 26 61.90 6 33.33 1 S
b) Hosteller 16 38.09 12 66.67
Table 6 highlighted the relationship between skipping breakfast and socio-demographic variables of the
nursing students. There was a significant association between educational status of mother, area of residence
46
and type of staying and skipping breakfast at p-0.05.
Page
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
ARTICLES
DISCUSSION:
The first objective was to skipping breakfast habits among nursing students by using skipping breakfast
assessment sheet. The results were found to be maximum 42 (70%) students were skipping breakfast and 18
(30%) students were not skipping their breakfast. Most of 41(68.33%) students were having common reason
for skipping breakfast was lack of time. There was a significant association between skipping breakfast with
13
grade and BMI. The similar study was conducted by Devi Sarungbam Sarju et al. to assess the effect of
breakfast skipping on college performance and its nutritional status among Bsc nursing students. Results were
51 (70.8%) of the nursing students were skipping breakfast whereas 21 (29.2%) nursing students didn’t skip
their breakfast. Lack of time was utmost reason for skipping breakfast among breakfast skipper and non-
skipper. There was a significant association between skipping breakfast with grade at p-0.05.
CONCLUSION:
Breakfast skipping significantly affects a number of parameters like academic performance, attendance,
nutritional status etc. skipping breakfast affects both nutritional status and academic performance. There was
a significant association between skipping breakfast with grade and BMI as well as educational status of
mother, Area of residence and type of staying at p-0.05. Finally, nursing students should take breakfast
because it has many others benefits to eat. Students should eat breakfast daily especially when they are going
to hospitals.
REFERENCES:
1. Spence C.Breakfast: the most important meal of the day? Int J Gastron Food Sci .2017.8: 1-6.
2. Sandercock GRH, Voss C, Dye L (2010) Associations between habitual school-day breakfast consumption,
body mass index, physical activity and cardiorespiratory fitness in English schoolchildren. Eur J Clin Nutr 64:
1086- 1092.
3. Gardner MP, Wansink B, Kim J, Park SB (2014) Better moods for better eating? : How mood influences food
choice. J Consum Psychol 24: 320-335.
4. Mahoney CR, Taylor HA, Kanarek RB, Samuel P (2005) Effect of breakfast composition processes in
elementary school children. Physiol Behav 85: 635- 645.
5. Arnett JJ, Zukauskienė R, Sugimura K. The new life stage of emerging adulthood at ages 18–29 years:
implications for mental health. Lancet Psychiatry. 2014; 1(7):569–76.
6. Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011–12. Canberra, AUS: The
Australian Government; May 2014 . Report No.: 4364.0.55.007.
7. Agriculture USDo. What we eat in America 2018
(https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-
center/food-surveys-research-group/)
8. Smith Jordan. Can skipping breakfast hurt your heart? April 2019.
https://www.bicycling.com/news/a27259930/breakfast-benefits-lower-heart-attack-stroke-risk/
9. Sakurai M, Yoshita K, Nakamura K, Takamura T, Nagasawa SY, et al. (2017) Skipping breakfast and 5 year
changes in body mass index and waist circumference in Japanese men and women. Obesity Science & Practice
3: 162-170.
10. Donvito Tina. 12 things that happen to your body when you skip breakfast. Readers digest.
https://www.rd.com/health/wellness/skipping-breakfast/page/2/
11. Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee. World
Health Organization Technical Report Series. World Health Organization.1995; 854: 1–452.
12. New updated WHO classification of BMI (Body mass index) https://pgblazer.com/new-updated-who-
classification-of-bmi/
13. Devi Sarungbam Sarju et al. “An exploratory study to assess the effect of breakfast skipping on college
performance among Bsc nursing students in MM College of nursing, Mullana, Ambala.” 2017.
47
Page
The Research Reservoir of Paramedical Sciences July – December - 2019 Volume: 5; Issue: 2 ISSN: 2395 4507
