Cafs

RESEARCH
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

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. 1942 November 2007 Volume 107 Number 11 23. Grantham-McGregor SM, Chang S, Walker SP. Evaluation of school feeding programs: Some Jamaican examples. Am J Clin Nutr. 1998; 67:785S-789S. 24. Crompton DW. Nutritional aspects of infection. Trans R Soc Trop Med Hyg. 1986;80:697-705. 25. Commey JO, Dekyem P. Childhood deaths from anaemia in Accra, Ghana. West Afr J Med. 1995;14:101-104. 26. Abou-Zeid AH, Abdel-Fattah MM, Al-Shehri AA, Hifnawy TM, AlHassan SA. Anemia and nutritional status of schoolchildren living at Saudi high altitude area. Saudi Med J. 2006;27:862-869. 27. Galler JR, Ramsey F. A follow-up study of the influence of early malnutrition on development: Behavior at home and at school. J Am Acad Child Adolesc Psychiatry. 1989;28:254-261. 28. Chu NF. Prevalence of obesity in Taiwan. Obes Rev. 2005;6:271-274. 29. Epstein M, Cullinan D. Scale for Assessing Emotional Disturbance: Examiner’s Manual. Austin, TX: PRO-ED, Inc.; 1998. 30. Cheng L. Scale for Assessing Emotional Disturbance: Examiner’s Manual (Chinese edition). Taipei: Psychological Publishing Co; 2001. 31. Paeratakul S, Ferdinand DP, Champagne CM, Ryan DH, Bray GA. Fast-food consumption among US adults and children: Dietary and nutrient intake profile. J Am Diet Assoc. 2003;103:1332-1338. 32. Chiel HJ, Wurtman RJ. Short-term variations in diet composition change the pattern of spontaneous motor activity in rats. Science. 1981;213:676-678. 33. Prinz RJ, Roberts WA, Hantman E. Dietary correlates of hyperactive behavior in children. J Consult Clin Psychol. 1980;48:760-769. 34. Lehninger AL, Nelson DL. Biochemistry. New York, NY: Worth Publishers; 1993. 35. Finkelstein JD. Pathways and regulation of homocysteine metabolism in mammals. Semin Thromb Hemost. 2000;26:219-225. 36. Bates CJ. Riboflavin. In: Callabero B, ed. Encyclopedia of Human Nutrition. London, UK: Academic Press; 1999:1722-1730. 37. Trimble MR. Biological Psychiatry. 2nd ed. New York, NY: John Wiley & Sons; 1996. 38. Finkelstein JD. The metabolism of homocysteine: Pathways and regulation. Eur J Pediatr. 1998;157(suppl 2):S40-S44. 39. Meister A, Kleuser BP, Ollert MW, Gercken G. Betaine generation in cardiac myocytes after adrenergic activation of phosphatidylcholine hydrolysis. J Mol Cell Cardiol. 1996;28:1109-1118. 40. Blusztajn JK, Wurtman RJ. Choline and cholinergic neurons. Science. 1983;221:614-620. 41. Finkelman D, Ferrarese MJ, Garmezy N. A factorial, reliability, and validity study of the Devereux Elementary School Behavior Rating Scale. Psychol Rep. 1989;64:535-547. 42. Spencer MB, Dobbs B, Swanson DP. African American adolescents: Adaptational processes and socioeconomic diversity in behavioural outcomes. J Adolesc. 1988;11:117-137. 43. Luthar SS, Latendresse SJ. Comparable “risks” at the socioeconomic status extremes: Preadolescents’ perceptions of parenting. Dev Psychopathol. 2005;17:207-230. 44. Serra-Majem L, Ribas L, Perez-Rodrigo C, Garcia-Closas R, PenaQuintana L, Aranceta J. Determinants of nutrient intake among children and adolescents: Results from the enKid Study. Ann Nutr Metab. 2002;46(suppl 1):31-38. 45. Mazur RE, Marquis GS, Jensen HH. Diet and food insufficiency among Hispanic youths: Acculturation and socioeconomic factors in the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2003;78:1120-1127. 46. Neter D, Kutner MH, Nachtsheim CJ, Wasserman W. Applied Linear Statistical Models. New York: McGraw-Hill Companies, Inc; 2002. November 2007 ● Journal of the AMERICAN DIETETIC ASSOCIATION 1943