skip to main content

The Association between Sleep Duration, Breakfast Routine and Nutritional Status in Indonesian Adolescents during COVID-19 Pandemic

1Faculty of Public Health, Mulawarman University, Indonesia

2Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Netherlands

Received: 11 Jan 2022; Published: 1 Jun 2022.

Citation Format:
Abstract

Background: Adolescents are susceptible to nutritional status issues, both undernutrition, and over-nutrition, becoming a public health concern promptly. There were 912 junior and high-school adolescents who were obese and 249 high-school adolescents who had low body mass index (BMI) in Samarinda City. During the COVID-19 pandemic, adolescents experienced changes in sleep duration, and many adolescents were skipping breakfast. Sleep duration and breakfast can affect the nutritional condition of adolescents.

Objectives: The purpose of this study was to determine the association between sleep duration, breakfast routine and BMI in Samarinda, Indonesian adolescents during COVID-19 pandemic.

Materials and Methods: A total of 340 adolescents was sampled and assessed using a cross-sectional technique to ascertain their sleep duration, breakfast routine, and nutritional status. Nutritional status was classified based on BMI-for-age and z-value BMI. The amount of sleep duration was calculated by the average wake time and sleep time. Breakfast routine was obtained from seven days of breakfast before 9 am. Then, using multivariate analyses were tested for sleep duration, BMI z-value, breakfast routine, and nutritional status.

Results: This study revealed that 68.5% had good nutrition, with an average sleep duration of 8 hours (65.9%) and irregular breakfast (59.1%). Nutritional status was significantly influenced by breakfast routine (p=0.044), gender (p<0.001), and mother’s employment (p<0.001). A cubic association was found between sleep duration and BMI (p=0.045); and a significant association between breakfast routines and BMI, independent from age, gender, ethnicity, school.

Conclusion: Adolescents must consider their sleep duration and the frequency and composition of their breakfast. Future study in the longitudinal study is needed to explore in more detail.

Fulltext View|Download
Keywords: Sleep Duration; Breakfast; Nutritional Status; Adolescent

Article Metrics:

  1. Das JK, Salam RA, Thornburg KL, Prentice AM, Campisi S, Lassi ZS, Koletzko B, Bhutta ZA (2017) Nutrition in adolescents: physiology, metabolism, and nutritional needs. Ann N Y Acad Sci 1393:21–33
  2. Par’i HM, Wiyono S, Harjatmo TP (2017) Penilaian Status Gizi
  3. Mulu Birru G, Eshete Tadesse S, Hassen Abate K, Mekonnen TC, Genetu Chane M (2021) Malnutrition in School-Going Adolescents in Dessie Town, South Wollo, Ethiopia. J. Nutr. Metab. 2021:
  4. WHO (2020) Fact Sheet : Obesity and Overweight. In: World Heal. Organ
  5. Baniissa W, Radwan H, Rossiter R, Fakhry R, Al-Yateem N, Al-Shujairi A, Hasan S, Macridis S, Farghaly AA, Naing L (2020) Prevalence and determinants of overweight/obesity among school-aged adolescents in the United Arab Emirates: a cross-sectional study of private and public schools. BMJ Open 10:e038667
  6. Phan HD, Nguyen TNP, Bui PL, Pham TT, Doan TV, Nguyen DT, Van Minh H (2020) Overweight and obesity among Vietnamese school-aged children: National prevalence estimates based on the World Health Organization and International Obesity Task Force definition. PLoS One 15:e0240459
  7. Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, Adams RJ, Aekplakorn W, Afsana K, Aguilar-Salinas CA (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128· 9 million children, adolescents, and adults. Lancet 390:2627–2642
  8. Kementrian Kesehatan RI (2018) Laporan RISKESDAS Provinsi Kalimantan Timur 2018. Jakarta
  9. Jike M, Itani O, Watanabe N, Buysse DJ, Kaneita Y (2018) Long sleep duration and health outcomes: A systematic review, meta-analysis and meta-regression. Sleep Med Rev 39:25–36
  10. Karimy M, Parvizi F, Rouhani MR, Griffiths MD, Armoon B, Fattah Moghaddam L (2020) The association between internet addiction, sleep quality, and health-related quality of life among Iranian medical students. J Addict Dis 1–9
  11. Marelli S, Castelnuovo A, Somma A, Castronovo V, Mombelli S, Bottoni D, Leitner C, Fossati A, Ferini-Strambi L (2020) Impact of COVID-19 lockdown on sleep quality in university students and administration staff. J Neurol 1–8
  12. Roshifanni S (2016) Risiko Hipertensi Pada Orang Dengan Pola Tidur Buruk. J Berk Epidemiol 4:408–419
  13. Villa-González E, Huertas-Delgado FJ, Chillón P, Ramírez-Vélez R, Barranco-Ruiz Y (2019) Associations between active commuting to school, sleep duration, and breakfast consumption in Ecuadorian young people. BMC Public Health 19:85
  14. Theorell-Haglöw J, Lindberg E (2016) Sleep Duration and Obesity in Adults: What Are the Connections? Curr Obes Rep 5:333–343
  15. Zikrahadi H (2019) HUBUNGAN ASUPAN KARBOHIDRAT, ASUPAN SERAT DAN DURASI TIDUR DENGAN STATUS GIZI REMAJA DI SMA NEGERI 06 KOTA PADANG TAHUN 2018
  16. Wheaton AG, Jones SE, Cooper AC, Croft JB (2018) Short sleep duration among middle school and high school students—United States, 2015. Morb Mortal Wkly Rep 67:85
  17. Alves FR, de Souza EA, de França Ferreira LG, Neto J de OV, de Bruin VMS, de Bruin PFC (2020) Sleep duration and daytime sleepiness in a large sample of Brazilian high school adolescents. Sleep Med 66:207–215
  18. Sunwoo J-S, Yang KI, Kim JH, Koo DL, Kim D, Hong SB (2020) Sleep duration rather than sleep timing is associated with obesity in adolescents. Sleep Med 68:184–189
  19. Ma X, Chen Q, Pu Y, Guo M, Jiang Z, Huang W, Long Y, Xu Y (2020) Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis. Obes Res Clin Pract 14:1–8
  20. Brown JE (2016) Nutrition through the life cycle. Cengage Learning, Boston
  21. FATHIN FA (2018) HUBUNGAN KONTRIBUSI ENERGI SARAPAN DAN MAKANAN JAJANAN DENGAN STATUS GIZI PADA REMAJA PUTRI DI SMK NEGERI 1 SUKOHARJO. Skripsi S1 Ilmu Gizi FIK UMS
  22. Smith KJ, Breslin MC, McNaughton SA, Gall SL, Blizzard L, Venn AJ (2017) Skipping breakfast among Australian children and adolescents; findings from the 2011–12 National Nutrition and Physical Activity Survey. Aust N Z J Public Health 41:572–578
  23. Ardeshirlarijani E, Namazi N, Jabbari M, Zeinali M, Gerami H, Jalili RB, Larijani B, Azadbakht L (2019) The link between breakfast skipping and overweigh/obesity in children and adolescents: a meta-analysis of observational studies. J Diabetes Metab Disord 18:657–664
  24. Nugroho PS, Hikmah AUR (2020) Kebiasaan Konsumsi Junk Food dan Frekuensi Makan Terhadap Obesitas. J DUNIA KESMAS 9:185–191
  25. Badrah S, Noviasty R, Susanti R (2020) Screening of Eating Disorders Risk with Scoff Tool on Adolescents in Samarinda City. J La Medihealtico 1:26–31
  26. Noviasty R, Susanti R (2020) Perubahan Kebiasaan Makan Mahasiswa Peminatan Gizi Selama Masa Pandemi Covid 19. J. Kesehat. Masy. Mulawarman 2:
  27. Leone MJ, Sigman M, Golombek DA (2020) Effects of lockdown on human sleep and chronotype during the COVID-19 pandemic. Curr Biol 30:R930–R931
  28. Susanti CBJ (2019) Pengaruh kebiasaan melewatkan sarapan terhadap tingkat obesitas pada remaja SMA 7 Surakarta
  29. Iyer R, Hosmer DW, Lemeshow S (1991) Applied Logistic Regression. Stat. https://doi.org/10.2307/2348743
  30. Wisnuwardani RW, De Henauw S, Androutsos O, Forsner M, Gottrand F, Huybrechts I, Knaze V, Kersting M, Le Donne C, Marcos A (2019) Estimated dietary intake of polyphenols in European adolescents: the HELENA study. Eur J Nutr 58:2345–2363
  31. Bhan MK, Norum KR (2004) The WHO multicentre growth reference study (MGRS): Rationale, planning, and implementation. Food Nutr. Bull. 25:
  32. Salmela-Aro K (2011) Stages of Adolescence. In: Brown BB, Prinstein MJBT-E of A (eds). Academic Press, San Diego, pp 360–368
  33. Teji K, Dessie Y, Assebe T, Abdo M (2016) Anaemia and nutritional status of adolescent girls in Babile District, Eastern Ethiopia. Pan Afr. Med. J. 24:
  34. Roba KT, Abdo M, Wakayo T (2016) Nutritional status and its associated factors among school adolescent girls in Adama City, Central Ethiopia
  35. Hadush G, Seid O, Wuneh AG (2021) Assessment of nutritional status and associated factors among adolescent girls in Afar, Northeastern Ethiopia: a cross-sectional study. J Heal Popul Nutr 40:1–14
  36. Veronika AP, Puspitawati T, Fitriani A (2021) Associations between nutrition knowledge, protein-energy intake and nutritional status of adolescents. J Public health Res 10:2239
  37. Lampus C, Manampiring A (2016) Profil status gizi pada remaja di Kabupaten Bolaang Mongondow Utara. eBiomedik 4:
  38. Kurniawan AN (2020) HUBUNGAN ANTARA KEBIASAAN SARAPAN DAN AKTIVITAS FISIK TERHADAP STATUS GIZI REMAJA. J. Tata Boga 9:
  39. Stavridou A, Kapsali E, Panagouli E, Thirios A, Polychronis K, Bacopoulou F, Psaltopoulou T, Tsolia M, Sergentanis TN, Tsitsika A (2021) Obesity in Children and Adolescents during COVID-19 Pandemic. Children 8:135
  40. Kim ES, Kwon Y, Choe YH, Kim MJ (2021) COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity. Sci Rep 11:5494
  41. Badi’ah A (2019) Hubungan kebiasaan sarapan dan durasi tidur dengan kegemukan pada remaja di SMP Islam Al-Azhar 29 Semarang. UIN Walisongo
  42. Darling AM, Sunguya B, Ismail A, Manu A, Canavan C, Assefa N, Sie A, Fawzi W, Sudfeld C, Guwattude D (2020) Gender differences in nutritional status, diet and physical activity among adolescents in eight countries in sub‐Saharan Africa. Trop Med Int Heal 25:33–43
  43. Khasanah D, Endang Nur W, Rusdin Rauf STP (2016) hubungan aktivitas fisik dengan status gizi remaja putri di pondok pesantren ta’mirul islam surakarta
  44. Maltoni G, Zioutas M, Deiana G, Biserni GB, Pession A, Zucchini S (2021) Adolescent males suffered from reduced physical activity and increased BMI during COVID- 19 pandemic. Nutr Metab Cardiovasc Dis
  45. Sulistyorini E, Rahayu T (2017) Hubungan pekerjaan ibu balita terhadap status gizi balita di posyandu prima sejahtera Desa Pandean Kecamatan Ngemplak Kabupaten Boyolali Tahun 2009. J. Kebidanan Indones. 1:
  46. Parolin Z (2020) Unemployment and child health during COVID-19 in the USA. Lancet Public Heal 5:e521–e522
  47. Hutauruk KNSP (2017) HUBUNGAN ANTARA KARAKTERISTIK IBU (PENDIDIKAN, PEKERJAAN, PENGETAHUAN TENTANG GIZI) DENGAN STATUS GIZI SISWA SDN SAWAHAN I SURABAYA. J. Pendidik. Olahraga dan Kesehat. 5:
  48. Handari SRT, Loka T (2017) Hubungan Aktivitas Fisik dan Kebiasaan Konsumsi Fast Food dengan Status Gizi Lebih Remaja SMA Labschool Kebayoran Baru Jakarta Selatan Tahun 2016. J Kedokt dan Kesehat 13:153–162
  49. Mizuta A, Fujiwara T, Ojima T (2016) Association between economic status and body mass index among adolescents: a community-based cross-sectional study in Japan. BMC Obes 3:47
  50. Rompas KF (2016) Hubungan antara sosial ekonomi keluarga dengan status gizi pada pelajar di SMP wilayah Kecamatan Malalayang 1 Kota Manado. PHARMACON 5:
  51. Kline C (2013) Sleep Duration BT - Encyclopedia of Behavioral Medicine. In: Gellman MD, Turner JR (eds). Springer New York, New York, NY, pp 1808–1810
  52. Pollak C, Thorpy MJ, Yager J (2010) The encyclopedia of sleep and sleep disorders, 3th ed. InfoBase publishing, New York
  53. Carskadon MA (2002) Adolescent sleep patterns: Biological, social, and psychological influences. Cambridge University Press
  54. Sinha M, Pande B, Sinha R (2020) Impact of COVID-19 lockdown on sleep-wake schedule and associated lifestyle related behavior: A national survey. J. Public health Res. 9:
  55. Robbins R, Affouf M, Weaver MD, Czeisler MÉ, Barger LK, Quan SF, Czeisler CA (2021) Correction: Estimated Sleep Duration Before and During the COVID-19 Pandemic in Major Metropolitan Areas on Different Continents: Observational Study of Smartphone App Data. J Med Internet Res 23:e28057
  56. Rezaei N, Grandner MA (2021) Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities. Sleep Heal
  57. Yuksel D, McKee GB, Perrin PB, Alzueta E, Caffarra S, Ramos-Usuga D, Arango-Lasprilla JC, Baker FC (2021) Sleeping when the world locks down: Correlates of sleep health during the COVID-19 pandemic across 59 countries. Sleep Heal 7:134–142
  58. Panel CC, Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA (2015) Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. Sleep 38:1161–1183
  59. de Souza MR, Neves MEA, Souza A de M, Muraro AP, Pereira RA, Ferreira MG, Rodrigues PRM (2020) Skipping breakfast is associated with the presence of cardiometabolic risk factors in adolescents: Study of Cardiovascular Risks in Adolescents – ERICA. Br J Nutr 1–9
  60. Iwama M, Wilson S, Durant C, Alford C, Hank D, Hicks J, Smith-Windsor J, Franklin J, Boswell J, Thai J (2015) An occupational therapist’s guide to sleep and sleep problems. Jessica Kingsley Publishers, London
  61. Genta FD, Rodrigues Neto GB, Velletri Sunfeld JP, Porto JF, Xavier AD, Moreno CRC, Lorenzi-Filho G, Genta PR (2021) COVID-19 pandemic impact on sleep habits, chronotype and health-related quality of life among high school students: A longitudinal study. J Clin Sleep Med jcsm-9196
  62. Johansson AEE, Petrisko MA, Chasens ER (2016) Adolescent Sleep and the Impact of Technology Use Before Sleep on Daytime Function. J Pediatr Nurs 31:498–504
  63. Gariepy G, Danna S, Gobiņa I, Rasmussen M, de Matos MG, Tynjälä J, Janssen I, Kalman M, Villeruša A, Husarova D (2020) How are adolescents sleeping? Adolescent sleep patterns and sociodemographic differences in 24 European and North American countries. J Adolesc Heal 66:S81–S88
  64. Kuula L, Gradisar M, Martinmäki K, Richardson C, Bonnar D, Bartel K, Lang C, Leinonen L, Pesonen AK (2019) Using big data to explore worldwide trends in objective sleep in the transition to adulthood. Sleep Med 62:69–76
  65. Al-Haifi AA, AlMajed HT, Al-Hazzaa HM, Musaiger AO, Arab MA, Hasan RA (2016) Relative contribution of obesity, sedentary behaviors and dietary habits to sleep duration among Kuwaiti adolescents. Glob J Health Sci 8:107
  66. Litsfeldt S, Ward TM, Hagell P, Garmy P (2020) Association between sleep duration, obesity, and school failure among adolescents. J Sch Nurs 1059840520901335
  67. Liu B-P, Wang X-T, Liu Z-Z, Wang Z-Y, An D, Wei Y-X, Jia C-X, Liu X (2020) Depressive symptoms are associated with short and long sleep duration: A longitudinal study of Chinese adolescents. J Affect Disord 263:267–273
  68. Wang D, Li W, Cui X, Meng Y, Zhou M, Xiao L, Ma J, Yi G, Chen W (2016) Sleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studies. Int J Cardiol 219:231–239
  69. Cheng L, Pohlabeln H, Ahrens W, et al (2021) Cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness in European children and adolescents. Osteoporos Int 32:853–863
  70. Hermanto RA, Kandarina BJI, Latifah L (2020) Hubungan Antara Status Anemia, Tingkat Aktivitas Fisik, Kebiasaan Sarapan Dan Depresi Pada Remaja Putri Di Kota Yogyakarta. Media Gizi Mikro Indones 11:141–152
  71. Sokol RL, Grummon AH, Lytle LA (2020) Sleep duration and body mass: direction of the associations from adolescence to young adulthood. Int J Obes 44:852–856
  72. Schneider AC, Zhang D, Xiao Q (2020) Adolescent sleep characteristics and body-mass index in the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Sci Rep 10:1–10
  73. Rachmadianti D, Puspita ID (2020) Korelasi Antara Asupan Protein, Serat dan Durasi Tidur Dengan Status Gizi Remaja. J Ris GIZI 8:85–89
  74. Saputri W (2018) Hubungan Aktivitas Fisik Dan Durasi Tidur Dengan Status Gizi Pada Remaja Di SMP N 2 Klego Boyolali
  75. Utami NP, Purba MB, Huriyati E (2017) Hubungan durasi tidur terhadap asupan energi dan obesitas pada remaja SMP di Kota Yogyakarta
  76. Grandner MA, Schopfer EA, Sands‐Lincoln M, Jackson N, Malhotra A (2015) Relationship between sleep duration and body mass index depends on age. Obesity 23:2491–2498
  77. Gohil A, Hannon TS (2018) Poor sleep and obesity: concurrent epidemics in adolescent youth. Front Endocrinol (Lausanne) 9:364
  78. Ferranti R, Marventano S, Castellano S, Giogianni G, Nolfo F, Rametta S, Matalone M, Mistretta A (2016) Sleep quality and duration is related with diet and obesity in young adolescent living in Sicily, Southern Italy. Sleep Sci 9:117–122
  79. Maharjan N, Karki PK, Adhikari B, Bhaila A, Shrestha H (2020) Association between sleep duration, sleep quality and body mass index in medical students. J Chitwan Med Coll 10:34–38
  80. Husain W, Ashkanani F (2020) Does COVID-19 change dietary habits and lifestyle behaviours in Kuwait: a community-based cross-sectional study. Environ Health Prev Med 25:61
  81. Otuneye AT, Ahmed PA, Abdulkarim AA, Aluko OO, Shatima DR (2017) Relationship between dietary habits and nutritional status among adolescents in Abuja municipal area council of Nigeria. Niger J Paediatr 44:128–135
  82. Sidor A, Rzymski P (2020) Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland. Nutrients 12:1657
  83. Rukmana E, Permatasari T, Emilia E (2020) The Association Between Physical Activity with Nutritional Status of Adolescents During the COVID-19 Pandemic in Medan City. J Dunia Gizi 3:88–93
  84. Rachmayani SA, Kuswari M, Melani V (2018) Hubungan Asupan Zat Gizi dan Status Gizi Remaja Putri di SMK Ciawi Bogor. Indones J Hum Nutr 5:125–130
  85. Irdiana W, Nindya TS (2017) Hubungan kebiasaan sarapan dan asupan zat gizi dengan status gizi siswi SMAN 3 Surabaya. Amerta Nutr 1:227–235
  86. Noviasty R, Afiah N, Susanti R, Suja’i MNM, Pakkerai AD, Cahyantari U, Wirasti N (2020) Komposisi Menu Sarapan dan Status Gizi Pelajar Boarding School SMP Muhammadiyah 5 Samarinda. Ghidza J Gizi dan Kesehat 4:1–10
  87. Fayet-Moore F, McConnell A, Tuck K, Petocz P (2017) Breakfast and breakfast cereal choice and its impact on nutrient and sugar intakes and anthropometric measures among a nationally representative sample of Australian children and adolescents. Nutrients 9:1045
  88. Yanuarti R (2019) HUBUNGAN KEBIASAAN SARAPAN PAGI, ASUPAN ENERGI, DAN KEBIASAAN OLAHRAGA DENGAN KEJADIAN KEGEMUKAN PADA SISWA KELAS XI SMAN 3 CIMAHI
  89. Amalia SMK, Adriani M (2019) Hubungan antara Kebiasaan sarapan dengan Status Gizi pada siswa SMP Negeri 5 Banyuwangi. Amerta Nutr 3:212–217
  90. Forkert ECO, Moraes ACF De, Carvalho HB, et al (2019) Skipping breakfast is associated with adiposity markers especially when sleep time is adequate in adolescents. Sci Rep 9:6380
  91. Khan A, Khan S, Burton N (2019) Missing breakfast is associated with overweight and obesity in Bangladeshi adolescents. Acta Paediatr 108:178–179
  92. Sila S, Ilić A, Mišigoj-Duraković M, Sorić M, Radman I, Šatalić Z (2019) Obesity in adolescents who skip breakfast is not associated with physical activity. Nutrients 11:2511
  93. Rohmah MH, Rohmawati N, Sulistiyani S (2020) Hubungan kebiasaan sarapan dan jajan dengan status gizi remaja di Sekolah Menengah Pertama Negeri 14 Jember. Ilmu Gizi Indones 4:39–50
  94. Benitez D (2005) The Importance of Breakfast in Children and Adolescents. Unpubl. M S Diss. Submitt. to Fam. Consum. Sci
  95. Androutsos O, Perperidi M, Georgiou C, Chouliaras G (2021) Lifestyle Changes and Determinants of Children’s and Adolescents’ Body Weight Increase during the First COVID-19 Lockdown in Greece: The COV-EAT Study. Nutrients 13:930
  96. Enriquez-Martinez OG, Martins MCT, Pereira TSS, Pacheco SOS, Pacheco FJ, Lopez K V, Huancahuire-Vega S, Silva DA, Mora-Urda AI, Rodriguez-Vásquez M (2021) Diet and lifestyle changes during the COVID-19 pandemic in Ibero-American countries: Argentina, Brazil, Mexico, Peru, and Spain. Front. Nutr. 8:
  97. Kim SY, Yoo DM, Min C, Choi HG (2021) Changes in Dietary Habits and Exercise Pattern of Korean Adolescents from Prior to during the COVID-19 Pandemic. Nutrients 13:3314
  98. de Melo Souza TC, Oliveira LA, Daniel MM, Ferreira LG, Della Lucia CM, Liboredo JC, Anastácio LR Lifestyle and eating habits before and during COVID-19 quarantine in Brazil. Public Health Nutr 1–29

Last update:

  1. Was COVID-19 pandemic anxiety reflected on nutritional habits in adults?

    Yasemin Açar, Hilal Yıldıran. Nutrition & Food Science , 53 (4), 2023. doi: 10.1108/NFS-08-2022-0276

Last update: 2024-03-26 18:19:01

No citation recorded.