J Nutr Health.  2023 Jun;56(3):300-314. 10.4163/jnh.2023.56.3.300.

A prediction model for adolescents’ skipping breakfast using the CART algorithm for decision trees: 7th (2016–2018) Korea National Health and Nutrition Examination Survey

• Choi SA
• Chung SS
• Rho JO

• KMID: 2544286
• DOI: http://doi.org/10.4163/jnh.2023.56.3.300

Abstract

Purpose
This study sought to predict the reasons for skipping breakfast by adolescents aged 13–18 years using the 7^th Korea National Health and Nutrition Examination Survey (KNHANES).
Methods
The participants included 1,024 adolescents. The data were analyzed using a complex-sample t-test, the Rao Scott χ²-test, and the classification and regression tree (CART) algorithm for decision tree analysis with SPSS v. 27.0. The participants were divided into two groups, one regularly eating breakfast and the other skipping it.
Results
A total of 579 and 445 study participants were found to be breakfast consumers and breakfast skippers respectively. Breakfast consumers were significantly younger than those who skipped breakfast. In addition, breakfast consumers had a significantly higher frequency of eating dinner, had been taught about nutrition, and had a lower frequency of eating out. The breakfast skippers did so to lose weight. Children who skipped breakfast consumed less energy, carbohydrates, proteins, fats, fiber, cholesterol, vitamin C, vitamin A, calcium, vitamin B1, vitamin B2, phosphorus, sodium, iron, potassium, and niacin than those who consumed breakfast. The best predictor of skipping breakfast was identifying adolescents who sought to control their weight by not eating meals. Other participants who had low and middle-low household incomes, ate dinner 3–4 times a week, were more than 14.5 years old, and ate out once a day showed a higher frequency of skipping breakfast.
Conclusion
Based on these results, nutrition education targeted at losing weight correctly and emphasizing the importance of breakfast, especially for adolescents, is required. Moreover, nutrition educators should consider designing and implementing specific action plans to encourage adolescents to improve their breakfast-eating practices by also eating dinner regularly and reducing eating out.

Keyword

breakfast; decision trees; adolescent; algorithms; Korea