Correlation of Breakfast Behaviour with Immune Status and Stress Levels Among Senior High School in Rural Areas of Indonesia: Breakfast Behavior, Immunity, and Stress

Akia Kynatha Nadezhda Susanto; Bidayatul Hidayah

Authors

Akia Kynatha Nadezhda Susanto MAN 1 Jember, Jember, Indonesia Author
Bidayatul Hidayah MAN 1 Jember, Jember, Indonesia Author

Keywords:

adolescent health, breakfast behaviour, immune status, psychoneuroimmunology, stress

Abstract

Background: Breakfast plays a profoundly crucial role in the daily nutritional intake of adolescents, serving as the primary source of energy replenishment following overnight fasting. During this critical developmental phase, students require adequate energy and macro-micronutrients to support rigorous learning activities, optimal cognitive development, and stable mental health. Despite its established importance, the prevalence of routine breakfast consumption remains relatively low among high school students. Furthermore, based on a comprehensive literature review utilizing databases such as Google Scholar and PubMed, there is a distinct scarcity of national studies in Indonesia investigating the specific physiological and psychological impacts of breakfast behaviour on immune resistance and perceived stress.

Methods: This quantitative research utilized a cross-sectional study design. The study was conducted at Senior High Schools in rural areas, East Java, Indonesia. Data were gathered through a structured Google Form questionnaire encompassing four sections: demographics, the Breakfast Attitudes Questionnaire (BAQ), the Immune Status Questionnaire (ISQ), and the Perceived Stress Scale (PSS-10). Bivariate data analysis was performed using the Spearman’s rho correlation test.

Results: The sample consisted of 64 students, predominantly female (71.9%) with a normal Body Mass Index (64.1%). An overwhelming majority (98.4%) suffered from severe sleep deprivation, 78.1% experienced moderate stress, and the cohort exhibited a very poor overall immune status. Students displayed a positive attitude toward breakfast (mean BAQ = 49.66). Statistical tests revealed no significant correlation between breakfast behaviour and immune status (p = 0.085) or stress levels (p = 0.181). However, a highly significant positive correlation existed between immune status and stress levels (p = 0.016).

Conclusion: A positive attitude toward breakfast is insufficient to independently enhance immune status or alleviate stress. Psychological stress, heavily exacerbated by chronic sleep deprivation, acts as the primary immunosuppressant in this demographic.

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