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Nutritional Composition of Breakfast Meals Served in All-Girl Intermediate and Secondary Public Schools in Mecca, Saudi Arabia

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Nutritional Composition of Breakfast Meals Served in All-Girl Intermediate and Secondary Public Schools in Mecca, Saudi Arabia NUTRITIONAL COMPOSITION OF BREAKFAST MEALS SERVED IN ALL-GIRL INTERMEDIATE AND SECONDARY PUBLIC SCHOOLS IN MECCA, SAUDI ARABIA A master’s thesis submitted to the Kent State University College of Education, Health, and Human Services in partial fulfillment of the requirements for the degree of Master of Science By Lamyaa Yahya May 2017 A thesis written by Lamyaa Yahya B.A., Umm Al-Qura University, 2011 M.S., Kent State University, 2017 Approved by ________________________________, Director, Master’s Thesis Committee Karen Gordon ________________________________, Member, Master’s Thesis Committee Natalie Caine-Bish ________________________________, Member, Master’s Thesis Committee David Sharp Accepted by _______________________________, Director, School of Health Sciences Lynne Rowan _______________________________, Interim Dean, College of Education, Health and Mark A. Kretovics Human Services ii YAHYA. LAMYAA, M.S., May 2017 Nutrition NUTRITIONAL COMPOSITION OF BREAKFAST MEALS SERVED IN ALL-GIRL INTERMEDIATE AND SECONDARY PUBLIC SCHOOLS IN MECCA, SAUDI ARABIA (114 pp.) Director of Thesis: Karen Gordon, PhD., RD., LD. This study assessed the nutritional composition of school breakfast meals served in Saudi Arabian all-girl intermediate and secondary public schools in Mecca City only. Forty six intermediate schools and 43 secondary schools were randomly selected for breakfast meals assessment. The results from this study indicated high content of sugar, and low content of calcium, iron, and vitamin D in the breakfast meals. Findings from this study coincide with other studies that indicated school canteen foods to be nutritionally poor (Al-Jaaly, Khalifa & Badreldin, 2016; Togoo et al., 2012). This study also looked at obstacles to serving healthy food options and found that canteen managers’ educational background and lack of funding contributed to the quality of school breakfast meals. Results from this study indicated that schools must employ different environmental factors in order to succeed in providing healthy breakfast meals. ACKNOWLEDGMENTS I would like to thank my parents, Abdullah and Alawiyah, for encouraging me to continue my post-bachelor degree education, supporting me when I got accepted to study in America, and for always pushing me to be a better person. I would also like to thank the Saudi government for giving me the financial support that was necessary to pursue my master’s degree and for providing me with the opportunity to study abroad. Many thanks go to my advisor, Dr. Karen Gordon, for her patience, guidance, and her support of my approach to execute this research. Also thanks to the thesis committee members, Dr. Natalie Caine-Bish and Dr. David Sharp, for their time and helpful feedback that were valuable in building this research. Finally, I would like to thank the head of the General Education Department of Makkah, Mohammed Al-Harthy, and the participated schools for supporting this research. iii TABLE OF CONTENTS Page ACKNOWLEDGMENTS ................................................................................................ iii LIST OF TABLES ............................................................................................................. vi CHAPTER I. INTRODUCTION ..................................................................................................... 1 Problem Statement ..................................................................................................... 4 Purpose Statement ...................................................................................................... 5 Research Hypotheses ..................................................................................................5 Operational Definitions .............................................................................................. 5 II. REVIEW OF THE LITERATURE ........................................................................... 7 Adolescence Definition .............................................................................................. 7 Nutrient Status and Recommendation for Adolescents ............................................. 8 Fats .................................................................................................................... 8 Carbohydrates ..................................................................................................10 Protein ..............................................................................................................12 Calcium and vitamin D ....................................................................................14 Iron ...................................................................................................................16 Benefit of Healthy Nutrition .................................................................................... 17 Common Nutrition-Related Issues of Adolescence ..................................................19 Obesity ............................................................................................................ 19 Micronutrient Deficiency ................................................................................ 20 Eating Disorder ............................................................................................... 21 Dental Carries ..................................................................................................22 Physical Inactivity ........................................................................................... 23 Factors Influencing Adolescence Eating Behavior ...................................................24 School Breakfast Program in the United States ....................................................... 25 Benefits of Breakfast for Children and Adolescents .................................................29 School Canteens in Saudi Arabia ..............................................................................31 III. METHODOLOGY ...................................................................................................34 Research Design........................................................................................................34 Study Population .......................................................................................................34 Instruments ................................................................................................................35 Procedures .................................................................................................................36 Statistical Tests .........................................................................................................37 iv IV. JOURNAL ARTICLE ..............................................................................................38 Introduction ..............................................................................................................38 Methodology .............................................................................................................40 Study Population ............................................................................................. 40 Instruments ...................................................................................................... 40 Procedures ........................................................................................................41 Statistical Tests ............................................................................................... 43 Results .......................................................................................................................43 General Characteristics and Breakfast Content ...............................................44 School Education Level and Nutritional Composition ....................................52 Canteen Providers and Nutritional Composition .............................................54 Discussion .................................................................................................................55 General Characteristics and Breakfast Content ...............................................56 Nutritional Composition and Educational Level .............................................57 Nutritional Composition and Canteen Providers .............................................60 Limitations ................................................................................................................61 Application ................................................................................................................62 Conclusion ................................................................................................................63 APPENDICES ...................................................................................................................64 APPENDIX A. TELEPHONE RECRUITMENT SCRIPT ..................................... 65 APPENDIX B. TELEPHONE SURVEY ................................................................ 67 APPENDIX C. FACE-TO-FACE SURVEY ........................................................... 71 APPENDIX D. TRANSLATION: CANTEEN GUIDELINES FOR BOYS’ AND GIRLS’ SCHOOLS THAT ARE AFFILIATED WITH THE MINISTRY OF EDUCATION, SAUDI ARABIA ...............................................75 APPENDIX E. SAMPLE OF THE COLLECTED ONE-DAY FOOD LISTS ....... 79 APPENDIX F. CONSENT FORM ...........................................................................83 APPENDIX G. LETTER OF SUPPORT ...............................................................
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