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PubMed2006

Comparison of attitudes towards breakfast by Turkish fourth graders living in Turkey and Germany.

The purpose of this article is to identify and compare Turkish fourth graders attitudes towards breakfast living in Turkey and Germany. A sample group of 882 Turkish students enrolled in fourth grade in Hamburg (Germany, N=422) and Konya (Turkey, N=460) were surveyed. Independent t-tests, chi(2) test and Pearson product-moment correlations were used. More students living in Turkey had breakfast and had enough time before going to school (P<0.01). Students living in Turkey reported that eating breakfast affected them positively (P<0.01). Students living in Germany reported that eating breakfast made them feel tired (P<0.01). The consumption of breakfast cereal (P<0.05) and fruit juice (P<0.01) that had not been consumed widely in Turkey increased in Germany. Students who eat breakfast also eat lunch (r=0.296 and -0.236, P<0.01, students living in Turkey and Turkish students living in Germany, respectively). Nutrition education programs in primary schools may change Student's attitudes about breakfast and offering a breakfast programme in schools may greatly improve breakfast consumption rates.

Child↗

PubMed1996

Trends in breakfast consumption of US adults between 1965 and 1991.

OBJECTIVE: To examine breakfast consumption patterns and trends between 1965 and 1991 for adults in the United States. DESIGN: Trends analysis pooling three cross-sectional surveys. SETTING: Nationally representative samples obtained from the Nationwide Food Consumption Survey (NFCS) of 1965, the NFCS of 1977-1978, and the 1989-1991 Continuing Survey of Food Intakes by Individuals. SUBJECTS: Adults aged 18 years and older: 6,274 in 1965, 18,033 in 1977-1978, and 10,812 in 1989-1991. All results reflect use of sampling weights, so results reflect nationally representative samples in each time period. MAIN OUTCOME MEASURES: Breakfast consumption, defined as the consumption of food and/or beverage between the hours of 5 AM and 9 AM, was the focus of the trends analysis. Population prevalence rates are reported for the entire population and population subgroups. STATISTICAL ANALYSIS PERFORMED: Probit analysis was used to identify factors associated with changes in breakfast consumption over time. RESULTS: Breakfast consumption declined in the 26-year period between 1965 and 1991 from 86% to 75% for US adults. Breakfast consumption increased with age, and the age differential increased over time. Urban-rural and South-non-South differences in breakfast consumption narrowed over time, whereas black-nonblack and college-noncollege differences increased slightly or remained constant. The nutritional quality of food consumed at breakfast has improved since 1965. CONCLUSIONS: Although part of the decline in breakfast consumption can be explained by personal and demographic determinants, other unknown factors contributed to the trends. Elucidation of such factors is necessary to predict differences in breakfast as a health-related behavior.

Adolescent↗

PubMed2005

Dietary intake of whole and refined grain breakfast cereals and weight gain in men.

OBJECTIVE: Prospective studies have suggested that substituting whole grain for refined grain products may lower the risk of overweight and obesity. Breakfast cereal intake is a major source of whole and refined grains and has also been associated with having a lower BMI. The aim of this study was to prospectively assess the association between whole and refined grain breakfast cereal intakes and risk of overweight (BMI >or= 25 kg/m(2)) and weight gain. RESEARCH METHODS AND PROCEDURES: We examined 17,881 U.S. male physicians 40 to 84 years of age in 1982 who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline and reported measures of breakfast cereal intake, weight, and height. RESULTS: Over 8 and 13 years of follow-up, respectively, men who consumed breakfast cereal, regardless of type, consistently weighed less than those who consumed breakfast cereals less often (p value for trend = 0.01). Whole and refined grain breakfast cereal intake was inversely associated with body weight gain over 8 years, after adjustment for age, smoking, baseline BMI, alcohol intake, physical activity, hypertension, high cholesterol, and use of multivitamins. Compared with men who rarely or never consumed breakfast cereals, those who consumed >or=1 serving/d of breakfast cereals were 22% and 12% less likely to become overweight during follow-up periods of 8 and 13 years (relative risk, 0.78 and 0.88; 95% confidence interval, 0.67 to 0.91 and 0.76 to 1.00, respectively). DISCUSSION: BMI and weight gain were inversely associated with intake of breakfast cereals, independently of other risk factors.

Adult↗

PubMed2002

Family resemblance in breakfast energy intake: the Stanislas Family Study.

BACKGROUND: There seems to be a consensus that family influences on dietary habits are important. However, no data relative to breakfast have been published yet. OBJECTIVE: To investigate whether and how breakfast energy intake aggregates within French families. DESIGN: A total of 398 families of the Stanislas Family Study who filled in a 3 day food consumption diary were selected. Absolute and relative breakfast energy intakes (BEI in kcal/day and RBEI in percentage of daily intake, respectively) were both studied. RESULTS: By using a variance component analysis, no genetic influence was shown in family aggregation of both BEI and RBEI. Intra-generation common environmental contribution to total phenotypic variance of BEI and RBEI was higher than inter-generation; both were increased with frequency of sharing breakfast. Furthermore frequency of sharing breakfast contributed to increase family resemblance in breakfast energy intake, particularly in offspring for BEI and RBEI, and in spouses for RBEI. Smoking habits, alcohol consumption, BMI or physical activity were related to family resemblance, but after adjustment on each factor degrees of resemblance were almost unchanged. CONCLUSION: General findings of this study were that family aggregation in breakfast absolute and relative energy intakes was significant within Stanislas families. Family resemblance depended on inter- and intra-generation components and was modified by the number of shared breakfasts. Our study confirmed that familial habits act on family resemblance in both absolute and relative breakfast energy intakes, so that family should be a favorite unit for health and diet promotion programs. SPONSORSHIP: Kellogg's PA, France.

Adolescent↗

PubMed2004

Post-prandial plasma ghrelin levels in people with different breakfast hours.

OBJECTIVES: To investigate the changes in post-meal plasma ghrelin levels in people with different breakfast hours. DESIGN AND INTERVENTIONS: The subjects adhered to strict breakfast times starting 2 weeks before the study. Blood was drawn hourly from 0530 or 0630 until 1130. Plasma ghrelin, leptin, and insulin levels were measured by radioimmunoassay. SETTING: Medical Research Institute, Pusan National University Hospital, Korea. SUBJECTS: A total of 16 healthy volunteers. RESULTS: The mean plasma ghrelin level in subjects consuming breakfast was 548.7 +/- 239.6 fmol/ml before breakfast and 384.8 +/- 168.7 fmol/ml 1 h after breakfast, with leptin levels of 6.8 +/- 2.6 and 6.5 +/- 2.5 ng/ml, respectively. Plasma ghrelin levels were lowest 1 h after the meal, although the breakfast times differed. The plasma ghrelin level was lowest at 0730 in subjects not eating breakfast. CONCLUSIONS: These findings suggest that the plasma ghrelin levels are lowest 1 h after breakfast despite the variance in breakfast times. This timing might best reflect an individual's plasma ghrelin level and enable reasonable comparisons.

Adult↗

PubMed2002

Faecal bulking efficacy of Australasian breakfast cereals.

Faecal bulk may play an important role in preventing a range of disorders of the large bowel, but as yet there is little information available on the relative faecal bulking capacities of various foods. Breakfast cereals are often promoted as a good source of potential bulk for 'inner health' because they provide dietary fibre, but their relative abilities to provide faecal bulk per se have not been described. The faecal bulking efficacy of 28 representative Australasian breakfast cereals was therefore measured. A rat model developed for the purpose, and shown to give similar responses as humans to cereal fibres, was used to measure faecal bulking efficacy as increases in fully hydrated faecal weight/100 g diet, based on precise measurements of food intake, faecal dry matter output and faecal water-holding capacity (g water held without stress/g faecal dry matter). Compared to a baseline diet containing 50% sucrose, increments in hydrated faecal weight due to 50% breakfast cereal ranged from slightly negative (Cornflakes, -2 g/100 g diet) to about 80 g/100 g diet (San Bran). Most breakfast cereals increased hydrated faecal weight by between 10 and 20 g/100 g diet from a baseline of 21 +/- 1.5 g/100 g diet, but four products containing high levels of wheat bran had an exceptionally large impact on hydrated faecal weight (increment > 20 g/100 g diet), and the changes resulted more from relative changes in dry matter output than in faecal water retention/gram. However, as faecal water retention was about 2.5 g water/g faecal dry matter on average, increases in dry matter represented large increases in faecal water load. Faecal bulking indices (FBI) for most of the breakfast cereals were less than 20 (wheat bran = 100). The content of wheat bran equivalents for faecal bulk (WBE(fb)) in the breakfast cereals was calculated from FBI. Most breakfast cereals contributed, per serve, less than 10% of a theoretical daily reference value for faecal bulk (DRV(fb) = 63 WBE(fb)/day), which was based on data from human clinical trials and dietary fibre recommendations. Based on the WBE(fb) contribution/serving that would be required to meet the DRV(fb) from the number of servings of dietary fibre sources in the CSIRO 12345+ food and nutrition plan, the results suggest that although some high bran breakfast cereals may contribute substantially to, and many are reasonable sources of, faecal bulk, for most of them, one or two servings at breakfast cannot be relied on to effectively redress shortfalls in faecal bulk elsewhere in the diet.

Animals↗

PubMed1986

The role of breakfast in diet adequacy of the U.S. adult population.

Breakfast consumption patterns of the U.S. adult population were examined by using the U.S.D.A. Nationwide Food Consumption Survey. Results indicated that approximately one-quarter of the adult population skipped breakfast regularly. For those adults who consumed breakfast, the four most commonly consumed breakfasts were eggs, bread, and coffee; ready-to-eat cereal with milk; coffee and bread; and eggs, bread, and milk. The sample was partitioned by six age/sex classes and by four breakfast consumption patterns. Assessments of average intakes of seven frequently underconsumed nutrients showed that omission of the breakfast meal had a significant negative impact, particularly among adult females, on the diet quality. Findings indicated that for all age/sex classes, consumption of ready-to-eat cereal at breakfast, whether frequently or on a more limited basis, increased the average daily intake levels of the underconsumed nutrients. Further, groups of adults who regularly consumed ready-to-eat cereal at breakfast had, on average, lower average daily intakes of fat and cholesterol. It was concluded that regular breakfast consumption greatly enhanced the overall diet quality of the U.S. adult population.

Adolescent↗

PubMed1998

Trends in breakfast consumption for children in the United States from 1965-1991.

We examined breakfast consumption patterns and trends between 1965 and 1991 for children (1-10 y old) and adolescents (11-18 y old) in the United States. The analysis was undertaken by pooling nationally representative samples obtained from the Nationwide Food Consumption Surveys of 1965 and 1977-1978 and the 1989-1991 Continuing Survey of Food Intakes by Individuals. Breakfast consumption, defined as the consumption of food, beverage, or both between 0500 and 1000, was the focus of the trends analysis. Descriptive results indicated a decline in breakfast consumption between 1965 and 1991, particularly for older adolescents aged 15-18 y; the rates for boys and girls declined from 89.7% and 84.4%, respectively, in 1965 to 74.9% and 64.7%, respectively, in 1991. Multivariate results indicated that breakfast consumption declined predominantly because of behavioral changes and not the population's changing sociodemographic patterns. The nutritional quality of foods consumed at breakfast has improved since 1965, with significant shifts toward consumption of lower-fat milk and smaller changes in other food groups. The improvement over time in the quality of food consumed at breakfast, however, is offset by the large percentage of persons aged > or = 11 y who do not presently consume breakfast. Given the association of obesity with less frequent breakfast consumption and the rise in obesity among persons of this age group, a renewed emphasis on the importance of breakfast is warranted.

Adolescent↗

PubMed1999

Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects.

BACKGROUND: Diets with a low glycemic index (GI) have been shown to improve glucose tolerance in both healthy and diabetic subjects. Two potential mechanisms are discussed in relation to long-term metabolic effects: a decreased demand for insulin in the postprandial phase and formation of short-chain fatty acids from fermentation of indigestible carbohydrates in the colon. OBJECTIVE: The objective was to study the effect of the GI and the indigestible carbohydrate--resistant starch (RS) and dietary fiber (DF)--content of cereal-based breakfasts on glucose tolerance at a second meal (lunch) in healthy subjects. DESIGN: The effects of 7 test breakfasts with known GIs (GI: 52-99) and RS + DF contents (2-36 g) were evaluated. White-wheat bread was used as a reference breakfast (high GI, low RS + DF content). Glucose and insulin responses after the second meal were measured in healthy subjects. In addition, the satiating capacity of 4 of the 7 test breakfasts was estimated before and during the second meal. RESULTS: Two of the 4 low-GI breakfasts improved glucose tolerance at the second meal. Only these 2 breakfasts were capable of postponing the in-between-meal fasting state. There was no measurable effect of fermentable carbohydrates on glucose tolerance at the second meal. The highest satiety score was associated with the barley breakfast that had a low GI and a high RS + DF content. CONCLUSIONS: Glucose tolerance can improve in a single day. Slow absorption and digestion of starch from the breakfast meal, but not the content of indigestible carbohydrates in the breakfast meal, improved glucose tolerance at the second meal (lunch).

Adult↗

PubMed1994

Interval between insulin injection and breakfast in diabetes.

The relationship between the insulin-breakfast interval, postprandial increase in blood glucose, and glycaemic control was studied in 58 children with diabetes. Patients recorded insulin-breakfast intervals in a home diary over a seven day period, and during a 24 hour period at the weekend provided eight serial capillary dried blood spots for glucose analysis. The highest mean blood glucose value occurred two hours after breakfast and showed a significant correlation with fructosamine concentrations. Weekend insulin-breakfast intervals ranged from 2-30 minutes, with 70% reporting intervals of less than 15 minutes. There was a significant correlation between the weekend insulin-breakfast interval and the after breakfast increase in blood glucose with a mean increment of 0.4 mmol/l in the 30 minute group and 7.2 mmol/l in the 2 minute group. Over the whole study period, children with mean insulin-breakfast intervals of two to 12 minutes had a mean fructosamine concentration of 376 mumol/l compared with 341 mumol/l in those with intervals of 15-35 minutes. This study has shown that the interval between insulin injection and breakfast significantly influences the morning postprandial rise in blood glucose and consequently short term glycaemic control. It is therefore important that patients are encouraged to leave an interval of about 30 minutes between insulin injection and breakfast.

Adolescent↗

PubMed1998

College and University Students' Breakfast Consumption Patterns: Behaviours, Beliefs, Motivations and Personal and Environmental Influences.

This qualitative study was designed to identify the beliefs, motivations and personal and environmental influences shaping breakfast consumption patterns of a group of college and university students. Twenty-eight women and 28 men participated in individual interviews where they discussed their usual breakfast habits and their beliefs about this meal. Most of the participants always or usually ate breakfast. Weekday breakfasts were consistent, convenient and included a small number of foods, while weekend breakfasts were more varied and sometimes included richer foods that required more preparation time. Breakfast was believed to be an important meal, providing energy and increasing productivity during the morning. The marked similarities in participants' beliefs and practices demonstrated the strong definition that breakfast has within mass North American culture. However, there were variations between individuals, with specific practices being influenced by personal food preferences, time availability, health beliefs and concerns, food availability, and the physical and social environment. Nutrition intervention programs encouraging regular consumption of a healthy breakfast should recognize the factors that relate to commonalities and differences in students' breakfast eating habits and help participants identify strategies that would work for their particular situation.

Journal Article↗

PubMed2001

[Relationship between skipping breakfast and cardiovascular disease risk factors in the national nutrition survey data].

PURPOSE: To investigate the relationship between skipping breakfast and cardiovascular disease risk factors such as blood pressure, serum lipids, smoking, and lock of exercise. MATERIALS AND METHODS: Data from the National Nutrition survey conducted by the Ministry of Health and Welfare, from 1995 through 1997 were employed for the analysis. Data were used only if subjects were between 20 and 59 years old and had participated in the nutrition survey, and values for height and weight, blood pressure, serum lipids, blood sugar, number of steps per day, and smoking, drinking, and exercise habits were available. The number of subjects with data available for all of the above was 11,778 (4,438 men and 7,340 women). Analyses were performed separately by sex. The relationship between skipping breakfast and continuous variables such as nutrient intake ratio (nutrient intake divided by recommended dietary allowances), body mass index, blood pressure, serum lipids, blood sugar, and the number of steps per day was examined controlling for age using analysis of covariance (ANCOVA). The relationship between skipping breakfast and categorical variables such as smoking, drinking, and exercise habits was assessed controlling for age using Cochran-Mantel-Haenszel statistics. RESULTS: The younger the generation, the higher the rate of skipping breakfast. The rate of skipping breakfast in men was twice as high as in women. The breakfast skippers tended to intake less energy and calcium, both in men and women, that non-skippers. Female skippers tended to intake less iron and vitamin D. The number of steps per day was smaller in breakfast skippers than that in non-skippers both in men and women. Male skippers tended to have higher blood pressure than non-skippers, and female skippers tended to have a higher serum total cholesterol level than non-skippers. The breakfast skippers tended to smoke more than non-skippers, both in men and women, and female skippers tended to drink more alcohol and take less exercise. CONCLUSIONS: Skipping breakfast is related to cardiovascular risk factors such as lack of exercise, smoking, high blood pressure, and high serum total cholesterol.

Adult↗

PubMed2005

Australian sweet lupin flour addition reduces the glycaemic index of a white bread breakfast without affecting palatability in healthy human volunteers.

The addition of some legume ingredients to bread has been associated with effects on glycaemic, insulinaemic and satiety responses that may be beneficial in controlling type 2 diabetes, cardiovascular disease and obesity. However, the effect of Australian sweet lupin (Lupinus angustifolius) flour (ASLF) is unknown. This investigation examined the effect of adding ASLF to standard white bread on post-meal glycaemic, insulinaemic and satiety responses and palatability in healthy subjects. Using a randomised, single-blind, cross-over design, 11 subjects consumed one breakfast of ASLF bread and two of standard white bread > or =7 days apart after fasting overnight. Each breakfast also included margarine, jam, and tea with milk and contained 50 g available carbohydrate. On each test day, blood samples were taken after fasting, then several times over 2 hours post-prandially, and analysed for plasma glucose and serum insulin. Subjects rated breakfast palatability and perception of satiety, in the fasting state and over 3 hours post-prandially, after which food intake from an ad libitum buffet and for the rest of the day was recorded. Incremental areas under the curves for glucose, insulin and satiety, glycaemic index, insulinaemic index and satiety index were calculated. ASLF addition to the breakfast reduced its glycaemic index (mean +/-SEM; ASLF bread breakfast = 74.0 +/-9.6. Standard white bread breakfast = 100, P=0.022), raised its insulinaemic index (ASLF bread breakfast = 127.7 +/-12.0. Standard white bread breakfast = 100, P=0.046), but did not affect palatability, satiety or food intake. ASLF addition resulted in a palatable breakfast; however, the potential benefits of the lowered glycaemic index may be eclipsed by the increased insulinaemic index.

Adult↗

PubMed1998

[Comparison of gastric emptying, blood glucose, and oro-cecal transit times after a conventional morning meal and a Kollath breakfast].

Blood glucose kinetics and intestinal transit times were investigated in 12 adult volunteers aged 28 to 52 years after ingestion of a conventional morning meal made up of white flour rolls, butter, marmalade, and coffee with sugar as compared with an isocaloric Kollath-breakfast consisting of whole wheat flakes as a basis. For estimation of gastric emptying time the sodium-[13C]acetate breath test technique was used. Oro-coecal transit time and gastric emptying were determined by simultaneous administration of lactose-[13C]ureide and consecutive drawings of breath samples in intervals of 15, 30, and 60 min through 12 h. The 13CO2-excess of the breath test samples was measured by continuous flow isotope ratio mass spectrometry. The postprandial rise in blood glucose following the ingestion of the Kollath-breakfast was lower as compared with the conventional morning meal, showing significant differences between the 90 min values and the area below the blood glucose curve. The half time of gastric emptying was not different between the two breakfast versions (1.7 vs. 1.6 h). The oro-coecal transit time averaged out at 4.2 h after the Kollath-breakfast and 5.3 h following the conventional morning meal. Likewise, there were no significant differences in the coecal retention time nor in the cumulative percentage of 13CO2-exhalation between the two breakfast versions. Concerning the blood glucose kinetics the differences in the nutritional physiology between the breakfast based on whole wheat flakes and the conventional breakfast as claimed by Kollath were only detectable in outlines in our study. Gastric emptying time showed no differences between the two breakfast versions.

Adult↗

PubMed1999

Breakfast cereal and caffeinated coffee: effects on working memory, attention, mood, and cardiovascular function.

This study examined the effects of breakfast cereal and caffeinated coffee on working memory, attention, mood, and cardiovascular function. One hundred and forty-four volunteers (72 male, 72 female, mean age 21 years) were assigned to one of the groups formed by combining breakfast (cereal versus no breakfast) and caffeine (caffeinated versus decaffeinated coffee) conditions. The volunteers completed a baseline session between 0800 and 0845 h. The breakfast/caffeine administration took place between 0845 and 0915 h. They then completed another test session (starting at 0945) and had a coffee break at 1045, followed by a final session starting at 1145. The results showed that those who consumed breakfast cereal had a more positive mood at the start of the test sessions, performed better on a spatial memory task, and felt calmer at the end of the test session than those in the no breakfast condition. Ingestion of caffeine had no effect on initial mood or working memory, but it did improve encoding of new information and counteracted the fatigue that developed over the test session. Caffeine increased blood pressure and pulse rate, whereas breakfast cereal consumption only had an effect on pulse. Overall, these results confirm previous findings on the effects of breakfast and caffeine, and demonstrate distinct profiles for two common examples of early-morning food and drink, breakfast cereal and caffeinated coffee.

Adult↗

PubMed2002

Long-term weight loss and breakfast in subjects in the National Weight Control Registry.

OBJECTIVE: To examine breakfast consumption in subjects maintaining a weight loss in the National Weight Control Registry (NWCR). RESEARCH METHODS AND PROCEDURES: A cross-sectional study in which 2959 subjects in the NWCR completed demographic and weight history questionnaires as well as questions about their current breakfast consumption. All subjects had maintained a weight loss of at least 13.6 kg (30 lb) for at least 1 year; on average these subjects had lost 32 kg and kept it off for 6 years. RESULTS: A large proportion of NWCR subjects (2313 or 78%) reported regularly eating breakfast every day of the week. Only 114 subjects (4%) reported never eating breakfast. There was no difference in reported energy intake between breakfast eaters and non-eaters, but breakfast eaters reported slightly more physical activity than non-breakfast eaters (p = 0.05). DISCUSSION: Eating breakfast is a characteristic common to successful weight loss maintainers and may be a factor in their success.

Adult↗

PubMed2005

Palatability and glucose, insulin and satiety responses of chickpea flour and extruded chickpea flour bread eaten as part of a breakfast.

OBJECTIVE: To determine the effect of adding chickpea flour or extruded chickpea flour to white bread on palatability and postprandial glycaemia, insulinaemia and satiety. DESIGN: A randomised, single-blind, cross-over study of four 50 g available carbohydrate breakfasts. SETTING: School of Exercise and Nutrition Sciences, Deakin University. SUBJECTS: In all, 12 healthy subjects were recruited through posted notices. Totally, 11 (nine male, two female) completed the study (mean+/-s.e.m.; age 32+/-2 y; body mass index, 24.7+/-0.8 kg/m(2)). INTERVENTION: After overnight fasting, subjects consumed a control (white) bread (WB) breakfast twice, a chickpea bread (CHB) breakfast once and an extruded chickpea bread (EXB) breakfast once. Palatability and postprandial blood glucose, insulin and satiety responses were determined. Following this, food intakes from an ad libitum buffet and for the remainder of the day were assessed. RESULTS: A trend towards a lower incremental area under the curve (IAUC) of glucose for the CHB breakfast compared to the WB breakfast was observed (P=0.087). The IAUC of insulin and insulinaemic index (II) of the CHB breakfast were higher (P<0.05) than for the WB breakfast. No differences in glycaemic index (GI), satiety response, food intake or palatability were observed. CONCLUSIONS: CHB and EXB demonstrated acceptable palatability. CHB demonstrated some hypoglycaemic effect compared to WB, but neither CHB nor EXB demonstrated effects on satiety or food intake. The hyperinsulinaemic effect of CHB observed in this study requires further investigation.

Adult↗

PubMed2001

Breakfast consumption in Spanish children and young people.

BACKGROUND AND OBJECTIVES: Breakfast consumption is important for nutritional balance in all population groups. The objective of this paper is to describe breakfast consumption patterns in Spanish children and young people. DESIGN: Random population cross-sectional nutritional survey. METHODS: A random sample of 3534 people aged 2 to 24 years were interviewed by a team of 43 dietitians. The protocol included 24-hour recalls (a second 24-hour recall in 30% of the sample), a food-frequency questionnaire and other questions including lifestyles, knowledge and food preferences. RESULTS: Participation rate in the survey was 68%. Of the boys, 91.2% and 92.2% of the girls in the sample usually had breakfast. Males aged 18 years and above and 14-17-year-old girls showed the lowest consumption rates. Some 4.1% of the sample did not have any food at all before lunch. Main sources of energy with breakfast were milk and dairy products (34%) and buns, cookies, croissants, etc. (24.6%). Some 44.7% of the sample was classified in the poor-quality breakfast group. Subjects from a low socio-economic background and low educated parents had lower Quality Breakfast Score. CONCLUSIONS: The proportion of children having breakfast before attending school has increased in Spain in recent decades. However, intake of breakfast is not adequate in a large proportion of this population and a number of children and young people still do not eat anything before lunch. School-based nutrition education involving families, teachers and health professionals, supported by community actions, can contribute to improve this situation.

Adolescent↗