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PubMed2006

Breakfast eating and overweight in a pre-school population: is there a link?

OBJECTIVES: To analyse the socio-economic factors related to breakfast eating, the association between breakfast eating and overweight, and to gain a more thorough understanding of the relationship between these two elements in a population-based cohort of 4.5-year-old children. We hypothesised that a relationship could be observed between breakfast skipping and overweight independently of socio-economic factors such as ethnicity, maternal education, single parenting and family income. DESIGN: A population-based study whereby standardised nutritional interviews were conducted with each child's parent. The children's height and weight were taken by a trained nutritionist and parents were asked about their child's breakfast eating. SETTING: The analyses were performed using data from the Québec Longitudinal Study of Child Development (1998-2002), conducted by Santé Québec (Canada). SUBJECTS: Subjects were 1549 children between the ages of 44 and 56 months, with a mean age of 49 months. RESULTS: Almost a tenth (9.8%) of the children did not eat breakfast every day. A greater proportion of children with immigrant mothers (19.4% vs. 8.3% from non-immigrant mothers), with mothers with no high school diploma (17.5% vs. <10% for higher educated mothers) and from low-income families (15% for income of $39,999 or less vs. 5-10% for better income) did not eat breakfast every day. Not eating breakfast every day nearly doubled the odds (odds ratio=1.9, 95% confidence interval 1.2-3.2) of being overweight at 4.5 years when mother's immigrant status, household income and number of overweight/obese parents were part of the analysis. CONCLUSION: Although our results require replication before public policy changes can be advocated, encouraging breakfast consumption among pre-school children is probably warranted and targeting families of low socio-economic status could potentially help in the prevention of childhood obesity.

Adult↗

PubMed1984

The influence of ready-to-eat cereal consumption at breakfast on nutrient intakes of individuals 62 years and older.

From 7-day food diaries of a cross-sectional sample of American elderly individuals (n = 561), breakfast consumption patterns were assessed and related to average daily nutrient intake patterns. Results indicated that, in general, breakfast consumption made a significant contribution to the average elderly individual's daily nutrient intake and, in particular, breakfasts containing ready-to-eat cereal had a greater impact on nutrient intake levels than did breakfasts not containing ready-to-eat cereal. More specifically, elderly individuals who had ready-to-eat cereal at breakfast 4-7 times during the week surveyed consumed significantly less (P less than or equal to 0.05) fat and cholesterol and significantly more fiber, carbohydrate, total sugar, protein, thiamin, niacin, riboflavin, vitamins B6, B12, and A, iron, calcium, phosphorus, potassium, magnesium, copper, and zinc at the breakfast meal than those who had no ready-to-eat cereal at breakfast. Fewer statistically significant differences between the two groups were evidenced when vitamin/mineral supplement usage was included in the analysis. Average daily intake levels of frequent consumers of ready-to-eat cereal were significantly (P less than or equal to 0.05) greater than those of nonconsumers for all dietary components except protein, fat, cholesterol, vitamin E, and sodium when supplement usage was excluded from the calculations. When supplements were included, significant differences between the two groups decreased to nine dietary components. Comparison of the average nutrient composition of breakfasts containing ready-to-eat cereal and those not containing ready-to-eat cereal revealed those including ready-to-eat cereal contained significantly greater quantities of all nutrients assessed regardless of whether or not vitamin/mineral supplements were included in the calculations.

Aged↗

PubMed1999

Breakfast type, daily nutrient intakes and vitamin and mineral status of French children, adolescents, and adults.

OBJECTIVE: To examine associations between the consumption of different types of breakfasts, dietary intakes, and selected indices of nutritional status. METHODS: Dietary intakes were obtained using the dietary history method, and serum bioassays were used to assess vitamin and mineral status in a representative community-based sample of 1108 French children (ages 2 to 10 years), adolescents (ages 10 to 18 years), and adults (ages 18 to 65 years). Breakfasts were divided into three categories: low-energy (<15% of the energy RDA), medium-energy (15-25%) and high-energy (>25%). RESULTS: High-energy breakfasts were associated with the consumption of ready-to-eat (RTE) cereals. High-energy breakfasts and cereal consumption, both more common among children and adolescents than among adults, were also associated with a greater proportion of daily energy from carbohydrate and lower proportion of energy from fat. High-energy breakfasts and cereal consumption were further associated with higher intakes of vitamins and minerals as measured by percent RDAs. High-energy breakfasts and cereal consumption were associated with lower serum cholesterols and improved biochemical indices of nutritional status. Serum concentrations of vitamin B1 (in children and adolescents), vitamin B2 and beta-carotene (in adults) were significantly linked to the level of energy provided by breakfast. CONCLUSION: The consumption of breakfast cereals appears to have a positive impact on nutritional status regardless of age.

Adolescent↗

PubMed1999

Efficacy of a preschool breakfast program in reducing refined sugar intake.

The objective of this study was to measure nutritional differences between breakfasts eaten at home and those eaten in a preschool setting, which were prepared and served following the guidelines of the School Breakfast Program (SBP). During the fall semester, baseline data on children's breakfasts were obtained from families of 3- and 4-year-old children attending our laboratory school. Two weeks later, we began providing breakfasts for the children at preschool, before they began their school day. Breakfast menus varied but were always in compliance with SBP guidelines. Six weeks after initiating the SBP, we recorded breakfasts eaten at school, and the entire procedure was repeated during the spring semester. Children's intake of macronutrients from the breakfast meal was altered through participation in the SBP. During each intervention period, the consumption of starch-rich foods and fibre increased while the intake of simple sugars decreased. Protein, fat, and micronutrient intake were not affected. The implementation of the SBP appeared to be an effective way to increase the intake of starch-rich foods and fibre in a low-risk sample of preschool-aged children who regularly are breakfast prior to their participation in this investigation.

Child, Preschool↗

PubMed1981

The role of breakfast in nutrient intake of 5- to 12-year-old children.

From 7-day food diaries of a cross-sectional sample of American children (n = 657), breakfast consumption patterns were assessed and related to average daily nutrient intake patterns. Results indicated that few of the children skipped breakfast and that breakfast consumption made a significant contribution to the average child's daily nutrient intake. Further, children who had ready-to-eat cereals at breakfast three or more times during the 1-wk period were found to have consumed significantly less (p less than 0.001) fat and cholesterol and significantly more (p less than 0.001) fiber, thiamin, niacin, riboflavin, iron, folacin, pyridoxine, and vitamins B12, A and D than those who had no ready-to-eat cereal at breakfast. Average total daily intakes of the same groups had fewer significant differences. Comparison of the average nutrient composition of the three types of consumed breakfasts revealed that the average breakfast containing presweetened or nonsweetened ready-to-eat cereal had a higher content of sixteen nutrients and a lower content of five nutrients than did the average breakfast including no ready-to-eat cereal.

Child↗

PubMed1998

Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children.

Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programs, few programs have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age < or = -1 SD of the National Center for Health Statistics references) and the adequately nourished group comprised 407 children matched for school and class (weights-for-age >-1 SD). Both groups were stratified by class and school, then randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for 1 school year. Children in the control group were given one-quarter of an orange and the same amount of attention as children in the breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the schools' registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast group. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children's nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programs including health and educational inputs as well as school meals.

Absenteeism↗

PubMed2006

Self-reported weight perceptions, dieting behavior, and breakfast eating among high school adolescents.

This study explored the relationships among weight perceptions, dieting behavior, and breakfast eating in 4597 public high school adolescents using the Centers for Disease Control and Prevention Youth Risk Behavior Survey. Adjusted multiple logistic regression models were constructed separately for race and gender groups via SUDAAN (Survey Data Analysis). Adjusted odds ratios [ORs] and 95% confidence intervals were calculated to determine the strength of relationships. Approximately 42% of the sample reported not eating breakfast within the past 5 days, while 41% were trying to lose weight, and 37% were dieting to lose weight. Excessive dietary practices (eg, fasting, taking diet pills or laxatives, and vomiting to lose weight) were reported by approximately 25% of the sample. When compared to those eating breakfast within the past 5 days, all race and gender groups that did not report eating breakfast were significantly more likely to report fasting to lose weight (ORs = 1.70-2.97). In addition, all race/gender groups, with the exception of black females, were significantly more likely to perceive themselves as overweight (ORs = 1.44-1.61) and trying to lose weight (ORs = 1.40-1.72). Among males, not eating breakfast was significantly associated with taking diet pills to lose weight (ORs = 2.31-2.40), eating fewer calories to lose weight (ORs = 1.38-1.49), and inversely associated with trying to gain weight (ORs = 0.71-0.74). Results suggest that these adolescents may be skipping breakfast as part of a patterned lifestyle of unhealthy weight management and that efforts to encourage youth to eat breakfast will likely not ameliorate all dietary challenges that appear beyond the scope of increased breakfast offerings.

Adolescent↗

PubMed2005

The breakfast-eating habits of inner city high school students.

This cross-sectional, descriptive correlational research study describes the breakfast-eating habits of 846 inner-city high school students. Fifty-seven percent of students reported skipping breakfast on the day of the survey, despite the free hot-breakfast program at their high school. Significantly more girls than boys skipped breakfast, and 10th grade students had the highest rate of skipping breakfast. Sixty-four percent of breakfast-skippers cited a lack of time, and 28% stated they could not eat early in the morning. More breakfast eaters reported eating at home (48%); only 14% reported eating at school, with 3% reportedly eating both at home and school. Milk, orange juice, cereal, and foods in the bread group were the most frequently eaten foods. Patterns of eating by gender and by grade level are discussed in this article, as are implications for school nursing, including assessment, teaching, and research. It is important to educate students and parents about the importance of eating breakfast, because it provides an important part of a student's daily intake of nutrients needed for energy, growth, and learning.

Adolescent↗

PubMed1984

Failure of a midnocturnal insulin infusion to suppress the increased insulin need for breakfast in insulin-dependent diabetic patients.

Insulin requirements for meals were measured in eight insulin-dependent diabetic patients, using a closed-loop insulin infusion system. Patients required more insulin for breakfast than for an isocaloric lunch (35.7 +/- 5.5 mU/kcal/3 h versus 26.9 +/- 5.1 mU/kcal/3 h, P less than 0.02) or an isocaloric supper (35.7 +/- 5.5 mU/kcal/3 h versus 26.6 +/- 6.6 mU/kcal/3 h, P = 0.05). To determine whether this insulin resistance at breakfast might be due to low basal insulin levels overnight, the insulin needs for breakfast were compared after an overnight fast (day 1) and after a midnocturnal (0200 h-0500 h) insulin infusion (day 2). Breakfast insulin requirements were similar on both days (35.7 +/- 5.5 mU/kcal/3 h versus 37.7 +/- 5.1 mU/kcal/3 h, P = NS). Whereas nonobese diabetic patients required approximately 60% more insulin for breakfast than for other meals, obese diabetic patients in this study did not demonstrate insulin resistance at breakfast. These findings provide a basis for the common clinical practice of allocating more insulin for breakfast than for other meals. The absence of an increased insulin need at breakfast in our obese patients cautions against a similar algorithm for obese diabetic patients. We postulate that growth hormone may be a cause for morning insulin resistance.

Adult↗

PubMed1998

Difference in the breakfast habits of overweight/obese and normal weight schoolchildren.

The aim of the present study was to analyse the differences between the breakfast habits of obese/overweight (O) (those with body mass index [BMI] above the 75th percentile) and normal weight schoolchildren (N) (those with BMI equal to or below the 75th percentile). A seven consecutive days "food record" was used to record the intake of foods at breakfast and throughout the rest of the day. O subjects, and in particular female O subjects, omitted breakfast more frequently and took significantly smaller quantities of cereals than did N subjects. The energy supplied by breakfast, measured as a percentage of energy expenditure, was significantly lower in O subjects (17.0 +/- 8.5% in males and 14.6 +/- 6.1% in females) than in N subjects (20.9 +/- 9.4% in males and 17.6 +/- 6.5% in females). With respect to the energy and nutrients supplied by breakfast, O subjects took lower quantities of carbohydrates, thiamin, niacin, pyridoxine, vitamin D and iron than did N subjects. The energy profiles of O subjects breakfasts were more imbalanced than those of N subjects. A significant difference was seen between the amounts of energy supplied by carbohydrates. Without doubt, O subjects have less satisfactory breakfast habits than N subjects. This might be a reflection of whole diet that is less adequate, however, it is possible that an inadequate breakfast contributes to the making of poor food choices over the rest of the day, and, in the long term, to an increased risk of obesity.

Adolescent↗

PubMed1996

Acute effects on mood and cognitive performance of breakfasts differing in fat and carbohydrate content.

Sixteen subjects consumed low-fat/high-carbohydrate (LFHC), medium-fat/ medium-carbohydrate (MFMC), high-fat/low-carbohydrate (HFLC) iso-energetic breakfasts and no breakfast in a counterbalanced order on four separate days. The LFHC breakfast was similar in macronutrient composition, though not in meal size (more kcal) and types of foods offered, to the habitual breakfast of the subjects. A battery of cognitive performance tasks together with mood and appetite ratings were completed before and during the 3 h following breakfast. Results showed no clear differences in performance between the four dietary conditions, but significant effects on mood were observed. Mood improved (a decline in fatigue/dysphoria) following the LFHC breakfast compared to the other meals. The findings show that the macronutrient content of breakfast, independent of energy value and oro-sensory qualities, can exert small but reliable effects on subsequent mood, and suggest that deviation from habitual meal composition can produce a relative decline in mood state. These conclusions are supported by results from a previous study of the effects of lunch which found very similar relationships between meal composition, habitual choices and postprandial mood changes.

Adult↗

PubMed1996

Breakfasts with different fiber and macronutrient contents do not differentially affect timing, size or microstructure of the subsequent lunch.

The effects of four equienergetic breakfasts with varying fiber and macronutrient contents on hunger and satiety ratings, on subsequent lunch intake, and on postprandial carbohydrate and fat metabolism were investigated in normal weight male subjects in two experiments, in which lunch was offered at a predetermined time (Experiment 1) or in which the subjects were free to choose when to eat lunch (Experiment 2). Consumption of either a commercially available high fiber cereal (HFC, 10% fiber), a medium fiber cereal (MFC, 7% fiber), a low fiber cereal (LFC, 3% fiber), or a standard continental breakfast (0% fiber) on nonconsecutive days did not differentially affect hunger and satiety ratings, the size or microstructure of the subsequent lunch, and the breakfast to lunch intermeal interval (in Experiment 2). Plasma concentrations of glucose, lactate, and insulin increased more after the LFC breakfast than after the other breakfast varieties. A reactive postprandial hypoglycaemia occurred after the LFC breakfast, shortly before lunch. The plasma concentrations of fat metabolites (triglycerides, free fatty acids, beta-hydroxybutyrate) and of glucagon were not differentially affected by the breakfast varieties. The results are consistent with the assumption that energy content of a meal is the major determinant of subsequent energy intake in man and the fiber content and macronutrient composition have only a modulating effect.

3-Hydroxybutyric Acid↗

PubMed2004

Improvements in nutritional intake and quality of life among frail homebound older adults receiving home-delivered breakfast and lunch.

OBJECTIVE: This study evaluated the influence that expanding a home-delivered meals service to include breakfast and lunch would have on the nutritional status and quality of life of at-risk older adults. DESIGN: This cross-sectional field study compared two groups. The breakfast group (n=167) received a home-delivered breakfast and lunch, 5 days per week. The comparison group (n=214) received a home-delivered lunch 5 days per week. Participants' 24-hour food recall, demographics, malnutrition risk, functional status, and surveys of quality of life as health, loneliness, food enjoyment, food security, and depression were obtained. PARTICIPANTS: Study participants were recruited from five Elderly Nutrition Programs involved in the Morning Meals on Wheels breakfast service demonstration project. They formed a geographically and racially/ethnically diverse sample. Participants ranged in age from 60 to 100 years, were functionally limited, and at high nutritional risk. Most were low income, lived alone, and had difficulty shopping or preparing food. STATISTICAL ANALYSIS: Descriptive statistics were used to assess group comparability. Independent sample t tests were used to examine group differences, with Bonferroni's method used to control for familywise Type I error. RESULTS: Breakfast group participants had greater energy/nutrient intakes (P<.05), greater levels of food security (P<.05), and fewer depressive symptoms (P<.05) than comparison group participants. CONCLUSIONS: The addition of a breakfast service to traditional home-delivered meals services can improve the lives of frail, homebound older adults. Agencies should be encouraged to expand meals programs to include a breakfast service to a targeted population.

Aged↗

PubMed2005

The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To describe changes in breakfast and cereal consumption of girls between ages 9 and 19 years, and to examine the association of breakfast and cereal intake with body mass index (BMI) and consumption of nutrients. DESIGN: Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal biracial observational cohort study with annual 3-day food records. SUBJECTS/SETTING: The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 black), ages 9 and 10 years at baseline, from locations in the Berkeley, CA; Cincinnati, OH; and Washington, DC, areas. MAIN OUTCOME MEASURES: Frequency of consumption of breakfast (including cereal vs other foods) and cereal; BMI; and dietary fat, fiber, calcium, cholesterol, iron, folic acid, vitamin C, and zinc. STATISTICAL ANALYSES: Generalized estimating equations methodology was used to examine differences in the frequency of breakfast and cereal eating by age. Generalized estimating equations and mixed models were used to examine whether breakfast and cereal consumption were predictive of BMI and nutrient intakes, adjusting for potentially confounding variables. RESULTS: Frequency of breakfast and cereal consumption decreased with age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. After adjusting for energy intake, cereal consumption was related to increased intake of fiber, calcium, iron, folic acid, vitamin C, and zinc, and decreased intake of fat and cholesterol. Days eating cereal was predictive of lower BMI. CONCLUSIONS: Cereal consumption as part of an overall healthful lifestyle may play a role in maintaining a healthful BMI and adequate nutrient intake among adolescent girls.

Adolescent↗

PubMed2006

Fast food consumption and breakfast skipping: predictors of weight gain from adolescence to adulthood in a nationally representative sample.

PURPOSE: To investigate whether fast food consumption and breakfast skipping are associated with weight gain during the transition from adolescence to adulthood. METHODS: A prospective study of 9919 adolescents participating in Waves II (age range 11-21 years) and III (age range 18-27 years) of the National Longitudinal Study of Adolescent Health. BMI z scores (zBMI) were computed using the 2000 Centers for Disease Control and Prevention growth charts. Multivariate regression models assessed the relationship between Wave II fast food and breakfast consumption and change in fast food and breakfast consumption between Waves II and III and weight gain during the transition to adulthood. RESULTS: Marked increases in fast food consumption and decreases in breakfast consumption occurred over the 5-year interval. Greater days of fast food consumption at Wave II predicted increased zBMI at Wave III. Fewer days of breakfast consumption at Wave II and decreases in breakfast consumption between Waves II and III predicted increased zBMI at Wave III. CONCLUSIONS: Fast food consumption and breakfast skipping increased during the transition to adulthood, and both dietary behaviors are associated with increased weight gain from adolescence to adulthood. These behaviors may be appropriate targets for intervention during this important transition.

Adolescent↗

PubMed1997

Usefulness of a breakfast test in the management of women with gestational diabetes.

OBJECTIVE: To assess the usefulness of a breakfast test in determining which women with gestational diabetes do not need self-monitoring of blood glucose levels (home monitoring). METHODS: A 1-hour post-standardized breakfast blood glucose below 7.8 mmol/L (140 mg/dL) was measured in 227 women and at or above 7.8 mmol/L in 115. Within each group, women were randomized to home monitoring with a meter or to clinic follow-up. Target glucose values were 5.3 mmol/L (95 mg/dL) fasting, 5.6 mmol/L (101 mg/dL) before meals, and 7.8 mmol/L (140 mg/dL) 1 hour postprandial. Up to these thresholds women on clinic follow-up were transferred to home monitoring. Insulin therapy was started on the same thresholds in women randomized or transferred to home monitoring. Large for gestational age (LGA) newborns represented the main outcome, with the transfer rate to home monitoring and need of insulin therapy the secondary ones. RESULTS: The LGA delivery rate was not significantly different in the two follow-up groups in women with a breakfast result below 7.8 mmol/L (9.8 versus 4.3%) but was higher in the clinic follow-up among women with a breakfast result at or above 7.8 mmol/L (13.3% versus 30.9%; P < .05). Fewer women with a breakfast result below 7.8 mmol/L were transferred to home monitoring (2.6 versus 52.7%; P < .001) or started on insulin therapy (3.6 versus 25.2%; P < .001). The breakfast test cutoff of 7.8 mmol/L predicted insulin need with a sensitivity of 91.0% and a specificity of 72.0% CONCLUSION: A breakfast test is useful in identifying a low-risk population in which clinic follow-up may be used safety.

Birth Weight↗

PubMedDate not supplied

The influence of breakfast and a snack on psychological functioning.

Although there are reports that breakfast influences both mood and memory, there has been no attempt to consider whether a subsequent snack is beneficial. One hundred and fifty young female adults either fasted or consumed breakfasts of either 10 or 50 g of carbohydrate (corn flakes). Half received a further 25 g of carbohydrate in the form of corn flakes after 1 1/2 h (snack). Predictably, those who ate breakfast, and/or a snack, reported feeling less hungry. The larger the caloric intake, the less subjects reported hunger. Those who consumed a snack reported a better mood. Eating a larger breakfast was associated with poorer mood later in the morning, an effect reversed by eating a snack. Memory for the word lists was not influenced by eating breakfast, however, 20 but not 60 min after a midmorning snack, more words were recalled. Those who had eaten breakfast, as opposed to fasting, did, however, spend longer trying to recall the words. This finding was interpreted as evidence that eating breakfast was associated with better motivation. On a number of occasions, better memory was associated with lower blood glucose levels. These findings support previous observations that better glucose tolerance was associated with better memory.

Adult↗

PubMed2002

Relation between breakfast food choices and knowledge of dietary fat and fiber among Swedish schoolchildren.

PURPOSE: To investigate dietary knowledge and beliefs of schoolchildren, in relationship to breakfast choices, with specific attention to fat and fiber content. METHODS: Food choice and perceptions were studied by interviews using the "stacking box methodology". Youth (n = 181) aged 11-15 years were instructed to select food items among photographs of breakfast foods. In addition to choosing their own typical breakfasts, they were asked to exchange foods in hypothetical breakfasts to create meals with less fat and more fiber. The interview also dealt with recent changes in breakfast habits, and perceptions of healthy breakfasts, dietary fat, and foods rich in fiber. Data were analyzed by logistic regression. RESULTS: Knowledge concerning sources and health attributes of dietary fiber was associated with usual consumption of bread and breakfast cereals rich in fiber. In a similar way, a positive attitude toward limited fat intake predicted consumption of reduced-fat milk products. However, no association was observed between food choices and knowledge of a food-packaging symbol indicating low-fat and fiber-enriched foods. CONCLUSION: Lack of awareness of, and knowledge about, healthy eating may be important barriers to the development of health promoting food habits by schoolchildren.

Adolescent↗