Abstract
Most studies showing that children consuming breakfast have better nutrient intakes, diet quality, and lower weight than breakfast skippers have the incorrect premise that breakfast meals are homogeneous.The purpose of this study was to classify breakfast meals into patterns and determine the association of the breakfast patterns with daily and breakfast nutrient intakes, diet quality, and weight. Data from children (2–18 years of age; N = 14,200) participating in the National Health and Nutrition Examination Survey 2001–2008 were used. Intake was determined from one day 24-hour dietary recalls. Diet quality was measured using the Healthy Eating Index-2005 (HEI-2005). Body mass index (BMI) z-scores were determined. Twelve patterns (including No Breakfast [∼19% of population]), explaining 63% of the variance in energy from breakfast, were examined. Covariate adjusted general linear models were used to compare outcome variables of consumers of different patterns with breakfast skippers. The p value was Bonferroni corrected (< 0.05/12 = < 0.0042). Consumers of the Eggs/Grain/Meat, Poultry, Fish (MPF)/ Fruit Juice (FJ) and MPF/ Grain/FJ patterns showed higher daily intakes of saturated fats, solid fats, and sodium and lower daily intakes of added sugars than breakfast skippers. Consumers of most breakfast patterns showed higher daily intakes of some nutrients of public health concern (dietary fiber, vitamin D, calcium, and potassium); however, those consuming the Grain or MPF/Grain/FJ pattern did not. Consumers of the Grain/Lower Fat Milk (LFM)/Sweets/FJ, Presweetened (PS) Ready-to-eat Cereal (RTEC)/ LFM, RTEC/LFM, Cooked Cereal/Milk/FJ, and Whole Fruit patterns had higher total HEI-2005 scores than breakfast skippers; those consuming the MPF/ Grain/FJ pattern had lower diet quality than breakfast skippers. Consumption of the Grain/ LFM/Sweets/FJ, PSRTEC/whole milk, Soft Drinks/ FJ/Grain/Potatoes, RTEC/whole milk, and Cooked Cereal/ Milk/ FJ patterns was associated with lower BMI z-scores than seen in breakfast skippers. There are dietary and weight advantages of consuming breakfast, especially breakfasts that include grains, cereals, LFM, and fruit/ FJ, in contrast to the potential adverse effects of skipping breakfast.
Highlights
Breakfast has traditionally been considered to be the most important meal of the day [1,2]
Data from the most recent What We Eat in America (WWEIA) component of the National Health and Nutrition Examination Survey (NHANES) data [15] showed that 2%, 11%, and 24% of males 2–5, 6–11, and 12–18 years of age, respectively, skipped breakfast; whereas, 5%, 9%, and 29% of females 2–5, 6–11, and 12-18 years, respectively, skipped breakfast
Results from this study suggested that consuming breakfast was not associated with a higher diet quality when compared with breakfast skippers, but that the specific foods or food groups consumed at the breakfast meal may have influenced total diet quality
Summary
Breakfast has traditionally been considered to be the most important meal of the day [1,2]. Breakfast consumption has been associated with lower body mass index (BMI) [1,3,4,5,6,7,8,9,10,11] and higher levels of physical activity [8,12], as well as improved motor skills [9], attention [13], and cognition [14]; these results are inconsistent and additional confirmative studies are needed Despite these potential benefits, children often skip the breakfast meal. This is especially important, for the reasons stated above, but since consumption of breakfast has been shown to track into young adulthood [17]
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