Abstract
<h3>Background</h3> Breakfast consumption is associated with lower rates of chronic disease and higher intakes of vitamins and minerals, including calcium, folic acid, and zinc. Skipping breakfast may further pose a threat to diet quality, which may result in less desirable food choices later in the day. Previously, breakfast consumption in children was examined, yet less is known regarding adults. <h3>Objective</h3> To examine the proportional contribution of food sources to energy intake for adults who skipped vs ate breakfast. <h3>Study Design, Setting, Participants</h3> This cross-sectional study used data from 31,514 adults, aged 18 years+, from the 2005-2016 National Health and Nutrition Examination Survey. Participants were categorized according to whether they skipped (n = 4,993) or ate (n = 26,521) breakfast on the recorded day of intake. <h3>Measurable Outcome/Analysis</h3> Dietary intakes were assessed by a 24-hour dietary recall and meal occasions were self-designated by participants. Food sources were categorized into What We Eat in America Food Categories. Sums of energy were aggregated and used to determine the proportions of energy from each food source for the total day as well as during breakfast and snacks. <h3>Results</h3> Adults who skipped breakfast consumed greater proportions of total energy from mixed dishes, sweetened-beverages, alcoholic beverages, and sandwiches, and less energy from breads, plant-proteins, milk, fruit, and eggs than those who ate breakfast. Breakfast energy mainly came from breads, eggs, and milk. Snack energy came from sweetened-beverages, alcoholic beverages, sweets, and savory snack-foods for those who skipped breakfast. For adults who ate breakfast, it came from sweets, alcoholic beverages, and savory foods; however, they also consumed more plant-proteins and fruit than those who skipped breakfast. <h3>Conclusions</h3> Making 1 poor nutritional decision, such as skipping breakfast, likely leads to other poor nutritional decisions throughout the day. Educational efforts should address breakfast's role in promoting nutritional adequacy and improving overall diet quality.
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