Abstract
Breakfast frequency is associated with cardiovascular disease (CVD) risk in Western populations, possibly via the types of food eaten or the timing of food consumption, but associations in Malaysian adolescents are unknown. While the timing of breakfast is similar, the type of food consumed at breakfast in Malaysia differs from Western diets, which allows novel insight into the mechanisms underlying breakfast–CVD risk associations. We investigated foods eaten for breakfast and associations between breakfast frequency and CVD risk factors in the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs). Breakfast (frequency of any food/drink reported as breakfast in 7-day diet history interviews) and CVD risk factors (body mass index (BMI), waist circumference, fasting blood glucose, triacylglycerol, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and systolic and diastolic blood pressure) were cross-sectionally associated using linear regression adjusting for potential confounders (n = 795, age 13 years). Twelve percent of adolescents never ate breakfast and 50% ate breakfast daily, containing mean (SD) 400 (±127) kilocalories. Commonly consumed breakfast foods were cereal-based dishes (primarily rice), confectionery (primarily sugar), hot/powdered drinks (primarily Milo), and high-fat milk (primarily sweetened condensed milk). After adjustment, each extra day of breakfast consumption per week was associated with a lower BMI (−0.34 kg/m2, 95% confidence interval (CI) −0.02, −0.66), and serum total (−0.07 mmol/L 95% CI −0.02, −0.13) and LDL (−0.07 mmol/L 95% CI −0.02, −0.12) cholesterol concentrations. Eating daily breakfast in Malaysia was associated with slightly lower BMI and total and LDL cholesterol concentrations among adolescents. Longitudinal studies and randomized trials could further establish causality.
Highlights
Cardiovascular disease (CVD) is the number one cause of death globally [1]
In this cross-sectional analysis of a large sample of Malaysian adolescents with detailed dietary data and a broad range of cardiovascular disease (CVD) risk factors, we found evidence that breakfast frequency was inversely associated with body mass index (BMI) and fasting total and LDL cholesterol concentrations, but not waist circumference, fasting glucose, HDL or TAG concentrations, or blood pressure
The present study suggests that adolescents in Malaysia who eat breakfast more frequently have a lower BMI, and lower plasma total and LDL cholesterol concentrations independent of a range of confounders
Summary
Cardiovascular disease (CVD) is the number one cause of death globally [1]. In Malaysia, CVD is the biggest cause of mortality, accounting for 36% of total deaths [2]. The incidence of Nutrients 2019, 11, 973; doi:10.3390/nu11050973 www.mdpi.com/journal/nutrients. 22 of CVD (e.g. myocardial infarction and stroke) does not emerge until adulthood, CVD risk factors often. CVD (e.g., myocardial infarction and example, stroke) does not emerge until adulthood, CVD have risk factors often present during adolescence [3]. For. Malaysian children and adolescents the highest present during adolescence [3]. Malaysian children and adolescents have the highest prevalence of overweight and obesity across the South and Southeast Asian countries, at 22.5% Prevalence overweight and obesity across the South(95% andCI Southeast
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