Is consumption of breakfast associated with body mass index in US adults?

Chronic and immediate refined carbohydrate consumption and facial attractiveness

The Western diet has undergone a massive switch since the second half of the 20th century, with the massive increase of the consumption of refined carbohydrate associated with many adverse health effects. The physiological mechanisms linked to this consumption, such as hyperglycaemia and hyperinsulinemia, may impact non medical traits such as facial attractiveness. To explore this issue, the relationship between facial attractiveness and immediate and chronic refined carbohydrate consumption estimated by glycemic load was studied for 104 French subjects. Facial attractiveness was assessed by opposite sex raters using pictures taken two hours after a controlled breakfast. Chronic consumption was assessed considering three high glycemic risk meals: breakfast, afternoon snacking and between-meal snacking. Immediate consumption of a high glycemic breakfast decreased facial attractiveness for men and women while controlling for several control variables, including energy intake. Chronic refined carbohydrate consumption had different effects on attractiveness depending on the meal and/or the sex. Chronic refined carbohydrate consumption, estimated by the glycemic load, during the three studied meals reduced attractiveness, while a high energy intake increased it. Nevertheless, the effect was reversed for men concerning the afternoon snack, for which a high energy intake reduced attractiveness and a high glycemic load increased it. These effects were maintained when potential confounders for facial attractiveness were controlled such as age, age departure from actual age, masculinity/femininity (perceived and measured), BMI, physical activity, parental home ownership, smoking, couple status, hormonal contraceptive use (for women), and facial hairiness (for men). Results were possibly mediated by an increase in age appearance for women and a decrease in perceived masculinity for men. The physiological differences between the three meals studied and the interpretation of the results from an adaptive/maladaptive point of view in relation to our new dietary environment are discussed.

The Relationship of Ready-to-Eat Cereal Intake and Body Weight in Adults: A Systematic Review of Observational Studies and Controlled Trials

Results from observational studies indicate that consumption of ready-to-eat cereal (RTEC) is associated with higher diet quality and lower incidence of overweight and obesity in adults compared with other breakfasts or skipping breakfast. However, randomized controlled trials (RCTs) have had inconsistent results regarding effects of RTEC consumption on body weight and composition. This systematic review aimed to evaluate the effect of RTEC intake on body weight outcomes in observational studies and RCTs in adults. A search of PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) databases yielded 28 relevant studies, including 14 observational studies and 14 RCTs. Results from observational studies demonstrate that frequent RTEC consumers (usually ≥4 servings/wk) have lower BMI, lower prevalence of overweight/obesity, less weight gain over time, and less anthropometric evidence of abdominal adiposity compared with nonconsumers, or less frequent consumers. RCT results suggest that RTEC may be used as a meal or snack replacement as part of a hypocaloric diet, but this approach is not superior to other options for those attempting to achieve an energy deficit. In addition, RTEC consumption was not associated with significantly less loss of body weight, or with weight gain, in any of the RCTs. RTEC intake is associated with favorable body weight outcomes in adults in observational studies. RTEC does not hinder weight loss when used as a meal or snack replacement within a hypocaloric diet. Additional long-term RCTs (≥6 mo) in both hypocaloric and ad libitum conditions are recommended to evaluate further the potential effects of RTEC consumption on body weight outcomes. PROSPERO (CRD42022311805).

Describing the longitudinal breakfast quality index trajectories in early childhood: results from Melbourne InFANT program

BACKGROUND

Breakfast quality in early childhood remains understudied. This study describes the changes in breakfast quality index (BQI) (i.e. trajectory) in early childhood and assesses its associations with obesity outcomes.

METHODS

Data from children who participated in the Melbourne InFANT Program were used (n = 328). The Melbourne InFANT Program was a 15-month early obesity prevention intervention conducted from 2008 to 2013. Dietary intakes at ages 1.5, 3.5 and 5.0 years were assessed using three parent-proxy reported 24 h recalls. A revised nine-item BQI tool developed based on Australian dietary recommendations for young children was used to calculate BQI scores. Group-based trajectory modelling identified BQI trajectory groups. Multivariable linear and logistic regression examined the associations between identified BQI trajectory groups and obesity outcomes at age 5 years.

RESULTS

Mean BQI at ages 1.5, 3.5 and 5.0 years was 4.8, 4.8, 2.7 points, respectively. Two BQI trajectory groups were identified, and both showed a decline in BQI. The mean BQI of most children (74%) decreased from 5.0 to 4.0 points from ages 1.5 to 5.0 years (referred as "High BQI" group). The remaining children (26%) had a mean BQI of 4.8 and 1.2 points at age 1.5 and 5.0 years, respectively (referred as "Low BQI" group). The "Low BQI" group appeared to show higher risk of overweight (OR:1.30, 95% CI: 0.60, 2.81, P = 0.66) at age 5 years than the "High BQI" group. No difference in body mass index (BMI) z-score was found between the two groups.

CONCLUSIONS

Two BQI trajectory groups were identified. Both groups showed a decline in breakfast quality from ages 1.5 to 5.0 years. Our study highlights the need for early health promotion interventions and strategies to improve and maintain breakfast quality across early childhood.

Delayed feeding of a high-sucrose diet led to increased body weight by affecting the circadian rhythm of body temperature and hepatic lipid-metabolism genes in rats

Skipping breakfast is an irregular feeding behavior, typically in young people. In our previous study, we established a 4 h-delayed feeding protocol for rats as a breakfast-skipping model and showed that the 4 h-delayed feeding of a high-fat diet led to body weight gain in rats. Excess sucrose induces metabolic syndrome and fatty liver. Recently, excess sucrose intake has received increased attention. Young people generally consume more sugar than adults do. In the present study, we investigated whether a 4 h-delayed feeding promoted high-sucrose diet-induced abnormalities in lipid metabolism, such as fatty liver and obesity in rats. The 4 h-delayed feeding rats showed increased body weight gain, although it did not induce fatty liver and hyperlipidemia compared to normal feeding rats. Serum insulin concentration during the feeding period was higher than in the control rats, suggesting that slight insulin resistance was induced by the 4 h-delayed feeding. The surge in body temperature was also delayed by 4 h in response to the 4 h-delayed feeding. This delay would result in less energy expenditure to increase body weight. The oscillations of hepatic lipid and glucose metabolism-related gene expression were delayed by almost 2-4 h, and the clock genes were delayed by approximately 2 h. The 4 h-delayed feeding induced weight gain by affecting body temperature, insulin resistance, and circadian oscillation of lipid metabolism-related genes in rats fed a high-sucrose diet, suggesting that a high sucrose intake with breakfast skipping leads to obesity.

Effects of Differences of Breakfast Styles, Such as Japanese and Western Breakfasts, on Eating Habits

A balanced diet and protein source intake are reportedly good for health. However, many people skip breakfast or have a light breakfast. Thus, this study aimed to examine the influence of breakfast styles on eating habits among Japanese workers, including traditional Japanese-style breakfast (JB), a pattern in which Japanese foods are eaten; Japanese-Western-style breakfast (J-W B), a pattern in which Japanese and Western foods are eaten alternately; Western-style breakfast (WB), a pattern in which Western foods are eaten; and cereal-style breakfast (CB), a pattern in which cereal is eaten. We hypothesized that breakfast style may be related to good eating habits. Data from 4274 respondents (67.97% male, 33.03% female, age 48.12 ± 0.19 years), excluding night shift workers and breakfast absentees out of a total of 5535 respondents, were analyzed. The results suggest that Japanese food is linked to the intake of protein sources such as fish, eggs, and soy. Furthermore, it was suggested that Japanese food breakfast is effective for good eating habits, such as not eating irregular amounts of food, not eating snacks, not drinking sweet juices, and having a balanced diet.

Prospective study of breakfast frequency and timing and the risk of incident type 2 diabetes in community-dwelling older adults: the Cardiovascular Health Study

BACKGROUND

No evidence-based recommendations regarding optimal breakfast frequency and timing and type 2 diabetes mellitus (T2DM) exist for older adults because of limited studies.

OBJECTIVES

We sought to prospectively assess relations between breakfast frequency and timing and T2DM risk among older adults and determine whether these depended on sex or cardiometabolic risk factors.

METHODS

Weekly breakfast frequency and usual daily breakfast time were assessed by questionnaire at baseline in 3747 older adults (aged ≥ 65 y) from the Cardiovascular Health Study (CHS) who were free of cancer and T2DM and followed for 17.6 y. Multivariable-adjusted hazard ratios (aHRs) with 95% CIs estimated from Cox proportional hazards models were used to quantify associations with T2DM.

RESULTS

Most CHS participants (median age: 74 y; IQR: 71-78 y) consumed breakfast daily (85.5%), and 73% had their first daily eating occasion between 07:00 and 09:00, both of which were associated with higher socioeconomic status, factors that are indicative of a healthier lifestyle, and lower levels of cardiometabolic risk indicators at baseline. During follow-up, 547 T2DM cases were documented. No strong evidence was observed linking breakfast frequency and risk of T2DM. Compared with participants whose breakfast timing (first eating occasion of the day) was 07:00-09:00, those who broke fast after 09:00 had an aHR for T2DM of 0.71 (95% CI: 0.51, 0.99). This association was present in participants with impaired fasting glucose at baseline (aHR: 0.61; 95% CI: 0.39, 0.95) but not in those without (aHR: 0.83; 95% CI: 0.50, 1.38). No associations between eating frequency or timing and T2DM were observed within other prespecified subgroups.

CONCLUSIONS

Eating breakfast daily was not associated with either higher or lower risk of T2DM in this cohort of older adults, whereas a later (after 09:00) daily first eating occasion time was associated with lower T2DM risk in participants with impaired fasting glucose at baseline.This trial was registered at clinicaltrials.gov as NCT00005133.

Hydration and meal habits of physicians and medical learners: a literature review

PURPOSE

Nutrition and hydration are important components of physician and medical learner well-being; meal-skipping and insufficient hydration are known to negatively impact cognition. Existing data on these phenomena are sparse and rarely considered together; furthermore, there is a lack of literature on interventions to address these problems. We therefore aimed to characterize existing literature on this topic.

METHODS

We conducted a literature review of existing literature on the prevalence of and reasons for meal-skipping and insufficient hydration in physicians and medical learners.

RESULTS

Reported prevalences varied widely, as did the ways in which the data were collected. Reasons for meal-skipping and insufficient hydration are less studied, but a lack of time is the most commonly reported reason, among a variety of other barriers.

CONCLUSION

Further research is required to better characterize the prevalences and reasons for meal-skipping in physicians and medical learners. By consolidating the state of current knowledge on this topic in this work, we establish the groundwork for future studies and allow intervention studies to be based on a broader data set.

Breakfast consumption frequency is associated with dyslipidemia: a retrospective cohort study of a working population

Background

Dyslipidemia is a significant contributor to cardiovascular and cerebrovascular diseases. Research on the relationship between breakfast consumption frequency and dyslipidemia in the working population is lacking. Therefore, we aimed to investigate this relationship based on a retrospective cohort study of a large working population in China.

Methods

This retrospective cohort study used data from the physical examinations and questionnaire survey of working participants at Nanfang Hospital from January 20, 2015 to October 16, 2020. Univariate and multivariate analyses were conducted to explore the relationship between breakfast consumption frequency and dyslipidemia in this working population (n = 7644).

Results

The prevalence of dyslipidemia among the participants was 26.4%. The univariate logistic regression test showed that the breakfast consumption frequency was inversely correlated with dyslipidemia. After adjusting for multiple factors, such as sex, age, body mass index, hypertension, hyperuricaemia, diabetes, smoking status, alcohol consumption, education level, marital status, long-term exposure to kitchen oil fumes, attending business dinners, and sleep time, it was found that breakfast consumption remained inversely associated with dyslipidaemia. The odds ratio for daily breakfast consumption was 0.466 (95% confidence interval 0.283–0.770, P = 0.003). After adjusting for confounding factors, we found that the higher the frequency of breakfast consumption, the lower the odds ratios for hypertriglyceridaemia.

Conclusions

This study demonstrated that breakfast consumption frequency was inversely correlated with dyslipidemia. The higher the frequency of breakfast, the lower the risk of hypertriglyceridaemia. This study provides a basis on which dietary suggestions for the working population and lifestyle guidance for patients with a clinical need to prevent dyslipidemia can be made.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-022-01641-x.

Characterisation, procedures and heritability of acute dietary intake in the Twins UK cohort: an observational study

Background

Estimated food records (EFR) are a common dietary assessment method. This investigation aimed to; (1) define the reporting quality of the EFR, (2) characterise acute dietary intake and eating behaviours, (3) describe diet heritability.

Methods

A total of 1974 one-day EFR were collected from 1858 participants in the TwinsUK cohort between 2012 and 2017. EFR were assessed using a six-point scoring system to determine reporting quality. The frequency and co-occurrence of food items was examined using word clouds and co-occurrence networks. The impact of eating behaviours on weight, BMI and nutrient intake were explored using mixed-effect linear regression models. Finally, diet heritability was estimated using ACE modelling.

Results

We observed that 75% of EFR are of acceptable reporting quality (score > 5). Black tea and semi-skimmed milk were the most consumed items, on an individual basis (respectively 8.27, 6.25%) and paired (0.21%) as co-occurring items. Breakfast consumption had a significantly (p = 5.99 × 10^− 7) greater impact on energy (kcal) (mean 1874.67 (±SD 532.42)) than skipping breakfast (1700.45 (±SD 620.98)), however only length of eating window was significantly associated with body weight (kg) (effect size 0.21 (±SD 0.10), p = 0.05) and BMI (effect size 0.08 (±SD 0.04), p = 0.04) after adjustment for relevant covariates. Lastly, we reported that both length of eating window (h2 = 33%, CI 0.24; 0.41), and breakfast consumption (h2 = 11%, CI 0.02; 0.21) were weakly heritable.

Conclusions

EFR describing acute dietary intake allow for eating behaviour characterisation and can supplement habitual diet intake assessments. Novel findings of heritability warrant further investigation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-022-00763-3.

Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study

OBJECTIVES

French Guiana is a multicultural overseas territory where obesity is a major public health problem. This study aimed to highlight the nutritional and socioeconomic determinants of overweight and obesity in different populations in French Guiana.

METHODS

A two-stage random sample of 1390 individuals aged 15 to 75 years was surveyed by telephone, and the participants were initially screened for diabetes. Logistic regression was fitted on the sample to adjust for potential confounding factors.

RESULTS

Overweight and obesity were found in 54.7% of the respondents, a higher proportion than in mainland France. There was a significant body image discrepancy in our population, with a higher risk of obesity among single women, often immigrants from the non-French Caribbean and South America, unemployed or low education.

CONCLUSIONS

The main factors associated with obesity were being a precariousness immigrant; there was often a mismatch between body image and overweight/obesity, which is a major obstacle to the improvement of dietary behaviors and lifestyle. This information provides operational clues as to where to act and the necessary adaptations to attempt to modify behaviors in a culturally-adapted manner.

Delayed Meal Timing, a Breakfast Skipping Model, Increased Hepatic Lipid Accumulation and Adipose Tissue Weight by Disintegrating Circadian Oscillation in Rats Fed a High-Cholesterol Diet

Background: To investigate whether shifted timing of eating, breakfast skipping, induces alterations in the circadian clock and abnormal lipid metabolism, we have established a delayed meal timing (DMT) protocol for rats, which started eating food 4 h delay. In the present study, control and DMT rats were fed a high-cholesterol diet during zeitgeber time (ZT) 12-24 and ZT 16-4, respectively. The DMT protocol increased the hepatic lipids and epididymal adipose tissue weight without changes in food intake and body weight. The surge in body temperature was delayed by 4 h in the DMT group, suggesting that energy expenditure was decreased in response to DMT. The peaks of the diurnal rhythm of serum non-esterified fatty acids and insulin were delayed by 2 and 4 h due to DMT, respectively. The oscillation peaks of hepatic de novo fatty acid synthesis gene expression was delayed by 4 h in response to DMT, whereas the peak of hepatic clock genes were 2 h delayed or not by DMT. Although metabolic oscillation is considered to be controlled by clock genes, the disintegration rhythms between the clock genes and lipid metabolism-related genes were not observed in rats fed a high-fat diet in our previous study. These data suggest that the circadian rhythm of de novo fatty acid metabolism is regulated by timing of eating, but is not directly controlled by clock genes. The present study suggests that breakfast skipping would complicate fatty liver and body fat accumulation.

Breakfast Location Effect on Breakfast Quality and Obesity Risk in Saudi Female College Students

Background:

There is a lack of data regarding breakfast consumption and quality among college students in the Kingdom of Saudi Arabia.

Objective:

The objective of this study was to assess the prevalence of breakfast consumption and examine the effect of breakfast location on breakfast nutritional quality and obesity risk among female college students at Taibah University.

Methods:

A total of 658 students participated in this cross-sectional study. Based on the Child and Adult Care Food Program (CACFP) recommendations, breakfast quality scores were computed by summing the individual food components and categorizing participants according to tertiles of the breakfast score distribution. Mixed-effects repeatedmeasures models were used to examine BMI categories with increasing tertiles of breakfast quality scores, stratified by breakfast location.

Results and Discussion:

Approximately 68% of the participants reported having breakfast regularly. The mean breakfast quality score was determined for students who had breakfast at home (12.5 ± 0.11), at college (10.41± 0.06), and in other places (8.19± 0.48). Obesity was associated with lower average breakfast quality scores based on breakfast location [mean quintile 3 compared with 1 difference: home 13.6 (P < 0.001), college 9.1 (P < 0.001), other 8.6 (P < 0.001)].

Conclusion:

The findings presented here indicated that a high percentage of students consume breakfast regularly. Students who had breakfast at home had high scores, which indicated good breakfast quality and a decreased risk of obesity. Further research on breakfast quality is needed in this area, as it affects the nutritional status and quality of life of the younger population.

Effect of Breakfast Consumption and Meal Time Regularity on Nutrient Intake and Cardiometabolic Health in Korean Adults

Objective

Dietary factors are important contributors to obesity and related metabolic disorders. Few studies have evaluated the impact of dietary habits (e.g., breakfast consumption frequency and meal regularity) on metabolic health. We investigated the effects of breakfast consumption frequency and meal time regularity on nutrient intake and cardiometabolic status in Korean adults.

Methods

Participants without diagnosed diseases (n=217) were examined for anthropometric and biochemical parameters, lifestyle, dietary habits, and nutrient intake. They were categorized into 4 groups by breakfast consumption frequency (≥6 or <6 times/week) and meal time regularity (regular or irregular): breakfast ≥6 times/week and regular eating (HBRE), breakfast ≥6 times/week and irregular eating (HBIE), breakfast <6 times/week and regular eating (LBRE) and breakfast <6 times/week and irregular eating (LBIE).

Results

Participants in the LBIE group were the youngest, had higher waist circumference, body mass index, triglyceride levels, and inflammation, and consumed the highest daily total caloric intake (TCI), the highest proportion of fats, and the lowest proportion of carbohydrates. The LBIE group also had the lowest proportion of energy intake at breakfast and the highest proportion at dinner. The LBIE group consumed the lowest amounts of fiber, beta-carotene, vitamin K, folate, calcium and iron, and had the highest prevalence of inadequate nutrient intake for TCI, protein, vitamins A, C, B6, and B12, folate, calcium, iron, zinc, and copper.

Conclusion

Regular breakfast consumption and meal times are related to healthy lifestyle habits and adequate nutrient intake, which affect metabolic health, thereby helping prevent obesity and related metabolic disorders.

The association of skipping breakfast with cancer-related and all-cause mortality in a national cohort of United States adults

PURPOSE

Many lifestyle and dietary factors have been recognized as risk factors for cancer morbidity and mortality. However, investigations of the association of the frequency of breakfast consumption and cancer are limited. This study aimed to examine the association of skipping breakfast with all-cause and cancer-related mortality in a national cohort of United States men and women.

METHODS

Data were from 7,007 adults aged ≥ 40 years who participated in the third National Health and Nutrition Examination Survey (1988-1994) and had follow-up information on mortality up until 31 December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS

The mean age of participants was 55.4 years, with 54.4% and 79% being women and non-Hispanic whites, respectively. Approximately, 16% of participants rarely consumed breakfast, 23.0% consumed breakfast some days, and 61% consumed breakfast every day. During a median follow-up of 22.2 years, 3,573 deaths occurred with 795 being related to cancer. In models adjusting for sociodemographic factors, smoking, physical activity, body mass index, hypertension, diabetes, cholesterol levels, total energy intake and diet quality, persons who rarely consumed breakfast had a higher risk of cancer-related mortality (HR = 1.52; CI:1.06-2.18) and all-cause (HR = 1.69; CI: 1.42-2.02) compared to those who took breakfast every day.

CONCLUSION

In this nationally representative sample, skipping breakfast was associated with elevated risks for all-cause and cancer-related mortality. This study provides evidence for the benefits of regular breakfast consumption in reducing the risk of all-cause and cancer mortality.

Possible association between eating behaviors and cardiovascular disease in the general population: Analysis of a nationwide epidemiological database

BACKGROUND AND AIMS

Epidemiological evidence on the relationship between eating behaviors, including breakfast skipping, late night dinner, and bedtime snacking, and cardiovascular disease (CVD) events among the general population is scarce. We sought to explore the association of eating behaviors with subsequent CVD using a nationwide epidemiological database.

METHODS AND RESULTS

Medical records of 1,941,125 individuals without prior history of CVD were extracted from the Japan Medical Data Center contracting with more than 60 insurers from multiple regions in Japan, mainly including employed working-age individuals. Skipping breakfast <3 times per week, late night dinner <3 times per week, and bedtime snacking <3 times per week were defined as optimal eating behaviors. Median age was 45 (interquartile range 39-53) years, and 1,138,676 were men. Median follow-up period was 978 (interquartile range 481-1790) days. Among them, 948,805 individuals (48.9%) had optimal eating behaviors, whereas 647,383 individuals (33.4%), 283,017 individuals (14.6%), and 61,920 individuals (3.2%) had single, double, and triple non-optimal eating behaviors, respectively. Individuals with non-optimal eating behaviors were younger and more likely to be men. Obesity and high waist circumference were more commonly observed in those with non-optimal eating behaviors. Multivariable Cox regression analysis showed that, compared with no non-optimal eating behavior, having non-optimal eating behaviors would have higher risk of myocardial infarction, angina pectoris, stroke, and heart failure. However, the dose-response relationship was not clear in the association between the number of non-optimal eating behaviors and incident CVD. Multivariable Cox regression analysis after multiple imputation for missing values also showed the association between non-optimal eating behaviors and incident CVD.

CONCLUSIONS

Using a nationwide epidemiological database, we found a possible relationship between eating behaviors including skipping breakfast, late night dinner, and bedtime snacking, and subsequent cardiovascular events among the general population, suggesting the potential importance of maintaining optimal eating behaviors for the primordial and primary CVD prevention in the general population.

Dietary Habits and their Association with Metabolic Syndrome in a sample of Iranian adults: A population-based study

BACKGROUND

Central obesity, insulin resistance, dyslipidemia, and hypertension are the core components of metabolic syndrome (MetS) which is coincident with unhealthy dietary habits in the Middle-Eastern countries. The aim of this study was to explore the association between dietary habits and MetS of the adult population living in Yazd Greater Area, Iran.

METHODS

This is a cross-sectional study that uses the data of a population-based cohort study on Iranian adults, known as Yazd Health Study (YaHS). The relationship between dietary habits and metabolic syndrome among adults (n = 2,896) was analyzed using multiple logistic regression method.

RESULTS

The prevalence of MetS among the participants was 32.2%. Outcomes from logistic regression examination show that breakfast consumption has a significant inverse effect on the occurrence of MetS after adjustment for age, education level, physical activity statue, history of chronic diseases, and smoking (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.14, 0.97). This effect remains significant even after adjustment for body mass index (BMI) and reveals that odds of having MetS is 69% lower in breakfast consumers in contrast to nonconsumers (OR = 0.31, 95% CI = 0.11, 0.87). However, no significant relationship was observed between other dietary habits including consumption of sweetened drinks, sugar cubes, and fast foods and MetS after adjustment for all potential confounders.

CONCLUSIONS

This study revealed that eating breakfast has an inverse relationship with metabolic syndrome. To find out stronger evidence in relation to dietary habits and MetS, more researches especially population-based cohort studies are needed to be conducted.

Prospective Study of Skipping Meals to Lose Weight as a Predictor of Incident Type 2 Diabetes With Potential Modification by Cardiometabolic Risk Factors: The Canadian 1995 Nova Scotia Health Survey

BACKGROUND

Skipping meals is an increasingly common practice to lose weight among North American adults. However, the long-term effect of this practice on incident type 2 diabetes mellitus (T2DM) remains unknown. We assessed whether skipping meals to lose weight is associated with T2DM risk and whether this association is modified by cardiometabolic risk factors.

METHODS

Skipping meals to lose weight was assessed by questionnaire in 2,288 adults from the 1995 Nova Scotia Health Survey and was linked to administrative health databases to determine T2DM incidence in the following 23 years. Multivariable-adjusted Cox proportional hazards models estimated hazard ratios (aHRs) and 95% confidence intervals (CIs) for T2DM.

RESULTS

During follow up, 378 T2DM cases were diagnosed. Compared with participants who did not skip meals to lose weight, those who did (2.2%) had a 125% higher risk of T2DM (aHR, 2.25; 95% CI, 1.31 to 3.86). This association was no longer present after further adjustment for baseline body mass index (BMI) (aHR, 1.66; 95% CI, 0.96 to 2.85). Skipping meals to lose weight was associated with T2DM among participants who were men (n=1,135; aHR, 2.09; 95% CI, 1.09 to 4.02) or had a BMI <30 kg/m² (n=1,676; aHR, 2.64, 95% CI, 1.15 to 6.06), elevated cholesterol (n=1,146; aHR, 2.11; 95% CI, 1.06 to 4.22), high blood pressure (n=1,133; aHR, 2.10; 95% CI, 1.10 to 4.01) and restless sleep (n=1,186; aHR, 2.19; 95% CI, 1.13 to 4.25), but not among women, those with a BMI of ≥30 kg/m² and those without elevated cholesterol, high blood pressure or restless sleep.

CONCLUSIONS

Skipping meals to lose weight may be a predictive modifiable risk factor for developing T2DM over time, potentially working in connection with other T2DM risk factors.

Extending the Overnight Fast: Sex Differences in Acute Metabolic Responses to Breakfast

Fasting for over 24 h is associated with worsening glucose tolerance, but the effect of extending the overnight fast period (a form of time-restricted feeding) on acute metabolic responses and insulin sensitivity is unclear. The aim of this pilot study was to determine the acute impact of an increased fasting period on postprandial glycaemia, insulinemia, and acute insulin sensitivity responses to a standard meal. Twenty-four lean, young, healthy adults (12 males, 12 females) consumed a standard breakfast after an overnight fast of 12, 14, and 16 h. Each fast duration was repeated on three separate occasions (3 × 3) in random order. Postprandial glucose and insulin responses were measured at regular intervals over 2 h and quantified as incremental area under the curve (iAUC). Insulin sensitivity was determined by homeostatic modelling assessment (HOMA). After 2 h, ad libitum food intake at a buffet meal was recorded. In females, but not males, insulin sensitivity improved (HOMA%S +35%, p = 0.016, marginally significant) with longer fast duration (16 h vs. 12 h), but paradoxically, postprandial glycaemia was higher (glucose iAUC +37%, p = 0.002). Overall, males showed no differences in glucose or insulin homeostasis. Both sexes consumed more energy (+28%) at the subsequent meal (16 h vs. 12 h). Delaying the first meal of the day by 4 h by extending the fasting period may have adverse metabolic effects in young, healthy, adult females, but not males.

Association between Non-Alcoholic Fatty Liver Disease and Dietary Habits, Stress, and Health-Related Quality of Life in Korean Adults

Considering the increasing prevalence of non-alcoholic fatty liver disease (NAFLD), this study aimed to evaluate the association between NAFLD and dietary habits, stress, and health-related quality of life (HRQoL) in Korean individuals by using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI 2013-2015. NAFLD was defined in individuals with a hepatic steatosis index (HSI) value ≥36. Eating habits were assessed based on the frequencies of eating and eating out; stress was assessed through the stress perception rate; and the EuroQol-5D (EQ-5D) questionnaire was used to assess the HRQoL. We performed a complex sample logistic regression analysis and estimated the odds ratios by adjusting for significant factors to evaluate associations between NAFLD and dietary habits, stress, and HRQoL. Occurrence of NAFLD was not significantly associated with meal frequencies over one week. With an increase in stress, based on the stress perception rate, the risk of NAFLD increased 1.316-fold (95% confidence interval (CI): 1.175-1.469, p < 0.05). Additionally, a decrease in the EQ-5D score by 1 increased the risk of NAFLD 3.38-fold (95% CI: 1.893-4.844, p < 0.05). Thus, NAFLD treatment should include stress management, and underlying HRQoL should be considered during treatment.

Breakfast Intake Effect on the Association between Fast-Food Consumption and the Risk of Obesity and Dyslipidemia in Korean Adults Aged 20-39 Years Based on the Korea National Health and Nutrition Examination Survey IV 2013-2014

We investigated the association between fast-food (FF) consumptions and the risk of overweight/obesity and dyslipidemia in Korean adults (20-39 years) based on the Korea National Health and Nutrition Examination Survey (2013-2014). We also examined the effect of breakfast intake on the risk of overweight/obesity and dyslipidemia according to their frequencies of FF consumption. FF consumption was categorized into 3 groups: < 1 time/month (n = 79); 1-3 times/month (n = 1,173); and ≥ 1 time/week (n = 474). People consuming FF ≥ 1 time/week had unhealthy lifestyles, higher intake of total calorie, fat, and protein, and higher levels of blood pressure, total cholesterol (TC) and low-density lipoprotein (LDL)-cholesterol than those consuming FF < 1 time/month. Logistic regression analysis showed higher risk of overweight/obesity in people consuming FF 1-3 times/month (odds ratio [OR], 2.525; confidence intervals [CIs], 1.169-5.452; p = 0.018) and ≥ 1 time/week (OR, 2.646; CIs, 1.128-6.208; p = 0.025) than those consuming FF < 1 time/month after the adjustment. The risk of dyslipidemia was also higher in people consuming FF ≥ 1 time/week than those consuming FF < 1 time/month after the adjustment (OR, 2.444; CIs, 1.047-5.704; p = 0.039). Furthermore, among people consuming FF ≥ 1 time/week, irregular breakfast consumers (≤ 2 times/week, n = 215) had significantly higher levels of triglyceride, TC, and LDL-C than regular breakfast consumers (5-6 times/week, n=180). Irregular breakfast consumers also showed a higher risk of dyslipidemia than regular breakfast consumers after the adjustment (OR, 2.913; CIs, 1.463-5.801; p = 0.002). In conclusion, frequent FF consumption increases the risk of obesity and dyslipidemia in Korean adults aged 20-39 years. Particularly among the frequent FF consumers, irregular breakfast intake may contribute to the increased risk of dyslipidemia. It may provide an evidence for proper dietary education to reduce the risk of overweight/obesity and dyslipidemia in Koreans adults aged 20-39 years.

Consequences of Circadian Disruption in Shift Workers on Chrononutrition and their Psychosocial Well-Being

The workers and employees in various institutions are subjected to different shifts and work schedules. The employees work not only at daytime but also during odd hours at night. The biological clock of an individual is often altered during night shifts. This affects the psychosocial well-being and circadian nutritional intake of the worker. Disturbance in circadian rhythm results in the development of metabolic disorders such as hypertension, dyslipidemia, dysglycemia, and abdominal obesity. In the present review, we discuss the nature of shift work, sleep/wake cycle of an individual, chrononutrition, dietary habits, and meal changes with regard to timing and frequency, related to shift work. We also discuss the relationship between nutritional intake and psychosocial well-being among shift workers. The review may be beneficial for prevention of metabolic disorders and maintaining sound psychological condition in shift workers.

Breakfast skipping is related to inadequacy of vitamin and mineral intakes among Japanese female junior high school students: a cross-sectional study

Breakfast skipping is a public health issue which affects nutrient intake among adolescents worldwide. However, there have been few reports comparing intake and reference values to assess the deficiency of nutrient intake between breakfast consumers and skippers. Therefore, the present study aimed to examine the relationship between breakfast skipping and adequacy of total habitual nutrient intake among junior high school female students. The participants were 516 Japanese female junior high school students. Dietary habits during the preceding month were assessed using a brief self-administered diet history questionnaire. Inadequacy of each nutrient intake was assessed by the cut-point method, based on the estimated average requirement for fourteen nutrients and on dietary goal values for five nutrients. The overall nutritional inadequacy in participants was assessed by the number of consumed nutrients which did not meet the requirements as per the dietary reference intakes for Japanese, 2015 version. The participants were classified into two groups according to the frequency of breakfast eating: breakfast consumers (seven times/week) and breakfast skippers (0-6 times/week). Adequacy of vitamin A, vitamin B1, vitamin B2, vitamin C, Ca, Fe, Zn and K was higher among breakfast consumers than among skippers. Breakfast consumers had more intakes of fruits, vegetables and dairy products. Our findings suggest that breakfast skipping was related to deficiencies in vitamin and mineral intakes, and to an unfavourable dietary pattern, among Japanese female junior high school students.

Skipping Breakfast Is Associated with an Atherogenic Lipid Profile in Overweight and Obese Prepubertal Children

BACKGROUND

Skipping breakfast has been associated with a higher risk of obesity and cardiovascular (CV) risk factors. However, it is not known if skipping breakfast is also correlated with CV risk factors independently from obesity. The mechanisms explaining the role of skipping breakfast on promoting fat accumulation as well as CV risk are not known. Hormones, in particular, insulin-like growth factor-1 (IGF-1), may potentially play a role in the metabolic profile of breakfast skippers.

AIM

This cross-sectional study aims to test, in a sample of overweight/obese children, the hypotheses that skipping breakfast is associated with a worse metabolic profile and that IGF-1 levels are associated with this unfavorable metabolic profile.

METHODS AND RESULTS

We enrolled 112 overweight/obese prepubertal children (3-12 years). Anthropometric characteristics (height SDS, weight SDS, and body mass index (BMI) z-score) were measured. Blood samples were collected to evaluate glucose and lipid metabolisms and hormone profile (growth hormone (GH), IGF-1, insulin, and cortisol). The triglycerides/high-density lipoprotein (HDL) cholesterol ratio was calculated as a predictor of cardiovascular risk. Children were divided into two groups according to breakfast habits: consumers (≥5 weekly; N = 76) and skippers (≤4 weekly; N = 36). Glycaemia, total and low-density lipoprotein (LDL) cholesterol, triglycerides (p < 0.05), and triglycerides/HDL cholesterol ratio (p < 0.001) were higher, while HDL cholesterol was lower (p < 0.01) in skippers as compared to consumers. IGF-1 concentrations were inversely correlated with LDL cholesterol (r = -0.279, p=0.013) and directly correlated with HDL cholesterol (r = 0.226, p=0.047). IGF-1 correlated positively with HDL cholesterol (r = 0.266, p=0.045) in consumers and correlated negatively with LDL cholesterol (r = -0.442, p=0.024) in skippers. Breakfast consumption among prepubertal overweight/obese children showed a better lipid profile in comparison with those who skipped breakfast [OR: 0.165 (95% CI: 0.053-0.518), p=0.001]; these latter odds of the increased triglycerides/HDL cholesterol ratio was 6.1-fold higher.

CONCLUSIONS

Breakfast skippers show a worse lipid profile when compared to breakfast consumers. IGF-1 might play a role as an independent modulator of lipid metabolism.

Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality in Adults in the National Health and Nutrition Examination Survey 2015-2016

This study examined differences in dietary intake between ready-to-eat cereal eaters and non-eaters in adults from the United States. Participants (n = 5163) from the National Health and Nutrition Examination Survey 2015–2016 were included. One-day dietary recall was used to define ready-to-eat cereal consumption status and estimate dietary intake in eaters and non-eaters. Data from Food Patterns Equivalent Database 2015–2016 were used to compare intakes of food groups by consumption status. Diet quality was assessed by Healthy Eating Index 2015. Nineteen percent of US adults were ready-to-eat cereal eaters; they had a similar level of energy intake as non-eaters, but they had significantly higher intake of dietary fiber, and several vitamins and minerals, such as calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B₆, folate, vitamin B₁₂, and vitamin D. They were also more likely to meet nutrient recommendations. Compared to non-eaters, ready-to-eat cereal eaters had the same level of added sugar intake but they had significantly higher intake of whole grains, total fruits, and dairy products. The diet quality of ready-to-eat cereal eaters was significantly higher than that of non-eaters. The study supports that ready-to-eat cereal eaters have better dietary intake with a healthier dietary pattern than non-eaters in the United States.

Higher eating frequency, but not skipping breakfast, is associated with higher odds of abdominal obesity in adults living in Puerto Rico

Puerto Ricans have a high prevalence of obesity, yet little information is available regarding its association with eating patterns in this population. We hypothesized that higher eating frequency and skipping breakfast would be associated with increased odds of abdominal obesity among adults living in Puerto Rico (PR). In a cross-sectional study of adults living in PR aged 30-75 years (N = 310), participants reported their frequency of eating meals per day including snacks and breakfast. Trained interviewers measured waist (WC) and hip circumferences. We calculated the waist-to-hip ratio (WHR) dividing the waist by the hip measurement. Abdominal obesity was defined as either high WC (men ≥94 cm; women ≥80 cm) or high WHR (men ≥0.90; women ≥0.85). We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) to assess the association of eating frequency (≤1.5; 1.5-3; ≥3 times/day) and breakfast consumption (vs none) with abdominal obesity. Models were adjusted for age, sex, income, smoking, physical activity, TV watching, energy intake, diet quality, and eating frequency (only for breakfast consumption). Most participants consumed breakfast (70%), ate 1.5-3 times/d (47%), and had high WC (75%) and WHR (77%). Participants who ate 1.5-3 (OR: 2.75, 95% CI: 1.23-6.15) and ≥3 times/day (OR: 2.88; 95% CI: 1.14-7.31) were more likely to have high WC compared with participants who ate ≤1.5 times/d (P trend = .04). Breakfast consumption was not associated with abdominal obesity. In conclusion, higher eating frequency, but not skipping breakfast, is associated with abdominal obesity among adults in PR. Consuming less frequent meals may help prevent abdominal obesity in this population.

Timing of Breakfast, Lunch, and Dinner. Effects on Obesity and Metabolic Risk

(1) Background: Eating is fundamental to survival. Animals choose when to eat depending on food availability. The timing of eating can synchronize different organs and tissues that are related to food digestion, absorption, or metabolism, such as the stomach, gut, liver, pancreas, or adipose tissue. Studies performed in experimental animal models suggest that food intake is a major external synchronizer of peripheral clocks. Therefore, the timing of eating may be decisive in fat accumulation and mobilization and affect the effectiveness of weight loss treatments. (2) Results: We will review multiple studies about the timing of the three main meals of the day, breakfast, lunch and dinner, and its potential impact on metabolism, glucose tolerance, and obesity-related factors. We will also delve into several mechanisms that may be implicated in the obesogenic effect of eating late. Conclusion: Unusual eating time can produce a disruption in the circadian system that might lead to unhealthy consequences.

Association between breakfast skipping and postprandial hyperglycaemia after lunch in healthy young individuals

Breakfast skipping has become an increasing trend in the modern lifestyle and may play a role in obesity and type 2 diabetes. In our previous studies in healthy young individuals, a single incident of breakfast skipping increased the overall 24-h blood glucose and elevated the postprandial glycaemic response after lunch; however, it was difficult to determine whether this response was due to breakfast omission or the extra energy (i.e. lunch plus breakfast contents). The present study aimed to assess the postprandial glycaemic response and to measure their hormone levels when healthy young individuals had identical lunch and dinner, and the 24-h average blood glucose as a secondary outcome. Nine healthy young men (19−24 years) participated in two-meal trials: with breakfast (three-meal condition) or without breakfast (breakfast skipping condition). During the meals, each individual’s blood glucose was continuously monitored. Skipping breakfast resulted in a significantly higher (P &lt; 0·001) glycaemic response after lunch as compared with the glycaemic response after an identical lunch when breakfast was consumed. Despite the difference in the total energy intake, the 24-h average blood glucose was similar between the two-meal conditions (P = 0·179). Plasma NEFA level was significantly higher (P &lt; 0·05) after lunch when breakfast was omitted, and NEFA level positively correlated with the postprandial glycaemic response (r 0·631, P &lt; 0·01). In conclusion, a single incident of breakfast skipping increases postprandial hyperglycaemia, and associated impaired insulin response, after lunch. The present study showed that skipping breakfast influences glucose regulation even in healthy young individuals.

Irregularity in breakfast consumption and daily meal timing patterns in association with body weight status and inflammation

Irregular breakfast consumption and food timing patterns in relation to weight status and inflammation were investigated in a cross-sectional manner among 644 participants in the Cancer Prevention Study-3 Diet Assessment Sub-study. Breakfast consumption, and the individual means and the intra-individual standard deviation (isd) of time at first intake of the day, duration of daily intake window and midpoint of daily intake window were collected via six 24-h recalls and examined in relation to BMI, waist circumference (WC) and inflammation (glycoprotein acetyl (GlycA)). Compared with consuming breakfast on all six recalls, linear regression models showed those who consumed breakfast on 4 or 5 of the days had a 1·29 (95 % CI 0·19, 2·38) and 1·64 (95 % CI 0·12, 3·16) kg/m2 higher BMI; no association was found for consuming breakfast ≤3 d. At 1 h later, the average time of first intake was associated with a 0·44 (95 % CI 0·04, 0·84) kg/m2 higher BMI. A 1-h increase in the isd of first intake was associated with a 1·12 (95 % CI 0·49, 1·75) kg/m2 higher BMI; isd in duration and midpoint of intake window were significant prior to additional adjustment for isd in the first intake. One-hour increases in isd for the first intake time (β: 0·15; 95 % CI 0·04, 0·26) and the midpoint of intake window (β: 0·16; 95 % CI 0·02, 0·31) were associated with higher GlycA. No associations were observed for WC independent of BMI. The results provide evidence that irregularity in breakfast consumption and daily intake timing patterns, particularly early in the day, may be related to weight status and inflammation.

Dietary habits in association with general and abdominal obesity in central Iran: Results from Yazd Health Study (YaHS)

AIMS

Findings from few studies that investigated the relation between dietary habits and obesity are inconsistent so we aimed to assess the association between dietary habits with general and abdominal obesity in central Iran.

METHODS

This study has been conducted on 8652 adults aged 20-70 years participated in Yazd Health Study (YAHS). Data regarding dietary habits, socio-demographic characteristics and history of chronic illnesses were collected via questionnaire. Anthropometric parameters were measured using a scale and body analyzer. Odds ratio of obesity were assessed using a Binary Logistic Regression test.

RESULTS

Study participants consisted of 49.6% men and 50.4% women. The prevalence of general and abdominal obesity in this population was 25.9 and 45.3%, respectively. Our analysis revealed that subjects who drank carbonated drinks ≥3 times/week had significantly higher odds of general and abdominal obesity compared to participants never did so (OR 1.89; 95%CI: 1.37-2.61, OR 1.11; 95%CI: 1.50-2.04) and those ate fast food more than 4 times a month had higher odds of abdominal obesity (OR 1.51; 95%CI: 1.12-2.03). The results also pointed that intake of low fat dairy products was inversely associated with general obesity (OR 0.79; 95% CI 0.63-0.98) and abdominal obesity (OR 0.66; 95% CI 0.54-0.82) when compared with full fat dairy products.

CONCLUSION

Carbonated drinks and fast food intake were positively associated with general/abdominal obesity, whereas low fat dairy products intake was inversely associated. Future cohort studies in this under-studied area are recommended.

Effect of skipping breakfast for 6 days on energy metabolism and diurnal rhythm of blood glucose in young healthy Japanese males

BACKGROUND

Skipping breakfast has become a common trend that may lead to obesity and type 2 diabetes. Previous studies, which imposed a single incidence of breakfast skipping, did not observe any decrease in 24-h energy expenditure. Furthermore, the effects of breakfast skipping on diurnal blood glucose profiles over 24 h are contradictory.

OBJECTIVE

The aim of this study was to clarify the influence of 6 consecutive days of breakfast skipping and sedentary behavior on energy metabolism and glycemic control.

METHODS

Ten young men participated in 2 trials (with or without breakfast) that lasted for 6 consecutive days, and the 2 trials were conducted 1 wk apart with a repeated-measures design. During the meal intervention, each subject's blood glucose was measured using the continuous glucose monitoring system. If breakfast was skipped, subjects ate large meals at lunch and dinner such that the 24-h energy intake was identical to that of the 3-meal condition. At 2200 on the fifth day, the subjects entered a room-sized respiratory chamber, where they remained for 33 h, and were instructed to carry out sedentary behavior.

RESULTS

The glucose levels were similar between the 2 meal conditions during the first 5 d of meal intervention, but the blood glucose at 2300 was higher in the breakfast-skipping condition than in the 3-meal condition. Breakfast skipping elevated postprandial glycemic response after lunch on the first day of meal intervention. On the sixth day, there were no significant differences in 24-h energy expenditure and substrate oxidation. When subjects remained in a metabolic chamber, the level of physical activity significantly decreased, glycemic stability slightly deteriorated, and mean blood glucose over 24 h was higher in the breakfast-skipping trial than in the 3-meal trial.

CONCLUSIONS

Sedentary lifestyle and repeated breakfast skipping caused abnormal glucose fluctuations, whereas 24-h energy metabolism remained unaffected. Clinical Trial Registry: This trial was registered at http://www.umin.ac.jp/english/ as UMIN000032346.

Association between Breakfast Frequency and Atherosclerotic Cardiovascular Disease Risk: A Cross-Sectional Study of KNHANES Data, 2014-2016

The burden of cardiovascular disease (CVD) is increasing worldwide and one related lifestyle choice is breakfast consumption. This study examined the association between breakfast frequency and the 10-year risk of atherosclerotic CVD (ASCVD). The 10-year risk of ASCVD was defined as the risk of the first event of nonfatal myocardial infarction, coronary heart disease death, and nonfatal or fatal stroke within 10 years. Data from the Korean National Health and Nutrition Examination Survey, 2014–2016 were analyzed, and 7212 participants aged 40–79 years with no history of CVD were included. ASCVD risk was calculated according to the pooled cohort ASCVD equation, and participants with a score >7.5% were considered at high risk of ASCVD. The association between breakfast frequency and high ASCVD risk was confirmed by logistic regression analysis. Participants who never ate breakfast were more likely to be in the high-risk group compared to participants who ate breakfast >5 times per week (OR (adjusted odds ratio) = 1.46; 95% CI (confidence interval) = 1.12–1.89), and the risk was especially higher in female participants and those with a family history of CVD. Our study confirms that breakfast consumption even once per week may prevent CVD.

Six Weeks of Morning Fasting Causes Little Adaptation of Metabolic or Appetite Responses to Feeding in Adults with Obesity

OBJECTIVE

The aim of this study was to determine the effects of sustained morning fasting or breakfast consumption on metabolism, energy intake, and appetite in healthy adults with obesity.

METHODS

An independent-measures randomized controlled trial with baseline and follow-up laboratory assessment days separated by a 6-week intervention of either morning fasting (0 kcal until 12:00 pm) or daily breakfast (> 700 kcal by 11:00 am) was performed. Measures included metabolic outcomes (glucose, insulin, nonesterified fatty acids), hormones regulating appetite (total/acylated ghrelin, peptide YY, leptin), and energy expenditure (diet-induced thermogenesis) parameters throughout a laboratory test day and ad libitum intake following a fixed breakfast.

RESULTS

Allocation to fasting versus breakfast resulted in minimal adaptation as reflected by the metabolic outcomes or the majority of appetite regulatory outcomes for either area under curve or time-course-based measures (P > 0.05). Ad libitum lunch intake was not different (P = 0.13), nor was diet-induced thermogenesis or a composite appetite score (both P > 0.10). However, there was a reduced total area under the curve for peptide YY (P = 0.05) and increased postprandial hunger ratings (P = 0.05) in the breakfast group.

CONCLUSIONS

There was little evidence of metabolic adaptation to acute feeding or negative consequences from sustained morning fasting. This indicates that previously observed differences between breakfast consumers and skippers may be acute effects of feeding or may have resulted from other lifestyle factors.

Day-to-day regularity in breakfast consumption is associated with weight status in a prospective cohort of women

Background:

Evidence suggests that regular eating patterns (i.e., consistent day-to-day frequency and timing of consumption) may be favorable with respect to weight status, and breakfast may be a particularly important meal for weight maintenance. We examined the relationship between regular breakfast consumption habits and weight status among women.

Materials and Methods:

Modified Poisson regression models examined day-to-day regularity in breakfast consumption among 46,037 women in the prospective Sister Study cohort in relation to weight status. Cross-sectional outcomes included overweight (body mass index (BMI) ≥25.0 kg/m²) and obesity (BMI ≥30.0 kg/m²); waist circumference (WC) ≥88 cm; and waist-to-hip ratio (WHR) ≥0.85. Self-reported weight 5 years post-baseline was used to calculate 5kg weight gain and incident overweight and obesity using BMI.

Results:

Compared to women who reported eating breakfast 3 to 4 days/week (irregular breakfast eaters), women who ate breakfast 7 days/week were between 11% to 17% less likely to be obese as measured by WHR (prevalence ratio (PR): 0.89; 95%CI: 0.85, 0.94), WC (PR: 0.85; 95%CI: 0.82, 0.88), and BMI (PR: 0.83; 95%CI: 0.79, 0.87) after multivariable adjustment. Women who never ate breakfast were between 11% to 22% less likely to be obese as measured by WHR (PR: 0.89; 95%CI: 0.83, 0.96), WC (PR: 0.82; 95%CI: 0.78, 0.87), and BMI (PR: 0.78; 95%CI: 0.72, 0.84) compared to irregular breakfast eaters. Prospective analyses showed a 21% and 28% lower risk of 5-year incident obesity among participants who always (relative risk (RR): 0.79; 95%CI: 0.70, 0.90) or never (RR: 0.72; 95%CI: 0.59, 0.87) ate breakfast, respectively, compared to those who ate breakfast 3 to 4 days/week. No association was observed for incident 5kg weight gain.

Conclusions:

Results suggest that a regular breakfast consumption habit, comprising eating breakfast every day or never, may be important for maintaining a healthy weight.

Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To examine the effect of regular breakfast consumption on weight change and energy intake in people living in high income countries.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, Ovid Medline, and CINAHL were searched for randomised controlled trials published between January 1990 and January 2018 investigating the effect of breakfast on weight or energy intake. ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform search portal were also searched in October 2018 to identify any registered yet unpublished or ongoing trials.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised controlled trials from high income countries in adults comparing breakfast consumption with no breakfast consumption that included a measure of body weight or energy intake. Two independent reviewers extracted the data and assessed the risk of bias of included studies. Random effects meta-analyses of the effect of breakfast consumption on weight and daily energy intake were performed.

RESULTS

Of 13 included trials, seven examined the effect of eating breakfast on weight change, and 10 examined the effect on energy intake. Meta-analysis of the results found a small difference in weight favouring participants who skipped breakfast (mean difference 0.44 kg, 95% confidence interval 0.07 to 0.82), but there was some inconsistency across trial results (I²=43%). Participants assigned to breakfast had a higher total daily energy intake than those assigned to skip breakfast (mean difference 259.79 kcal/day, 78.87 to 440.71; 1 kcal=4.18 kJ), despite substantial inconsistency across trial results (I²=80%). All of the included trials were at high or unclear risk of bias in at least one domain and had only short term follow-ups (mean period seven weeks for weight, two weeks for energy intake). As the quality of the included studies was mostly low, the findings should be interpreted with caution.

CONCLUSION

This study suggests that the addition of breakfast might not be a good strategy for weight loss, regardless of established breakfast habit. Caution is needed when recommending breakfast for weight loss in adults, as it could have the opposite effect. Further randomised controlled trials of high quality are needed to examine the role of breakfast eating in the approach to weight management.

STUDY REGISTRATION

PROSPERO registration number CRD42017057687.

Breakfast Choice Is Associated with Nutrient, Food Group and Discretionary Intakes in Australian Adults at Both Breakfast and the Rest of the Day

Breakfast choice is correlated with daily nutrient intakes, but this association may not be solely explained by the breakfast meal. We profiled breakfast consumer groups among Australian adults and compared the role that breakfast versus the rest of the day had on daily intakes of the Five Food Groups, discretionary foods, and nutrients. Breakfast groups were breakfast cereal consumers, non-cereal breakfast consumers, and breakfast skippers. One-day dietary recall data from the 2011⁻2012 National Nutrition and Physical Activity Survey were analysed (n = 9341, ≥19 years), as well as socio-demographic and anthropometric measures. Twelve per cent of adults were breakfast skippers, 41% were breakfast cereal consumers, and 47% were non-cereal breakfast consumers. Females were more likely to have a non-cereal breakfast than males, and the non-cereal breakfast was predominantly bread-based. Breakfast skipping decreased with age (p < 0.001), while breakfast cereal consumption increased with age (p < 0.001). Breakfast skippers were more likely to be male, had a lower socio-economic status, and lower physical activity levels (p < 0.001). Breakfast skippers had the highest mean body mass index (BMI) and waist circumference (p < 0.001), the lowest intake of wholegrain foods, fruits and vegetables, and the highest intake of discretionary foods (p < 0.001). Breakfast cereal consumers had the lowest mean BMI and waist circumference (p < 0.001) and had healthier diets at both breakfast and throughout the rest of the day. They were the most likely to meet the daily recommended serves for grain foods, fruit, dairy, and vegetables, had the highest wholegrain food intake, and the lowest discretionary intake (p < 0.001). Additionally, breakfast cereal consumers had the most favourable daily nutrient intakes, including the lowest added sugars intakes. Differences in daily diet between breakfast groups were attributed to differences in food choices both at breakfast and throughout the rest of the day.

The influence of a fruit smoothie or cereal and milk breakfast on subsequent dietary intake: a pilot study

Smoothies are popular breakfast foods. This study examined the effect of consuming Cereal & Milk (CM) or a nutritionally-comparable Fruit Smoothie (FS) for breakfast on daily energy intake (EI) in free-living adults and the extent to which individuals compensated for calories ingested in a High Energy Fruit Smoothie (HE). Ten participants (28.4 ± 2.2y; 23.3 ± 1.0 kg·m ^-2, Mean ± SEM) attended the laboratory on 3 consecutive days per week for 3 weeks. Each week, they received a CM, FS or HE breakfast, then recorded all food/beverages consumed across the remainder of the day. The CM and FS were energy-matched to participants' usual breakfast (1675 ± 283 kJ), while the HE contained an additional 100 kJ·kg^-1 of maltodextrin (3019 ± 335 kJ). Mean 3-day EI was similar on CM and FS (7894 ± 547 vs. 7570 ± 463 kJ, p > .05), but elevated on HE (8861 ± 726 kJ, p =  .012). Thus, individuals who substitute CM for a FS breakfast should be mindful that energy-dense beverages may result in increased daily EI.

Lifestyle behaviours or socioeconomic characteristics? Gender differences in covariates of BMI in Hungary

Objective

Lifestyle behaviours are everyday activities that result from individual's values, knowledge, and norms shaped by broader cultural and socioeconomic context. These behaviours affect body weight as well as overall health and are influenced by a number of social characteristics. The aim of this paper was to examine the net effects of lifestyle behaviours and socioeconomic factors on body mass index (BMI), and how these differed by gender.

Methods

This study used the 2009/2010 Hungarian Time Use Survey combining behavioural records, background information, and measures of self‐reported health and weight. The sample (n = 7765) was representative for the Hungarian population. Multivariate linear OLS regression models were employed to analyse the net effects of lifestyle and sociodemographic variables.

Results

Daily behaviours were associated with BMI for women, but not for men, except for smoking. Meals frequency and duration of sleep had negative effects on female BMI, whereas duration of TV viewing had a positive effect. Occupational class was associated with male BMI, but not with female. The strong negative effect of smoking was significant for both genders.

Conclusions

Lifestyle behaviours were linked with female BMI, with socioeconomic characteristics impacting on male BMI. These results suggest that a gender‐specific approach may be appropriate to address obesity issues in the Hungarian population.

Nutrition knowledge related to breakfast skipping among Japanese adults aged 18-64 years: a cross-sectional study

OBJECTIVE

Breakfast skipping is regarded as a public health issue among adults worldwide. Nutrition knowledge has been reported to be one of predictors of dietary behaviour. Therefore, the aim of the present study was to examine the association between nutrition knowledge and breakfast skipping.

DESIGN

Data regarding nutrition knowledge were obtained by using a validated, self-administered general nutrition knowledge questionnaire for Japanese adults (JGNKQ). Participants were classified into three nutrition knowledge level groups according to total JGNKQ score: Low, Middle and High. In addition, participants reported the frequency of meal consumption per week and rated the difficulty in finding time to eat breakfast, lunch and dinner in the lifestyle questionnaire. The differences in frequency of breakfast, lunch and dinner consumption among Low, Middle and High nutrition knowledge groups were determined by using ANCOVA adjusted for potential confounding factors.

SETTING

Kanto region, Japan.ParticipantsJapanese adults aged 18-64 years (n 1165, 57·3% women).

RESULTS

Mean age of the participants was 43·8 (sd 8·9) years. There were no significant differences found in the proportion of respondents reporting difficulty in finding time to eat each meal among the three groups. However, the frequency of breakfast consumption was significantly different among Low, Middle and High groups, while lunch and dinner frequency did not differ among the three groups.

CONCLUSIONS

The present study suggests that nutrition knowledge level is related to breakfast skipping among Japanese adults.

Starvation reduces hyaluronan synthesis by suppressing TGF-β1/IGF-I signaling in rat skin

Although starvation has been reported to influence the functions of various tissues, its effects on the skin are not well understood. In this study, we investigated the effect of starvation on hyaluronan synthesis in rat skin. Starvation reduced hyaluronan synthesis in the skin. Starvation also decreased the skin mRNA expression of transforming growth factor (TGF)-β1, which enhances the gene expression of rhas2 and rhas3. The serum levels of insulin-like growth factor (IGF)-I, which enhances rhas2, rhas3, and TGF-β1 mRNA expression, in the starvation group were considerably lower than those in the control (CO) group. IGF-IR phosphorylation was substantially lower in the starvation group compared with the CO group. These findings suggest that starvation reduces hyaluronan synthesis in the skin by suppressing TGF-β1/IGF-I signaling. Abbreviations: HAS: hyaluronan synthase; IGF-I: insulin-like growth factor-I; IGFBP-1: insulin-like growth factor binding protein-1; TGF-β1: transforming growth factor-β1; TBST: tris buffered saline containing 0.5% (v/v) Tween 20; HABP: hyaluronic acid binding protein; GAPDH: glyceraldehyde-3-phosphate dehydrogenase.

Breakfast patterns and their association with body mass index in Brazilian adults

The objective was to investigate the relationships between body mass index (BMI), skipping breakfast, and breakfast patterns in Brazilian adults. We analyzed data of 21,003 individuals aged between 20 to 59 from the Brazilian National Dietary Survey 2008-2009. Breakfast was defined as the eating occasion between 5 and 10a.m. with the highest usual food consumption (exceeding 50Kcal/209.2kJ). Dietary patterns were derived by the factor analysis of 18 food groups (usual intake). Controlling for confounders linear regressions of BMI were used to verify the associations considering the survey design. Skipping breakfast was not associated with BMI. Three breakfast patterns were observed (48% variability): Brazilian Northern (positive loading for meats, preparations with corn, eggs, tubers/roots/potatoes, dairy products, savory snacks/crackers, fruit juices/fruit drinks/soy-based drinks); Western (positive for fruit juices/fruit drinks/soy-based drinks, sandwiches/pizza, baked/deep-fried snacks, chocolate/desserts, cakes/cookies) and Brazilian Southeastern (cold cut meat, milk, cheese, coffee/tea, bread). The Brazilian Southeastern pattern was inversely associated with BMI, while the Brazilian Northern pattern was directly associated with it. Therefore, the results suggest a role for breakfast quality in the association with BMI. Thus, a Brazilian Southeastern breakfast usual intake may be inversely associated with BMI.

Breakfast Skipping and overweight/obesity among European adolescents, a cross-sectional analysis of the HELENA dataset: a DEDIPAC study

Background: The aim was to examine demographic and dietary factors associated with breakfast skipping, and the relationship of breakfast skipping with overweight/obesity among adolescents across Europe. Methods: Cross-sectional data from the Healthy Lifestyle in Europe by Nutrition in Adolescence study (n=3528) conducted in ten European cities: Athens (Greece), Dortmund (Germany), Ghent (Belgium), Herkalion (Greece), Lille (France), Pecs (Hungary), Rome (Italy), Vienna (Austria), Stockholm (Sweden) and Zaragoza (Spain) were used.  Analysis was carried out using a sub-sample of adolescents (n=1894) aged 12.5-17.49 years with data on breakfast skipping and two days of 24-Hour Diet Recall data. As 24-Hour Recall data was not available from Pecs (Hungary) this city was excluded. Using responses from the Food Choices and Preferences Questionnaire adolescents were classified as breakfast skippers or non-breakfast skippers. All analyses were stratified by sex. Differences in the intake of macronutrients, both overall and when breakfast was excluded, and key foods were compared between skippers and non-skippers using Wilcoxen Rank Sum test. Multivariate logistic regression was used to examine the relationship between breakfast skipping and overweight/obesity. Results: Overall, 44% of females were skippers compared to 36% of males. Among both male and female estimated mean fibre intake and median fruit intake were significantly lower among skippers compared to non-skippers. Male skippers were significantly more likely than non-skippers to be overweight/obese [AOR = 2.34, 95% CI, 1.40-3.90] but this was not observed among females [AOR = 0.89, 95% CI 0.59-1.34]. Conclusions: Different patterns of daily macronutrient intake were observed among adolescents who skip and do not skip breakfast.  In males, breakfast skipping was associated with increased odds of being overweight/obese. Gender may play a key part in breakfast skipping behaviours. These results present an opportunity to identify and target adolescents who may be at risk of a poorer nutritional profile or overweight/obesity.

Understanding the risk and protective factors associated with obesity amongst Libyan adults - a qualitative study

Background

There are a range of multifaceted behavioural and societal factors that combine to contribute to the causes of obesity. However, it is not yet known how particularly countries’ cultural norms are contributing to the global obesity epidemic. Despite obesity reaching epidemic proportions in Libya, since the discovery of oil in 1959, there is a lack of information about obesity in Libyan adults. This study sought to explore the views of key informants about the risk and protective factors associated with obesity among Libyan men and women.

Methods

A series of qualitative semi-structured interviews were conducted with Libyan healthcare professionals and community leaders.

Results

Eleven main themes (risk and protective factors) were identified, specifically: socio-demographic and biological factors, socioeconomic status, unhealthy eating behaviours, knowledge about obesity, social-cultural influences, Libya’s healthcare facilities, physical activity and the effect of the neighbourhood environment, sedentary behaviour, Libyan food-subsidy policy, and suggestions for preventing and controlling obesity.

Conclusions

Key recommendations are that an electronic health information system needs to be implemented and awareness about obesity and its causes and consequences needs to be raised among the public in order to dispel the many myths and misconceptions held by Libyans about obesity. The current political instability within Libya is contributing to a less-active lifestyle for the population due to security concerns and the impact of curfews. Our findings have implications for Libyan health policy and highlight the urgent need for action towards mitigating against the obesity epidemic in Libya.

Postprandial Metabolism and Appetite Do Not Differ between Lean Adults that Eat Breakfast or Morning Fast for 6 Weeks

Background

It remains unknown whether sustained daily feeding-fasting patterns modify the acute response to specific feedings on a given day.

Objective

We conducted a randomized controlled trial to establish if daily breakfast consumption or fasting until noon modifies the acute metabolic and appetitive responses to a fixed breakfast and ad libitum lunch.

Methods

With the use of a parallel group design, we randomly assigned 31 healthy, lean men and women (22-56 y) to 6 wk of either consuming ≥700 kcal of self-selected items before 1100 or fasting (0 kcal) until 1200 daily. Following 48 h of diet and physical activity standardization, we examined metabolic and appetite responses to a standardized breakfast and ad libitum lunch before and after the intervention. Data were analyzed using 3- and 2-way ANCOVA.

Results

Systemic concentrations of energy balance regulatory hormones total and acylated ghrelin, leptin, and peptide tyrosine-tyrosine) responded similarly to breakfast and lunch before and after 6 wk of either morning fasting or regular breakfast, with the exception of a tendency for increased glucagon-like peptide-1 concentrations from baseline to follow-up in the Breakfast Group compared with a decrease over that period in the Fasting Group [P = 0.06, partial eta squared value (ƞ2) = 0.16]. Subjective appetite sensations also did not differ over the course of the day, and ad libitum energy intake at lunch was not systematically affected by either intervention, decreasing by 27 kcal (95% CI: -203, 149 kcal) with fasting and by 77 kcal (95% CI: -210, 56 kcal) with breakfast. Similarly, glycemic, insulinemic, lipemic, and thermogenic responses to breakfast and lunch were very stable at baseline and follow-up and, thus, did not differ between treatment groups.

Conclusions

Our results indicate that a sustained period of either extended morning fasting or eating a daily breakfast has minimal effect upon acute metabolic and appetite responses in lean adults. This trial was registered at www.isrctn.org as ISRCTN31521726.

Breakfast habits and differences regarding abdominal obesity in a cross-sectional study in Spanish adults: The ANIBES study

BACKGROUND

Previous studies have indicated that breakfast has a protective effect against obesity. The aim of this study was to describe the breakfast habits of the Spanish adult population and to assess the possible association between breakfast frequency and the presence of abdominal obesity, in a cross-sectional analysis of the ANIBES Study.

METHODS

A representative sample of 1655 Spanish adults (aged 39±12 y; (mean±sd)) from the ANIBES Study was investigated. The final field work was carried out from mid-September to November (three months) 2013. Collected data included a dietary data collected by a 3-days food record, and health, socioeconomic, physical activity and anthropometric (weight, height and waist circumference) data. Abdominal obesity was defined as having a waist-to-height ratio ≥0.5. The adults were also classified into three groups based on the number of days they ate breakfast (never (0/3 days), sometimes (1-2/3 days) and always (3/3 days)). Logistic regression analyses were used to evaluate the association between breakfast and abdominal obesity.

RESULTS

In total, 3.6% of adults skipped breakfast and 14.1% ate breakfast sometimes. Having always breakfast was negatively associated with abdominal obesity [OR = 0.738 (0.558-0.975) p = 0.033]. The odds of abdominal obesity after full adjustment (age, gender, and educational and activity level) were 1.5 times higher for those who skipped breakfast when compared to those who always have breakfast. By correcting the model considered for other variables, the odds among smokers decreased when they have breakfast sometimes [OR = 0.032 (0.003-0.387) p = 0.007] and always [OR = 0.023 (0.002-0.270) p = 0.003] comparing with smokers who skip breakfast.

CONCLUSION

Breakfast frequency could be negatively associated with abdominal obesity, especially among smokers.

Replacing American Breakfast Foods with Ready-To-Eat (RTE) Cereals Increases Consumption of Key Food Groups and Nutrients among US Children and Adults: Results of an NHANES Modeling Study

Replacing the typical American breakfast with ready-to-eat cereals (RTECs) may improve diet quality. Our goal was to assess the impact of RTECs on diet quality measures for different age groups, using substitution modeling. Dietary intakes came from the 2007-2010 National Health and Examination Surveys (NHANES; n = 18,112). All breakfast foods, excluding beverages, were replaced on a per calorie basis, with frequency-weighted and age/race specific RTECs. Model 1 replaced foods with RTECs alone; Model 2 replaced foods with RTECs and milk. Diet quality measures were based on desirable food groups and nutrients, Healthy Eating Index (HEI)-2010 scores, and estimated diet costs. Model 1 diets were significantly higher in whole grains (+84.6%), fiber (+14.3%), vitamin D (+14.0%), iron (+54.5%) and folic acid (+104.6%), as compared to observed diets. Model 2 diets were additionally higher in dairy (+15.8%), calcium (+11.3%) and potassium (+3.95%). In Model 1, added sugar increased (+5.0%), but solid fats declined (-10.9%). Energy from solid fats and added sugars declined (-3.2%) in both models. Model 2 offered higher diet quality (57.1 vs. 54.6, p-value < 0.01) at a lower cost ($6.70 vs. $6.92; p < 0.01), compared to observed diets. Substitution modeling of NHANES data can assess the nutritional and economic impact of dietary guidance.

Is lack of breakfast contributing to nutrient deficits and poor nutritional indicators among adolescent girls?

BACKGROUND

Breakfast is considered the first and most important meal of the day. Missing the first meal may result in significant nutritional deficits, if not compensated in subsequent meals.

AIM

To describe the nutrient intake through breakfast and to study its association with nutritional indicators among adolescent girls.

METHODS

A cross-sectional study among adolescent girls ( n = 565) 16-18 years was carried out in urban slums of Pune, Maharashtra, India. Haemoglobin was assessed by cyanmethemoglobin method. Nutritional status was assessed through anthropometry and three 24-hours diet recall. Z scores, independent sample test, and linear logistic regression were used to assess undernutrition, to compare means of nutrient intake and to associate nutrient intake with nutritional status, respectively.

RESULTS

Almost 50% did not consume solid food for breakfast and 99% of the participants consumed inadequate breakfast (<610 kcal). Two types of breakfast emerged: I (bakery products + beverage) and II (traditional breakfast + beverage). Although the mean energy intake of type II breakfast (235±100.55 kcal) and the mean micronutrient intake was significantly higher than type I (micronutrients: vitamin C and folate ( p = 0.001), iron ( p = 0.01)) it did not meet the adequacy norms for breakfast. Among nutritional indicators breakfast intake was not directly associated with body mass index. However, mean intake of nutrients such as energy, protein and iron through the day were significantly lesser ( p = 0.001, p = 0.01 and p = 0.01 respectively) among anaemic adolescents. Linear regression showed significant association between energy, fat intake and BAZ scores.

CONCLUSIONS

Compensating dietary deficits that arise in the first meal would directly address the day's nutrient deficit. The results highlight the need for a food-based approach to address undernutrition among adolescent girls in resource-poor settings.

Priming Effect of a Morning Meal on Hepatic Glucose Disposition Later in the Day

We used hepatic balance and tracer ([³H]glucose) techniques to examine the impact of "breakfast" on hepatic glucose metabolism later in the same day. From 0-240 min, 2 groups of conscious dogs (n = 9 dogs/group) received a duodenal infusion of glucose (GLC) or saline (SAL), then were fasted from 240-360 min. Three dogs from each group were euthanized and tissue collected at 360 min. From 360-600 min, the remaining dogs underwent a hyperinsulinemic (4× basal) hyperglycemic clamp (arterial blood glucose 146 ± 2 mg/dL) with portal GLC infusion. The total GLC infusion rate was 14% greater in dogs infused with GLC than in those receiving SAL (AUC_360-600min 2,979 ± 296 vs. 2,597 ± 277 mg/kg, respectively). The rates of hepatic glucose uptake (5.8 ± 0.8 vs. 3.2 ± 0.3 mg ⋅ kg^-1 ⋅ min^-1) and glycogen storage (4.7 ± 0.6 vs. 2.9 ± 0.3 mg ⋅ kg^-1 ⋅ min^-1) during the clamp were markedly greater in dogs receiving GLC compared with those receiving SAL. Hepatic glycogen content was ∼50% greater, glycogen synthase activity was ∼50% greater, glycogen phosphorylase activity was ∼50% lower, and the amount of phosphorylated glycogen synthase was 34% lower, indicating activation of the enzyme, in dogs receiving GLC compared with those receiving SAL. Thus, morning GLC primed the liver to extract and store more glucose in the presence of hyperinsulinemic hyperglycemia later in the same day, indicating that breakfast enhances the liver's role in glucose disposal in subsequent same-day meals.