The role of breakfast in health: definition and criteria for a quality breakfast

Irregular breakfast eating in type 2 diabetes mellitus is associated with greater social jetlag and poorer metabolic health

Circadian disruption, arising from conflict between internal circadian time and behavioural sleep-wake and fasting-feeding rhythms, may contribute to the prevalence of type 2 diabetes mellitus and disease severity. Previous studies have demonstrated a link between irregular breakfast eating and poorer metabolic health. We aimed to further explore the relationships between breakfast habits, circadian misalignment (social jetlag), and metabolic parameters in a cohort of adult participants with type 2 diabetes mellitus. A total of 330 adult participants with type 2 diabetes mellitus attending for routine clinical review completed structured questionnaires to assess habitual sleep timing, chronotype, and social jetlag. Statistical analysis was via inferential groupwise approaches and path analysis to establish interdependencies of effects of social jetlag, chronotype, and breakfast eating regularity on HbA1c. 22.7% of the participants reported eating breakfast five times or fewer a week, and were categorised as irregular breakfast eaters. Compared with those who ate breakfast six or seven times a week, irregular breakfast eaters had significantly higher HbA1c and diastolic blood pressure, were younger and had greater social jetlag. In the path analysis, irregular breakfast eating exerted a direct effect on HbA1c, whilst social jetlag exerted only an indirect effect on HbA1c through breakfast eating regularity. Chronotype did not exert any effect on HbA1c, but did exert an indirect effect on breakfast eating regularity via social jetlag. Our results showed that adult participants with type 2 diabetes mellitus, who ate breakfast irregularly had poorer metabolic health and greater social jetlag. The relationship between social jetlag and glycaemic control appears to be mediated through breakfast eating habits.

Rise and dine: unraveling breakfast habits among tenth graders - a cross-sectional study among 646 students in the City of Witten, Germany (GeWIT study)

BACKGROUND

Despite widespread recognition of breakfast as a key contributor to adolescent health, breakfast skipping remains common and concerning. It has been associated with increased consumption of energy-dense snacks, lower intake of essential nutrients, and irregular eating patterns throughout the day. This study aimed to assess the prevalence of breakfast skipping on the day of the survey among adolescents in Witten, Germany, and to explore its associations with selected sociodemographic characteristics, health-related behaviours, and self-reported health indicators.

METHODS

Between November 2, 2021, and February 25, 2022, a cross-sectional, survey-based study was conducted among 10th-grade students in all nine municipally managed secondary schools in Witten. The questionnaire assessed breakfast consumption on the surveyed day, school type, sociodemographic factors, health status, and physical activity. Statistical analyses were conducted using SPSS, including chi-square tests and multivariable logistic regression to estimate odds ratios and identify predictors of breakfast skipping.

RESULTS

In a sample of 646 students (response rate 98.3%), 50.6% (n = 327) reported skipping breakfast before school on the day of the survey. Students attending intermediate secondary schools (aOR 1.66, 95% CI 1.1-2.51) or comprehensive schools (aOR 1.62, 95% CI 1.11-2.36), and those with a migration background (defined in Germany as having at least one parent born abroad) (aOR 1.46, 95% CI 1.04-2.04), were significantly more likely to skip breakfast. In contrast, students reporting "excellent" (aOR 0.29, 95% CI 0.17-0.48) or "very good" (aOR 0.63, 95% CI 0.43-0.91) general health, and those categorized as underweight (aOR 0.44, 95% CI 0.2-0.98), were significantly less likely to skip breakfast. No significant associations were found for gender, age, socioeconomic status, physical activity, or family doctor consultations.

CONCLUSION

This study indicates that the educational environment and cultural background might significantly impact adolescents' breakfast consumption behaviours on the surveyed day, underscoring the need for targeted educational interventions. Promoting a positive perception of personal health is key to encouraging regular breakfast consumption among adolescents. These findings provide important insights for public health strategies to enhance adolescents' dietary habits.

TRIAL REGISTRATION

Not applicable.

Prospective association between breakfast consumption frequency and BMI z-score among European school-aged children. The Feel4Diabetes Study

BACKGROUND

The long-term effects of breakfast on childhood z-BMI remain inconclusive.

OBJECTIVE

To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries.

METHODS

Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Feel4Diabetes study were used. Children's lifestyle behaviors, including breakfast frequency, were assessed through parent-reported questionnaires. Weight and height were objectively measured and converted to z-BMI. Participants were categorized into trajectories combining breakfast consumption habit (i.e., regular consumption, irregular consumption or omission) at baseline and follow up. Logistic regression analyzed the prospective association between breakfast trajectories and z-BMI increase, with adjustment for demographic and lifestyle variables.

RESULTS

A statistically significant effect of breakfast trajectories was observed in z-BMI, both at baseline and follow up. Stable skippers was the only trajectory that showed a significant increase in BMI z-score from baseline to follow up (0.891 ± 1.058 vs. 1.034 ± 1.072 respectively, p < 0.05). BMI z-score at follow up of regular eaters (0.615 ± 0.967) was significantly lower, compared to both irregular eaters (1.229 ± 0.890) and stable skippers (both p < 0.05). Stable regular consumption and transition from omission to regular consumption were independently associated with significantly lower risk of z-BMI gain, compared to stable omission [OR, 95% CI: 0.55 (0.31, 0.97), p = 0.039 and 0.43 (0.21, 0.88), p = 0.021 respectively].

CONCLUSION

Stable regular breakfast consumption or transition from omission to regular consumption seem to contribute to superior weight regulation in children and to independently protect against z-BMI gain, compared to stable omission. Further studies are warranted to extend the evidence on the breakfast habit-BMI association among children.

The Association Between Breakfast Skipping and Positive and Negative Emotional Wellbeing Outcomes for Children and Adolescents in South Australia

Background/Objectives: The prevalence of child and adolescent breakfast skipping is concerning, and limited existing evidence suggests an association between skipping breakfast and negative emotional wellbeing outcomes. However, positive emotional wellbeing outcomes have been neglected from research in this space. Methods: This study explored child and adolescent breakfast skipping and associations with both positive and negative emotional wellbeing outcomes. We utilised existing population-level data (n = 80,610, aged 8-18 years) collected in 2023 via a statewide census among children and adolescents in South Australian schools, the Wellbeing and Engagement Collection. Results: Adjusted linear regression analyses indicated lower scores on positive wellbeing outcomes for students who skipped breakfast every day compared to students who never skipped breakfast, ranging from β = -0.19 for happiness (95% CI = -0.21, -0.17) to β = -0.23 for optimism (95% CI = -0.25, -0.21). Results also highlighted higher scores on negative wellbeing indicators, sadness (β = 0.12, 95% CI = 0.10, 0.15), and worries (β = 0.05 95% CI = 0.03, 0.08) among students who always skipped relative to those who never skipped breakfast. Conclusions: Findings support the potential for child and adolescent emotional wellbeing to be fostered through interventions designed to promote daily breakfast consumption. Future research focused on gaining a deeper understanding of the circumstances surrounding child and adolescent breakfast consumption behaviours is needed to inform the development of effective interventions to increase breakfast consumption.

Chrononutrition, diet quality and perceived stress: results from two population-based studies in Brazil

Chrononutrition and diet quality appear to influence stress, however, evidence on this relationship needs to be better elucidated. We aim to assess the association between chrononutrition, diet quality, and perceived stress in adults from Southern Brazil. Population-based cross-sectional study conducted in two Brazilian cities, with individuals aged ≥18 years. Chrononutrition and diet quality were the exposure, and perceived stress was the outcome. To assess the associations, Poisson regression was used to calculate crude and adjusted prevalence ratio. 2,170 individuals were analyzed: 12.3% did not have breakfast, 27.5% had less than four meals per day, 30.4% presented poor diet quality, 14% referred irregular consumption of healthy foods, and 43.2% had regular consumption of unhealthy foods. Perceived stress was reported by 38.2% of the sample. Individuals who ate less than four meals per day, with poor diet quality, with regular consumption of unhealthy foods, and with irregular consumption of healthy foods were more likely to present perceived stress. These results may contribute to the development of joint actions on nutrition and mental health.

A Cross-Sectional Study on the Prevalence of Skipping Breakfast Among College-Going Students in a Private University

Background Breakfast is considered one of the important meals of the day as it repletes glucose supply to the brain and improves learning. Skipping breakfast has become more common among college students. It is prompting them to adopt unhealthy lifestyles which might affect their health in the long term. The present study aimed to assess the health effects of skipping breakfast among college students. The main objective of this study is to estimate the prevalence of breakfast-skipping patterns and the factors associated with skipping breakfast among college students. Methods This descriptive cross-sectional study involved 540 college students from four institutions (Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Chengalpattu, Karpaga Vinayaga Institute of Dental Sciences, Chengalpattu, Karpaga Vinayaga Institute of Dental Sciences, Chengalpattu, and Karpaga Vinayaga College of Nursing, Chengalpattu) in Tamil Nadu. A Simple Random Sampling method was used to select the sample. Data were gathered using a pre-tested, semi-structured questionnaire, and ethical clearance was obtained from the institution. The data were analyzed with IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States), employing both descriptive and inferential statistics. Results The prevalence of breakfast skipping among college-going students was 368 (68.2%). The timing of breakfast was a strong predictor; those eating after 10 AM had an adjusted odds ratio of 3.98 (95% CI: 1.65 - 9.61). The use of snacks as meal replacements also showed a significant association, with an odds ratio of 2.90 (95% CI: 1.95 - 4.32). Spending pocket money on breakfast was linked to an increased likelihood of skipping, with an adjusted odds ratio of 1.251 (95% CI: 0.82 - 1.90). Conclusion This study shows that a higher proportion of college students skip their breakfast at least once a week. This study also showed that male gender, lower socioeconomic status, mealtime after 11 a.m., and snacking as a meal substitute more than four times a week are important risk factors for college students who were skipping breakfast. The results indicate that specific programs that encourage eating breakfast earlier and adopting healthy eating behavior may enhance student's general dietary habits.

Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults

OBJECTIVES

Not skipping breakfast is associated with a better overall diet quality and lower cardiometabolic risk. However, the impact of calorie intake and dietary quality of breakfast on cardiovascular health remains unexplored. We aimed to study the associations between breakfast energy intake and quality and time trajectories of cardiometabolic traits in high cardiovascular risk participants.

DESIGN

Prospective observational exploratory study with repeated measurements.

SETTING

Spanish older adults.

PARTICIPANTS

383 participants aged 55-75 with metabolic syndrome from PREDIMED-Plus, a clinical trial involving a weight-loss lifestyle intervention based on the Mediterranean diet.

MEASUREMENTS

Participants were followed for 36 months. Longitudinal averages of breakfast energy intake and quality were calculated. Three categories were defined for energy intake: 20-30% (reference), <20% (low), and >30% (high). Quality was estimated using the Meal Balance Index; categories were above (reference) or below the median score (low). Natural cubic spline mixed effects regressions described trajectories of cardiometabolic indicators (anthropometry, blood pressure, lipids, glucose, glycated hemoglobin, and kidney function) in breakfast groups. Inter-group differences in predicted values were estimated by linear regressions. Analyses were adjusted for age, sex, PREDIMED-Plus intervention group, education, smoking, physical activity, and total daily kilocalorie intake. Lipid profile analyses were further adjusted for baseline hypercholesterolemia, blood pressure analyses for baseline hypertension, and glucose/glycated hemoglobin analyses for baseline diabetes. Breakfast energy intake analyses were adjusted for breakfast quality, and vice versa.

RESULTS

At 36 months, compared to the reference, low- or high-energy breakfasts were associated with differences in body mass index (low: 0.61 kg/m² [95% confidence interval: 0.19; 1.02]; high: 1.18 kg/m² [0.71; 1.65]), waist circumference (low: 2.22 cm [0.96; 3.48]; high: 4.57 cm [3.13; 6.01]), triglycerides (low: 13.8 mg/dL [10.8; 16.8]; high: 28.1 cm [24.7; 31.6]), and HDL cholesterol (low: -2.13 mg/dL [-3.41; -0.85]; high: -4.56 mg/dL [-6.04; -3.09]). At 36 months, low-quality breakfast was associated with higher waist circumference (1.50 cm [0.53; 2.46]), and triglycerides (5.81 mg/dL [3.50; 8.12]) and less HDL cholesterol (-1.66 mg/dL [-2.63; -0.69]) and estimated glomerular filtration rate (-1.22 mL/min/1.73m2 [-2.02; -0.41]).

CONCLUSIONS

Low- or high-energy and low-quality breakfasts were associated with higher adiposity and triglycerides, and lower HDL cholesterol in high-risk older adults. Low-quality breakfasts were also linked to poorer kidney function.

Modifying the timing of breakfast improves postprandial glycaemia in people with type 2 diabetes: A randomised controlled trial

AIMS

Investigate the effects of breakfast timing on postprandial glycaemia in adults with type 2 diabetes (T2D), and the impact of a 20-min walk after breakfast.

METHODS

Eleven adults with T2D (57 ± 7 y; HbA1c 7.4 ± 1%) participated in a six-week randomised crossover controlled trial comprising three 4-day conditions: Early (0700 h), Mid (0930 h) and Delayed (1200 h). After each condition, a second 4-day intervention of 20-min walk after each condition was undertaken. Standardised breakfast was provided. Interstitial glucose and physical activity were measured. Incremental area under the curve (iAUC) 2-h post-breakfast, 24-h iAUC, and fasting glucose were analysed with linear mixed-effects models. Cohen's d of the 2-h iAUC post-breakfast 20-min walk was calculated.

RESULTS

Mid and Delayed had lower 2-h post-breakfast iAUC (p < 0.002, -57 mmol/L×2h; p < 0.02, -41 mmol/L×2h) compared to Early. There were no differences in fasting (0600 h) glucose or 24-h iAUC. There was a small effect of the 20-min walk on lowering 2-h post-breakfast iAUC for Early (d = 0.35) and Delayed (d = 0.37), with no effect in Mid.

CONCLUSION

In people with T2D, delaying breakfast from 0700 h to mid-morning or midday reduced postprandial glycaemia. Additional post-meal walking for 20 min had a small effect in lowering postprandial glycaemia when breakfast was at 0700 h or midday, but provided no additional benefit when breakfast was at mid-morning.

Meal Timing and Depression Among Chinese Children and Adolescents: Cross-Sectional Study

Background

Depression in children and adolescents is a rising concern in China. Dietary behavior is a critical determinant of mental health. Meal timing, or the schedule of meal consumption, has been related to several metabolic disorders. However, the effect of meal timing on mental health is scarce, particularly in children and adolescents who are in a critical period of physical and psychological development.

Objective

This research examined the relationship between meal timing and depression in children and adolescents in China.

Methods

Children and adolescents from grades 1 to 9 were recruited from 16 districts in Shanghai, China, from January 3 to January 21, 2020. Ten schools attended the study. A survey was distributed to the students and their parents to collect demographic and health-related information. Depression was measured by the Children's Depression Inventory-Short Form. Breakfast consumption was analyzed as a binary outcome. Participants were defined as breakfast consumers if they never skipped breakfast during the week. They were otherwise defined as breakfast skippers if they skipped breakfast at least once per week. A similar categorization was applied to analyze food intake proximal to bed. Daily eating windows were calculated using the last food intake time frame-the first food intake time frame. Participants were classified into eating window groups of less than 10 hours, 10-12 hours, and more than 12 hours. A logistic regression model was used to compute the odds ratio (OR) and 95% CI.

Results

A total of 6874 participants were included in the analysis. Participants who skipped breakfast were associated with a 2.70 times higher occurrence of depression (OR 2.70, 95% CI 2.24-3.26; P<.001). The prevalence of depression was 1.28 times higher in participants who ate before bed than in those who never ate before bed (OR 1.28, 95% CI 1.08-1.50; P<.001). The occurrence of depression was 1.37 times higher if the eating time window was shorter than 10 hours (OR 1.37, 95% CI 1.08-1.73; P=.009) and 1.23 times higher if the eating time window was longer than 12 hours (OR 1.23, 95% CI 1.01-1.50; P=.004). The lowest occurrence of depression was observed at 11.5 hours. Subgroup analysis showed that such relationships remained significant in adolescents aged 10 years or older. In children, only skipping breakfast was associated with a higher odds of depression (OR 2.77, 95% CI 1.94-3.96; P<.001).

Conclusions

Breakfast skipping and eating before bed significantly increase the occurrence of depression. The optimal daily eating window to lower the occurrence of depression is 11.5 hours in children and adolescents. Daily eating windows longer than 12 hours or shorter than 10 hours are associated with an elevated occurrence of depression. Current findings advocate evidence-based dietary strategies to prevent and treat depression in children and adolescents.

Comparing the Dietary Habits and the Food Choices Between Italian and Dominican Adult Populations: Focus on Fruit and Vegetable Intakes and Their Association with Skin Carotenoid Levels

The Mediterranean Diet (MD) is characterized by a high intake of fruits and vegetables (FVs), which is considered as an important contributor to the beneficial effects of the MD pattern. In this cross-sectional study, we compared the food choices, evaluated by dietary habit questionnaires, of a sample of 995 adults, including 601 and 394 participants from Southern Italy and the Dominican Republic, respectively. In addition, we focused on their FV consumption, assessed by the Mediterranean Diet Adherence Screener (MEDAS) questionnaire, and on its association with skin carotenoid levels as measured by the Veggie Meter®. We found that a significantly higher percentage of Italians had five meals/day and breakfast compared to Dominicans (five meals/day: 43 vs. 25, p < 0.05; breakfast: 89 vs. 79, p < 0.05), whereas a lower percentage of participants from Italy consumed snacks between the two meals compared to the Dominican Republic population (47 vs. 70, p < 0.005). Most of the participants from both populations had breakfast at home. However, 59.3% of Italians and 27.5% of Dominicans (p = 0.005) had breakfast between 7:00 and 9:00 a.m., whereas 5.8% and 27.5% (p = 0.001) had breakfast after 9:00 a.m., respectively. Milk/yogurt and eggs were the most consumed foods for breakfast in Italy and the Dominican Republic, respectively. Regarding the main meals, most of the Italians and Dominicans had a first course for lunch and a second course for dinner. Of note, we observed that approximately half of the Italians ate FVs in their main meals and had a higher carotenoid score than the Dominicans. Interestingly, in the multiple linear regression analysis, we found that the carotenoid score was positively associated with sex (β = 0.078; p = 0.009), age (β = 0.008; p = 0.001), vegetable consumption (β = 0.12; p = 0.041) and the perception of a healthy diet (β = 0.12; p = 0.001) in the Dominic Republic population, while the carotenoid score was directly associated with sex (β = 54.97; p < 0.0001) and both vegetable (β = 25.42; p = 0.0008) and fruit (β = 38.61; p < 0.0001) consumption in the Italian sample. Our findings confirm the need to promote nutrition-based interventions to encourage FV intake, particularly in non-Mediterranean countries.

Association of breakfast skipping on nutrient intake and adiposity in Malaysian children: Findings from SEANUTS II

Malaysian children often skip breakfast, an important meal providing essential nutrients for optimal growth and maintaining proper nutritional status. Therefore, this study aims to investigate the associations between breakfast skipping with dietary intake, diet quality, and adiposity indicators among primary schoolchildren aged 6.0-12.9 years. This study involved 1383 children from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia. Information collected through questionnaires included sociodemography and breakfast consumption, defined as the first meal before noon. Breakfast skipping was identified as skipping breakfast at least once a week. Anthropometric measures, including height, body weight, and waist circumference, as well as percentage of body fat, were collected. Body mass index (BMI) and waist-to-height ratio were calculated, and BMI-for-age-z-scores was determined using WHO (2007) growth reference. A one-day 24-hour dietary recall was employed to assess dietary intake, and diet quality was analyzed using Malaysian Healthy Eating Index. Binary logistic regression was applied to examine relationship between breakfast skipping on diet quality and adiposity indicators. Over one-third (36.0%) of children skipped breakfast at least once a week, resulting in lower intakes of energy, nutrients, cereals/grains, vegetables, and milk/dairy products, though not affecting total diet quality score. Breakfast skipping was associated with higher odds of overweight/obesity (aOR 2.04, 95%CI: 1.52-2.76) and central obesity (aOR 1.87, 95%CI 1.34-2.61). In conclusion, primary schoolchildren in Peninsular Malaysia who skipped breakfast tended to have lower consumption of nutrients and specific basic food groups, as well as increased body fat. This study highlights the importance of continuing to educate parents and children about healthy eating habits, especially the need to adhere to dietary recommendations, with an emphasis on breakfast consumption.

Determinants of breakfast skipping among pregnant women from South Ethiopia Gamo Zone: a case-control study

Skipping breakfast during pregnancy presents several challenges and potential health risks for both the mother and her baby. Breakfast plays a crucial role in providing essential nutrients and energy after an overnight fast. Skipping breakfast during pregnancy creates an unhealthy environment for the fetus. Thus, this study aimed to identify the determinants of breakfast skipping among pregnant women. An unmatched, community-based case-control study was conducted among 116 randomly selected cases (breakfast skippers) and 232 neighboring controls (regular breakfast consumers). Data was collected using pre-tested interviewer-administered structured questionnaire. Binary logistic regression analysis was employed to determine predictors of breakfast skipping using STATA version 16. The odds of non-formal education (AOR = 3.92; 95% CI: 1.75, 8.78), low socioeconomic status (AOR = 2.93; 95% CI: 1.12, 7.68), poor dietary knowledge (AOR = 2.89; 95% CI: 1.29, 6.47), and experiencing morning sickness (AOR = 2.57; 95% CI: 1.13, 5.84) were higher among cases than controls. The odds of breakfast skipping were higher for every increase in family size (AOR = 1.65; 95% CI: 1.25, 2.18), but decrease with every unit increase in mid-upper arm circumference (AOR = 0.58; 95% CI: 0.46, 0.72) and weekly frequency of drinking coffee leaf tea beverage (AOR = 0.84; 95% CI: 0.78, 0.89). Findings of this study showed that poor economic status, lack of formal education, poor dietary knowledge, having morning sickness, having large family size, maternal nutritional status, and frequent consumption of coffee leaf tea beverage were significantly associated with breakfast skipping among pregnant women. Thus, efforts should focus on improving dietary awareness during pregnancy, strengthening dietary counseling during antenatal care, enhancing access to contraceptive services, and ensuring timely management of morning sickness.

Associations between Meal Patterns and Risk of Overweight/Obesity in Children and Adolescents in Western Countries: A Systematic Review of Longitudinal Studies and Randomised Controlled Trials

Childhood overweight/obesity (OV/OB) is a major public health problem in Western countries, often accompanied with comorbidities (e.g., hypertension and insulin resistance) (i.e., metabolically unhealthy obesity-MUO). Among diet-related risk factors of OV/OB risk and MUO, meal patterns remain limitedly studied. The aim of this systematic review was to explore associations between meal patterns and the risk of childhood OV/OB and MUO in children/adolescents aged 2-19 years. Longitudinal studies and randomised controlled trials from PUBMED and Scopus published between January 2013 and April 2024 were retrieved. Twenty-eight studies were included, all of which reported on OV/OB risk, with none on MUO risk. Regular consumption of breakfast (n = 3) and family meals (n = 4) and avoiding dining while watching TV (n = 4) may be protective factors against childhood OV/OB, whereas meal skipping (primarily breakfast; n = 4) may be a detrimental factor. Mixed effects of meal frequency on OV/OB risk were observed; no effects of frequency of lunch or of fast-food consumption and of meals served at school were found. There was insufficient evidence to support the role of other patterns (meal timing, eating in other social contexts). Meals were mainly participant-identified, leading to increased heterogeneity. Research focusing on childhood MUO and the use of harmonised definitions regarding the assessment of meal patterns are highly warranted.

Longitudinal associations of skipping breakfast and night eating with 4-year changes in weight and waist circumference among Chinese adults

BACKGROUND

The longitudinal association between specific eating behaviors, such as skipping breakfast and night eating, and changes in weight and waist circumference (WC) has been understudied.

OBJECTIVES

The objective of this study was to investigate whether skipping breakfast and night eating were individually or jointly associated with the annual changes in weight and WC.

METHODS

In the current longitudinal study, included were 48,150 Chinese adults (mean age: 50.1 ± 13.9 y) who were free of diabetes, cardiovascular diseases, and cancer in 2014, when data on dietary intake and the presence of night-eating behavior and skipping breakfast were collected via questionnaires. Weight and WC were measured repeatedly in 2014, 2016, and 2018. The associations between night eating and/or skipping breakfast and annual changes in weight and WC were evaluated using the generalized estimating equation models, adjusting for age, sex, total energy, diet quality, and other potential confounders.

RESULTS

During 4-y of follow-up, among people who had both 2 unhealthy eating behaviors, the mean difference in annual weight change was 0.53 kg (95% confidence interval: 0.43, 0.63 kg) and 0.41 cm (95% confidence interval: 0.27, 0.55 cm) in annual WC change, compared with participants without either behavior. The associations of eating behaviors and change in weight and WC were more pronounced in participants with higher baseline body mass index (in kg/m2) relative to their counterparts. Similarly, the associations between these eating behaviors and WC change were stronger in those with poorer diet quality relative to those with better diet quality.

CONCLUSIONS

Individuals with frequent skipping breakfast and/or night eating experienced faster gains in weight and WC, even after adjusting for diet quality and energy intake.

A healthy breakfast each and every day is important for students' motivation and achievement

Breakfast is often cited as the most important meal of the day and vital for students' academic functioning at school. Although much research has linked students' breakfast consumption to better achievement, there has been debate about why and how breakfast has academic benefits. The present study of 648 Australian high school students investigated (a) the role of breakfast consumption and breakfast quality in students' self-reported motivation and their achievement in a science test, (b) the role of motivation in mediating the link between breakfast consumption and quality and students' achievement, and (c) the extent to which breakfast consumption effects are moderated by the quality of breakfast (e.g., more vegetables, fruit, dairy/protein, wholegrains, cereals, water; less sugary drinks, processed meat, fast take-away, unhealthy snack foods). Findings indicated that beyond the effects of personal, home, and classroom factors, breakfast consumption predicted higher adaptive motivation (p < .05), breakfast quality predicted lower maladaptive motivation (p < .05), and in turn, students' adaptive (positively, p < .01) and maladaptive (negatively, p < .01) motivation predicted their achievement. Moreover, adaptive motivation significantly mediated the relationship between breakfast consumption and achievement (p < .05). The effect of breakfast consumption was moderated by the quality of breakfast such that consuming a high-quality breakfast in the morning was associated with the highest levels of adaptive motivation (p < .01) and achievement (p < .05) later in the day. Findings have implications for educational practice and policy seeking to promote a healthy start to the school day to optimize students' motivation and achievement.

Development, validation, and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P)

BACKGROUND

During pregnancy, physiological changes can affect eating and sleeping habits, which may eventually have negative consequences for maternal and foetal health. To better understand these changes, it is essential to develop a reliable questionnaire that addresses lifestyle habits such as snacking and daytime napping. This study aimed to determine the validity and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P).

METHODS

A total of 399 women in their second and third trimester of pregnancy were recruited from government maternal and child health clinics in Kuala Lumpur and Putrajaya and completed a self-administered online questionnaire. Content validity was conducted with an expert panel consisting of 4 members. Confirmatory factor analysis (CFA) using maximum likelihood was conducted to determine the construct validity. Internal consistency was determined by Cronbach's alpha coefficient (CAC), while the test-retest reliability was conducted using intraclass correlation coefficient (ICC).

RESULTS

The questionnaire had an appropriate content validity index of 0.91. The CPQ-P consists of 22 items, measuring 5 constructs, including morning chrono-habits, sleeping habits, evening eating, temporal eating, and pregnancy symptoms. The factor model showed good fit with χ2/df = 2.486, GFI = 0.893, CFI = 0.912, and RMSEA = 0.065. The 22 items in CPQ-P showed fair to excellent test-retest reliability (ICC: 0.42 to 0.98). The 5 constructs in CPQ-P were found to have a good to excellent internal consistency (α = 0.612-0.963).

CONCLUSIONS

The CPQ-P is a valid and reliable tool for assessing lifestyle habits during pregnancy. The questionnaire can be used to identify areas where pregnant women may need additional support or intervention to adopt healthy behaviours and reduce the risk of adverse maternal and foetal outcomes.

TRIAL REGISTRATION

NCT05700136 (clinicaltrials.gov). Trial registration date: 26/01/2023.

Breakfast quality and its sociodemographic and psychosocial correlates among Italian children, adolescents, and adults from the Italian Nutrition & HEalth Survey (INHES) study

BACKGROUND

Breakfast quality, together with regularity of breakfast, has been suggested to be associated with cardiometabolic health advantages. We aimed to evaluate the quality of breakfast and its socioeconomic and psychosocial correlates in a large sample of the Italian population.

METHODS

Cross-sectional analyses on 7,673 adult and 505 children/adolescent regular breakfast eaters from the Italian Nutrition & Health Survey (INHES; 2010-2013). Dietary data were collected through a single 24-h dietary recall. Breakfast quality was assessed through the Breakfast Quality Index (BQI) combining intake of ten food groups, energy, and nutrients of public health concern, and potentially ranging from 0 to 10. The association of sociodemographic and psychosocial factors with BQI were analyzed by multivariable-adjusted linear regression models.

RESULTS

The average BQI was 4.65 (SD ± 1.13) and 4.97 (SD ± 1.00) in adults and children/adolescents, respectively. Amongst adults, older age (β = 0.19; 95%CI 0.06 to 0.31 for > 65 vs. 20-40 years) and having a high educational level (β = 0.13; 0.03 to 0.23; for postsecondary vs. up to elementary) were independent predictors of better breakfast quality, while men reported lower BQI (β = -0.08; -0.14 to -0.02 vs. women). Perceived stress levels at home and work and financial stress were inversely associated with BQI. Children/adolescents living in Central and Southern Italian regions had lower BQI compared to residents in Northern Italy (β = -0.55; -0.91 to -0.19 and β = -0.24; -0.47 to -0.01, respectively).

CONCLUSIONS

In adults, breakfast quality was associated with age, sex, and educational level. Perceived stress levels were inversely associated with the quality of breakfast. In children/adolescents, a north-south gradient in breakfast quality was observed.

Breaking prolonged sitting increases 24-h physical activity and self-perceived energy levels but does not acutely affect cognition in healthy adults

INTRODUCTION

It is unknown whether predetermined (un)interrupted sitting within a laboratory setting will induce compensatory changes in human behaviours (energy intake and physical activity) once people return to a free-living environment. The effects of breaking up prolonged sitting on cognition are also unclear.

METHODS

Twenty-four (male = 13) healthy participants [age 31 ± 8 y, BMI 22.7 ± 2.3 kg/m2 (mean ± SD)] completed 320 min mixed-feeding trials under prolonged sitting (SIT) or with 2 min walking at 6.4 km/h every 20 min (ACTIVE), in a randomised crossover design. Human behaviours were recorded post-trial under free-living conditions until midnight. Cognitive performance was evaluated before and immediately after SIT and ACTIVE trials. Self-perceived sensations (appetite, energy and mood) and finger prick blood glucose levels were collected at regular intervals throughout the trials.

RESULTS

There were no differences between trials in eating behaviour and spontaneous physical activity (both, p > 0.05) in free-living conditions, resulting in greater overall total step counts [11,680 (10740,12620) versus 6049 (4845,7253) steps] and physical activity energy expenditure (PAEE) over 24-h period in ACTIVE compared to SIT (all, p < 0.05). Greater self-perceived levels of energy and lower blood glucose iAUC were found in ACTIVE trial compared to SIT trial (both, p < 0.05). No differences were found in cognitive performance between trials (all, p > 0.05).

CONCLUSION

Breaking up sitting does not elicit subsequent behavioural compensation, resulting in greater 24-h step counts and PAEE in healthy adults. Breaking up sitting reduces postprandial glucose concentrations and elicits greater self-perceived energy levels, but these positive effects do not acutely translate into improved cognitive function.

Effect of 100% Orange Juice and a Volume-Matched Sugar-Sweetened Drink on Subjective Appetite, Food Intake, and Glycemic Response in Adults

Dietary recommendations to reduce the consumption of free sugars often group 100% fruit juice with other sugar-containing beverages. The objective of this study was to determine the effect of consuming 100% orange juice compared to an orange drink on next-meal food intake (FI), glycemic response, average appetite, emotions, and sensory characteristics in normal-weight adults. Thirty-six normal-weight adults (age: 26.8 ± 0.9 years) consumed, in random order and at least 5 days apart, three 240 mL test beverages as follows: (a) 100% orange juice, (b) orange drink, or (c) water. Subjective sweetness and pleasantness were determined immediately after test beverage consumption. Glycemic response, average appetite, and subjective emotions were measured every 15 min for 60 min. Food intake was determined at a pizza lunch 60 min later. Rest-of-day glycemic response and energy intake (EI) were determined using a continuous glucose monitor and food record, respectively. Lunch FI (p = 0.054) and total EI (p = 0.01) were both lower after 100% orange juice compared with the orange drink. Caloric compensation was 84% after 100% orange juice and -25% after the orange drink (p = 0.047). Average appetite was not significantly different between the test beverages (p > 0.05). Blood glucose iAUC adjusted for available carbohydrate was lower after 100% orange juice compared with the orange drink (p < 0.001). Rest-of-day blood glucose concentrations were lower after 100% orange juice compared with the orange drink (p = 0.03) and water control (p < 0.001). In conclusion, consumption of 100% orange juice as a preload resulted in higher caloric compensation, lower total daily EI, and lower blood glucose concentrations compared to the orange drink.

No food for thought-How important is breakfast to the health, educational attainment and wellbeing of school-aged children and young people?

There have been reports from teachers of pupils in the United Kingdom arriving at school hungry. Poor nutritional intake during childhood can increase the risk of developing both short- and long-term health problems. Breakfast consumption has been associated with several outcomes including better diet quality and healthier weight status. Nevertheless, skipping breakfast is a frequent behaviour in young people, particularly adolescents, and those from lower socio-economic groups, who are less likely to meet dietary recommendations and nutritional targets. The aim of this narrative review is to explore the contribution of breakfast consumption at home or at school and the impact of breakfast skipping on nutrient intakes in school-aged children (aged 4-18 years), and their effect on weight and cardiometabolic health. We will also summarise evidence for a link with cognitive function and educational attainment. A broadly positive effect of breakfast intake on diet quality, weight status and school-related outcomes was found in the literature, although inconsistencies in findings and methodological limitations within the evidence base are notable. Further research is warranted to better understand impact of breakfast intake and school breakfast provision on longer-term learning, educational attainment and health outcomes. This also needs to consider the cost benefit, type of breakfast and any unintended consequences such as encouraging multiple breakfasts. Breakfast consumption could improve the nutritional intakes of the most vulnerable young people and may help to address inequalities in educational outcomes at least in the short term.

Association of breakfast, total diet quality, and mental health in adolescents: a cross-sectional study of HBSC in Greece

The emerging field of nutritional psychiatry offers proof that diet quality can be changed to reduce one's risk of developing mental illness. What you eat has a big impact on teenage mental health, and the quality and frequency of breakfast, as well as the different food groups, can affect adolescent mental health. In this study, regression models were employed to analyze four indicators (self-rated health, body satisfaction, life satisfaction, and eight symptoms) of mental health problems as well as demographic factors (gender, age, body mass index, affluence class, physical activity), with forest plots displaying the regression connections. This study, a descriptive cross-sectional survey of 3480 adolescents aged 11 to 15 years, chosen data from the 2018 Greek Health Behaviour in School-aged Children (HBSC) International Study for secondary analysis. The data revealed that high levels of four indicators of mental health (self-rated health, body satisfaction, life satisfaction, and eight symptoms) were significantly related to breakfast quality, total dietary patterns. Students reporting poor total food quality, for example, were more predictive of self-assessment when unhealthy (2.286 95% CI 1.851-2.824), and the largest connections with eating a "bad" breakfast were discovered when the eight symptoms of mental status were the worst (- 0.869 95% CI: - 1.300, - 0.439); physical activity may enhance the positive relationship of diet quality on mental health, while obesity weakens this positive relationship; and age patterns varied by gender, with girls and older individuals showing a higher risk of diet quality and mental health.   Conclusions: The findings revealed that each of the four indices of general mental health was correlated with teenage breakfast and overall diet quality. Physical activity and weight were shown to be moderating factors, and obesity had the biggest impact on psychological risk. Gender, age, and family economic inequality were potential explanations for the rise in psychological symptoms. Researchers are urged to focus more on nutritional psychiatry research and look into psychological perception disparities in the future. What is Known: • There is a potential correlation between adolescent dietary patterns or quality and mental health. • Factors such as age, gender, socio-economic status, body weight and physical activity all have an impact on diet and mental health outcomes. What is New: • There have been no studies of the ability to simultaneously predict breakfast quality and overall diet quality for broadly defined mental health complaints [positive (life satisfaction), neutral (body satisfaction, self-rated health) and negative (eight symptoms: depressed mood, irritability, nervousness, difficulty sleeping, dizziness, headache, stomachache and backache)]. • Differences in overall diet quality trends between demographic subgroups remain unclear.

Enhancing cardiometabolic health through physical activity and breakfast manipulations in children and adolescents: good for humans, good for the planet

The human health benefits of cardiometabolic disease prevention can be accompanied by planetary co-benefits. Focusing efforts towards young people, including children and adolescents, is conducive to disease prevention. In the context of cardiometabolic disease prevention, this review paper critically summarises the available literature on the acute cardiometabolic responses to physical activity and breakfast manipulations among young people. Given the seriousness of global climate change, which will disproportionally affect our younger generations, this review paper offers new insights into the inherent interactions between child-adolescent behaviour and cardiometabolic health from an environmental sustainability perspective to aid climate change mitigation efforts, including exploring future research avenues. A growing evidence base suggests acute moderate- to high-intensity exercise bouts can attenuate postprandial plasma glucose, insulin and triacylglycerol concentrations for up to 24-48 h in young people. Whether accumulating physical activity throughout the day with short, frequent bouts promotes cardiometabolic risk marker attenuations is unclear. Breakfast consumption may enhance free-living physical activity and reduce glycaemic responses to subsequent meals for a possible additive impact. If repeated habitually, attenuations in these cardiometabolic risk factors would be conducive to disease prevention, reducing the greenhouse gas emissions associated with disease diagnosis and treatment. To progress current understanding with high public health and planetary relevance, research among samples of 'at risk' young people that span cellular-level responses to ecologically valid settings and address human and planetary health co-benefits is needed. Indeed, certain physical activity opportunities, such as active travel to school, offer important direct co-benefits to humans and planetary health.

Breakfast consumption trends among young Australian children aged up to 5 years: results from InFANT program

Breakfast is considered a healthy dietary habit which can track over time from childhood to adulthood. The breakfast meal has the potential to improve daily dietary quality, particularly if it includes a range of food groups and adequate nutrient intakes. However, research on breakfast consumption trends among young Australian children aged up to 5 years is currently limited. This study assessed children's usual breakfast food group and nutrient intakes at ages 1.5 (n = 369), 3.5 (n = 242), and 5.0 (n =240) years using three 24-hour dietary recalls from the Melbourne InFANT program. Tracking of food groups at breakfast across the three ages was assessed by Pearson correlation of energy-adjusted food intake residuals. The main food groups consumed at breakfast were grains, milk/alternatives and discretionary items, with vegetables rarely consumed at any age. Our study found that while breakfast contributed about 20% of total daily energy, this provided 20%-29.1% of total daily intake across all ages for carbohydrates, total sugars, calcium and potassium. For the contribution to daily recommendations, breakfast contributed more than about a third of daily recommended intakes for some micronutrients (e.g., iron, calcium and zinc), and a large proportion (over 40%) of sodium intake. Children consumed 11.9% -15.2% of their energy at breakfast from saturated fat, which is higher than the recommended total energy contribution of saturated fat (no more than 10% from saturated fat). For tracking of most food groups and nutrients, tracking was found to be low or moderate over time. Given the contribution that breakfast can make to ensure children achieve their daily dietary intakes, early interventions for young Australian children should focus on practical strategies to increase vegetable intake while reducing sodium and saturated fat intake at breakfast.

Acute Cardiometabolic and Exercise Responses to Breakfast Omission Versus Breakfast Consumption in Adolescent Girls: A Randomised Crossover Trial

Girls often begin to skip breakfast during adolescence. This study compared the acute effect of breakfast omission versus consumption on cardiometabolic risk markers and perceived appetite and mood during rest and/or exercise in adolescent girls classified as habitual breakfast consumers. Girls (aged 13.2 ± 0.7 years) completed two 5.5 h conditions in a randomised crossover design: breakfast omission (BO) and standardised breakfast consumption (BC). A standardised lunch was provided at 3 h. Incremental cycling exercise was performed at 5 h. Blood and expired gas samples were taken at regular intervals. Whilst pre-lunch plasma glucose, insulin, and Metabolic Load Index incremental area under the curve (IAUC) were significantly lower in BO versus BC, post-lunch differences were reversed and larger in magnitude. Peak plasma glucose and insulin were significantly higher in BO versus BC. Pre-lunch perceived fullness and hunger were significantly lower and higher, respectively, in BO versus BC. Perceived energy and concentration were lower, and tiredness was higher, in BO versus BC. Exercise peak fat oxidation and Fatmax were unaffected. The lower physical activity enjoyment in BO versus BC approached significance. To conclude, acutely omitting breakfast adversely affects cardiometabolic risk markers and exercise enjoyment among adolescent girls who habitually consume breakfast.

Exploring the effects of health behaviors and mental health on students' academic achievement: a cross-sectional study on lebanese university students

BACKGROUND

High academic achievement, an important determinant of future success, is known to be influenced by many factors including dietary behavior, lifestyle and mental health, among others. The objectives of the current study were to explore university students' nutritive habits, daily lifestyle, and mental status, and to scrutinize the associations between these factors and students' academic achievement.

METHODS

A cross-sectional study was conducted among students of a private Lebanese university, using an electronic survey. Diet, eating habits, physical activity, sleep, and smoking were evaluated, and mental health was assessed using a validated Arabic version of the combined Depression, Anxiety, Stress Score (DASS-8). Academic achievement was measured using the Subjective Academic Achievement Scale (SAAS).

RESULTS

A total of 1677 students participated in the questionnaire. The results of a linear regression taking the SAAS score as the dependent variable, showed that students who have a non-scientific versus scientific major (Beta = 0.53), and having breakfast ≥ 4 days per week compared to less than 2 days (Beta = 0.28) were significantly associated with higher SAAS scores. More psychological distress (Beta = - 0.06) and a higher number of days of eating out (Beta = - 0.07) were significantly associated with lower SAAS scores.

CONCLUSIONS

This is the first investigation on a Lebanese university students' academic success in relation to lifestyle and mental profiles. Better academic achievement was demonstrated by students having healthier dietary and lifestyle habits, as well as less distressing mental status. Such results, in light of the compounded and unprecedented crises with which Lebanon has been assailed, suggest the need to focus on promoting healthy habits among students in higher education as a possible driver of better academic success.

Influence of education and subjective financial status on dietary habits among young, middle-aged, and older adults in Japan: a cross-sectional study

BACKGROUND

Research has suggested an association between lower socioeconomic status (SES) and unhealthy dietary habits. However, differences in the effects of different SES indicators and age remain unclear. The current study addressed this research gap by investigating the relationship between SES and unhealthy dietary habits, specifically focusing on educational attainment and subjective financial status (SFS) among varied age groups.

METHODS

Data were derived from a mail survey of 8,464 people living in a suburb of Tokyo, Japan. Participants were classified into three age groups (20-39 years: young adults; 40-64 years: middle-aged adults; and 65-97 years: older adults). SES was assessed based on individual educational attainment and SFS. Unhealthy dietary habits were defined as skipping breakfast and a low frequency of balanced meal consumption. Participants were asked how often they ate breakfast, and those who did not respond "every day" were categorized as "breakfast skippers." Low frequency of balanced meal consumption was defined as eating a meal that included a staple meal, main dish, and side dishes at least twice a day for less than five days per week. Poisson regression analyses with robust variance adjusted for potential covariates were used to determine the interactive effects of educational attainment and SFS on unhealthy dietary habits.

RESULTS

Individuals with lower educational attainment across all age groups skipped breakfast more frequently compared to those with higher educational attainment. For older adults, poor SFS was associated with skipping breakfast. Young adults with poor SFS and middle-aged adults with lower educational attainment tended to eat less balanced meals. In addition, an interaction effect was found in older adults, where those with lower education despite good SFS and those with poor SFS despite higher education were at a greater risk of falling into unhealthy diet.

CONCLUSIONS

The findings suggested that different SES indicators affect healthy dietary habits in different generations, and therefore, health policies should consider the potential influence of different SES on promoting healthier dietary habits.

Nutritional Composition of Breakfast in Children and Adolescents with and without Celiac Disease in Spain-Role of Gluten-Free Commercial Products

Eating a nutritionally balanced breakfast can be a challenge when following a gluten-free diet (GFD). We assessed the ingredients and nutrient composition of 364 gluten-free breakfast products (GFPs) and 348 gluten-containing counterparts (GCCs), and we analysed the nutritional quality of breakfast in a group of Spanish children and adolescents with celiac disease (CD) (n = 70), as compared to controls (n = 67). Food intakes were estimated using three 24 h dietary records. The composition of GFPs and GCCs was retrieved from the package labels of commercially available products. Most participants (98.5%) ate breakfast daily, and only one person in each group skipped breakfast once. The breakfast contribution of the total daily energy was 19% in participants with CD and 20% in controls. CD patients managed a balanced breakfast in terms of energy (54% from carbohydrates; 12% from proteins; 34% from lipids) and key food groups (cereals, dairy, fruits), but their intake of fruits needs improvement. Compared to controls, breakfast in the CD group provided less protein and saturated fat, a similar amount of carbohydrates and fibre, and more salt. Fibre is frequently added to GFPs, but these contain less protein because of the flours used in formulation. Gluten-free bread contains more fat and is more saturated than is GCC. Sugars, sweets, and confectionery contribute more to energy and nutrient intakes in participants with CD, while grain products do so in controls. Overall, breakfast on a GFD can be adequate, but can be improved by GFPs reformulation and a lower consumption of processed foods.

Breakfast Practices in Malaysia, Nutrient Intake and Diet Quality: A Study Based on the Malaysian Food Barometer

Breakfast is often referred to as the "most important meal of the day" in shaping diet quality. This study established the patterns of breakfast consumption in Malaysia and assessed its contribution to the overall quality of the diet based on the 24 h recall data from the nationally representative and cross-sectional Malaysian Food Barometer (MFB, second data collection, 2018) to assess breakfast intake among adults (n = 1604). Diet quality was measured using the Nutrient Rich Food index (NRF) 9.3. The nutritional profile of breakfast was compared across tertiles of NRF 9.3. Overall, 89% of Malaysians consume breakfast. Breakfast was found to provide 474 kcal on average. The Malaysian daily diet was found to be rich in fats, saturated fats, total sugars, and sodium, with breakfast making a significant contribution to the daily intakes of these nutrients. Intakes of fiber, potassium, calcium, vitamins C and D, folate, iron, zinc, and magnesium were low. Breakfast was related to the overall diet quality measured by the NRF index. This study revealed that the breakfasts consumed by Malaysian adults were found to be nutritionally unbalanced. This analysis could serve as a basis for nutrient recommendations grounded in existing social and cultural breakfast patterns.

Investigating the quality of breakfast for female adolescents using a multi-method approach in Saudi Arabia: A cross-sectional study

Breakfast has been shown to provide nutritional adequacy and improve the healthy lifestyle status of adolescents. However, limited information is available on the quality of breakfast among adolescents. Thus, this study aimed to evaluate the quality of breakfast among adolescents using a multiple-method approach in Saudi Arabia. This cross-sectional, school-based study was conducted in 3 public high schools in Al-Jumum, Saudi Arabia. High school females (n = 174) aged 15 to 18 years old were selected considering the regularity of consuming breakfast (≥ 4 d/wk and not after 10:00 a.m.). The quality of breakfast was assessed using 3 approaches: the modified Saudi food frequency questionnaire, the adapted method of breakfast quality, and the nutrient profile model. Sweet food items were consumed most frequently (64.9%, n = 113), followed by drinks (57.4%, n = 100), while the least frequently consumed items were sandwiches and burgers (43.52%, n = 76), snacks (41.9%, n = 72), and dairy and fats (41.8%, n = 71). The majority of breakfast eaters were classified as eating breakfasts of poor quality (50.6%), while the rest ate breakfasts of either good quality (38.1%) or very poor breakfast quality (10.8%). Based on the nutrient profile model of breakfast, high fat salt sugar (HFSS) food/drink items and non-HFSS items were consumed by 44.4% and 55.5% of the participants, respectively. This study showed that the majority of female adolescents consume poor-quality breakfast, mostly sweets and sweetened beverages. The nutrient content analysis emphasized these results by presenting a similar consumption of non-HFSS and HFSS breakfast foods. Future education programs on healthy breakfast options should be implemented among this population.

Consumption and Breakfast Patterns in Children and Adolescents with Congenital Heart Disease

Little is known about skipping breakfast and breakfast patterns (BP) and their evaluation according to sociodemographic, clinical, lifestyle, cardiometabolic and nutritional data in children and adolescents with congenital heart disease (CHD). This cross-sectional study with 232 children and adolescents with CHD identified the prevalence and patterns of the breakfast, described these according to sociodemographic, clinical and lifestyle characteristics, and assessed their association with cardiometabolic and nutritional markers. Breakfast patterns were identified by principal components, and bivariate and linear regression analysis were applied. Breakfast consumption was observed in 73% of participants. Four BP were identified: pattern 1 "milk, ultra-processed bread, and chocolate milk", pattern 2 "margarine and processed bread", pattern 3 "cold meats/sausages, cheeses and butter/cream" and pattern 4 "fruits/fruit juices, breakfast cereals, yogurts, and homemade cakes/pies and sweet snacks". Family history for obesity and acyanotic CHD were associated with breakfast skipping. Younger participants and greater maternal education were associated with greater adherence to pattern 1 and pattern 4. Older participants and longer post-operative time showed greater adherence to pattern 3. No association between skipping breakfast or BP and cardiometabolic and nutritional markers was observed. Nonetheless, the findings reinforce the need for nutritional guidance for healthy breakfast, aiming to reduce the consumption of ultra-processed foods and to prioritize fresh and minimally processed foods.

Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors

BACKGROUND

Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors.

METHODS

Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA).

RESULTS

Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: -3.28, 95% C.I.: -5.7 to -0.86), diastolic blood pressure (b: -1.85, 95% C.I.: -3.34 to -0.36), augmentation index (b: -3.17, 95% C.I.:-4.98 to 1.35) and left carotid intima media thickness (b: -0.03, 95% C.I.:-0.06 to -0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10-20% of daily total energy intake (dTEI) was inversely associated with Aix (b: -2.31, 95% C.I.:-4.05 to -0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90).

CONCLUSION

SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.

Breakfast Size and Prevalence of Metabolic Syndrome in the European Prospective Investigation into Cancer and Nutrition (EPIC) Spanish Cohort

BACKGROUND

Recent evidence suggest that energy distribution during the daytimecould be a potential determinant for the development of metabolic syndrome (MetS).

OBJECTIVE

To cross-sectionally assess the association between breakfast size and the prevalence of MetS in Spanish adults.

METHODS

Our study included a subset of 3644 participants from the European Prospective Investigation into Cancer and Nutrition Spain study recontacted between 2017-2018. Information on diet, sociodemographic, lifestyle, sleep quality, and chronotype was collected using standardized questionnaires, while anthropometric and blood pressure data were measured in a face-to-face personal interview by a nurse. MetS was defined according to the Adult Treatment Panel III (ATPIII) definition by measuring serum levels of total cholesterol, tryglycerides and glucose. Breakfast size was calculated as: (energy from breakfast/total energy intake) * 2000 kcal. To evaluate the association between breakfast size and MetS prevalence, a multivariable logistic regression model adjusted by potential confounders was used to estimate OR and 95% CI.

RESULTS

Prevalence of MetS in our study was 40.7%. The mean breakfast size was 306.6 * 2000 kcal (15% of the total daily energy intake), with 14 (0.4%) participants skipping breakfast. Participants in the highest quartile of breakfast size had a lower MetS prevalence compared to participants in the lowest quartile (OR_Q4vsQ1 = 0.62; 95% CI = 0.51-0.76; p-trend < 0.001). No modification of the estimated ORs by sex, breakfast time, and number of eating occasions per day were observed.

CONCLUSION

Our results suggest that higher breakfast size is associated with lower prevalence of MetS in Spanish adults, supporting the importance of a high energy breakfast. Further prospective studies are necessary to confirm these findings.

Time-related meal patterns and breakfast quality in a sample of Iranian adults

BACKGROUND

Some evidence shows that meal timing is associated with diet quality. We aimed to investigate the relationship between meal timing and breakfast quality in a sample of Iranian adults.

METHODS

This cross-sectional study was conducted on 850 men and women living in Tehran, Iran. Dietary data was recorded by three non-consecutive 24-h dietary recalls. The Breakfast Quality Index (BQI) was calculated. Time-related meal patterns included the interval between the first and last meal (eating and fasting window), frequency of meals, length of sleep, and time of first and last eating occasion. The multiple linear regression analysis was used to identify the relationships between time-related meal patterns and BQI.

RESULTS

The mean (95% CI) of BQI was 4.52 (4.45-4.65) and the maximum was 8. Bread, cheese, vegetables, fruits, energy, and carbohydrate intake showed positive associations with BQI scores. Longer fasting time showed a positive association with fruits (β (CI 95%)) (0.11 (0.0003-0.005), and vegetable consumption (0.12 (0.009-0.07)) and BQI score (0.39 (0.001-0.06)). Time of first eating occasions indicated a negative association with protein and fat intake and BQI score. Time of last eating occasions showed a positive association with vegetables consumption and BQI score. The longer length of sleep was associated with a higher BQI score. The frequency of meals was significantly and positively related to energy and macronutrients intake and BQI.

CONCLUSION

Earlier first and last meal, longer sleep length, longer fasting window, and a greater meal frequency were associated with a better breakfast quality.

Breakfast Quality and Insulin Resistance in Spanish Schoolchildren: A Cross-Sectional Study

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8−13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01−0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

Skipping breakfast regimen induces an increase in body weight and a decrease in muscle weight with a shifted circadian rhythm in peripheral tissues of mice

Meal timing is a key factor in synchronising the circadian clock in peripheral tissues. Circadian disorders are associated with the metabolic syndrome. Previously, we demonstrated that a skipping breakfast regimen (SBR) with a high-fat diet increased body weight gain in rats. In this study, we investigated whether SBR with a normal diet led to abnormal lipid metabolism and muscle metabolism in mice. Male C57BL/6 mice were fed during zeitgeber time (ZT) 12-24 in the control group and ZT 16-24 in the SBR group for 2 weeks. SBR mice showed increased body weight gain and perirenal adipose tissue weight. The plantar muscle weight was decreased in the SBR group compared with that in the control group. Furthermore, SBR delayed the circadian oscillations in clock gene expression in peripheral tissues, such as the liver, adipose tissue and muscle, as well as the oscillations in the expression of lipid metabolism-related genes in the liver and adipose tissue. These results suggest that skipping breakfast over a long period of time is associated with a risk of obesity, the metabolic syndrome and muscle loss, such as sarcopenia.

Breakfast consumption and its relationship with diet quality and adherence to Mediterranean diet in European adolescents: the HELENA study

OBJECTIVE

The aim of the current study is to analyze the associations between breakfast consumption and adherence to diet quality index (DQI) and Mediterranean Diet Score (MDS) in European adolescents.

METHODS

A multinational cross-sectional study was carried out in 1804 adolescents aged 12.5-17.5 years. The Food Choices and Preferences questionnaire was used to ascertain breakfast consumption (consumers, occasional consumers and skippers), and two non-consecutive 24 h dietary recalls were used to estimate the total daily intake and to calculate the subsequent DQI and MDS. Mixed linear regression models were used to examine the relationship between breakfast consumption and DQI-A and MDS. Age, maternal education, BMI, country and total energy intake were included as covariates.

RESULTS

In both sexes, significant differences were observed among the breakfast consumption categories. In both boys and girls, breakfast consumers had significantly higher DQI indices than those adolescents who skipped breakfast regularly (p < 0.001). Regarding total MDS, in both boys and girls, breakfast consumers had a higher total MDS than breakfast skippers (p < 0.001), however, no associations were shown between occasional breakfast consumers and DQI indices and MDS.

CONCLUSION

Breakfast consumption has been linked with better dietary quality scores compared with those children who usually skip breakfast. Promotion of regular breakfast consumption in adolescents could be an effective strategy to improve the overall diet quality.

Breakfast skipping and timing of lunch and dinner: Relationship with BMI and obesity

OBJECTIVE

To determine whether breakfast-skipping, late-lunch, and late-dinner eating are cross-sectionally associated with higher BMI and obesity. Also, to identify obesogenic behaviors and circadian-related variables, associated with late eating.

METHODS

Participants(n = 776) were part of exploratory, population-based research, with data collection in a virtual environment. They were grouped into breakfast-eaters (first meal until 10:00) and skippers (first meal after 10:00), and the population median for the lunch and dinner timing was used to stratify participants into early (lunch/dinner-time before 12:34/20:55) and late (lunch/dinner-time after 12:34/20:55) eaters. Student's t-test and chi-square test were performed to assess differences in characteristics and lifestyle traits between groups. Logistic regression models were used to assess differences in obesity between groups. Linear regression analysis was conducted to determine the association of the clock time of meals with BMI. Analyses were adjusted for potential confounders variables.

RESULTS

BMI raised of 0.74 Kg/m2 for each additional hour of lunch-time [95 %CI= 0.31;1.18,P ≤ 0.001]. Breakfast-skippers [OR(95 % CI):1.84(1.02;3.31);P ≤ 0.05] and late-lunch eaters [OR(95 % CI):1.61(1.04;2.49),P ≤ 0.05] had higher odds of having obesity, compared with breakfast-eaters and early-lunch eaters, respectively. These associations were independent of age, gender, diet quality, physical activity duration, and region. No statistically significant differences were found in the comparison between early and late-dinner eaters.

CONCLUSIONS

Our results suggest that skipping breakfast and eating late-lunch are associated with BMI and higher odds of having obesity. Insights into the obesogenic behaviors/characteristics related to breakfast-skipping and late-eating may be helpful for future nutritional recommendations and obesity prevention and treatment.

Meal patterns and the quality of breakfast and snacks in relation to adolescents' dental health in southeast of Iran

Aim: The objective was to determine the frequency pattern and nutritional quality of breakfast and snacks in Iranian adolescents and to investigate these dietary habits in relation to tooth decay and tooth erosion. Methods: A multistage cluster random sampling method was adopted to recruit 600 adolescents with equal sex distribution in the city of Kerman/southeast of Iran. Decayed, Missing and Filled Teeth (DMFT) and Tooth Wear Index (TWI) were recorded for each subject. Snacking and breakfast quality, frequency of snacking and regular/irregular use of main meals were also recorded. Poisson regression and Firth's bias-reduced penalized-likelihood logistic regression were used for data analysis. Results: DMFT score of adolescents who consumed low-quality snacks were 1.13 times more than those who consumed high-quality snacks. Regular use of all three main meals was associated with a lower DMFT score. DMFT score of adolescents who did not have regular use of breakfast was 1.19 times more than those who consumed breakfast on a regular basis. Also, regarding adolescents who had an irregular use of lunch, the DMFT score was 1.3 times more than those who had a regular lunch schedule. In addition, participants with irregular dinner consumption had 1.24 times more DMFT scores compared to those with a regular dinner schedule. Conclusions: Regular breakfast consumption, decreased snacking occasions, use of higher nutritional quality snacks, and increased nutritional education are important in order to prevent a higher chance of dental caries and promote dental health status.

Association between Dietary Patterns and Physical Fitness among Chinese Children and Adolescents in Shaanxi Province

Background: This study aims to investigate the associations between dietary patterns (breakfast, egg, dairy products, and sugared beverage intake frequencies) and physical fitness among Chinese children and adolescents in Shaanxi Province. METHODS: Data were extracted from the Chinese National Survey on Students’ Constitution and Health (CNSSCH). The study ultimately included 7305 participants (48.4% male, 51.6% female) aged 6–22 in Shaanxi Province, China. Multiple linear regression was used to examine the association of the frequency of breakfast, egg, dairy product, and sugared beverage intakes with physical fitness. RESULTS: The frequency of breakfast, egg, and dairy product intakes were all independently and positively associated with the level of physical fitness. The frequency of sugared beverage intake was negatively associated with the level of physical fitness. CONCLUSION: Healthier dietary patterns (i.e., higher breakfast, egg, and dairy product intakes and lower sugared beverage intake) were associated with greater physical fitness. Specifically, maintaining a healthy dietary pattern of breakfast, egg, and dairy product intakes can positively affect the strength and endurance performance of children and adolescents. Increased dairy product intake plays a crucial part in boosting the physical fitness total scores of children and adolescents.

[Influence of sleep and chrononutrition on hypertension and diabetes: a population-based study]

The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.

Health behaviours as predictors of the Mediterranean diet adherence: a decision tree approach

OBJECTIVE

This study aimed to identify health behaviours that determine adolescent's adherence to the Mediterranean diet (MD) through a decision tree statistical approach.

DESIGN

Cross-sectional study, with data collected through a self-fulfilment questionnaire with five sections: (1) eating habits; (2) adherence to the MD (KIDMED index); (3) physical activity; (4) health habits and (5) socio-demographic characteristics. Anthropometric and blood pressure data were collected by a trained research team. The Automatic Chi-square Interaction Detection (CHAID) method was used to identify health behaviours that contribute to a better adherence to the MD.

SETTING

Eight public secondary schools, in Algarve, Portugal.

PARTICIPANTS

Adolescents with ages between 15 and 19 years (n 325).

RESULTS

According to the KIDMED index, we found a low adherence to MD in 9·0 % of the participants, an intermediate adherence in 45·5 % and a high adherence in 45·5 %. Participants that regularly have breakfast, eat vegetable soup, have a second piece of fruit/d, eat fresh or cooked vegetables 1 or more times a day, eat oleaginous fruits at least 2 to 3 times a week, and practice sports and leisure physical activities outside school show higher adherence to the MD (P < 0·001).

CONCLUSIONS

The daily intake of two pieces of fruit and vegetables proved to be a determinant health behaviour for high adherence to MD. Strategies to promote the intake of these foods among adolescents must be developed and implemented.

Time-limited diets and the gut microbiota in cardiometabolic disease

In recent years, intermittent fasting (IF), including periodic fasting and time-restricted feeding (TRF), has been increasingly suggested to constitute a promising treatment for cardiometabolic diseases (CMD). A deliberate daily pause in food consumption influences the gut microbiome and the host circadian clock, resulting in improved cardiometabolic health. Understanding the molecular mechanisms by which circadian host-microbiome interactions affect host metabolism and immunity may add a potentially important dimension to effective implementation of IF diets. In this review, we discuss emerging evidence potentially linking compositional and functional alterations of the gut microbiome with IF impacts on mammalian metabolism and risk of development of hypertension, type 2 diabetes (T2D), obesity, and their long-term micro- and macrovascular complications. We highlight the challenges and unknowns in causally linking diurnal bacterial signals with dietary cues and downstream metabolic consequences and means of harnessing these signals toward future microbiome integration into precision medicine.

Breakfast skipping and its relationship with academic performance in Ethiopian school-aged children, 2019

Breakfast skipping and its relationship with academic achievement among primary school children were investigated in this study. A cross-sectional study was conducted among 848 primary school children. Breakfast skipping was analyzed using a 2-item questionnaire. A 19-item Social Academic and Emotional Behavior Risk Screening questionnaire was used to collect data on children’s behavior. The prevalence of breakfast skipping was found to be 38.1%. Living in a rural area (AOR = 5.2; 95% CI: 3.54, 7.71); having illiterate parents (AOR = 6.66; 95% CI 3.0, 14.7); having parents with a primary education level (AOR 5.18, 95% CI: 2.25, 11.94); living with guardians or other relatives (AOR = 4.06; 95%CI: 2.1, 7.9); and having lower academic achievement (AOR = 2.76; 95% CI: 1.44, 5.29) were factors associated with skipping breakfast.

In conclusion, breakfast skipping has been identified as a significant public health concern that requires an immediate response from stakeholders. It is recommended to intervene based on the identified factors.

Haemoglobin status to determine nutritional anaemia and its association with breakfast skipping and BMI among nursing undergraduates of Farasan Island, KSA

The present study was conducted to determine nutritional anaemia using haemoglobin levels of female nursing undergraduates studying at Farasan Island with the purpose to intervene at a point, before the potential problems become serious later in life. In total, 130 apparently healthy, female students of Department of Nursing were recruited by a random sampling method to collect information on socio-demographic, lifestyle and anthropogenic characteristics, and dietary habits including breakfast skipping. Haemoglobin content was estimated using Sahli's Haemoglobinometer and observations were interpreted as per WHO's criteria for anaemia. Body mass index (BMI) was recorded using a digital weighing machine. Correlation between haemoglobin concentration, breakfast skipping and body mass index of study participants was assessed by Pearson's correlation. Data analyses were done using Origin software. Overall, 51⋅6 % (n = 67) students were all together anaemic with 28⋅5 % (n = 37) had mild anaemia, 15⋅4 % (n = 20) moderate and 7⋅69 % (n = 10) had severe anaemia. Of these, 20⋅8 % (n = 27) were underweight, 63⋅8 % (n = 83) normal weight and 15⋅4 % (n = 20) were above normal weight (over weight and obese). The Hb content showed a positive correlation with the BMI and exhibited an increasing trend with increase in the BMI among study participants (P < 0⋅05). Questionnaire analyses revealed that the majority (96⋅9 %, n = 126) of students were taking junk food as bulk of their meal. A strong negative correlation was recorded between Hb contents and breakfast skipping tendencies (r = −0⋅987, P < 0⋅05). Findings of the present study are of high significance for public health professionals and educators to prioritise actions that could motivate these future nurses to adapt healthy lifestyles to strategically combat nutritional anaemia.

Prevalence of Obesity and Associated Risk Factors among Children and Adolescents in the Eastern Cape Province

Obesity is a global public health concern that begins in childhood and is on the rise among people aged 18 and up, with substantial health consequences that offer socioeconomic challenges at all levels, from households to governments. Obesity and associated risk factors were investigated in children and adolescents in the Eastern Cape Province of South Africa. A cross-sectional study was conducted at Mt Frere among 209 conveniently selected participants using anthropometric measurements and a structured questionnaire. Chi-squared statistics or Fisher's exact test were used to evaluate the risk factors predicting different outcomes such as hypertension or diabetes mellitus. A 5% level of significance was used for statistical significance (p-value 0.05). The prevalence of overweight or obesity among females when using waist circumference (2.7%), triceps skinfold (6.9%), and body mass index cut-offs (16.4%) were respectively higher when compared to those of males. About 89% engaged in physical activities. After school, 53% watched television. About 24.9% of participants did not eat breakfast. Most of overweight or obese participants (92.9%) brought pocket money to school. Use of single anthropometric measurements for assessing nutritional status indicated inconclusive results. Strengthening parental care, motivation for consumption of breakfast and limiting pocket money for children going to school are important steps to improve child health.

Breakfast Skipping among a Multi-Ethnic Population of Young Men and Relationship with Sociodemographic Determinants and Weight Status

Breakfast skipping is linked with obesity incidence. This study was conducted to assess the prevalence of breakfast skipping among a multi-ethnic population of young men residing in Saudi Arabia and its relationship with sociodemographic determinants and weight status. A total of 3600 young men aged 20 to 35 years and living in Riyadh, Saudi Arabia, were involved in this cross-sectional study. Sociodemographic determinants and breakfast-consumption frequency were collected from subjects by personal interviews. This study defines breakfast skipping as skipping breakfast at least one day per week. Weight and height were measured following standardized methods. The prevalence of breakfast skipping was observed among 52.8% of the study subjects. Nationality was a predictor of breakfast skipping, with the lowest and highest rates of breakfast skipping reported among young men from Bangladesh (14.0%) and Saudi Arabia (86.5%), respectively. Weight status was another predictor of breakfast skipping, as the mean body mass index for breakfast skippers (25.4 kg/m2) was significantly (p-value < 0.001) higher than that for breakfast consumers (24.8 kg/m2). Overweight/obese subjects have a significantly higher rate of breakfast skipping (56.9%) than underweight/normal weight subjects (48.9%). In conclusion, breakfast skipping prevalence is relatively high among young men residing in Saudi Arabia. The findings confirm a relationship between breakfast skipping and sociodemographic determinants and weight status.

Perceptions and knowledge of school management teams about non-communicable diseases and strategies to prevent them

Background

In 2016, non-communicable diseases (NCDs) were reported to be responsible for 41 million of the world’s 57 million deaths. These deaths were reported to be associated with modifiable lifestyle behaviours, such as tobacco smoking, poor physical activity and diets of poor nutritional value. There could be a knowledge gap on NCD risk factors amongst non-health professionals. Knowledge of NCDs is, therefore, important for the implementation of preventive measures to onset of NCDs.

Aim

This study aimed at describing perceptions and knowledge of school management teams about NCDs and strategies to prevent them.

Setting

This study was conducted in Mt Frere, South Africa.

Methods

This explorative qualitative study using a phenomenological data collection approach was conducted amongst purposively selected school authorities in 2016–2017 to understand their perceptions and knowledge about NCDs and what can be performed to prevent them. Two focus group discussions (FGDs) were conducted using open-ended and unstructured questions guided by interview schedule. Tesch’s eight phases of thematic analysis approach was used to analyse narrative data resulting in two main themes and nine subthemes.

Results

Two themes (understanding and prevention of NCDs, and control measures for NCDs) and nine sub-themes emerged from the data analysis. Inconsistent description of NCDs, its causes and controls were identified amongst school management teams in the FGD. Diet, poverty, societal factors, gaps between decision makers and communities, and poor policy implementation were identified by participants as major issues in the development of NCDs.

Conclusion

There was no adequate knowledge on NCDs amongst the school management team participants. Improved visibility of health promotion personnel is needed to ensure community empowerment on NCDs prevention.

Contribution

The findings in this study will help in closing the gaps in the implementation of preventive health services for NCDs within school health.

Breakfast Skipping in a Multi-Ethnic Population of Middle-Aged Men and Relationship With Sociodemographic Variables and Weight Status

Background

Breakfast eating is regarded to be necessary for maintaining a healthy body weight. On the other hand, breakfast skipping has been linked with obesity incidence. This study was carried out to determine the prevalence of breakfast skipping among a multi-ethnic group of middle-aged men living in Saudi Arabia and the association between breakfast skipping and sociodemographic variables and weight status.

Methods

This cross-sectional study included 1,800 middle-aged men aged 36–59 years. Participants' sociodemographic information and frequency of breakfast eating were obtained through personal interviews. The body mass index was determined after measuring body weight and height using standardized methods.

Results

The prevalence of breakfast skipping was 42.1% of the study participants. Nationality was a predictor of breakfast skipping. Bangladeshi participants (N = 100) have the lowest rate of breakfast skipping (9.0%), whilst Saudi participants (N = 161) have the highest rate (73.3%). Weight status was another predictor of breakfast skipping as breakfast skippers had a significantly higher average body mass index (27.1 ± 3.8) than breakfast consumers (26.2 ± 3.5). Overweight/obese participants have a significantly higher breakfast skipping rate (44.9%) than participants with underweight/normal weight (36.6%).

Conclusion

The rate of breakfast skipping is relatively high among middle-aged men living in Saudi Arabia. The data support a link between breakfast skipping and sociodemographic variables and weight status.