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Martinez CF, Ruggiero E, Di Castelnuovo A, Esposito S, Costanzo S, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M. Breakfast quality and its sociodemographic and psychosocial correlates among Italian children, adolescents, and adults from the Italian Nutrition & HEalth Survey (INHES) study. Nutr J 2024; 23:20. [PMID: 38369481 PMCID: PMC10875855 DOI: 10.1186/s12937-024-00924-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
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.
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Affiliation(s)
- Claudia Francisca Martinez
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | | | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy.
- Department of Medicine and Surgery, LUM University "Giuseppe Degennaro", Casamassima, BA, Italy.
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Dell'Elettronica, Pozzilli, IS, 86077, Italy
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Jeans MR, Landry MJ, Asigbee FM, Vandyousefi S, Ghaddar R, Bray MS, Leidy HJ, Davis JN. Comparison of School vs Home Breakfast Consumption with Cardiometabolic and Dietary Parameters in Low-Income, Multiracial/Ethnic Elementary School-Aged Children. J Acad Nutr Diet 2021; 122:833-847. [PMID: 34634512 DOI: 10.1016/j.jand.2021.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 08/27/2021] [Accepted: 10/05/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Breakfast consumption is often associated with improving cardiometabolic parameters and diet quality. However, literature evaluating breakfast consumption with these outcomes between the school and home environments is limited. OBJECTIVE This study examined relationships between breakfast consumption locations (school vs home) and cardiometabolic parameters, breakfast dietary intake, and daily dietary intake. DESIGN This cross-sectional study used baseline data from TX Sprouts, a 1-year school-based gardening, nutrition, and cooking cluster-randomized trial, implemented in 16 elementary schools in Austin, TX, during 2016 to 2019. PARTICIPANTS/SETTING Analyses included 383 low-income, multiracial/ethnic elementary school-aged children (mean age = 9.2 years; 60.6% Hispanic; 70.5% free/reduced lunch; 58.5% home breakfast consumers). MAIN OUTCOME MEASURES Cardiometabolic parameters were obtained via fasting blood draws, and dietary intake was assessed using one 24-hour dietary recall conducted on a random, unannounced weekday. Cardiometabolic and dietary parameters (ie, energy intake, macronutrients, and food group servings) for breakfast and for the day were evaluated. STATISTICAL ANALYSES PERFORMED Multivariate analysis of covariance was performed to examine cardiometabolic parameters and dietary intake between school and home breakfasts. RESULTS School breakfast consumers (SBC) had lower fasting triglyceride levels than home breakfast consumers (HBC) (89.0 mg/dL vs 95.7 mg/dL; P = 0.03) (to convert to mmol/L, multiply by 0.0113). SBC had lower total fat for the day (P = 0.02) and lower total and saturated fat, sodium, and refined grains at breakfast (P ≤ 0.01) than HBC. However, SBC had lower protein at breakfast (P = 0.01) and higher carbohydrates, total sugar, and added sugar for the day and at breakfast (P ≤ 0.03) than HBC. CONCLUSIONS SBC compared with HBC had lower fat intake, which may have contributed to the lower triglyceride level observed in SBC, but also had lower protein intake at breakfast and higher added sugar intake for the day and at breakfast. These results suggest dietary intake differed between HBC and SBC; that is, the home and school environments, but more research is needed to evaluate if such differences are due to School Breakfast Program guidelines.
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Affiliation(s)
- Matthew R Jeans
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas.
| | - Matthew J Landry
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas; Department of Pediatrics, Dell Medical Center, The University of Texas at Austin, Austin, Texas
| | - Fiona M Asigbee
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas
| | - Sarvenaz Vandyousefi
- Department of Pediatrics, Bellevue Hospital, New York University Grossman Medical Center, New York, New York
| | - Reem Ghaddar
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas
| | - Molly S Bray
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas
| | - Heather J Leidy
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas; Department of Pediatrics, Dell Medical Center, The University of Texas at Austin, Austin, Texas
| | - Jaimie N Davis
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas
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Bauer KW, Foster GD, Weeks HM, Polonsky HM, Davey A, Sherman S, Abel ML, Ruth KJ, Dale LC, Fisher JO. Breakfast in the Classroom Initiative and Students' Breakfast Consumption Behaviors: A Group Randomized Trial. Am J Public Health 2020; 110:540-546. [PMID: 32078356 PMCID: PMC7067086 DOI: 10.2105/ajph.2019.305511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To identify the effect of a Breakfast in the Classroom (BIC) initiative on the foods and drinks students consume in the morning.Methods. Sixteen public schools in Philadelphia, Pennsylvania, that provide universal breakfast participated in a group randomized trial to examine the effects of BIC with complementary nutrition promotion between 2013 and 2016. Control schools (n = 8) offered breakfast in the cafeteria before school. Baseline data were collected from 1362 students in grades 4 to 6. Endpoint data were collected after 2.5 years. Students self-reported the foods and drinks they consumed in the morning.Results. At endpoint, there was no effect of the intervention on breakfast skipping. Nearly 30% of intervention students consumed breakfast foods or drinks from multiple locations, as compared with 21% of control students. A greater proportion of intervention students than control students consumed 100% juice, and a smaller proportion consumed sugar-sweetened beverages and foods high in saturated fat and added sugar.Conclusions. A BIC initiative led to improvements in the types of foods and drinks students consumed in the morning. However, the program did not reduce breakfast skipping and increased the number of locations where students ate.
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Affiliation(s)
- Katherine W Bauer
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Gary D Foster
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Heidi M Weeks
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Heather M Polonsky
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Adam Davey
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Sandy Sherman
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Michelle L Abel
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Karen J Ruth
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Lauren C Dale
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Jennifer O Fisher
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
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Soldavini J, Ammerman AS. Serving Breakfast Free to All Students and Type of Breakfast Serving Model Are Associated with Participation in the School Breakfast Program. J Acad Nutr Diet 2019; 119:1142-1149. [PMID: 31076260 DOI: 10.1016/j.jand.2019.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/31/2019] [Accepted: 03/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Many students experience challenges participating in the School Breakfast Program (SBP) when breakfast is served before school in the cafeteria. Serving breakfast free to all students or offering innovative breakfast serving models, such as breakfast in the classroom (BIC), grab n' go, or second chance breakfast, may encourage higher SBP participation rates. OBJECTIVE To examine the association between offering breakfast free to all students as well as breakfast serving model with student participation in the SBP in October 2017 among public schools in North Carolina. DESIGN Cross-sectional study using data from the North Carolina Department of Public Instruction. PARTICIPANTS/SETTING This study included data from 2,285 North Carolina public schools who served breakfast in October 2017 with 1,445,287 students. MAIN OUTCOME MEASURES The main outcome measures are the odds of a student participating in the SBP among students overall, students eligible for free or reduced-price (FRP) meals, and students not eligible for FRP meals. STATISTICAL ANALYSES PERFORMED Multiple logistic regression assessed the association between offering breakfast free to all students and breakfast serving model with the probability of participating in the SBP (number of students participating out of number of students enrolled) for students overall, eligible for FRP meals, and not eligible for FRP meals. Statistical models were stratified by school type (elementary, middle, and high schools). RESULTS Breakfast serving models positively associated with SBP participation were BIC and BIC plus grab n' go for elementary and high school students and grab n' go and second chance for middle and high school students (P<0.05). Serving breakfast free to all students was positively associated with SBP participation alone and in combination with BIC, second chance, and BIC plus grab n' go (P<0.05). CONCLUSIONS Serving breakfast free to all students and breakfast serving model were associated with SBP participation, and different relationships existed for different school levels.
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