Serum cholesterol,fat intake,and breakfast consumption in the United States adult population.

Morgan et al demonstrated that adults who consumed ready-to-eat cereals had significantly lower fat and cholesterol intakes than those who ate other foods at breakfast. Not discussed in that study was the effect of breakfast consumption habits on serum cholesterol levels. The NHANES II study of 11,864 adults was used to both verify the Morgan et al results with a different sample and to extend that research by including serum cholesterol. The analysis disclosed that serum cholesterol levels are lowest among adults eating a breakfast that includes ready-to-eat cereal and highest among breakfast skippers.     

The role of breakfast in diet adequacy of the U.S. adult population.

Breakfast consumption patterns of the U.S. adult population were examined by using the U.S.D.A. Nationwide Food Consumption Survey. Results indicated that approximately one-quarter of the adult population skipped breakfast regularly. For those adults who consumed breakfast, the four most commonly consumed breakfasts were eggs, bread, and coffee; ready-to-eat cereal with milk; coffee and bread; and eggs, bread, and milk. The sample was partitioned by six age/sex classes and by four breakfast consumption patterns. Assessments of average intakes of seven frequently underconsumed nutrients showed that omission of the breakfast meal had a significant negative impact, particularly among adult females, on the diet quality. Findings indicated that for all age/sex classes, consumption of ready-to-eat cereal at breakfast, whether frequently or on a more limited basis, increased the average daily intake levels of the underconsumed nutrients. Further, groups of adults who regularly consumed ready-to-eat cereal at breakfast had, on average, lower average daily intakes of fat and cholesterol. It was concluded that regular breakfast consumption greatly enhanced the overall diet quality of the U.S. adult population.     

The role of breakfast in diet adequacy of the U.S. adult population

Breakfast consumption patterns of the U.S. adult population were examined by using the U.S.D.A. Nationwide Food Consumption Survey. Results indicated that approximately one-quarter of the adult population skipped breakfast regularly. For those adults who consumed breakfast, the four most commonly consumed breakfasts were eggs, bread, and coffee; ready-to-eat cereal with milk; coffee and bread; and eggs, bread, and milk. The sample was partitioned by six age/sex classes and by four breakfast consumption patterns. Assessments of average intakes of seven frequently underconsumed nutrients showed that omission of the breakfast meal had a significant negative impact, particularly among adult females, on the diet quality. Findings indicated that for all age/sex classes, consumption of ready-to-eat cereal at breakfast, whether frequently or on a more limited basis, increased the average daily intake levels of the underconsumed nutrients. Further, groups of adults who regularly consumed ready-to-eat cereal at breakfast had, on average, lower average daily intakes of fat and cholesterol. It was concluded that regular breakfast consumption greatly enhanced the overall diet quality of the U.S. adult population.     

Breakfast Consumption Patterns of Older Americans

Breakfast consumption patterns of adults ages 50 years and older were examined through utilization of the U.S.D.A. 1977-78 Nationwide Food Consumption Survey. Results indicated that adults ages 50 to 61 years skipped approximately 16 to 18 percent of possible breakfasts while those 62 years and older skipped about 9 percent of possible breakfasts. The composition and the two most commonly consumed breakfasts was: eggs, bread and coffee; bread and coffee. The sample was partitioned into four age/sex classes and within each class into four breakfast consumption patterns. Assessments of average dietary component intakes showed that omission of breakfast had a strong negative impact on diet quality. For all age/sex classes, consumption of ready-to-eat cereal at breakfast, whether frequently or on a more limited basis, increased the average daily intake of all vitamins and minerals, particularly those which have been identified as underconsumed by elderly individuals. Further, groups of adults who regularly consumed ready-to-eat cereal at breakfast had greater average daily intakes of fat and cholesterol. The authors concluded that breakfast, particularly breakfast containing ready-to-eat cereal, greatly enhanced the nutritional quality of diets of invinduals ages 50 years and older.     

The influence of ready-to-eat cereal consumption at breakfast on nutrient intakes of individuals 62 years and older

From 7-day food diaries of a cross-sectional sample of American elderly individuals (n = 561), breakfast consumption patterns were assessed and related to average daily nutrient intake patterns. Results indicated that, in general, breakfast consumption made a significant contribution to the average elderly individual's daily nutrient intake and, in particular, breakfasts containing ready-to-eat cereal had a greater impact on nutrient intake levels than did breakfasts not containing ready-to-eat cereal. More specifically, elderly individuals who had ready-to-eat cereal at breakfast 4-7 times during the week surveyed consumed significantly less (P less than or equal to 0.05) fat and cholesterol and significantly more fiber, carbohydrate, total sugar, protein, thiamin, niacin, riboflavin, vitamins B6, B12, and A, iron, calcium, phosphorus, potassium, magnesium, copper, and zinc at the breakfast meal than those who had no ready-to-eat cereal at breakfast. Fewer statistically significant differences between the two groups were evidenced when vitamin/mineral supplement usage was included in the analysis. Average daily intake levels of frequent consumers of ready-to-eat cereal were significantly (P less than or equal to 0.05) greater than those of nonconsumers for all dietary components except protein, fat, cholesterol, vitamin E, and sodium when supplement usage was excluded from the calculations. When supplements were included, significant differences between the two groups decreased to nine dietary components. Comparison of the average nutrient composition of breakfasts containing ready-to-eat cereal and those not containing ready-to-eat cereal revealed those including ready-to-eat cereal contained significantly greater quantities of all nutrients assessed regardless of whether or not vitamin/mineral supplements were included in the calculations.     

The role of breakfast in nutrient intake of 5- to 12-year-old children

From 7-day food diaries of a cross-sectional sample of American children (n = 657), breakfast consumption patterns were assessed and related to average daily nutrient intake patterns. Results indicated that few of the children skipped breakfast and that breakfast consumption made a significant contribution to the average child's daily nutrient intake. Further, children who had ready-to-eat cereals at breakfast three or more times during the 1-wk period were found to have consumed significantly less (p less than 0.001) fat and cholesterol and significantly more (p less than 0.001) fiber, thiamin, niacin, riboflavin, iron, folacin, pyridoxine, and vitamins B12, A and D than those who had no ready-to-eat cereal at breakfast. Average total daily intakes of the same groups had fewer significant differences. Comparison of the average nutrient composition of the three types of consumed breakfasts revealed that the average breakfast containing presweetened or nonsweetened ready-to-eat cereal had a higher content of sixteen nutrients and a lower content of five nutrients than did the average breakfast including no ready-to-eat cereal.     

Growth, hemoglobin, cholesterol, and blood pressure observed in rats fed common breakfast cereals.

Most of the common breakfast cereals tested were unable to support growth or promote health in young rats that consumed these products as their only food. An anemia, accompanied by fatty liver and large concentrations of iron stored in the liver, was observed with cereals having the lowest protein content. Some cereals produced a marked elevation of systolic blood pressure at certain times. Low cholesterol levels were invariably associated with fatty livers, whereas high cholesterol levels seemed to be associated with hypertension at the 45-day period. When only the ready-to-eat cereals were considered, there was a positive correlation between the dietary zinc/copper ratio and the plasma cholesterol concentration.     

Breakfast type, daily nutrient intakes and vitamin and mineral status of French children, adolescents, and adults

OBJECTIVE: To examine associations between the consumption of different types of breakfasts, dietary intakes, and selected indices of nutritional status. METHODS: Dietary intakes were obtained using the dietary history method, and serum bioassays were used to assess vitamin and mineral status in a representative community-based sample of 1108 French children (ages 2 to 10 years), adolescents (ages 10 to 18 years), and adults (ages 18 to 65 years). Breakfasts were divided into three categories: low-energy (<15% of the energy RDA), medium-energy (15-25%) and high-energy (>25%). RESULTS: High-energy breakfasts were associated with the consumption of ready-to-eat (RTE) cereals. High-energy breakfasts and cereal consumption, both more common among children and adolescents than among adults, were also associated with a greater proportion of daily energy from carbohydrate and lower proportion of energy from fat. High-energy breakfasts and cereal consumption were further associated with higher intakes of vitamins and minerals as measured by percent RDAs. High-energy breakfasts and cereal consumption were associated with lower serum cholesterols and improved biochemical indices of nutritional status. Serum concentrations of vitamin B1 (in children and adolescents), vitamin B2 and beta-carotene (in adults) were significantly linked to the level of energy provided by breakfast. CONCLUSION: The consumption of breakfast cereals appears to have a positive impact on nutritional status regardless of age.     

Differences in food patterns at breakfast by sociodemographic characteristics among a nationally representative sample of adults in the United States

BACKGROUND: Eating breakfast is considered an important determinant of a healthy lifestyle. This study explores the different food patterns of breakfast for adults aged 18-65 in the United States. METHODS: Data are from the 1994-1996 Continuing Survey of Food Intake by Individuals, n = 15,641. Dietary assessment method used was the 24-h recall. Nutrient differences among the breakfast food patterns as well as the sociodemographic characteristics of individuals following each eating pattern are examined. RESULTS: The primary food patterns were based on consumption of eggs (15.3% of adults), ready-to-eat cereals (17.4%), bread (21.7%), cooked cereal (4.4%), fruit and fruit juice (5.5%), and coffee, soft drinks, and high-fat desserts (15.1%). Seventeen and three-tenths percent of the adults skipped breakfast. These food patterns provide remarkably different nutrient profiles adjusting for energy intake. The egg pattern is highest in total fat, lowest in fiber density, and low in iron and calcium density. In contrast, the ready-to-eat cereal pattern is high in fiber, highest in calcium density, and very low in fat. Breakfast food patterns differ markedly by various sociodemographic factors such as gender, ethnicity, and educational level. CONCLUSION: Different segments of our population consume different types of foods at breakfast, contributing to differences in their nutrient intakes.     

Folate status in women of childbearing age,by race/ethnicity--United States, 1999-2000

In September 1992, the U.S. Public Health Service (PHS) recommended that women of childbearing age (i.e., aged 15-44 years) who are capable of becoming pregnant should consume 400 microg of the B-vitamin folic acid to reduce the number of cases of spina bifida and anencephaly (neural tube defects [NTDs]). Since then, an ongoing national effort has encouraged women to consume dietary supplements containing folic acid. In 1998, the Food and Drug Administration (FDA) required the fortification of enriched cereal grain products with folic acid, and manufacturers have voluntarily added more folic acid to many ready-to-eat breakfast cereals (CDC, unpublished data, 2002). To assess temporal changes in serum and red blood cell (RBC) folate concentrations among childbearing-aged women, CDC compared folate concentrations for childbearing-aged women who participated during 1988-1994 and 1999-2000 in the National Health and Nutrition Examination Survey (NHANES). This report outlines the results of this comparison and describes serum and RBC folate levels by race/ethnicity. The results indicate that over the period studied, the median serum folate concentration for women aged 15-44 years increased approximately threefold, and the median RBC folate concentration increased approximately twofold. These findings indicate that the national health objective for 2010 to increase the median RBC folate level among women of childbearing age to 220 ng/mL RBC (objective 16.16b) has been met for Mexican-American and non-Hispanic white women but not for non-Hispanic black women. To reduce the number of pregnancies affected by NTDs further, all women of childbearing age capable of becoming pregnant should consume the PHS-recommended level of folic acid daily.     

Serum zinc and serum lipid profiles in 778 adults

There has been increasing use of high-dosage zinc supplementation in the population, in particular as a potential treatment for age-related macular degeneration. We examined the relationship between fasting serum zinc and serum lipid levels in 778 adults, aged 22 to 80 years, who were control subjects in a multicenter, clinic-based case-control study. The samples were taken during 1987 to 1990, a time when vitamin/mineral supplementation was becoming increasingly common. We found that higher serum zinc levels, most notably those above the highest quintile, were associated with higher levels of total serum cholesterol, low-density-lipoprotein cholesterol, and triglycerides. No significant trend was noted for high-density-lipoprotein cholesterol. Previous studies demonstrated that high-dosage zinc supplements raise serum zinc levels. The possibility that use of such supplements can adversely affect serum lipid profiles suggests that chronic ingestion of such supplements should not be done without adequate medical supervision.     

The effect of breakfast cereal on diet and serum cholesterol: a randomized trial in North Karelia, Finland.

OBJECTIVE: To test the hypothesis that a high carbohydrate breakfast with breakfast cereal leads to a meaningful reduction in dietary energy intake from fat, especially from saturated fat, and thus lower serum cholesterol levels. DESIGN: An open randomized controlled cross-over trial. The subjects were randomized into intervention breakfast cereal or usual breakfast (control) groups. SETTING: Free-living subjects aged 29-71 y in Eastern Finland SUBJECTS: 224 enrolled, 209 completed the study. The subjects were recruited from a survey of a random population sample and from other sources, and their serum cholesterol was not lower than 5.0 mmol/l. Recruited persons did not have any chronic disease or very low saturated fat intake. INTERVENTION: The cereal group consumed 80 g (men) or 60 g (women) cereal at breakfast and the control group continued their usual dietary habits for six weeks. After a wash out of six weeks, a cross-over with another six week trial period took place. Measurements (including serum samples and a 3 d food record) took place before and after the two trial periods. RESULTS: The intervention period led to 2.5 en% (energy percent units) reduction in saturated fatty acids intake. The reduction in total fat intake was 5.5 en%. This was compensated for by increased intake of carbohydrates. The reduction in saturated fatty acids intake led to modest (but in group 1 significant) 0.15 mmol/l (2.5%) reduction in total serum cholesterol level. CONCLUSIONS: The trial showed that regular cereal breakfast can lead to reduced intake of total and saturated fatty acids of the daily diet and consequently to reduction in serum cholesterol level.     

Iron and folate in fortified cereals.

BACKGROUND: Fortification of cereal-grain products was introduced in 1941 when iron and three vitamins were added to flour and bread. Ready-to-eat cereals were fortified at about the same time. These fortifications have contributed to increased dietary iron intake and reductions in iron deficiency anemia in the US. In 1996, FDA finalized rules for fortification of specific enriched cereal-grain products with folic acid. This measure was instituted to increase the folate intakes of women of child-bearing age and thereby reduce the risk of having a pregnancy affected with a neural tube birth defect. However, with recent increases in fortification, public health officials in the US are concemed that excess intake of specific nutrients such as iron and folic acid may result in toxic manifestations. OBJECTIVE: Our objective was to measure iron and total folate content in breakfast cereals and compare assay to label values for % Daily Value. We also determined by weight the amount of a ready-to-eat breakfast cereal adults would eat and compared this to the labeled serving size, for which the reference amount for this cereal per eating occasion was 1 cup or 30 g. DESIGN: Twenty-nine breakfast cereals were analyzed for iron content using the bathophenanthroline reaction. Twenty-eight cereals were analyzed for total folate, utilizing a microbiological assay with tri-enzyme digestion. Serving size quantities were estimated in seventy-two adults who regularly ate breakfast cereal and were asked to fill a 16 or 22 cm round bowl with the amount of cereal that they would consume for breakfast. RESULTS: When the labeled value was compared to the assayed value for iron content 21 of the 29 breakfast cereals were 120% or more of the label value and 8 cereals were 150% or more of the label value. Overall, analyzed values for iron ranged from 80% to 190% of label values. Analyzed values for folate ranged from 98% to 320% of label values. For 14 of 28 cereals, analyzed values exceeded label declarations by more than 150%. Bran-containing cereals contained the highest amounts of folate relative to their label declarations. The median analyzed serving size for the breakfast cereal was 47 g for females, 61 g for males with a combined median of 56 g as compared to the label value of 30 g. CONCLUSIONS: Analyzed values of iron and folic acid in breakfast cereals were considerably higher than labeled values. For adults, the amount of cereal actually consumed was approximately 200% of the labeled serving size. When the quantity of cereal consumed is more than the labeled serving size and when the levels of iron and folate are higher than declared, the intake of both will be significantly greater than the labeled values. It will be important to continue monitoring serum ferritin and folate levels in NHANES IV, since daily consumption of breakfast cereals may contribute to excessive intakes of iron and folate.     

Lipid responses to consumption of a beta-glucan containing ready-to-eat cereal in children and adolescents with mild-to-moderate primary hypercholesterolemia

This trial evaluated the efficacy of a ready-to-eat cereal containing beta-glucan, incorporated into a low saturated fat and cholesterol diet, for reducing LDL cholesterol levels in children and adolescents with mild-to-moderate primary hypercholesterolemia. Following diet lead-in and baseline assessment phases, 29 subjects (aged 6-14 years) were randomized to either control cereal or ready-to-eat cereal that provided 3 g/d of beta-glucan, for four weeks. Subjects then received the alternate product for an additional four weeks. Among subjects who were at least 80% compliant (n = 18), total and soluble dietary fiber intakes increased significantly (26.7%, p = 0.01 and 30.8%, p = 0.02, respectively) and LDL cholesterol was reduced by a mean of 5.3% (p = 0.03). The reduction in LDL cholesterol appeared to be most pronounced (9.2%, p = 0.001) among those with body mass index below the median (25.7 kg/m²). Thus, consumption of a beta-glucan containing cereal modestly lowers cholesterol levels in hypercholesterolemic children and adolescents.     

Disparities in screening for and awareness of high blood cholesterol--United States, 1999-2002

High blood cholesterol is a major modifiable risk factor for atherosclerotic cardiovascular disease. Two national health objectives for 2010 are to reduce to 17% the proportion of adults with high total blood cholesterol levels and to increase to 80% the proportion of adults who had their blood cholesterol checked during the preceding 5 years. In addition, an overall national health objective is to eliminate racial/ethnic and other disparities in all health outcomes. During 1960-1994, total blood cholesterol levels among the overall U.S. population declined; however, levels have changed little since then, despite increases in cholesterol screening and awareness. To assess racial/ethnic and other disparities among persons who were screened for high blood cholesterol during the preceding 5 years and among persons who were aware of their high blood cholesterol, CDC analyzed data from the 1999-2000 and 2001-2002 National Health and Nutrition Examination Surveys (NHANES). This report summarizes the results of that analysis, which indicated that Mexican Americans, blacks, and younger adults were less likely to be screened for high blood cholesterol, and persons in those populations who had high cholesterol were less likely to be aware of their condition. Efforts are needed to encourage persons, especially among these populations, to seek screening and gain awareness of high blood cholesterol.     

The combination of daily breakfast consumption and optimal breakfast choices in childhood is an important public health message

The aim of this study was to investigate the association of breakfast consumption with children’s diet quality and cardiometabolic risk factors. Study sample consisted of 1558 children aged 4–8 years from Cyprus. Breakfast frequency was assessed through a parental questionnaire. Body mass index (BMI), BMI z-scores, waist circumference, blood lipid profile and blood pressure were examined in relation to breakfast frequency consumption. Habitual breakfast consumers’ daily nutrient intake was assessed through a 24-Hour Dietary Recall, according to their breakfast choices. Girls who have breakfast on a daily basis had lower mean BMI and BMI z-score; they were also less likely of having abnormal levels of serum triglycerides, atheromatic index (total cholesterol to high density lipoprotein-cholesterol ratio) and diastolic blood pressure after controlling for several confounding factors. Within regular breakfast consumers, of both boys and girls, those having ready to eat cereals had a superior nutrient intake profile. Daily breakfast consumption along with good breakfast choices is an important public health message for Cypriot children.     

The Relationship of Ready-to-Eat Cereal Consumption to Nutrient Intake, Blood Lipids, and Body Mass Index of Children as They Age through Adolescence

Objective

To examine sex differences and longitudinal changes in ready-to-eat (RTE) cereal and breakfast consumption in the Dietary Intervention Study in Children, and the relationship between RTE cereal intake with nutrient intake, blood lipids, and body mass index (BMI).

Design

Secondary analyses based on data from Dietary Intervention Study in Children, a randomized, controlled, multicenter, clinical trial with five sets of three 24-hour recalls.

Subjects/setting

Children (n=660) from six clinics aged 8 to 10 years at study entry. Participants had serum low-density lipoprotein cholesterol levels between the 80th and 98th percentiles for age, and were followed for a mean of 7.5 years.

Intervention

Children were randomized to a total fat- and saturated fat-modified dietary intervention or usual care.

Statistical analyses

Frequency of RTE cereal and breakfast consumption was examined by sex and age. Mixed models by sex were used to examine the relationship of RTE cereal consumption to average daily intake of nutrients, blood lipids, and BMI.

Results

For all children, RTE cereal and breakfast consumption declined with age. Boys consumed RTE cereal more often compared with girls. Except for energy, RTE cereal consumption was positively associated with all measures of nutrients for both sexes. In boys, higher RTE cereal consumption was associated with lower total and low-density lipoprotein cholesterol levels and lower BMI.

Conclusions

Food and nutrition professionals should continue to educate youth and their parents on the nutritional benefits of routinely eating RTE cereal.     

Breakfast consumption patterns of U.S. children and adolescents

The Nationwide Food Consumption Survey was used to evaluate the breakfast consumption patterns of the U.S. child and adolescent population. Results indicated that breakfast skipping increased with age and was most prevalent among female adolescents. The sample was partitioned into four age/sex classes and by breakfast consumption patterns. The most popular breakfasts consumed by the sample populations were identified. Analyses of average dietary component intake levels of seven identified problem nutrients, i.e., pyridoxine, vitamin A, iron, calcium, magnesium, copper and zinc showed that omission of breakfast had a strong negative impact, particularly among female adolescents, on the quality of diets. Individuals who consumed readyto-eat (RTE) cereal at breakfast on a somewhat frequent basis had higher average daily intakes of the problem nutrients as well as higher average daily total sugars intakes. Highest average daily cholesterol intakes were evidenced for breakfast consumers not eating RTE cereal. No consistent relationship between breakfast consumption patterns and total daily intakes of fat and sodium were found. It was concluded that breakfast, particularly breakfasts containing RTE cereal, made a valuable contribution to the nutritional quality of the diets of children and adolescents.     

Possible effects of diets on serum lipids,fatty acids and blood pressure levels in male and female Japanese university students

Objectives  To prepare a dietary recommendation for young Japanese for the prevention of coronary heart disease, we surveyed the dietary habits, serum lipids, serum fatty acids and blood pressure levels among male and female students. Methods  In this study, 175 male and 246 female university students were interviewed for the frequency of consumption of selected food items and the habit of skipping breakfast. Serum fatty acids were analyzed by gas chromatography. Results  The frequencies of consumption of dishes cooked with oil and intake of vegetables were higher in female students than in male students. Serum n-6 polyunsaturated fatty acids were slightly higher in females students than in male students while that of serum n-3 polyunsaturated fatty acids was 6.4% in both sexes. For both males and females, those who skipped breakfast at least once a week were less likely to consume vegetables and fruits than those who did not. Female students who skipped breakfast were also less likely to consume fish and had lower composition of n-3 polyunsaturated fatty acid and higher systolic and diastolic blood pressure levels than males. For female, the intake of milk and dairy products correlated inversely with systolic blood pressure levels and the intake of n-3 polyunsaturated fatty acids correlated inversely with diastolic blood pressure levels. For males, the intake of fruits and consumption of dishes cooked with oil correlated inversely with systolic and diastolic blood pressure levels. Conclusion  Our findings suggest that increased intake of fish, milk and dairy products, fruits and vegetables from early adulthood and a regular dietary pattern are important to reduce the risk factors for coronary heart disease.     

Adverse influences of alcohol, tobacco, and oral contraceptive use on cardiovascular risk factors during transition to adulthood

Risk factors for cardiovascular disease were measured in 990 young adults, aged 17-24 years, in a 1982-1983 survey of the biracial (black-white) community of Bogalusa, Louisiana. Even after controlling for age and obesity, several lifestyle factors (cigarette smoking, alcohol consumption, and oral contraceptive use) were independently related (p less than 0.05) to levels of serum lipids, lipoprotein cholesterol fractions, and blood pressure. Oral contraceptive use was associated with increased levels of both serum triglycerides (20 mg/dl, blacks; 25 mg/dl, whites) and low density lipoprotein (LDL) cholesterol (19 mg/dl, whites), and decreased levels of high density lipoprotein (HDL) cholesterol (-6 mg/dl, whites). Linear regression analyses also showed that cigarette smoking was associated with elevated levels of serum triglycerides (ranging from 15 to 26 mg/dl) and decreased levels of HDL cholesterol (ranging from -9 to -11 mg/dl) in white males and females. Although persons who smoked cigarettes were also likely to consume alcohol, alcohol intake in nonsmokers was positively associated with levels of serum triglycerides, LDL cholesterol, and very low density lipoprotein cholesterol in white males, and with blood pressure levels in black males. A statistically significant association between alcohol intake and HDL cholesterol levels (r = 0.24) was observed only in white females who did not smoke. These adverse influences of lifestyle factors on cardiovascular disease risk may provide a rational basis for intervention during adolescence and early adulthood.