Eating breakfast and its impact on children's daily diet

Objective: To describe the impact of breakfast eating on the nutrient intakes of New Zealand children aged 5–14 years. Design: Secondary data analysis of a cross‐sectional national survey. Subjects: A total of 3275 children aged 5–14 years. Setting: Dietary data were collected primarily in the homes of the children. Main outcome measures: ‘Breakfast consumption’ was based on whether any food items were consumed between 6 and 9 a.m. from 24‐hour diet recall data. Nutrient intake was also based on 24‐hour diet recall. Data analyses: Demographic profile of breakfast eaters was determined. Difference in daily nutrient intakes between breakfast and non‐breakfast eaters was determined. Results: In total, 84% of New Zealand children reported eating breakfast. Younger children were more likely to eat breakfast than older children. Breakfast habits differed between Māori, Pacific and ‘New Zealand European & Others’ children. When intakes were adjusted for the demographic variables that significantly affected breakfast consumption patterns, daily nutrient intake of children who ate breakfast compared with those who did not, was significantly better. This was true for all ethnic groups. Cereal (including cold, ready‐to‐eat and cooked) was the most common breakfast food. Conclusion: Although the majority of New Zealand children consume breakfast, a significant improvement in daily nutrient intake could be achieved for children of all ethnic groups who currently do not consume breakfast.     

The contribution of ready-to-eat cereals to daily nutrient intake and breakfast quality in a Mediterranean setting

OBJECTIVES: To examine if and how ready-to-eat cereals (RTEC) contribute to the quality of the diet of children, adolescents and young adults in a Mediterranean setting. METHODS: A random sample of 3534 subjects aged 2 to 24 years in Spain was studied. Food and nutrient intakes were determined by a 24 hour recall. RTEC consumption was assessed by a quantitative food frequency questionnaire. Additional questions on socioeconomic level and nutritional knowledge were administered. Cereal consumption was classified into non-consumers and daily intakes between 1 and 20g, 21 and 40g, and more than 40g. After excluding the underreporters the final sample consisted of 2852 individuals. RESULTS: About half of the population (49.8%) reported eating RTEC. Macronutrient profile improved with increasing cereal consumption. Intakes of thiamine, riboflavin and vitamin B6 increased significantly with increasing consumption of RTEC in all age-sex groups, whereas niacin and folate intake improved in almost all groups and calcium, iron and vitamin D in at least half of the groups. Except for magnesium, vitamin B12 and vitamin E in males, consumption of RTEC was significantly associated with increased coverage of the daily nutrient requirements for all micronutrients studied. Higher levels of RTEC consumption was associated with a greater consumption of dairy products, and related to better breakfast quality. CONCLUSIONS: Level of RTEC consumption is associated with a better nutritional profile in the diets of Spanish children, adolescents and young adults and a lower risk for inadequate micronutrient intakes. RTEC consumers have better quality breakfasts, in terms of both food choices as well as energy and nutrient content.     

The role of breakfast cereals in the diets of 16–17-year-old teenagers in Britain

Dietary data was collected from almost 5000 16–17-year-old teenagers throughout Britain using 4-day unweighed dietary diaries. The data was quantitatively coded and analysed to investigate the role of breakfast cereals in the diets of teenagers. The total daily nutrient intakes of consumers and non-consumers of breakfast cereals have been examined, by both frequency of cereal consumption and type of cereal consumed. Using generalized linear-modelling techniques, the relationships between nutrient intake, region, social class, frequency of breakfast cereal consumption and type of cereal consumed were investigated. Regular consumption of any type of breakfast cereal was associated with a significantly lower intake of fat when expressed as a percentage of energy intake, having allowed for regional or social-class differences. Non-consumers of breakfast cereals had significantly lower intakes of some micronutrients and a significant proportion of those who ate no breakfast cereal failed to achieve the reference nutrient intakes for riboflavin, vitamin B₆ and folates. The consumption of breakfast cereals appears to be associated with an increased intake of micronutrients amongst teenagers in Britain, and while these associations may be due to the cereals (and milks consumed with them), they may also be due to the effect that eating cereals has on subsequent feeding during the day. However, this may be important amongst those consuming diets lower in energy or high in foods of low-micronutrient density.     

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.     

The contribution of breakfast to micronutrient adequacy of the Irish diet

A 7-day diet history was completed by 1213 subjects in Ireland between the ages of 8 and 80 years. Subjects were divided into breakfast skippers, cereal eaters or non-cereal eaters.
Ninety-seven per cent of the population ate breakfast. Sixty-eight per cent were breakfast-cereal consumers and of these 62% ate breakfast six to seven times per week. The contribution which breakfast cereal makes to the total daily nutrient intake was calculated for males and females separately, and also for the two age-groups 8–18 years and >18 years. Iron intakes were lower than the RNI for all females but cereal consumers appeared more likely to achieve their RNI than breakfast skippers and non-cereal consumers. Breakfast-cereal consumers had significantly higher intakes of vitamins B, B₁₂, niacin, folate, B₁₂, vitamin D, calcium and iron. For females not consuming a breakfast cereal, mean nutrient intakes of folate and calcium were lower than the RNI. From this study, it appears that breakfast cereal consumption makes a significant contribution to nutrient intake in the Irish diet.     

Body mass,frequency of eating and breakfast consumption in 9–13‐year‐olds

Background: Unhealthy eating patterns in childhood can lead to adverse health conditions, particularly obesity. However, debate remains around the precise eating behaviours that lead to these conditions. The present study aimed to address this lack of evidence by reporting on the eating frequency, breakfast consumption and body mass index (BMI, kg m^–2) of youth in the UK. Methods: A total of 264 (133 boys and 131 girls) participants, aged 10–13 years, completed self‐report measures of dietary intake via 3‐day food/drink diaries (Friday to Sunday). Trained researchers recorded height and weight to calculate the BMI. Diaries were analysed using dietplan 6 nutritional analysis software (Forestfield Software, Horsham, UK) and multivariate linear regression was used to examine any association between breakfast consumption, frequency of eating and BMI. Results: No relationship existed between BMI Z‐score, eating frequency and breakfast consumption. However, frequent breakfast consumers had significantly lower mean (SD) BMI Z‐scores [0.18 (1.06) versus 0.57 (1.23)] and higher intakes of iron, calcium and vitamin E than those who did not eat breakfast regularly. Those aged ≥11 years consumed breakfast less frequently [0.92 (0.20)] and were less likely to eat regularly [4.6 (1.4)] than those aged ≤10 years. Conclusions: Older boys were the least likely to eat regularly and the least likely to consume breakfast. Promoting the importance of regular eating, particularly breakfast consumption to these boys, may be essential to ensure healthier, long‐term eating patterns. Furthermore, the lower breakfast intakes in 11–13‐year‐olds and higher BMI Z‐scores of those who did not eat breakfast regularly should be monitored.     

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 relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study

OBJECTIVE: To describe changes in breakfast and cereal consumption of girls between ages 9 and 19 years, and to examine the association of breakfast and cereal intake with body mass index (BMI) and consumption of nutrients. DESIGN: Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal biracial observational cohort study with annual 3-day food records. SUBJECTS/SETTING: The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 black), ages 9 and 10 years at baseline, from locations in the Berkeley, CA; Cincinnati, OH; and Washington, DC, areas. MAIN OUTCOME MEASURES: Frequency of consumption of breakfast (including cereal vs other foods) and cereal; BMI; and dietary fat, fiber, calcium, cholesterol, iron, folic acid, vitamin C, and zinc. STATISTICAL ANALYSES: Generalized estimating equations methodology was used to examine differences in the frequency of breakfast and cereal eating by age. Generalized estimating equations and mixed models were used to examine whether breakfast and cereal consumption were predictive of BMI and nutrient intakes, adjusting for potentially confounding variables. RESULTS: Frequency of breakfast and cereal consumption decreased with age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. After adjusting for energy intake, cereal consumption was related to increased intake of fiber, calcium, iron, folic acid, vitamin C, and zinc, and decreased intake of fat and cholesterol. Days eating cereal was predictive of lower BMI. CONCLUSIONS: Cereal consumption as part of an overall healthful lifestyle may play a role in maintaining a healthful BMI and adequate nutrient intake among adolescent girls.     

The effect of breakfast type on total daily energy intake and body mass index: results from the Third National Health and Nutrition Examination Survey (NHANES III)

OBJECTIVE: The objective of this study was to investigate the relationship between breakfast type, energy intake and body mass index (BMI). We hypothesized not only that breakfast consumption itself is associated with BMI, but that the type of food eaten at breakfast also affects BMI. METHODS: Data from the Third National Health and Nutrition Examination Survey (NHANES III), a large, population-based study conducted in the United States from 1988 to 1994, were analyzed for breakfast type, total daily energy intake, and BMI. The analyzed breakfast categories were "Skippers," "Meat/eggs," "Ready-to-eat cereal (RTEC)," "Cooked cereal," "Breads," "Quick Breads," "Fruits/vegetables," "Dairy," "Fats/sweets," and "Beverages." Analysis of covariance was used to estimate adjusted mean body mass index (BMI) and energy intake (kcal) as dependent variables. Covariates included age, gender, race, smoking, alcohol intake, physical activity and poverty index ratio. RESULTS: Subjects who ate RTEC, Cooked cereal, or Quick Breads for breakfast had significantly lower BMI compared to Skippers and Meat and Egg eaters (p < or = 0.01). Breakfast skippers and fruit/vegetable eaters had the lowest daily energy intake. The Meat and Eggs eaters had the highest daily energy intake and one of the highest BMIs. CONCLUSIONS: This analysis provides evidence that skipping breakfast is not an effective way to manage weight. Eating cereal (ready-to-eat or cooked cereal) or quick breads for breakfast is associated with significantly lower body mass index compared to skipping breakfast or eating meats and/or eggs for breakfast.     

Efficiency of breakfast consumption patterns of ninth graders: nutrient-to-cost comparisons

OBJECTIVE: To assess the efficiency of breakfast consumption patterns in terms of nutrient-to-cost comparisons. DESIGN: Twenty-four-hour dietary recalls were collected and food items named were priced (prices from local grocery stores and restaurants were averaged). Three breakfast consumption groups were identified: restaurant foods (fast foods), ready-to-eat (RTE) cereal, and other foods. SUBJECTS: Subjects consisted of 567 ninth-grade students (57% female, 86% white, mean age 14.8 years) in New Orleans, La. STATISTICAL ANALYSES: Analysis of variance techniques were used to test statistical significance for total nutrient intake levels, intake levels of nutrients per 1,000 kcal, and nutrient intake levels per dollar spent. Groupings were determined using the Duncan test or pairwise comparisons. RESULTS: Five percent of students ate a fast-food breakfast, 30% ate RTE cereal, and 65% ate other breakfasts. The mean cost of the breakfast meals was significantly (P<.0001) higher for the fast-food breakfast than for the RTE cereal breakfast and the other breakfast (fast>other=RTE). For every dollar spent, the RTE cereal and other breakfasts provided significantly more energy, carbohydrate, fiber, sugar, and protein than the fast-food breakfast. The other breakfast provided significantly (P<.001) more total and saturated fat per dollar than the fast-food or RTE cereal breakfasts. The RTE cereal breakfast provided significantly (P<.001) more, per dollar spent, of folic acid, iron, niacin, vitamins A and D, and zinc than the other 2 breakfast meals. APPLICATIONS: The importance consumers place on taste, cost, and convenience continues to influence types of foods consumed. Yet, their food choices may not be as efficient in terms of the nutrients obtained per dollar spent. With the increasing demands being placed on families and the decreasing amount of time being spent on food preparation, nutrition education programs should continue to promote a higher level of efficient food choices.     

At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors

OBJECTIVE: The evidence supporting the relationship between breakfast consumption and body weight is growing, but the mechanisms to explain this relationship are less understood. This study aims to describe the relationship between breakfast consumption and body mass index (BMI) and relevant nutrition behaviors. DESIGN: Cross-section design using the New Zealand's 2002 National Children's Nutrition Survey. Participants were interviewed about their food habits and physical activity, completed a food frequency questionnaire, and were weighed and measured for height. SUBJECTS/SETTING: A nationally representative sample of 3,275 children aged 5 to 14 years. MAIN OUTCOME MEASURES: Breakfast consumption, BMI, and nutrition behaviors. STATISTICAL ANALYSES PERFORMED: The demographic characteristics of children by breakfast consumption were generated by cross-tabulations. Regression models were used to examine the relationships between breakfast consumption and BMI and nutrition behaviors. RESULTS: Breakfast consumption was most frequent among boys, children aged 5 to 6 years, children aged 7 to 10 years, New Zealand European children, and children from more affluent neighborhoods. Age differences in breakfast consumption increased with socioeconomic deprivation; older children experiencing the most socioeconomic deprivation were the least likely to eat breakfast. Skipping breakfast was associated with a higher BMI (P=0.002). Children who missed breakfast were significantly less likely to meet recommendations for fruit and vegetable consumption (P=0.005) and more likely to be frequent consumers of unhealthy snack foods. No relationship was found between breakfast consumption and physical activity. DISCUSSION: Results from our study suggest that efforts to increase breakfast consumption should be prioritized for older children from more deprived backgrounds. Increasing at home breakfast consumption may limit the amount of unhealthful snack foods children consume later in the day. Schools also have the potential to make a reasonable nutritional impact by providing healthful and affordable breakfast options for children who do not eat breakfast at home.     

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

OBJECTIVE: To test the hypothesis that breakfast consumption is associated with weight status measured by body mass index in US adults. DESIGN: Analyses of data from the National Health and Nutrition Examination Survey, 1999-2000. PARTICIPANTS/SETTING: Men and women aged > or = 19 years (N=4,218), excluding pregnant and/or lactating women. STATISTICAL ANALYSES PERFORMED: SAS (release 8.1, 2000, SAS Institute Inc, Cary, NC) and SUDAAN (release 8.0.2, 2003, Research Triangle Institute, Research Triangle Park, NC) software were used to calculate sample-weighted means, standard errors, and population percentages of breakfast consumers. Multiple logistic and linear regression models, with controls for covariates, were used to determine the predictability of body mass index from breakfast consumption and from inclusion of ready-to-eat cereal (RTEC) in the breakfast meal. RESULTS: Breakfast consumers were more likely than breakfast nonconsumers to be older, female, white, nonsmokers, regular exercisers, and trying to control their weight. For women, daily energy intake was higher among breakfast consumers than among breakfast nonconsumers; for both men and women, energy intake from fat among RTEC breakfast consumers was significantly lower than among non-RTEC breakfast consumers, whereas energy from carbohydrate among RTEC breakfast consumers was significantly higher than among non-RTEC breakfast consumers. For women, the odds ratios for BMI > or = 25 were lower for breakfast consumers (odds ratio = 0.76) and RTEC breakfast consumers (odds ratio = 0.70) compared with breakfast nonconsumers and non-RTEC breakfast consumers, respectively, after adjusting the models for covariates. When RTEC consumption was added as a covariate, breakfast consumers no longer exhibited significantly lower odds ratios compared with breakfast nonconsumers. Furthermore, regression analyses supported an inverse association between RTEC breakfast consumption and body mass index in women (regression coefficient = -0.37, P<.01) after adjusting for covariates. CONCLUSIONS: When we document the association of breakfast consumption with lower prevalence of overweight and obesity, types of meal should be considered as an important determinant. RTEC breakfast consumption, associated with a desirable macronutrient profile for preventing obesity, predicted weight status in women, but not in men. In addition to sex difference in the association of breakfast consumption and RTEC breakfast consumption with lower prevalence of overweight, the effects of physiological variables and health-related behaviors on the relationship between total and RTEC intake at breakfast and weight status, remain to be established.     

Are people who regularly eat breakfast cereals slimmer than those who don’t? A systematic review of the evidence

Summary There is growing evidence that people who eat breakfast regularly tend to be slimmer than those who skip breakfast. However, this is not a consistent finding and it is not true for all types of breakfast. Also the relationship with breakfast can disappear in studies when adjusted for breakfast cereal consumption, suggesting it is breakfast cereal that is driving the association. This systematic review, therefore, looked specifically at the relationship between breakfast cereal consumption and weight. A systematic search of the literature identified nine references looking at the relationship between the consumption of breakfast cereals and BMI as an outcome measure. Five of the nine included studies were in adults. These studies consistently showed that people who eat breakfast cereals regularly tend to have a lower BMI and are less likely to be overweight than those who do not eat breakfast cereals regularly. Although not all of the results were statistically significant, they all point in the same direction. There was no evidence that regular breakfast cereal consumers have lower daily energy intakes than infrequent consumers. Four of the nine included studies were in children. As for adults, the evidence from the included studies is consistent that children who eat breakfast cereals regularly tend to have a lower BMI and are less likely to be overweight than those who eat breakfast cereals infrequently. There was no evidence that children who consume breakfast cereals regularly have lower energy intakes than infrequent cereal consumers. This systematic review considered whether the relationship between breakfast cereal consumption and weight is likely to be mediated either through lower energy intakes or higher energy expenditures. We found no clear evidence for this or for any other proposed mechanism. The relationship could arise out of confounding by lifestyle factors. There is consistent evidence of an association between breakfast cereal consumption and a healthy weight, but limited evidence for any proposed mechanism that would point to it being a causal relationship.     

The Relationship of Breakfast Skipping and Type of Breakfast Consumption with Nutrient Intake and Weight Status in Children and Adolescents: The National Health and Nutrition Examination Survey 1999-2006

Background

National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited.

Objective

To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status.

Subjects

Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339).

Design

Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006.

Methods

Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferroni's correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers.

Results

Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index ≥95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05).

Conclusions

RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents.     

Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes

Our aim was to evaluate adherence to the Mediterranean diet (MedDiet) among children and adolescents with type 1 diabetes (T1D) in relation to metabolic control. Adherence to the MedDiet was assessed with the Mediterranean Diet Quality Index (KIDMED) questionnaire and physical activity by the International Physical Activity Questionnaire for Adolescent (IPAQ-A) on 65 subjects (32 males, 9–18 years) with T1D. Clinical and metabolic evaluation was performed (standardized body mass index (BMI-SDS), hemoglobin A1C (HbA1c), continuous glucose monitoring metrics when present, blood pressure, lipid profile). Parental characteristics (age, body mass index (BMI), socio-economic status) were reported. The adherence to the MedDiet was poor in 12.3%, average in 58.6%, and high in 29.1% of the subjects. Furthermore, 23.4% of patients were overweight/obese. The most impacting factors on BMI-SDS were skipping breakfast and their father’s BMI. HbA1c and time in range % were positively associated with sweets and fish intake, respectively. Additionally, the father’s socio-economic status (SES) and mother’s age were associated with glucose control. Blood pressure was associated with travelling to school in vehicles, extra-virgin olive oil intake and milk/dairy consumption at breakfast. The promotion of the MedDiet, mainly having a healthy breakfast, is a good strategy to include in the management of T1D to improve glucose and metabolic control. This research is valuable for parents to obtain the best results for their children with T1D.     

Where do Australian children get their dietary fibre? A focus on breakfast food choices

Aims: There is little data in Australian children assessing dietary fibre intakes or ready‐to‐eat cereal consumption. The aims were to: (i) assess the dietary fibre intake of 2‐ to 16‐year‐old children from the 2007 Australian National Children's Nutrition and Physical Activity Survey; (ii) determine the percentage of children meeting adequate fibre intake; and (iii) determine the contribution of breakfast and ready‐to‐eat cereal fibre intake. Methods: Secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity Survey. Results: On the day of the survey, the mean (SE) dietary fibre intake among all children at breakfast was 4.5 (0.1) g and total daily fibre intake was 20.7 (0.2) g. Fibre adequacy was achieved by 50% of Australian children. Forty‐nine percent of all children consumed ready‐to‐eat cereal, providing 2/3 of fibre intake at breakfast and 1/10 of total daily fibre intake. Consuming ready‐to‐eat cereal was a significant predictor of total daily fibre intake (β= 0.028). Over 60% of all children consumed ready‐to‐eat cereal in which at least a ‘source’ of fibre (1.5–3.0 g) was available; however, <10% of children consumed ready‐to‐eat cereal containing a ‘very high source’ of fibre (≥6.0 g). Conclusions: While ready‐to‐eat cereal was only consumed by close to half of all children, it was a significant contributor of fibre at both the breakfast meal occasion and over the whole day. Randomised controlled trials are necessary to identify whether increasing consumption of fibre from ready‐to‐eat cereal alters health outcomes such as anthropometric and biochemical end points.     

Ready-to-eat breakfast cereal consumption enhances milk and calcium intake in the US population

BACKGROUND: Inadequate intake of calcium-rich foods among US adults and children is a public health concern. Fluid milk is one of the best calcium sources because of its bioavailability and its versatility as both a beverage and a complement to various solid foods. One of the foods commonly consumed with milk is ready-to-eat breakfast cereal (RTEC). OBJECTIVE: We aimed to establish the association between the intake of RTEC, milk, and calcium within the context of the most current population dietary practices. We hypothesized that RTEC consumption facilitates milk consumption and is associated with adequacy of calcium intake in the US population. DESIGN: The most recent National Health and Nutrition Examination Survey, 1999-2000, data set was used as the source of data for this research. SUBJECTS/SETTING: US subjects aged 4 years and older (n=7,403), excluding pregnant and/or lactating women. Data were stratified according to sex and age (4 to 8 years, 9 to 13 years, 14 to 18 years, 19 to 30 years, 31 to 50 years, 51 to 70 years, and 71+ years), and then by consumption of breakfast, RTEC, and milk. STATISTICAL ANALYSES PERFORMED: SAS (release 8.1, 2000, SAS Institute Inc, Cary, NC) and SUDAAN (release 8.0.2, 2003, Research Triangle Institute, Research Triangle Park, NC) were used to calculate sample weighted means, standard errors, and population percentages. Multiple regression and multiple logistic regression models, with controls for covariates, were used to determine the predictability of total calcium intake from breakfast consumption compared to breakfast nonconsumption, and from inclusion of RTEC and milk in the breakfast meal compared with breakfast meal content without RTEC and milk. RESULTS: RTEC was predominantly consumed at breakfast. Average calcium intake at breakfast was seven times greater when RTEC was consumed with milk than when RTEC was consumed without milk. In multiple regression analyses, breakfast consumption, and milk consumption with or without RTEC all strongly predicted total daily calcium intake (P<0.05) while controlling for covariates. The percentage of respondents below the Adequate Intake level for calcium was higher for non-RTEC breakfast consumers than for RTEC breakfast consumers in all age-sex categories except those older than age 70 years, and girls aged 9 to 13 years. CONCLUSIONS: Consumption of RTEC at breakfast was associated with greater daily intake of both milk and calcium in all age and sex groups in the US population.     

Relationship between skipping breakfast and cardiovascular disease risk factors in the national nutrition survey data]

PURPOSE: To investigate the relationship between skipping breakfast and cardiovascular disease risk factors such as blood pressure, serum lipids, smoking, and lock of exercise. MATERIALS AND METHODS: Data from the National Nutrition survey conducted by the Ministry of Health and Welfare, from 1995 through 1997 were employed for the analysis. Data were used only if subjects were between 20 and 59 years old and had participated in the nutrition survey, and values for height and weight, blood pressure, serum lipids, blood sugar, number of steps per day, and smoking, drinking, and exercise habits were available. The number of subjects with data available for all of the above was 11,778 (4,438 men and 7,340 women). Analyses were performed separately by sex. The relationship between skipping breakfast and continuous variables such as nutrient intake ratio (nutrient intake divided by recommended dietary allowances), body mass index, blood pressure, serum lipids, blood sugar, and the number of steps per day was examined controlling for age using analysis of covariance (ANCOVA). The relationship between skipping breakfast and categorical variables such as smoking, drinking, and exercise habits was assessed controlling for age using Cochran-Mantel-Haenszel statistics. RESULTS: The younger the generation, the higher the rate of skipping breakfast. The rate of skipping breakfast in men was twice as high as in women. The breakfast skippers tended to intake less energy and calcium, both in men and women, that non-skippers. Female skippers tended to intake less iron and vitamin D. The number of steps per day was smaller in breakfast skippers than that in non-skippers both in men and women. Male skippers tended to have higher blood pressure than non-skippers, and female skippers tended to have a higher serum total cholesterol level than non-skippers. The breakfast skippers tended to smoke more than non-skippers, both in men and women, and female skippers tended to drink more alcohol and take less exercise. CONCLUSIONS: Skipping breakfast is related to cardiovascular risk factors such as lack of exercise, smoking, high blood pressure, and high serum total cholesterol.     

Nutrient intake of children consuming breakfast at school clubs in London

Introduction: Research into the effectiveness of breakfast clubs has most commonly focused on social benefits to the child and school, such as improved attendance at school, punctuality and improved concentration levels in the classroom ( UEA, 2002 ). Limited research has been undertaken to investigate the nutritional value of the breakfast foods on offer, or the nutritional content of foods consumed by the child. The aim of this study was to find out what children eat and drink at school breakfast clubs in London. Method: The sample population consisted of 98 children (39 boys and 59 girls) aged 5–11 years attending four primary schools in London. Data were collected about the food on offer and the pricing of different food items, demographic data about the children attending the school club, qualitative data on food preferences and a weighed food intake on two different occasions for each child. Statistical tests (anova and chi‐squared tests) and nutrient analysis using Comp‐Eat were carried out. Results: The average nutrient content of the breakfast meal consumed was 330 kcal, 12 g protein, 11 g fat and 49 g carbohydrate. Variation was seen between schools. Generally intakes of vitamin C, calcium and sodium were high and intakes of iron were average. anova between schools showed statistically significant results for a number of nutrients – protein, fat, saturated fat, carbohydrate, sugar, calcium and sodium. Boys were consuming statistically significantly more fat, saturated fat and calcium than girls. One in five children did not have a drink at breakfast. Menu options and pricing of food items varied between the schools and it was noted to influence children's food choice and consumption. Mean energy intakes equated to 18% of the estimated average requirement for boys and 20% for girls, with girls consuming more carbohydrate and sugar, and boys consumed more fat and protein. Discussion: The findings suggest that careful planning of menus should be undertaken with cereal‐based options being offered daily and cooked options only occasionally, and that healthier eating messages can be incorporated effectively into school clubs when supported by the whole school approach to healthy eating. Conclusion: Food offered at school breakfast clubs can contribute substantial nutrients to a child's daily intake and therefore a varied menu, and guided food choices, should be developed incorporating healthier nutrient rich options. This work was supported by Brooke Bond working in partnership with the BDA Community Nutrition Group.