An investigation of the breakfast habits and dietary intakes of year 8 Auckland children : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutritional Science at Massey University

Breakfast is often referred to as the most important meal of the day. Studies have consistently shown that regular breakfast consumption makes a significant contribution to nutrient intake. Additionally, individuals who have skipped breakfast often do not make up for the missed nutrients during the remainder of the day. Results from the National Children's Nutrition Survey show that breakfast consumption varies with ethnicity and age. In particular, Pacific Island children and older children were less likely than other ethnic and age groups to have breakfast. The overall aim of the current study was to collect detailed information on dietary intake, breakfast habits, choices, and preferences of intermediate school children. Two multi-cultural decile six intermediate schools in North Shore City, Auckland were selected to participate. A dietary assessment of over two hundred students (12-13 years of age) was completed using a dietary recall methodology. Data were also collected on breakfast habits and preferences, and anthropometric measurements made. A subset group of 52 students was randomly selected to provide detailed information on their nutrient intake. Each student within the subgroup completed two 24-hour recalls during the school week, and a food diary on a Saturday. Findings from this research showed that both male and female students had a high level of breakfast consumption, with over half of the students reporting that this represented their daily habit. Overall, only 4% reported that they rarely or never have breakfast. The most reported reason given for skipping breakfast was not being hungry in the morning, followed by preferring to sleep in, and then lack of time. There was some evidence from this study that the daily commitments of family members (e.g., working parents) may influence breakfast eating habits. Additionally, it is likely that the availability of preferred breakfast foods at home contributed to high breakfast consumption observed in this study population. Interestingly, breakfast consumption was not significantly associated with gender, but was however influenced by ethnicity, with Maori/Pacific Island children less likely to eat breakfast than children of other ethnic groups (P = 0.001). Breakfast skippers had a significantly higher body mass index (BMI) compared to breakfast eaters, although further research is required to assess the association between habitual breakfast consumption and BMI. The majority of breakfast consumers chose foods and beverages that contributed to a balanced breakfast. Of those subjects who had breakfast, over 60% consumed a cereal, with the most popular being Weet-Bix. Findings from the subgroup analysis showed that the consumpton of breakfast made a significant contribution to the daily intake of nutrients such as iron, calcium, folate, riboflavin, and thiamin, for both male and female breakfast eaters. The information gained from this study may facilitate the implementation of nutrition education and intervention programmes designed to improve eating patterns (in particular breakfast consumption) and the dietary intake of children and adolescents. Promoting and maintaining good breakfast habits in children of this age group may lead to improved breakfast consumption patterns and health as they progress through adolescence

Association of Breakfast Intake with Obesity, Dietary and Physical Activity Behavior Among Urban School-Aged Adolescents in Delhi, India: Results of a Cross-Sectional Study

In developed countries, regular breakfast consumption is inversely associated with excess weight and directly associated with better dietary and improved physical activity behaviors. Our objective was to describe the frequency of breakfast consumption among school-going adolescents in Delhi and evaluate its association with overweight and obesity as well as other dietary, physical activity, and sedentary behaviors. Methods: Design: Cross-sectional study. Setting: Eight schools (Private and Government) of Delhi in the year 2006. Participants: 1814 students from 8th and 10th grades; response rate was 87.2%; 55% were 8th graders, 60% were boys and 52% attended Private schools. Main outcome measures: Body mass index, self-reported breakfast consumption, diet and physical activity related behaviors, and psychosocial factors. Data analysis: Mixed effects regression models were employed, adjusting for age, gender, grade level and school type (SES). Results: Significantly more Government school (lower SES) students consumed breakfast daily as compared to Private school (higher SES) students (73.8% vs. 66.3%; p<0.01). More 8th graders consumed breakfast daily vs. 10th graders (72.3% vs. 67.0%; p<0.05). A dose-response relationship was observed such that overall prevalence of overweight and obesity among adolescents who consumed breakfast daily (14.6%) was significantly lower vs. those who only sometimes (15.2%) or never (22.9%) consumed breakfast (p<0.05 for trend). This relationship was statistically significant for boys (15.4 % vs. 16.5% vs. 26.0; p<0.05 for trend) but not for girls. Intake of dairy products, fruits and vegetables was 5.5 (95% CI 2.4-12.5), 1.7 (95% CI 1.1-2.5) and 2.2 (95% CI 1.3-3.5) times higher among those who consumed breakfast daily vs. those who never consumed breakfast. Breakfast consumption was associated with greater physical activity vs. those who never consumed breakfast. Positive values and beliefs about healthy eating; body image satisfaction; and positive peer and parental influence were positively associated with daily breakfast consumption, while depression was negatively associated. Conclusion: Daily breakfast consumption is associated with less overweight and obesity and with healthier dietary-and physical activity-related behaviors among urban Indian students. Although prospective studies should confirm the present results, intervention programs to prevent or treat childhood obesity in India should consider emphasizing regular breakfast consumption.Obesity Prevention Center, University of MinnesotaPRIME program of the University of Texas, School of Public Health (Stigler, PI)Center for Health Promotion and Disease Prevention Research in Underserved Population

Family structure and breakfast consumption of 11-15 year old boys and girls in Scotland, 1994-2010

<p>Abstract</p> <p>Background</p> <p>The benefits of breakfast during childhood and adolescence have been reported previously though few studies have considered family structure inequalities in breakfast consumption. The proportion of young people living in non-traditional family types has increased in recent years, strengthening the need to describe and monitor the impact of the changing family unit on adolescent breakfast consumption. This study aimed to describe changes in daily breakfast consumption among adolescents in Scotland between 1994 and 2010, while also considering family structure inequalities, and the degree to which these have changed over time.</p> <p>Methods</p> <p>Data from the 1994, 1998, 2002, 2006 and 2010 Scottish Health Behaviour in School-aged Children (HBSC) surveys were analysed using logistic multilevel regression models for binary outcome variable daily breakfast consumption.</p> <p>Results</p> <p>Daily breakfast consumption among adolescents increased between 1994 and 2010, although there were differences by age and sex. In fact those aged over 14.5 years saw decreases in breakfast consumption, and girls saw significantly larger increases than boys. Daily breakfast consumption was more prevalent among adolescents from 'both parent' families, with lowest prevalence among those from single parent families. Trends in daily breakfast consumption between 1994 and 2010 also varied by family structure. While prevalence of daily breakfast consumption increased among those living with 'both parents', the largest proportion of the population, prevalence decreased over time among adolescents of single parent families, and particularly among those living with their father.</p> <p>Conclusions</p> <p>Family structure inequalities in daily breakfast consumption increased between 1994 and 2010, while breakfast consumption across the population as a whole increased. As the proportion of young people living in an alternative family structure continues to grow it is important to understand why these inequalities have increased and how these may be overcome. Possible reasons for family structure inequalities and their increase in recent years are discussed.</p

Breakfast and exercise contingently affect postprandial metabolism and energy balance in physically active males

The present study examined the impact of breakfast and exercise on postprandial metabolism, appetite and macronutrient balance. A sample of twelve (blood variables n 11) physically active males completed four trials in a randomised, crossover design comprising a continued overnight fast followed by: (1) rest without breakfast (FR); (2) exercise without breakfast (FE); (3) breakfast consumption(1859 kJ) followed by rest (BR); (4) breakfast consumption followed by exercise (BE). Exercise was continuous, moderate-intensity running (expending approximately 2·9MJ of energy). The equivalent time was spent sitting during resting trials. A test drink (1500 kJ) was ingested on all trials followed 90 min later by an ad libitum lunch. The difference between the BR and FR trials in blood glucose time-averaged AUC following test drink consumption approached significance (BR: 4·33 (SEM 0·14) v. FR: 4·75 (SEM 0·16) mmol/l; P¼0·08); but it was not different between FR and FE (FE: 4·77 (SEM 0·14) mmol/l; P¼0·65); and was greater in BE (BE: 4·97 (SEM 0·13) mmol/l) v. BR(P¼0·012). Appetite following the test drink was reduced in BR v. FR (P¼0·006) and in BE v. FE (P¼0·029). Following lunch, the most positive energy balance was observed in BR and least positive in FE. Regardless of breakfast, acute exercise produced a less positive energy balance following ad libitum lunch consumption. Energy and fat balance is further reduced with breakfast omission. Breakfast improved the overall appetite responses to foods consumed later in the day, but abrogated the appetite suppressive effect of exercise

Breakfast, Giardia and School Success of Girls in Ardebil Province, Iran

Eating breakfast is important for the growth and nutritional well-being of children. The aims of the study were to compare nutrient intake, Giardia infection, mean score and anthropometric factors, in 2 groups, children who ate breakfast and children who did not. This cross-sectional study was conducted with 20 randomly selected primary schools from 2 regions of Ardebil Province, Iran, in 2005. Anthropometric factors were measured, ie height, weight, and mid-arm muscle circumference (MAC) of 401 males. Three-day food intake was estimated for energy and other nutrients by 24-hour-recall method, and the children were asked whether they ate breakfast, or not. A stool specimen from each girl was prepared in saline and examined by light microscopy and direct smear using the zinc sulfate flotation method. The data were analyzed using independent samples-T test and Chi-square, and Iranian food processor. Of the girls, 20.8% reported having skipped breakfast. Among the girls who ate breakfast, the Giardia-infected skipped breakfast more often than the non-infected (15.4% vs 12.2%), but the difference was insignificant. On average, the taller girls skipped breakfast significantly more often (p < 0.05), but height was not a significant factor among the boys. Weight, BMI (body mass index) and MAC among the children skipping breakfast were significantly higher than among those who ate breakfast (p < 0.05). The average mean scores were not significantly different. There was no association between eating breakfast and Giardia infection. The caloric and nutrient intakes of the children who ate or skipped breakfast were not significantly different. In the present study, skipping breakfast was more prevalent among primary-school girls, which could affect anthropometric factors. However, it did not correlate with Giardia infection, school success, or caloric intake

Effects of breaking up prolonged sitting following low and high glycaemic index breakfast consumption on glucose and insulin concentrations

Purpose: Breaking up prolonged sitting can attenuate the postprandial rise in glucose and insulin. Whether such effects are dependent of the glycaemic index (GI) of the consumed carbohydrate is unknown. This study examined the acute effects of breaking up prolonged sitting following a low GI and a high GI breakfast on postprandial glucose and insulin concentrations. Procedures: Fourteen adult males aged 22.1 ± 1.2 years completed four, 4 h experimental conditions: high GI breakfast followed by uninterrupted sitting (HGI-SIT), low GI breakfast followed by uninterrupted sitting (LGI-SIT), high GI breakfast followed by 2 min activity breaks every 20 min (HGI-ACT), and low GI breakfast followed by 2 min activity breaks every 20 min (LGI-ACT). Positive incremental area under the curve (iAUC) for glucose and insulin (mean [95% CI]) for each 4h experimental condition was calculated. Statistical analyses were completed using linear mixed models. Results: The sitting × breakfast GI interaction was not significant for glucose positive iAUC (P=0.119). Glucose positive iAUC (mmol/L4 h−1) was significantly lower in the activity breaks conditions than the uninterrupted sitting conditions (2.07 [2.24, 2.89] vs. 2.56 [1.74, 2.40], respectively, P=0.004) and significantly lower in the low GI conditions than the high GI conditions (2.13 [1.80, 2.45] vs. 2.51 [2.18, 2.84], respectively, P=0.022). Insulin concentrations did not differ between conditions (P ≥ 0.203). Conclusions: Breaking up prolonged sitting and lowering breakfast GI independently reduced postprandial glucose responses. This indicates that interrupting prolonged sitting and reducing dietary GI are beneficial approaches for reducing cardiometabolic disease risk

The advantages and disadvantages of breakfast clubs according to parents, children, and school staff in the North East of England, UK

The provision of school breakfast has become increasingly popular in the UK in recent years. However, UK-based studies highlighting the views of parents, children, and school staff on school breakfast clubs are lacking. The current study set out to address this dearth in the literature by investigating the views of these key user and stakeholder groups on breakfast clubs within the North East of England. Fourteen parents, 21 children, and 17 school staff were recruited from four primary schools where breakfast clubs were available on site. Parents and school staff took part in semistructured interviews and children participated in focus groups, through which the advantages and disadvantages of breakfast clubs were discussed. Thematic analysis revealed that breakfast clubs provided children with a settled and enjoyable start to the school day. As well as providing children with a healthy and varied breakfast meal and unique opportunities for social interaction, breakfast clubs were recognized as an integral part of the school system that offered support to parents, particularly those who worked and relied on breakfast clubs as a means of affordable and reliable childcare. The few disadvantages identified related to practical issues such as a lack of adherence to school food standards, breakfast club staff missing class preparation time and concerns that some children were being excluded from participating in breakfast clubs particularly due to costs associated with attendance. The findings are discussed in relation to the School Food Plan, and areas for further investigation are proposed

Effects of Economic Policies Aimed at Encouraging a Healthier Grain Consumption

In this paper, we evaluate the effects of policy reforms aimed at achieving two policy objectives for grain consumption; (a) to double the intake of bread and breakfast cereals and (b) to ensure that half of the bread and breakfast cereals consumed are whole grain products. The overall aim of these policy objectives are to increase the dietary fibre intake from grain consumption so as to significantly contribute to the general recommended (minimum) increase of the fibre intake. Based on parameter estimates from a demand system we simulate the resulting changes in volumes purchased and fibre intake from two policy reforms entailing differentiated VAT on grain products. In the first reform we remove the VAT on "keyhole labelled" bread and breakfast cereals, in the second reform we consider a more extensive policy package of subsidizing the keyhole labelled bread and breakfast cereals by 20 percent while removing the VAT on all other grain products. Our results indicate that both reforms are likely to be successful in ensuring that the consumers attain the nutrition recommendations that half of the bread and breakfast cereals consumed are whole grain products, but that additional policy instruments are needed to reach the recommendation that the intake of bread and breakfast cereals should be doubled.Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety,

Effect of breakfast omission and consumption on energy intake and physical activity in adolescent girls: a randomised controlled trial

It is not known if breakfast consumption is an effective intervention for altering daily energy balance in adolescents when compared with breakfast omission. This study examined the acute effect of breakfast consumption and omission on free-living energy intake (EI) and physical activity (PA) in adolescent girls. Using an acute randomised crossover design, forty girls (age 13.3 ± 0.8 y, body mass index 21.5 ± 5.0 kg∙m-2) completed two, 3-day conditions in a randomised, counter-balanced order: no breakfast (NB) and standardised (~1962 kJ) breakfast (SB). Dietary intakes were assessed using food diaries combined with digital photographic records and PA was measured via accelerometry throughout each condition. Statistical analyses were completed using repeated measures analysis of variance. Post-breakfast EI was 483 ± 1309 kJ/d higher in NB vs. SB (P=0.025), but total daily EI was 1479 ± 1311 kJ/d higher in SB vs. NB (P<0.0005). Daily carbohydrate, fibre and protein intakes were higher in SB vs. NB (P<0.0005), whereas daily fat intake was not different (P=0.405). Effect sizes met the minimum important difference of ≥0.20 for all significant effects. Breakfast manipulation did not affect post-breakfast macronutrient intakes (P≥0.451) or time spent sedentary or in PA (P≥0.657). In this sample of adolescent girls, breakfast omission increased post-breakfast free-living EI, but total daily EI was greater when a standardised breakfast was consumed. We found no evidence that breakfast consumption induces compensatory changes in PA. Further experimental research is required to determine the effects of extended periods of breakfast manipulation in young people

Are glucose profiles well-controlled within the targets recommended by the International Diabetes Federation in type 2 diabetes? A meta-analysis of results from continuous glucose monitoring based studies

AIMS: To assess continuous glucose monitoring (CGM) derived intra-day glucose profiles using global guideline for type 2 diabetes recommended by the International Diabetes Federation (IDF). METHODS: The Cochrane Library, MEDLINE, PubMed, CINAHL and Science Direct were searched to identify observational studies reporting intra-day glucose profiles using CGM in people with type 2 diabetes on any anti-diabetes agents. Overall and subgroup analyses were conducted to summarise mean differences between reported glucose profiles (fasting glucose, pre-meal glucose, postprandial glucose and post-meal glucose spike/excursion) and the IDF targets. RESULTS: Twelve observational studies totalling 731 people were included. Pooled fasting glucose (0.81 mmol/L, 95% CI, 0.53-1.09 mmol/L), postprandial glucose after breakfast (1.63 mmol/L, 95% CI, 0.79-2.48 mmol/L) and post-breakfast glucose spike (1.05 mmol/L, 95% CI, 0.13-1.96 mmol/L) were significantly higher than the IDF targets. Pre-lunch glucose, pre-dinner glucose and postprandial glucose after lunch and dinner were above the IDF targets but not significantly. Subgroup analysis showed significantly higher fasting glucose and postprandial glucose after breakfast in all groups: HbA1c <7% and ≥7% (53 mmol/mol) and duration of diabetes <10 years and ≥10 years. CONCLUSIONS: Independent of HbA1c, fasting glucose and postprandial glucose after breakfast are not well-controlled in type 2 diabetes