Postpartum teens' breakfast consumption is associated with snack and beverage intake and body mass index

Breakfast in Latin America: Evaluation of Nutrient and Food Group Intake Toward a Nutrient-Based Recommendation

BACKGROUND

Little is known about breakfast habits of the Latin American (LA) population to support nutritional recommendations for a balanced breakfast in this region.

OBJECTIVE

To evaluate the nutritional composition of breakfast in the LA population and to propose recommendations for a balanced breakfast.

DESIGN

This multicenter cross-sectional study evaluated food and nutrient intake of nationally representative samples of urban populations of 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015.

PARTICIPANTS/SETTING

The sample comprised 8714 participants from the Latin American Study of Nutrition and Health, aged 15 to 65 years, randomly recruited according to geographical location, sex, age, and socioeconomic level.

MAIN OUTCOME MEASURES

Two 24-hour recalls were used to examine dietary intake. Breakfast consumers were stratified by tertiles of Nutrient-Rich Foods Index 9.3 (NRF9.3) to assess the overall diet quality of individuals. Nutrient intake at breakfast of those in the upper tertile of NRF9.3 pooled for the 8 countries was used as a reference for the development of recommendations for LA adolescents and adults.

STATISTICAL ANALYSES

Comparison of food and nutrient intake of breakfast across NRF9.3 tertiles were analyzed using the Kruskal-Wallis rank sum test.

RESULTS

Overall breakfast was an important contributor to protein, carbohydrate, and B vitamin intakes but also to added sugar and total and saturated fat intakes relative to daily intakes. Individuals in the upper NRF9.3 tertile had higher intake of key micronutrients such as calcium and potassium at breakfast compared with other tertiles. White breads/rolls/tortillas were the most consumed food group (60%), followed by butter/margarine (40%) and coffee/tea without milk (34%-50%).

CONCLUSIONS

Breakfast contributed to the daily intake of B vitamins, protein, and carbohydrates but also added sugar and total and saturated fat intakes for all countries. The proposed recommendations support the nutrient density of existing highest-quality breakfast in the LA population while addressing concerns about nutrients to be encouraged or reduced.

Breakfast Consumption Habit and Its Nutritional Contribution in Latin America: Results from the ELANS Study

The aim of this study was to provide updated data on breakfast consumption, associated factors and its contribution to daily intakes among Latin American populations. A total of 9218 subjects, 15 to 65 years old, were evaluated in the ELANS study, a multicenter cross-sectional study conducted in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela). Dietary data were obtained by two 24 h dietary recalls. Overall, 78.6% of the population were regular breakfast consumer, 15.9% occasional and 5.5% skippers. Adolescents were found to be the most frequent occasional consumers (19.2%) and skippers (6.8%). Among breakfast consumers (n = 8714), breakfast contributed to 444 ± 257 kcal, i.e., 23% of the total daily EI (16-27%). Breakfast consumers were more likely to be older adults than adolescents (OR = 1.49, 95% CI:1.06-2.10) and physically active than insufficiently active (OR = 1.29, 95% CI:1.07-1.55), and were less likely to be underweight than normal weight (OR = 0.63, 95% CI:0.41-0.98). In most countries, breakfast was rich in carbohydrates, added sugars, saturated fat and calcium relative to the entire day, and the energy contribution of protein and fats was lower at breakfast than for the entire day. These findings will contribute to the development of data-driven nutrient recommendations for breakfast in Latin America.

Dietary Habits and Physical Activity of 18-Year-Old Adolescents in Relation to Overweight and Obesity

BACKGROUND

The purpose of this study was to evaluate the correlations between the nutritional status, nutritional habits, and physical activity in the representative population of 18-year-old students.

METHODS

A total of 1,631 participants aged 18 years, originating from secondary schools/senior high schools in the city of Bialystok, Szpitalna, Bialystok, Poland were enrolled. Participants completed anonymous questionnaires, and their body mass index was assessed. Data were analyzed using standard statistical procedures with Statistical PL 12.0.

RESULTS

The analysis showed that consumption of only one to two or three meals was associated with an increased risk of overweight and obesity-in case of one or two meals among girls, OR=1.78 (P<0.05), in case of one or two meals among boys, OR=2.325 (P<0.01), and in case of three meals, OR=1.771 (P<0.05). First breakfast was consumed by 82.1% of boys with normal BMI and 73.1% overweight and obesity (OR=0.593; P<0.05). 24.5% of the eutrophic compared to only 20.3% of adolescents with elevated BMI reported attending all PE classes. Physical activity undertaken after school was associated with a 35.9% decrease risk of overweight and obesity among girls and 57.7% among boys.

CONCLUSION

A specific pattern of nutritional habits, that is, decreased meal frequency in adolescents, skipping meals, appear the most frequent nutritional mistakes associated with overweight and obesity. Insufficient physical activity and exposure to sedentary behaviors among adolescents are disturbing. The obesity problem requires monitoring, prevention and the change of nutritional habits and physical activity early in childhood.

Postpartum Teens' Perception of the Food Environments at Home and School

BACKGROUND

An environment that supports healthy eating is one factor to prevent obesity. However, little is known about postpartum teen's perceptions of their home and school environments and how this relates to dietary behaviors.

PURPOSE

This study explores the relationship between home and school environments and dietary behaviors for postpartum teens.

DESIGN

Conducted cross-sectionally during 2007-2009 across 27 states and included 889 postpartum teens enrolled in Parents as Teachers Teen Program. Data included measures of sociodemographics and perceptions of school and home food environments. A 7-day recall of snack and beverage frequency assessed dietary behaviors. Logistic regression explored associations between baseline environment measures and dietary behaviors at baseline and postintervention (approximately 5 months after baseline) for the control group.

RESULTS

Respondents reported greater access and selection (i.e., variety of choices) of healthy foods and beverages at home than school. At baseline, fruit and vegetable intake was associated with home selection (1.9, 95% confidence interval [CI: 1.3, 2.9]) and availability (1.8, 95% CI [1.3, 2.6]), sweet snack consumption was associated with selection (1.5, 95% CI [1.0, 2.1]), and total snack consumption and sugar-sweetened beverage intake were associated with selection (snack: 2.1, 95% CI [1.5, 3.0]; beverage: 1.7, 95% CI [1.2, 2.4]) and availability (snack: 2.1, 95% CI [1.4, 3.1]; beverage: 1.5, 95% CI [1.0, 2.3]). Water intake at baseline and at the postintervention for control group teens was associated with selection (1.6, 95% CI [1.1, 2.2]). No significant associations were identified between the school environment and dietary behaviors.

CONCLUSIONS

Interventions should target improvements in the home environment for high-risk, postpartum teens.

Dietary patterns for meals of Brazilian adults

The use of dietary patterns (DP) in nutritional research is well established; however, only a few studies of DP according to specific meals have been conducted. The purpose of this study was to identify the DP regarding breakfast, lunch and dinner meals of the population (aged 20 years and older of both sexes) that participated in the Health Care Survey of Sao Paulo. Food intake was estimated by using the Multiple Source Method – considering two 24- h dietary recalls. On the basis of the food groups for each meal, a factor analysis, with a principal component estimation, was applied (varimax rotation) in order to derive the DP. Prevalences of meal skipping were 5·6 % for breakfast, 3·6 % for lunch and 12·8 % for dinner. The findings revealed three breakfast DP: healthy, traditional and snack; five lunch DP: traditional, salad, sweetened juice, Western and meats; and four dinner DP: coffee with milk and bread, transitional, traditional, and soup and fruits. The results of this study indicate that the DP identified in accordance with the meal nicely discriminates food intake, emphasising peculiarities that are not found in global analyses and might support dietary advice.

Exploration of theoretical models: postpartum weight retention in african american adolescents

Obesity presents a public health challenge and is a serious chronic medical condition, associated with multiple co-morbidities and reduced survivability and longevity. Obesity accounts for about 300,000 deaths each year and is expected to cost the United States healthcare system almost 237 million dollars within the next decade. African American adolescents who retain weight after pregnancy are at the highest risk of becoming obese adults with the potential to develop chronic diseases or serious illnesses. The author explores non-nursing and nursing theories that could guide needed research to help understand the barriers that prevent weight loss and raise the risk of obesity among postpartum adolescents. After the exploration, Orem's self-care theory was selected for the proposed study based on nursing interventions that could facilitate postpartum adolescents' self-care and weight control behaviors.

Effect of skipping breakfast on subsequent energy intake

The objective was to examine the effect of consuming breakfast on subsequent energy intake. Participants who habitually ate breakfast and those who skipped breakfast were recruited for two studies. Using a randomized crossover design, the first study examined the effect of having participants consume either (a) no breakfast, (b) a high carbohydrate breakfast (335 kcals), or (c) a high fiber breakfast (360 kcals) on three occasions and measured ad libitum intake at lunch. The second study again used a randomized crossover design but with a larger, normal carbohydrate breakfast consumed ad libtum. Intake averaged 624 kcals and subsequent food intake was measured throughout the day. Participants ate only foods served from the Cornell Human Metabolic Research Unit where all foods were weighed before and after consumption. In the first study, neither eating breakfast nor the kind of breakfast consumed had an effect on the amount consumed at lunch despite a reduction in hunger ratings. In the second study, intake at lunch as well as hunger ratings were significantly increased after skipping breakfast (by 144 kcal), leaving a net caloric deficit of 408 kcal by the end of the day. These data are consistent with published literature demonstrating that skipping a meal does not result in accurate energy compensation at subsequent meals and suggests that skipping breakfast may be an effective means to reduce daily energy intake in some adults.

Factors associated with breakfasting in users of a public health service

OBJECTIVE: This study identified the sociodemographic, lifestyle, dietary and anthropometric factors of users of a public health promotion service who have breakfast regularly. METHODS: This cross-sectional study included all users aged 20 years or more who joined the service between March 2007 and December 2010. Their socioeconomic and anthropometric data, dietary habits and health status were investigated. Statistical treatment included the Chi-square, Mann-Whitney, Fisher's exact and Student's t tests and Poisson regression analysis (p<0.05). RESULTS: Most of the participants (87.1%, n=528) breakfasted often, especially those aged 48.5 years or more (p=0.041). Poisson regression analysis showed association between breakfasting often and not smoking (PR=1.45, 95%CI: 1.10-1.91), having a greater number of daily meals (PR=1.15, 95%CI: 1.06-1.25), appropriate intake of deep-fried foods (PR=1.12, 95%CI: 1.01-1.25), lower fat intake (PR=0.78, 95%CI: 0.68-0.89) and smaller prevalence of excess weight (PR=0.85, 95%CI: 0.78-0.92). CONCLUSION: The positive relationship found between breakfasting often and not smoking, appropriate food and nutrient intakes and a healthier body weight shows the need of emphasizing this meal in health services as a simple and doable health promotion strategy that helps to prevent and control chronic diseases.

Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, "breakfast-skipping," late-adolescent girls

BACKGROUND

Breakfast skipping is a common dietary habit practiced among adolescents and is strongly associated with obesity.

OBJECTIVE

The objective was to examine whether a high-protein (HP) compared with a normal-protein (NP) breakfast leads to daily improvements in appetite, satiety, food motivation and reward, and evening snacking in overweight or obese breakfast-skipping girls.

DESIGN

A randomized crossover design was incorporated in which 20 girls [mean ± SEM age: 19 ± 1 y; body mass index (in kg/m(2)): 28.6 ± 0.7] consumed 350-kcal NP (13 g protein) cereal-based breakfasts, consumed 350-kcal HP egg- and beef-rich (35 g protein) breakfasts, or continued breakfast skipping (BS) for 6 d. On day 7, a 10-h testing day was completed that included appetite and satiety questionnaires, blood sampling, predinner food cue-stimulated functional magnetic resonance imaging brain scans, ad libitum dinner, and evening snacking.

RESULTS

The consumption of breakfast reduced daily hunger compared with BS with no differences between meals. Breakfast increased daily fullness compared with BS, with the HP breakfast eliciting greater increases than did the NP breakfast. HP, but not NP, reduced daily ghrelin and increased daily peptide YY concentrations compared with BS. Both meals reduced predinner amygdala, hippocampal, and midfrontal corticolimbic activation compared with BS. HP led to additional reductions in hippocampal and parahippocampal activation compared with NP. HP, but not NP, reduced evening snacking of high-fat foods compared with BS.

CONCLUSIONS

Breakfast led to beneficial alterations in the appetitive, hormonal, and neural signals that control food intake regulation. Only the HP breakfast led to further alterations in these signals and reduced evening snacking compared with BS, although no differences in daily energy intake were observed. These data suggest that the addition of breakfast, particularly one rich in protein, might be a useful strategy to improve satiety, reduce food motivation and reward, and improve diet quality in overweight or obese teenage girls. This trial was registered at clinicaltrials.gov as NCT01192100.

The Benefits of Breakfast Consumption to Combat Obesity and Diabetes in Young People

The obesity epidemic, particularly in young people, is the greatest threat to public health this century. Several dietary factors have recently been identified to play a critical role in the etiology of this disease. Of particular interest is the common dietary habit of skipping breakfast, which has been strongly associated with obesity. Cross-sectional studies indicate that young people who habitually eat breakfast have a higher-quality diet, eat fewer unhealthy snacks, and have better body weight management compared with those who skip breakfast. Additionally, breakfast consumers also exhibit better glucose control throughout the day compared with those who skip the morning meal. These data lend support for the addition of breakfast to reduce factors contributing to obesity and diabetes in young people. Although evidence exists illustrating the benefits of cereal-based breakfast compared with skipping the morning meal, less is known with respect to the consumption of other breakfast foods, namely those rich in dietary protein. This article provides clinical evidence documenting the strong protective effect of breakfast consumption to prevent and/or treat obesity/type 2 diabetes and promote overall health in young people.

Factors influencing the implementation of school wellness policies in the United States, 2009

Introduction

The quality of school wellness policy implementation varies among schools in the United States. The objective of this study was to characterize the school wellness policy environment nationally and identify factors influencing the quality and effectiveness of policy implementation.

Methods

We invited school administrators from 300 high schools to complete a questionnaire; 112 administrators responded. We performed a 2-step cluster analysis to help identify factors influencing the implementation of school wellness policies.

Results

Eighty-two percent of schools reported making staff aware of policy requirements; 77% established a wellness committee or task force, 73% developed administrative procedures, and 56% trained staff for policy implementation. Most commonly reported challenges to implementation were lack of time or coordination of policy team (37% of respondents) and lack of monetary resources (33%). The core domains least likely to be implemented were communication and promotion (63% of respondents) and evaluation (54%). Cluster 1, represented mostly by schools that have taken action toward implementing policies, had higher implementation and effectiveness ratings than Cluster 2, which was defined by taking fewer actions toward policy implementation. In Cluster 1, accountability was also associated with high ratings of implementation quality and effectiveness.

Conclusion

The development of organizational capacity may be critical to ensuring an environment that promotes high-quality policy implementation. Assessing, preventing, and addressing challenges; establishing clear definitions and goals; and requiring accountability for enacting policy across all core domains are critical to ensuring high-quality implementation.