Breakfast Consumption, Family Breakfast, and Adiposity Trajectory in Adolescence-The Adolescent Nutritional Assessment Longitudinal Cohort Study

Prospective association between breakfast consumption frequency and BMI z-score among European school-aged children. The Feel4Diabetes Study

BACKGROUND

The long-term effects of breakfast on childhood z-BMI remain inconclusive.

OBJECTIVE

To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries.

METHODS

Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Feel4Diabetes study were used. Children's lifestyle behaviors, including breakfast frequency, were assessed through parent-reported questionnaires. Weight and height were objectively measured and converted to z-BMI. Participants were categorized into trajectories combining breakfast consumption habit (i.e., regular consumption, irregular consumption or omission) at baseline and follow up. Logistic regression analyzed the prospective association between breakfast trajectories and z-BMI increase, with adjustment for demographic and lifestyle variables.

RESULTS

A statistically significant effect of breakfast trajectories was observed in z-BMI, both at baseline and follow up. Stable skippers was the only trajectory that showed a significant increase in BMI z-score from baseline to follow up (0.891 ± 1.058 vs. 1.034 ± 1.072 respectively, p < 0.05). BMI z-score at follow up of regular eaters (0.615 ± 0.967) was significantly lower, compared to both irregular eaters (1.229 ± 0.890) and stable skippers (both p < 0.05). Stable regular consumption and transition from omission to regular consumption were independently associated with significantly lower risk of z-BMI gain, compared to stable omission [OR, 95% CI: 0.55 (0.31, 0.97), p = 0.039 and 0.43 (0.21, 0.88), p = 0.021 respectively].

CONCLUSION

Stable regular breakfast consumption or transition from omission to regular consumption seem to contribute to superior weight regulation in children and to independently protect against z-BMI gain, compared to stable omission. Further studies are warranted to extend the evidence on the breakfast habit-BMI association among children.

Investigating the quality of breakfast for female adolescents using a multi-method approach in Saudi Arabia: A cross-sectional study

Breakfast has been shown to provide nutritional adequacy and improve the healthy lifestyle status of adolescents. However, limited information is available on the quality of breakfast among adolescents. Thus, this study aimed to evaluate the quality of breakfast among adolescents using a multiple-method approach in Saudi Arabia. This cross-sectional, school-based study was conducted in 3 public high schools in Al-Jumum, Saudi Arabia. High school females (n = 174) aged 15 to 18 years old were selected considering the regularity of consuming breakfast (≥ 4 d/wk and not after 10:00 a.m.). The quality of breakfast was assessed using 3 approaches: the modified Saudi food frequency questionnaire, the adapted method of breakfast quality, and the nutrient profile model. Sweet food items were consumed most frequently (64.9%, n = 113), followed by drinks (57.4%, n = 100), while the least frequently consumed items were sandwiches and burgers (43.52%, n = 76), snacks (41.9%, n = 72), and dairy and fats (41.8%, n = 71). The majority of breakfast eaters were classified as eating breakfasts of poor quality (50.6%), while the rest ate breakfasts of either good quality (38.1%) or very poor breakfast quality (10.8%). Based on the nutrient profile model of breakfast, high fat salt sugar (HFSS) food/drink items and non-HFSS items were consumed by 44.4% and 55.5% of the participants, respectively. This study showed that the majority of female adolescents consume poor-quality breakfast, mostly sweets and sweetened beverages. The nutrient content analysis emphasized these results by presenting a similar consumption of non-HFSS and HFSS breakfast foods. Future education programs on healthy breakfast options should be implemented among this population.

The coexistence of obesogenic behaviors among Brazilian adolescents and their associated factors

BACKGROUND

The prevalence of obesity in adolescents has increased significantly in recent years. The growth of obesity is motivated by the association with modifiable behaviors, however, this behavioral are commonly evaluated individually, not considering the possibility of these factors coexisting in the individual. The purpose of this essay was to identify the coexistence of obesogenic behaviors among Brazilian adolescents and to assess the factors associated with the presence of these behaviors.

METHODS

This a cross-sectional, national, school-based study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), totaling a sample of 71,552 Brazilian adolescents. To identify the coexistence of obesogenic behaviors in adolescents, the Principal Component Analysis has been performed. To assess the association between factors that influence the coexistence of modifiable behaviors in the pattern of obesogenic behavior, logistic regression was used. The magnitude of the associations was estimated by the Odds Ratio (OR), with the respective 95% confidence intervals (95%CI).

RESULTS

The component was characterized by a higher percentage of ultra-processed food intake, longer in front of screens, having a habit of snacking in front of the television, and not having the habit of eating breakfast. In the adjusted logistic model, it shows that female adolescents and who declare themselves black are more likely to belong to the third tertile of the pattern of obesogenic behavior. As for teenagers who sometimes or almost always or always have lunch or dinner with parents or guardians, who have longer hours of sleep and who live in economically disadvantaged regions have reduced chances of belonging to the third tertile of the pattern of obesogenic behavior.

CONCLUSION

The identification of obesogenic behavior patterns allows assertive interventions to eliminate or reduce these changeable behaviors, also aiming at the possibility of reducing obesity among adolescents.

Breakfast skipping and cardiometabolic risk factors in adolescents: Systematic review

OBJECTIVE

To systematically review the results of the association between breakfast skipping and cardiometabolic risk factors in adolescents.

METHODS

The articles were searched in May 2020 from PubMed, Virtual Health Library, Scopus, Web of Science and Scientific Electronic Library Online (SciELO). The review included observational studies conducted with adolescents (10-19 years old), which estimated the association of breakfast skipping with at least one outcome (markers of body adiposity, blood pressure, serum lipid and glucose levels). Regarding the risk of bias, the articles were evaluated using the Research Triangle Institute (RTI) Item Bank on bias risk and accuracy of observational studies. The quality of the evidence was assessed by the Grade rating.

RESULTS

A total of 43 articles involving 192,262 participants met the inclusion criteria and were considered in this review. The prevalence of breakfast skipping ranged from 0.7% to 94% and 60.5% of studies were classified with low risk of bias. The significant association between breakfast skipping and cardiometabolic risk factors was found in twenty-nine cross-sectional articles (n = 106,031) and four longitudinal articles (n = 5,162) for excess adiposity, in three articles (n = 8,511) for high total cholesterol levels, low-density lipoprotein and triglycerides, and in three studies (n = 6,303) for high blood pressure levels. However, there was no significant association between breakfast skipping and glycemic profile. According to the Grade rating, all the associations had low quality of evidence.

CONCLUSION

The results of this review suggest that breakfast skipping is associated with cardiometabolic risk factors in adolescents aged 10 to 19 years. However, considering the low quality of the evidence, the present results should be interpreted carefully. In addition, our findings highlight the importance of standardizing the definition of breakfast skipping and that more prospective studies are needed to determine how skipping breakfast can affect cardiometabolic risk factors in the long time.

Level of Adherence to the Mediterranean Diet and Weight Status among Adolescent Female Gymnasts: A Cross-Sectional Study

Adolescent female gymnasts are a vulnerable population in terms of their diet, as their nutritional needs are higher due to their growth and high daily training demands. The Mediterranean diet (MD) is a well-known dietary pattern that is associated with a greater nutritional adequacy and a lower prevalence of overweight. The aim of this cross-sectional study was to evaluate the degree of adherence to the MD among adolescent female athletes who participated in all disciplines of gymnastics in Greece, as well as to explore the potential correlations between MD adherence, body weight, and body mass index (BMI). A total of 269 female gymnasts (between 11-18 years old) completed the Mediterranean Diet Quality Index (KIDMED) and reported their weight and height. Approximately 10% of the participants were underweight and a mere 5.6% were classified as overweight. A high adherence to the MD was reported by 34.9% of the sample and this was correlated with a healthier BMI. Moreover, specific eating habits, such as eating nuts 2-3 times per week and eating fast-food less than once-weekly, were also associated with BMI. Athletes, parents, and coaches of gymnastics should be informed and educated regarding balanced nutrition habits. Future studies could evaluate adherence to MD, as well as the factors that influence the eating behaviors of adolescent female and male athletes in various sports.

Breakfast patterns and weight status among adolescents: a study on the Brazilian National Dietary Survey 2008-2009

Examining the composition of breakfast concerning weight status is essential for evaluating adolescent health and understanding this gap. This study aimed to identify breakfast patterns and investigate the relationship with weight status among Brazilian adolescents. We used a subsample of 7425 adolescents aged 10-19 years from the 2008-2009 Brazilian Household Budget Survey. Breakfast eaters were those with intake of at least 50 kcal (209·2 kJ) between 05.00 and 10.00 hours. Breakfast dietary patterns were derived by principal component factor analysis with varimax rotation. We performed logistic regression analyses between breakfast patterns and weight status, considering the complexity of the survey sample design. Three breakfast patterns were identified explaining 44·8 % of data variability: (1) the Cereal, protein, fruit beverages and Northern/Northeastern pattern, characterised by high consumption of cookies, meats, dairy products, preparations with maize, eggs, fruit juices/fruit drinks/soya-based drinks, tubers/roots/potatoes and cereals, and negative adherence to cold cut meat and savoury snacks/crackers; (2) the Protein-based pattern, characterised by positive loadings for cold cut meat, milk and cheese, and negative for cookies, fruit juices/fruit drinks/soya-based drinks, tubers/roots/potatoes and cereals; and (3) the Mixed pattern, with positive loadings for cakes, coffee/tea, bread, fruit juices/fruit drinks/soya-based drinks, chocolate/desserts and savoury snacks/crackers. No association was found between skipping and weight status. Overweight adolescents had lower adherence to the Cereal, protein, fruit beverages and Northern/Northeastern pattern (OR = 0·67; 95 % CI 0·47, 0·96). This is the first study to address dietary patterns at the meal level with adolescent population-based data, which requires further investigation.

Association between breakfast omission and abdominal adiposity in low-income adolescents

ABSTRACT Objective To assess the association between breakfast omission, overweight/obesity, abdominal adiposity, and unhealthy lifestyle of low-income adolescents. Methods A cross-sectional population study involving 571 public school students aged between 15 and 19 years old. The habit of having breakfast was assessed using a form, checking the weekly frequency of a given meal and considered as breakfast omission when these adolescents did not have breakfast for at least 5 days in the past week. Sociodemographic and lifestyle variables (sedentarism, physical activity level, and sleep duration) were also assessed. Overweight/obesity was defined as a body mass index above a Z-score of +1, and the presence of abdominal adiposity was determined by a waist circumference/height ratio greater than 0.5. The association between breakfast omission and lifestyle variables was assessed using the chi-square test and a multivariate logistic regression of the anthropometric indicators. Results The omission of breakfast was found in 31% of the adolescents and was associated with physical inactivity (p<0.001). Regarding anthropometric indicators, breakfast omission was an independent factor for determining abdominal adiposity, with a 1.8 times greater chance of having this condition among those who omitted breakfast (p=0.037). Conclusions Omitting breakfast was frequent among the students assessed, and was associated with abdominal adiposity, a cardiometabolic risk factor. Investigation and early intervention are fundamental to change this behavior.

Family meal frequency and its association with food consumption and nutritional status in adolescents: A systematic review

This systematic review evaluated the association between frequency of family meals (FFM) and nutritional status (NS) and/or food consumption (FC) in adolescents. The protocol was registered with PROSPERO (CRD42017062180) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. No publication date, language, or meal type restrictions were imposed. Only full-text original articles were included; qualitative studies were excluded. Studies were identified by searching 5 electronic databases (PubMed, Web of Science, Scopus, BVS Brazil, and Adolec) and gray literature (Google Scholar) and by scanning reference lists of included articles. Risk of bias was assessed using the Newcastle-Ottawa scale for cohort and cross-sectional studies. Initial search yielded 2001 results and 47 articles were included. An updated literature search added 3 articles. Of the 50 studies included, 25 studied the association between FFM and NS, 32 investigated the association between FFM and FC, being that seven studies analyzed both outcomes. Thirty-four were cross-sectional studies, 12 were longitudinal studies, and 4 studies analyzed both cross-sectional and longitudinal data. Thirty-five studies were rated as having good quality, whereas 19 were of fair quality. Sample size ranged from 140 to 102 072 participants. Most investigations evaluated the frequency of breakfast, lunch, and/or dinner/supper/evening meals over a 1-week period. Seventeen studies identified a positive relationship between high FFM and better NS, and 26 found a positive association between high FFM and better FC. In conclusion, this review showed an association between FFM and healthy dietary patterns, such as increased consumption of fruits and vegetables. Further research is needed to understand the association between FFM and NS, since some studies showed a protective role of family meals against obesity in this age group, whereas other studies identified no significant association between these variables.