Breakfast Frequency and Quality in the Etiology of Adult Obesity and Chronic Diseases

Age-specific association between meal-skipping patterns and the risk of hyperglycemia in Korean adults: a national cross-sectional study using the KNHANES data

BACKGROUND

Glucose metabolism regulation is influenced by age and meal skipping, although research on their interplay with hyperglycemia remains limited. This study aims to explore the intricate relationship between meal-skipping patterns and hyperglycemia risk across distinct age groups in South Korean adults.

METHODS

Utilizing data from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2013 to 2020, comprising 28,530 individuals aged 19 years and older, this study employed multivariable logistic regression models to examine the associations between meal-skipping patterns and the risk of hyperglycemia.

RESULTS

Meal-skipping patterns were categorized into three groups: no skipping (NS), skipping breakfast (SB), and skipping dinner (SD). Age groups were defined as "young" (aged 19-44), "middle-aged" (aged 45-64), and "elderly" adults (over 65 years old). Among "young" adults, SB was associated with a 1.33-fold higher risk of hyperglycemia (OR = 1.33, 95% CI = 1.14-1.54) compared to NS. Conversely, in "elderly" adults, SD was linked to a 0.49-fold reduced risk (95% CI = 0.29-0.82) when compared to NS. Additionally, we observed that the Korean Health Eating Index (KHEI) scores, representing the quality of diet on a scale of 0 to 100, were consistently lower in SB compared to NS across all age groups. Intriguingly, specifically among the "elderly" group, this score was higher in SD compared to NS (p < 0.001).

CONCLUSIONS

This study demonstrates age-specific variations in the association between meal-skipping patterns and the risk of hyperglycemia.

Association between Dietary Quality and Non-Alcoholic Fatty Liver Disease in Korean Adults: A Nationwide, Population-Based Study Using the Korean Healthy Eating Index (2013-2021)

This study explored the relationship between the Korean Healthy Eating Index (KHEI) and non-alcoholic fatty liver disease (NAFLD). This cross-sectional study included 34,174 Korean adults. The KHEI was composed of three subcomponents (adequacy, moderation, and energy balance) and calculated based on a 24 h dietary recall. The total score ranged from 0 to 100, with a higher score indicating a greater adherence to the Korean dietary guidelines. The total KHEI scores were categorized into quartiles (Q1-Q4). NAFLD was classified using the hepatic steatosis index. Logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The adjusted OR (95% CI) of NAFLD was 0.95 (0.87-1.03) for the Q2 group, 0.90 (0.83-0.98) for the Q3 group, and 0.79 (0.72-0.87) for the Q4 group, compared with the Q1 group. Among the subcomponents of the KHEI, individuals with high scores in the adequacy component, characterized by an abundant consumption of fruits, vegetables, and dairy products, exhibited the most pronounced association with NAFLD. A higher KHEI score was negatively associated with NAFLD in Korean adults. Therefore, the promotion of healthy dietary patterns can play a beneficial role in the prevention or management of NAFLD.

Breakfast quality and its sociodemographic and psychosocial correlates among Italian children, adolescents, and adults from the Italian Nutrition & HEalth Survey (INHES) study

BACKGROUND

Breakfast quality, together with regularity of breakfast, has been suggested to be associated with cardiometabolic health advantages. We aimed to evaluate the quality of breakfast and its socioeconomic and psychosocial correlates in a large sample of the Italian population.

METHODS

Cross-sectional analyses on 7,673 adult and 505 children/adolescent regular breakfast eaters from the Italian Nutrition & Health Survey (INHES; 2010-2013). Dietary data were collected through a single 24-h dietary recall. Breakfast quality was assessed through the Breakfast Quality Index (BQI) combining intake of ten food groups, energy, and nutrients of public health concern, and potentially ranging from 0 to 10. The association of sociodemographic and psychosocial factors with BQI were analyzed by multivariable-adjusted linear regression models.

RESULTS

The average BQI was 4.65 (SD ± 1.13) and 4.97 (SD ± 1.00) in adults and children/adolescents, respectively. Amongst adults, older age (β = 0.19; 95%CI 0.06 to 0.31 for > 65 vs. 20-40 years) and having a high educational level (β = 0.13; 0.03 to 0.23; for postsecondary vs. up to elementary) were independent predictors of better breakfast quality, while men reported lower BQI (β = -0.08; -0.14 to -0.02 vs. women). Perceived stress levels at home and work and financial stress were inversely associated with BQI. Children/adolescents living in Central and Southern Italian regions had lower BQI compared to residents in Northern Italy (β = -0.55; -0.91 to -0.19 and β = -0.24; -0.47 to -0.01, respectively).

CONCLUSIONS

In adults, breakfast quality was associated with age, sex, and educational level. Perceived stress levels were inversely associated with the quality of breakfast. In children/adolescents, a north-south gradient in breakfast quality was observed.

Intermittent fasting and bone health: a bone of contention?

Intermittent fasting (IF) is a promising strategy for weight loss and improving metabolic health, but its effects on bone health are less clear. This review aims to summarise and critically evaluate the preclinical and clinical evidence on IF regimens (the 5:2 diet, alternate-day fasting (ADF) and time-restricted eating (TRE)/time-restricted feeding and bone health outcomes. Animal studies have utilised IF alongside other dietary practices known to elicit detrimental effects on bone health and/or in models mimicking specific conditions; thus, findings from these studies are difficult to apply to humans. While limited in scope, observational studies suggest a link between some IF practices (e.g. breakfast omission) and compromised bone health, although lack of control for confounding factors makes these data difficult to interpret. Interventional studies suggest that TRE regimens practised up to 6 months do not adversely affect bone outcomes and may even slightly protect against bone loss during modest weight loss (< 5 % of baseline body weight). Most studies on ADF have shown no adverse effects on bone outcomes, while no studies on the ‘5–2’ diet have reported bone outcomes. Available interventional studies are limited by their short duration, small and diverse population samples, assessment of total body bone mass exclusively (by dual-energy X-ray absorptiometry) and inadequate control of factors that may affect bone outcomes, making the interpretation of existing data challenging. Further research is required to better characterise bone responses to various IF approaches using well-controlled protocols of sufficient duration, adequately powered to assess changes in bone outcomes and designed to include clinically relevant bone assessments.

Effect of habitual breakfast skipping on information processing capacity, cortical response, and cognitive flexibility among medical collegiate - a cross-sectional study

OBJECTIVES

Breakfast replenishes glucose homeostasis and provides other micro-nutrients for the normal functioning of the body after a long night at night. Habitually skipping breakfast leads not only to metabolic disturbances but also to neurocognitive impairment. Hence, the current study was carried out to study the effect of skipping breakfast on neurocognitive functions.

METHODS

A 9-item breakfast questionnaire was distributed online to students for identifying habitual breakfast skippers from non-skippers based on inclusion criteria. Random blood glucose was noted and visual and auditory reaction time, critical flicker fusion frequency, and Stroop test were assessed in both groups to assess cognition.

RESULTS

Forty one habitual breakfast skippers who met the inclusion criteria showed increased visual reaction time, and auditory reaction time indicating cognitive impairment. A significant reduction in the Stroop test was observed among the non-skipper group when compared to the skipper group.

CONCLUSIONS

This study suggests that skipping breakfast diminishes neurocognitive functions like problem-solving, planning, judgment, information retention, and reasoning.

Whey Protein-Enriched and Carbohydrate-Rich Breakfasts Attenuate Insulinemic Responses to an ad libitum Lunch Relative to Extended Morning Fasting: A Randomized Crossover Trial

BACKGROUND

Typical breakfast foods are rich in carbohydrate, so they not only elevate blood glucose during the morning, but also elicit a second-meal effect that can attenuate blood glucose responses in the afternoon.

OBJECTIVES

To determine whether a reduced-carbohydrate protein-enriched breakfast can elicit similar effects on glucose control later in the day but without hyperglycemia in the morning.

METHODS

In a randomized crossover design, 12 healthy men and women (age 22 ± 2 y, BMI 24.1 ± 3.6 kg·m-2; Mean ± SD) completed 3 experimental conditions. In all conditions, participants consumed an ad libitum lunch at 1200 ± 1 h but differed in terms of whether they had fasted all morning (control) or had consumed a standardized porridge breakfast at 0900 ± 1 h (320 ± 50 kcal; prescribed relative to resting metabolic rate) that was either carbohydrate-rich (50 ± 10 g CHO) or protein-enriched (that is, isoenergetic substitution of carbohydrate for 15 g whey protein isolate).

RESULTS

The protein-enriched breakfast reduced the morning glycemic response (iAUC 87 ± 36 mmol·L-1·180 min) relative to the carbohydrate-rich breakfast (119 ± 37 mmol·L-1·180 min; P = 0.03). Despite similar energy intake at lunch in all 3 conditions (protein-enriched 769 ± 278 kcal; carbohydrate-rich 753 ± 223 kcal; fasting 790 ± 227 kcal), postlunch insulinemic responses were markedly attenuated when breakfasts had been consumed that were either protein-enriched (18.0 ± 8.0 nmol·L-1·120 min; P = 0.05) or carbohydrate-rich (16.0 ± 7.7 nmol·L-1·120 min; P = 0.005), relative to when lunch was consumed in an overnight fasted state (26.9 ± 13.5 nmol·L-1·120 min).

CONCLUSIONS

Breakfast consumption attenuates insulinemic responses to a subsequent meal, achieved with consumption of energy-matched breakfasts typically high in carbohydrates or enriched with whey protein isolate relative to extended morning fasting.

TRIAL REGISTRATION NUMBER

NCT03866720 (clinicaltrials.gov).

Timing Matters: The Interplay between Early Mealtime, Circadian Rhythms, Gene Expression, Circadian Hormones, and Metabolism-A Narrative Review

Achieving synchronization between the central and peripheral body clocks is essential for ensuring optimal metabolic function. Meal timing is an emerging field of research that investigates the influence of eating patterns on our circadian rhythm, metabolism, and overall health. This narrative review examines the relationship between meal timing, circadian rhythm, clock genes, circadian hormones, and metabolic function. It analyzes the existing literature and experimental data to explore the connection between mealtime, circadian rhythms, and metabolic processes. The available evidence highlights the importance of aligning mealtime with the body's natural rhythms to promote metabolic health and prevent metabolic disorders. Specifically, studies show that consuming meals later in the day is associated with an elevated prevalence of metabolic disorders, while early time-restricted eating, such as having an early breakfast and an earlier dinner, improves levels of glucose in the blood and substrate oxidation. Circadian hormones, including cortisol and melatonin, interact with mealtimes and play vital roles in regulating metabolic processes. Cortisol, aligned with dawn in diurnal mammals, activates energy reserves, stimulates appetite, influences clock gene expression, and synchronizes peripheral clocks. Consuming meals during periods of elevated melatonin levels, specifically during the circadian night, has been correlated with potential implications for glucose tolerance. Understanding the mechanisms of central and peripheral clock synchronization, including genetics, interactions with chronotype, sleep duration, and hormonal changes, provides valuable insights for optimizing dietary strategies and timing. This knowledge contributes to improved overall health and well-being by aligning mealtime with the body's natural circadian rhythm.

Association of breakfast skipping with habitual dietary intake and BMI in female rotating shift workers

OBJECTIVE

Higher BMI, lower quality of diet and a higher percentage of breakfast-skippers have been reported among rotating shift (RS) workers compared with day shift (DS) workers. As such, this study examined the association between breakfast skipping, habitual food consumption and BMI in RS workers.

DESIGN

Japanese nurses were studied using a self-administered questionnaire that assessed the height, weight, breakfast consumption habits, dietary consumption, physical activity, sleep habits, chronotype and demographic characteristics of the participants.

SETTING

A cross-sectional study was conducted in a population of nurses in Japan. Dietary and health-related questionnaires were mailed to 5536 nurses aged 20-59 years, working at 346 institutions.

PARTICIPANTS

A total of 3646 nurses at 274 institutions responded to the questionnaire. After removing those who met the exclusion criteria, 2450 participants were included in the statistical analysis.

RESULTS

The RS breakfast-skippers had lower total energy intake, diet quality and higher BMI than DS workers, whereas the RS breakfast-consumers had a higher total energy intake and BMI than the DS workers. In the RS workers, breakfast skipping on the days of DS and the end days of evening/night shift was associated with a poorer diet quality. Additionally, breakfast skipping on the days of DS was positively associated with BMI, independent of the total energy intake and diet quality.

CONCLUSIONS

Breakfast skipping on workdays may contribute to a difference in dietary intake and BMI between RS workers and DS workers and may increase BMI in RS workers, independent of dietary intake.

Acute Cardiometabolic and Exercise Responses to Breakfast Omission Versus Breakfast Consumption in Adolescent Girls: A Randomised Crossover Trial

Girls often begin to skip breakfast during adolescence. This study compared the acute effect of breakfast omission versus consumption on cardiometabolic risk markers and perceived appetite and mood during rest and/or exercise in adolescent girls classified as habitual breakfast consumers. Girls (aged 13.2 ± 0.7 years) completed two 5.5 h conditions in a randomised crossover design: breakfast omission (BO) and standardised breakfast consumption (BC). A standardised lunch was provided at 3 h. Incremental cycling exercise was performed at 5 h. Blood and expired gas samples were taken at regular intervals. Whilst pre-lunch plasma glucose, insulin, and Metabolic Load Index incremental area under the curve (IAUC) were significantly lower in BO versus BC, post-lunch differences were reversed and larger in magnitude. Peak plasma glucose and insulin were significantly higher in BO versus BC. Pre-lunch perceived fullness and hunger were significantly lower and higher, respectively, in BO versus BC. Perceived energy and concentration were lower, and tiredness was higher, in BO versus BC. Exercise peak fat oxidation and Fatmax were unaffected. The lower physical activity enjoyment in BO versus BC approached significance. To conclude, acutely omitting breakfast adversely affects cardiometabolic risk markers and exercise enjoyment among adolescent girls who habitually consume breakfast.

Eating behaviors and incident cardiovascular disease in Japanese people: The population-based Panasonic cohort study 14

Evidence on common eating behaviors to support the prevention of cardiovascular disease (CVD) in Japanese people is insufficient. This retrospective cohort study aimed to investigate the association of diet behaviors (e.g., skipping breakfast, eating speed, snack after dinner, and alcohol consumption) with incident CVD in Japanese individuals. Employees of Panasonic Corporation who underwent the annual health checkups and without a history of CVD at baseline were enrolled. The main outcome was incident 3-point major adverse cardiovascular events (MACE). The secondary outcomes were incident coronary artery disease (CAD) and stroke. To assess the effect of BMI, the subgroup analysis was conducted. In total, 132,795 participants were included. Overall, 3,115, 1,982, and 1,165 participants developed 3-point MACE, CAD, and stroke, respectively. Skipping breakfast (HR: 1.13, 95% CI: 1.03-1.23) and fast eating (HR: 1.23, 95% CI: 1.04-1.47) were associated with 3-point MACE in the participants overall. Skipping breakfast (HR: 1.23, 95% CI: 1.10-1.37) and fast eating (HR: 1.38, 95% CI: 1.12-1.71) were also associated with 3-point MACE in participants with BMI < 25 kg/m². In contrast, in participants with BMI ≥ 25 kg/m², these associations were not detectable (P value for the interaction between subgroups = 0.09 [skipping breakfast] and 0.03 [fast eating], respectively). The diet behavior is a potential risk factor of incident CVD in Japanese people, particularly in those with BMI < 25 kg/m².

Association of main meal frequency and skipping with metabolic syndrome in Korean adults: a cross-sectional study

BACKGROUND

Reduced meal frequency can increase the risk of metabolic syndrome (MetS). However, limited studies have examined the association between meal frequency and skipping meals with MetS. This study aims to analyze the association between main meal frequency and meal skipping with MetS in Korean adults aged ≥ 19 years.

METHODS

In this study, we included data from 22,699 Korean adult participants from the 2016-2020 Korea National Health and Nutrition Examination Survey (KNHANES). The 24-h dietary recall method was used to classify the participants into three groups based on main meal frequency (one, two, or three meals per day) and seven groups based on the type of main meal they skipped. Multivariable logistic regression analysis was conducted to determine the association between main meal frequency and the types of main meals skipped with the odds of MetS and its associated components. Appropriate estimates were accounted for using sampling weights, stratification, and clustering.

RESULTS

The prevalence of MetS in the study population was 33.8%. The average age of the participants was 47.2 years with 42.6% being men, and 57.4% being women. Men who consumed two meals per day had higher odds of MetS than those who consumed three meals per day (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.01-1.33). Women who consumed two meals per day, and skipped breakfast had increased odds of having elevated fasting blood glucose levels (OR 1.18, 95% CI 1.02-1.35), and elevated triglycerides (OR 1.19, 95% CI 1.02-1.39). However, women who skipped dinner had reduced odds of having elevated fasting blood glucose levels (OR 0.74, 95% CI 0.58-0.94).

CONCLUSIONS

Our findings suggest that meal frequency and the type of main meal skipped may be associated with MetS and emphasize the importance of consuming breakfast to prevent MetS.

Breakfast Practices in Malaysia, Nutrient Intake and Diet Quality: A Study Based on the Malaysian Food Barometer

Breakfast is often referred to as the "most important meal of the day" in shaping diet quality. This study established the patterns of breakfast consumption in Malaysia and assessed its contribution to the overall quality of the diet based on the 24 h recall data from the nationally representative and cross-sectional Malaysian Food Barometer (MFB, second data collection, 2018) to assess breakfast intake among adults (n = 1604). Diet quality was measured using the Nutrient Rich Food index (NRF) 9.3. The nutritional profile of breakfast was compared across tertiles of NRF 9.3. Overall, 89% of Malaysians consume breakfast. Breakfast was found to provide 474 kcal on average. The Malaysian daily diet was found to be rich in fats, saturated fats, total sugars, and sodium, with breakfast making a significant contribution to the daily intakes of these nutrients. Intakes of fiber, potassium, calcium, vitamins C and D, folate, iron, zinc, and magnesium were low. Breakfast was related to the overall diet quality measured by the NRF index. This study revealed that the breakfasts consumed by Malaysian adults were found to be nutritionally unbalanced. This analysis could serve as a basis for nutrient recommendations grounded in existing social and cultural breakfast patterns.

Non-Classical Aspects of Obesity Pathogenesis and Their Relative Clinical Importance for Obesity Treatment

Obesity is a chronic disease and a major public health problem due to its association with non-communicable diseases and all-cause mortality. An increased energy intake and decreased physical activity have been long recognized as the classical parameters that contribute to the development of obesity. However, several other, non-classical factors have also been associated with obesity through various complex mechanisms. Some of them are diet related, such as diet quality, dietary habits and speed of eating. Other factors are non-dietary, such as endocrine-disrupting chemicals, sleep quality and quantity, psychotropic medications and light at night. The scope of the present narrative review is to address these non-classical factors that are implicated in the pathogenesis of obesity, to clarify their potential role in the management of obesity and, where possible, to provide some practical clinical recommendations.

Identification of a Novel Score for Adherence to the Mediterranean Diet That Is Inversely Associated with Visceral Adiposity and Cardiovascular Risk: The Chrono Med Diet Score (CMDS)

Adherence to the Mediterranean diet (MedDiet) leads to reduction of mortality from all causes, especially in subjects with cardiovascular disease, obesity, and diabetes. Numerous scores have been proposed to evaluate the adherence to MedDiet, mainly focused on eating habits. In this study, we verified whether existing validated MedDiet scores, namely, MEDI-LITE and the Mediterranean Diet Score (MDS), could be associated with visceral adiposity. Failing to find a significant association with adiposity, we proposed the validation of a new, easy-to-use adherence questionnaire, the Chrono Med-Diet score (CMDS). CMDS contains eleven food categories, including chronobiology of dietary habits and physical activity. Compared to the MEDI-LITE score and MDS, low values of CMDS are linked to increased waist circumference (WC) and dysmetabolic conditions. CMDS was also inversely correlated with cardiovascular risk (CVR), as well as Fatty Liver Index (FLI). In conclusion, the CMDS is a novel questionnaire to study the adherence to the MedDiet that, focusing on type and timing of carbohydrates intake, has the peculiar capability of capturing subjects with abdominal obesity, thus being an easy-to-use instrument of personalized medicine.

Association between breakfast frequency and insulin resistance in Korean adults with prediabetes: A nationwide population-based cross-sectional study

AIMS

This study aimed to investigate the association between breakfast frequency and insulin resistance using the triglyceride and glucose (TyG) index in Korean adults with prediabetes.

METHODS

This study used data from the 2016-2018 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 16,925 participants were included in this study. Breakfast frequency was classified as 0 times, 1-4 times, and 5-7 times per week. High insulin resistance was defined as a TyG index of ≥8.5. A multivariate logistic regression analysis was performed.

RESULTS

Compared with the group whose breakfast frequency was 5-7 times per week, the odds ratio for high insulin resistance was 1.39 times (95% confidence interval (CI), 1.21-1.59) and 1.17 times (95% CI, 1.04-1.32) higher in the group whose breakfast frequency was 0 times and 1-4 times per week, respectively.

CONCLUSIONS

This study revealed that a lower frequency of breakfast consumption was significantly associated with a higher risk of insulin resistance in Korean adults with prediabetes. In the future, a large-scale prospective longitudinal study is required to establish the causal relationship between breakfast frequency and insulin resistance.

Weight status of working adults: The effects of eating misalignment, chronotype, and eating jetlag during mandatory confinement

This study aimed to examine the association between chronotype, eating jetlag, and eating misalignment with weight status among Malaysian adults during the COVID-19 restriction. This online cross-sectional study included 175 working adults recruited from March to July 2020. The chronotype was assessed using Morningness Eveningness Questionnaire (MEQ) while eating jetlag and mealtime variability were measured using Chrononutrition Profile Questionnaire (CPQ). Multiple linear regression demonstrated that lower breakfast frequency (β=-0.258, p = .002) and longer eating duration (β = 0.393, p < .001) were associated with later first eating events on workfree days. Both intermediate (β = 0.543, p < .001) and evening chronotypes (β = 0.523, p = .001) tend to eat their first meals later compared to morning person. Similar patterns were observed for overall eating jetlaggers in which lower breakfast frequency (β=-0.022, p = .011), longer eating duration (β = 0.293, p < .001), intermediate chronotype (β = 0.512, p < .001), and evening chronotype (β = 0.495, p = .003) were associated with eating later meals on workfree days. Additionally, higher BMI was also associated with eating later meals on workfree days (β = 0.181, p = .025). During movement restriction, discrepancies of mealtimes during work and workfree days offer new insight into modern eating habits that can influence weight status and general eating habits such as breakfast skipping and total daily eating duration. Population meal timing variability was affected during movement restrictions, and it was closely related to weight status.

Food Categories for Breakfast and Mental Health among Children in Japan: Results from the A-CHILD Study

There is limited evidence that what children eat for breakfast contributes to their mental health. This study aimed to examine the associations between food categories for breakfast and mental health among children in Japan. A proportion of participants aged 9-10 years in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in Japan who consumed breakfast daily were included (n = 281). Foods eaten for breakfast were reported by the children each morning for 7 consecutive days, and defined according to the food categories in the Japanese Food Guide Spinning Top. Child mental health was assessed by caregivers using the Strength and Difficulties Questionnaire. The mean intake frequencies per week were six times for grain dishes, two times for milk products, and one time for fruits. Linear regression analysis revealed an inverse association between the frequent intake of grain dishes, whether rice or bread, and problem behaviors after adjustment for potential confounders. However, confectionaries, which mainly consisted of sweet breads or pastries, were not associated with problem behaviors. The intake of non-sweet grain dishes at breakfast may be effective for preventing behavioral problems in children.

Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors

BACKGROUND

Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors.

METHODS

Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA).

RESULTS

Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: -3.28, 95% C.I.: -5.7 to -0.86), diastolic blood pressure (b: -1.85, 95% C.I.: -3.34 to -0.36), augmentation index (b: -3.17, 95% C.I.:-4.98 to 1.35) and left carotid intima media thickness (b: -0.03, 95% C.I.:-0.06 to -0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10-20% of daily total energy intake (dTEI) was inversely associated with Aix (b: -2.31, 95% C.I.:-4.05 to -0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90).

CONCLUSION

SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.

Meal Timing and Sleeping Energy Metabolism

There is a physiological link between sleep and eating. Insufficient sleep is a risk factor for overeating and excess body weight gain, and molecules such as orexin and insulin play a role in the control of sleep and energy intake. The effects of dietary timing on sleep and energy metabolism were examined in this review. First, we examined sleep energy metabolism and sleep quality under time-restricted eating, including skipping breakfast or dinner. Second, the mechanisms, benefits, and translational potential of the effects of time-restricted diets on sleep were discussed. Time-restricted eating under controlled conditions, in which daily caloric intake was kept constant, affected the time course of energy metabolism but did not affect total energy expenditure over 24 h. In free-living conditions, time-restricted eating for extended durations (4-16 weeks) decreased energy intake and body weight, and the effects of early time-restricted eating were greater than that of midday time-restricted eating. Although assessment of sleep by polysomnographic recording remains to be performed, no negative effects on the subjective quality of sleep have been observed.

Time-related meal patterns and breakfast quality in a sample of Iranian adults

BACKGROUND

Some evidence shows that meal timing is associated with diet quality. We aimed to investigate the relationship between meal timing and breakfast quality in a sample of Iranian adults.

METHODS

This cross-sectional study was conducted on 850 men and women living in Tehran, Iran. Dietary data was recorded by three non-consecutive 24-h dietary recalls. The Breakfast Quality Index (BQI) was calculated. Time-related meal patterns included the interval between the first and last meal (eating and fasting window), frequency of meals, length of sleep, and time of first and last eating occasion. The multiple linear regression analysis was used to identify the relationships between time-related meal patterns and BQI.

RESULTS

The mean (95% CI) of BQI was 4.52 (4.45-4.65) and the maximum was 8. Bread, cheese, vegetables, fruits, energy, and carbohydrate intake showed positive associations with BQI scores. Longer fasting time showed a positive association with fruits (β (CI 95%)) (0.11 (0.0003-0.005), and vegetable consumption (0.12 (0.009-0.07)) and BQI score (0.39 (0.001-0.06)). Time of first eating occasions indicated a negative association with protein and fat intake and BQI score. Time of last eating occasions showed a positive association with vegetables consumption and BQI score. The longer length of sleep was associated with a higher BQI score. The frequency of meals was significantly and positively related to energy and macronutrients intake and BQI.

CONCLUSION

Earlier first and last meal, longer sleep length, longer fasting window, and a greater meal frequency were associated with a better breakfast quality.

Delayed feeding of a high-sucrose diet led to increased body weight by affecting the circadian rhythm of body temperature and hepatic lipid-metabolism genes in rats

Skipping breakfast is an irregular feeding behavior, typically in young people. In our previous study, we established a 4 h-delayed feeding protocol for rats as a breakfast-skipping model and showed that the 4 h-delayed feeding of a high-fat diet led to body weight gain in rats. Excess sucrose induces metabolic syndrome and fatty liver. Recently, excess sucrose intake has received increased attention. Young people generally consume more sugar than adults do. In the present study, we investigated whether a 4 h-delayed feeding promoted high-sucrose diet-induced abnormalities in lipid metabolism, such as fatty liver and obesity in rats. The 4 h-delayed feeding rats showed increased body weight gain, although it did not induce fatty liver and hyperlipidemia compared to normal feeding rats. Serum insulin concentration during the feeding period was higher than in the control rats, suggesting that slight insulin resistance was induced by the 4 h-delayed feeding. The surge in body temperature was also delayed by 4 h in response to the 4 h-delayed feeding. This delay would result in less energy expenditure to increase body weight. The oscillations of hepatic lipid and glucose metabolism-related gene expression were delayed by almost 2-4 h, and the clock genes were delayed by approximately 2 h. The 4 h-delayed feeding induced weight gain by affecting body temperature, insulin resistance, and circadian oscillation of lipid metabolism-related genes in rats fed a high-sucrose diet, suggesting that a high sucrose intake with breakfast skipping leads to obesity.

Weight Gain, Comorbidities, and Its Associated Factors Among Korean Adults

BACKGROUND

Weight gain in adults is associated with an increased risk of obesity-related diseases and high healthcare costs. However, there have been limited studies on weight gain in Asians. This study investigated the prevalence, comorbidities, and associated factors of weight gain in the Korean population.

METHODS

This is a cross-sectional study of Korean adults aged 19-64 years who participated in the Korea National Health and Nutritional Examination Survey 2016-2019. We used data from 15,514 adults (subjects 1) to analyze the prevalence of weight gain. Finally, after excluding adults with suspicious debilitating conditions among them, 11,477 adults (subjects 2) were used to analyze comorbidities and associated factors. Weight changes and lifestyle factors were assessed using a self-report questionnaire. We analyzed odds ratios and 95% confidence intervals using multivariable logistic regression analysis to examine factors associated with weight gain.

RESULTS

The overall prevalence of weight gain was 25.7% in men and 31.3% in women and decreased significantly with age in both sexes. Weight gain of ≥ 6 kg was evident in 10.5% of men and 9.8% of women and was more pronounced with a higher baseline body mass index (BMI). Most metabolic comorbidities worsened the greater the weight gain. Young age was the strongest associated factor for weight gain. Other factors associated with weight gain were being unmarried, blue-collar job, lower income, and alcohol consumption in men; being married in women; smoking and skipping breakfast in both sexes.

CONCLUSION

Weight gain was much more pronounced in younger adults and at a higher baseline BMI in both sexes. Public education and health policies to prevent unnecessary weight gain should be strengthened by considering the associated harmful factors in Korean adults.

Evaluation of Caffeine Ingested Timing on Endurance Performance based on CYP1A2 rs762551 Profiling in Healthy Sedentary Young Adults

Background

Caffeine is generally suggested to increase VO2max in endurance performance. Nevertheless, the response to caffeine ingestion does not seem to be uniform across individuals. Therefore, caffeine ingested timing on endurance performance based on the type of CYP1A2 single nucleotide polymorphism rs762551, that were classified as fast and slow metabolizers, need to be evaluated.

Methods

Thirty participants participated in this study. DNA was obtained from saliva samples and genotyped using polymerase chain reaction-restriction fragment length polymorphism. Each respondent completed beep tests under three treatments blindly: placebo, 4 mg/kg body mass of caffeine one hour, and two hours before test.

Results

Caffeine increased estimated VO2max in fast metabolizers (caffeine=29.39±4.79, placebo=27.33±4.02, p<0.05) and slow metabolizers (caffeine=31.25±6.19, placebo=29.17±5.32, p<0.05) in one hour before test. Caffeine also increased estimated VO2max in fast metabolizers (caffeine=28.91±4.65, placebo=27.33±4.02, p<0.05) and slow metabolizers (caffeine=32.53±6.68, placebo=29.17±5.32, p<0.05) in two hour before test. However, for slow metabolizers, the increasing was greater when caffeine was administered two hours before test (slow=3.37±2.07, fast=1.57±1.62, p<0.05).

Conclusion

Genetic variance may affect the optimal caffeine ingestion timing, sedentary individuals who want to enhance their endurance performance may ingest caffeine 1 hour before exercise for fast metabolizers and 2 hours before exercise for slow metabolizers.

Gender Differences in Eating Habits of Polish Young Adults Aged 20-26

The aim of the study was to examine the nutritional behaviour of young adults depending on gender. A survey was conducted among 467 young adults using the "Questionnaire for the study of nutritional behaviour and opinions on food and nutrition". Questions concerned the frequency of consumption of selected groups of food products. The questionnaire was supplemented by questions regarding the number of portions of fruits and vegetables consumed, putting sugar in drinks, putting salt in dishes and the number of glasses of water drunk. Differences in nutritional behaviours were determined using the χ² test, at p < 0.05. The dietary choices of women more often than those of men corresponded to the principles of healthy nutrition, related to a greater number of meals consumed during the day, more frequent consumption of fruits and vegetables and the selection of products with lower energy value or preferring healthier methods of culinary processing. Health education programs should prevent the emergence of unfavourable dietary habits such as skipping breakfast or other meals or limiting the consumption of fruits and vegetables and frequently replacing them with high-energy snacks.

Breakfast skipping and timing of lunch and dinner: Relationship with BMI and obesity

OBJECTIVE

To determine whether breakfast-skipping, late-lunch, and late-dinner eating are cross-sectionally associated with higher BMI and obesity. Also, to identify obesogenic behaviors and circadian-related variables, associated with late eating.

METHODS

Participants(n = 776) were part of exploratory, population-based research, with data collection in a virtual environment. They were grouped into breakfast-eaters (first meal until 10:00) and skippers (first meal after 10:00), and the population median for the lunch and dinner timing was used to stratify participants into early (lunch/dinner-time before 12:34/20:55) and late (lunch/dinner-time after 12:34/20:55) eaters. Student's t-test and chi-square test were performed to assess differences in characteristics and lifestyle traits between groups. Logistic regression models were used to assess differences in obesity between groups. Linear regression analysis was conducted to determine the association of the clock time of meals with BMI. Analyses were adjusted for potential confounders variables.

RESULTS

BMI raised of 0.74 Kg/m2 for each additional hour of lunch-time [95 %CI= 0.31;1.18,P ≤ 0.001]. Breakfast-skippers [OR(95 % CI):1.84(1.02;3.31);P ≤ 0.05] and late-lunch eaters [OR(95 % CI):1.61(1.04;2.49),P ≤ 0.05] had higher odds of having obesity, compared with breakfast-eaters and early-lunch eaters, respectively. These associations were independent of age, gender, diet quality, physical activity duration, and region. No statistically significant differences were found in the comparison between early and late-dinner eaters.

CONCLUSIONS

Our results suggest that skipping breakfast and eating late-lunch are associated with BMI and higher odds of having obesity. Insights into the obesogenic behaviors/characteristics related to breakfast-skipping and late-eating may be helpful for future nutritional recommendations and obesity prevention and treatment.

Association between Breakfast Meal Categories and Timing of Physical Activity of Japanese Workers

Background: Breakfast is the most important meal of the day and has been associated with longevity. Regular breakfast consumers often have a healthy lifestyle, including a healthy diet and regular physical activity. Methods: We examined the association between breakfast type, chronotype (morningness-eveningness), and physical activity in 3395 Japanese workers using a cross-sectional web survey. Results: Participants who ate Japanese breakfasts showed an early chronotype, while those who ate breakfast cereal exhibited a later chronotype. Physical activity was positively associated with adopting a Japanese breakfast style. Japanese breakfast eaters performed physical activities from 6:00–9:00 compared with other breakfast eaters. Conclusion: Our findings suggest that eating a Japanese breakfast is associated with an earlier chronotype (morningness) and higher physical activity.

[Influence of sleep and chrononutrition on hypertension and diabetes: a population-based study]

The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.

Breakfast Skipping among a Multi-Ethnic Population of Young Men and Relationship with Sociodemographic Determinants and Weight Status

Breakfast skipping is linked with obesity incidence. This study was conducted to assess the prevalence of breakfast skipping among a multi-ethnic population of young men residing in Saudi Arabia and its relationship with sociodemographic determinants and weight status. A total of 3600 young men aged 20 to 35 years and living in Riyadh, Saudi Arabia, were involved in this cross-sectional study. Sociodemographic determinants and breakfast-consumption frequency were collected from subjects by personal interviews. This study defines breakfast skipping as skipping breakfast at least one day per week. Weight and height were measured following standardized methods. The prevalence of breakfast skipping was observed among 52.8% of the study subjects. Nationality was a predictor of breakfast skipping, with the lowest and highest rates of breakfast skipping reported among young men from Bangladesh (14.0%) and Saudi Arabia (86.5%), respectively. Weight status was another predictor of breakfast skipping, as the mean body mass index for breakfast skippers (25.4 kg/m2) was significantly (p-value < 0.001) higher than that for breakfast consumers (24.8 kg/m2). Overweight/obese subjects have a significantly higher rate of breakfast skipping (56.9%) than underweight/normal weight subjects (48.9%). In conclusion, breakfast skipping prevalence is relatively high among young men residing in Saudi Arabia. The findings confirm a relationship between breakfast skipping and sociodemographic determinants and weight status.

The relationship between the risk of eating disorder and meal patterns in University students

PURPOSE

This study was carried out to evaluate the relation between meal patterns and the risk of eating disorders in university students.

METHODS

The study was conducted on a total of 331 volunteer students with a mean age of 22.08 ± 1.80 years, 56.5% female. Participants' sociodemographic characteristics, health information and eating habits like meal skipping and dieting were questioned. Sick, Control, One stone, Fat, Food (SCOFF) Eating Disorders Scale and Eating Disorder Examination Questionnaire (EDE-Q) were used to determine eating behavior disorders, with face to face interviews by the researches.

RESULTS

A significant correlation was found between dieting and skipping meals and the risk of eating disorders in both genders (p < 0.05). In addition, when the reasons for skipping meals were questioned, a significant relationship was detected between skipping meals and eating behaviour disorders by 3.285 times (p = 0.000). Also, every unit of increase in body mass index (BMI) values of individuals who participated to the study led to an increase in eating disorders by a factor of 1.262 (p = 0.000).

CONCLUSIONS

Our findings support concerns about the negative health effects of increasing overweight among university students in accordance with the data that the increase in BMI values led to an increase in eating disorders. Notably a significant correlation was found between dieting, skipping meals and the risk of eating disorders in both genders it is highlighting the need for monitoring and early diagnosis of eating disorders in youth with simple scales like SCOFF.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

The Impact of the COVID-19 Pandemic on Young Australian Adults' Food Practices

Background

Young Australian adults exhibit poor food behaviors. These include increased consumption of Energy-Dense, Nutrient-Poor (EDNP) foods, sugar-sweetened beverages, and low consumption of fruit and vegetables. However, little is known about how the coronavirus disease 2019 (COVID-19) pandemic affected young Australian adults' pre-existing adverse food behaviors.

Objectives

The present study aimed to understand the impact of the COVID-19 pandemic on food practices by exploring views of young adults living in Australia.

Methods

Through qualitative descriptive methods, data gathered through individual interviews were thematically analyzed. Participants included 38 young adults aged 18-30 y with a mean age of 24.1 y (76% female).

Results

Five themes emerged: 1) disruption of routines, 2) increased flexibility, 3) changes in food practices, 4) heightened psychological distress, and 5) impact on future behaviors. Disruption of routines and increased flexibility associated with working/learning from home resulted in both positive and negative changes in food practices. Negative changes included increased consumption of EDNP foods, increased consumption of foods prepared outside of home, decreased purchases and consumption of fresh foods, meal skipping, and a lack of meal planning. Positive changes included an increase in home cooking; consistent weekly eating patterns; decreased consumption of EDNP foods; smaller, more frequent meals; and decreased consumption of foods prepared outside of home.

Conclusions

Young Australian adults reported more negative and fewer positive changes in food practices. The observed negative changes in food practices are likely to have accentuated young Australian adults' previously known poor food behaviors. This study adds to the international literature by reporting ways that young adults implemented positive changes during the pandemic and future directions of their food practices.

Breakfast Skipping in a Multi-Ethnic Population of Middle-Aged Men and Relationship With Sociodemographic Variables and Weight Status

Background

Breakfast eating is regarded to be necessary for maintaining a healthy body weight. On the other hand, breakfast skipping has been linked with obesity incidence. This study was carried out to determine the prevalence of breakfast skipping among a multi-ethnic group of middle-aged men living in Saudi Arabia and the association between breakfast skipping and sociodemographic variables and weight status.

Methods

This cross-sectional study included 1,800 middle-aged men aged 36–59 years. Participants' sociodemographic information and frequency of breakfast eating were obtained through personal interviews. The body mass index was determined after measuring body weight and height using standardized methods.

Results

The prevalence of breakfast skipping was 42.1% of the study participants. Nationality was a predictor of breakfast skipping. Bangladeshi participants (N = 100) have the lowest rate of breakfast skipping (9.0%), whilst Saudi participants (N = 161) have the highest rate (73.3%). Weight status was another predictor of breakfast skipping as breakfast skippers had a significantly higher average body mass index (27.1 ± 3.8) than breakfast consumers (26.2 ± 3.5). Overweight/obese participants have a significantly higher breakfast skipping rate (44.9%) than participants with underweight/normal weight (36.6%).

Conclusion

The rate of breakfast skipping is relatively high among middle-aged men living in Saudi Arabia. The data support a link between breakfast skipping and sociodemographic variables and weight status.

Breakfast Consumption and Academic Achievement Among Chinese Adolescents: A Moderated Mediation Model

The studies have shown that a healthy lifestyle has a significant impact on the academic achievement of adolescents. Behavior of breakfast eating is considered a hallmark of dietary patterns and an important component of a healthy lifestyle. The prior study explained that students had a lower level of achievement motivation at school because they were exposed to some militating factors in their families such as absenteeism, ill health, malnutrition, and hunger. This study examined the mediating role of achievement motivation and moderating role of socioeconomic status (SES) in the association between breakfast consumption and academic achievement. This study used a sample of 15-year-old Chinese students who participated in Program for International Student Assessment (PISA) 2015. In terms of gender, female students accounted for 47.2% and male students accounted for 52.8%. The results showed that (1) breakfast consumption had a positive predictive effect on academic achievement; (2) achievement motivation played a partial mediating role in the relationship between breakfast consumption and academic achievement; and (3) the direct and indirect effects were moderated by the SES of students, which meant that the effect of breakfast consumption on achievement motivation can differ depending on the SES of students. Besides, both the effects were stronger for individuals with higher SES. The conclusion of this study has an important theoretical value and reference value to guide the Chinese parents and Chinese adolescents to pay more attention to breakfast consumption and healthy lifestyles.

Breakfast Consumption Suppresses Appetite but Does Not Increase Daily Energy Intake or Physical Activity Energy Expenditure When Compared with Breakfast Omission in Adolescent Girls Who Habitually Skip Breakfast: A 7-Day Randomised Crossover Trial

With concerns that adolescent girls often skip breakfast, this study compared the effects of breakfast consumption versus breakfast omission on free-living physical activity (PA) energy expenditure (PAEE) and dietary intakes among adolescent girls classified as habitual breakfast skippers. The participants went through two 7-day conditions in a trial with a crossover design: daily standardised breakfast consumption (energy content: 25% of resting metabolic rate) before 09:00 (BC) and daily breakfast omission (no energy-providing nutrients consumed) until 10:30 (BO). Free-living PAEE, dietary intakes, and perceived appetite, tiredness, and energy levels were assessed. Analyses were linear mixed models. Breakfast manipulation did not affect PAEE or PA duration. Daily fibre intake was higher (p = 0.005; d = 1.31), daily protein intake tended to be higher (p = 0.092; d = 0.54), post-10:30 carbohydrate intake tended to be lower (p = 0.096; d = 0.41), and pre-10:30 hunger and fullness were lower and higher, respectively (p ≤ 0.065; d = 0.33-1.01), in BC versus BO. No other between-condition differences were found. Breakfast-skipping adolescent girls do not compensate for an imbalance in energy intake caused by breakfast consumption versus omission through subsequent changes in PAEE but may increase their carbohydrate intakes later in the day to partially compensate for breakfast omission. Furthermore, breakfast can make substantial contributions to daily fibre intake among adolescent girls.

Pengaruh Pemberian Diet Isokalori Tinggi Serat terhadap Tingkat Satiety pada Kelompok Usia Dewasa Awal

Latar Belakang: Belum banyak penelitian yang membandingkan pengaruh diet tinggi serat larut air dan diet tinggi serat tidak larut air terhadap tingkat satiety.Tujuan:Menganalisis pengaruh pemberian diet isokalori tinggi serat terhadap tingkat satiety pada kelompok usia dewasa awal status gizi normal.Metode: Penelitian eksperimentaldengan rancangan pre-post group design. Subjek penelitian adalah 16 orang dewasa awal usia 20-23 tahun (10 perempuan dan 6 laki-laki) yang diambil secara consecutive sampling. Semua subjek diberikan 2 jenis diet isokalori dengan rasio serat larut air : serat tidak larut air sebesar 3:2 dan 1:3 dengan masing-masing wash out period selama 1 hari. Energi yang diberikan sebesar 20% dari total kebutuhan masing-masing subjek. Variabel yang diukur adalah tingkat satiety yang terdiri dari tingkat desire to eat, hunger, fullness dan prospective food consumption/PFC menggunakan kuesioner Visual Analogue Scale. Analisis statistik menggunakan paired t-test, wilcoxon, mann-whitney dan independent t-test.Hasil: Diet tinggi serat larut air memiliki efek lebih lama 1 jam dalam menekan hunger dan desire to eat dan memiliki efek lebih lama 30 menit dalam menekan PFC dibandingkan diet tinggi serat tidak larut air, namun kedua diet tersebut sama-sama baik dalam meningkatkan fullness hingga 3 jam setelah intervensi.Kesimpulan: Pemberian diet tinggi serat dapat menekan tingkat desire to eat, hunger, PFC dan meningkatkan fullness. Diet tinggi serat larut air mempunyai efek lebih lama terhadap tingkat satiety dibandingkan diet tinggi serat tidak larut air.

Delayed Meal Timing, a Breakfast Skipping Model, Increased Hepatic Lipid Accumulation and Adipose Tissue Weight by Disintegrating Circadian Oscillation in Rats Fed a High-Cholesterol Diet

Background: To investigate whether shifted timing of eating, breakfast skipping, induces alterations in the circadian clock and abnormal lipid metabolism, we have established a delayed meal timing (DMT) protocol for rats, which started eating food 4 h delay. In the present study, control and DMT rats were fed a high-cholesterol diet during zeitgeber time (ZT) 12-24 and ZT 16-4, respectively. The DMT protocol increased the hepatic lipids and epididymal adipose tissue weight without changes in food intake and body weight. The surge in body temperature was delayed by 4 h in the DMT group, suggesting that energy expenditure was decreased in response to DMT. The peaks of the diurnal rhythm of serum non-esterified fatty acids and insulin were delayed by 2 and 4 h due to DMT, respectively. The oscillation peaks of hepatic de novo fatty acid synthesis gene expression was delayed by 4 h in response to DMT, whereas the peak of hepatic clock genes were 2 h delayed or not by DMT. Although metabolic oscillation is considered to be controlled by clock genes, the disintegration rhythms between the clock genes and lipid metabolism-related genes were not observed in rats fed a high-fat diet in our previous study. These data suggest that the circadian rhythm of de novo fatty acid metabolism is regulated by timing of eating, but is not directly controlled by clock genes. The present study suggests that breakfast skipping would complicate fatty liver and body fat accumulation.

Breakfast Location Effect on Breakfast Quality and Obesity Risk in Saudi Female College Students

Background:

There is a lack of data regarding breakfast consumption and quality among college students in the Kingdom of Saudi Arabia.

Objective:

The objective of this study was to assess the prevalence of breakfast consumption and examine the effect of breakfast location on breakfast nutritional quality and obesity risk among female college students at Taibah University.

Methods:

A total of 658 students participated in this cross-sectional study. Based on the Child and Adult Care Food Program (CACFP) recommendations, breakfast quality scores were computed by summing the individual food components and categorizing participants according to tertiles of the breakfast score distribution. Mixed-effects repeatedmeasures models were used to examine BMI categories with increasing tertiles of breakfast quality scores, stratified by breakfast location.

Results and Discussion:

Approximately 68% of the participants reported having breakfast regularly. The mean breakfast quality score was determined for students who had breakfast at home (12.5 ± 0.11), at college (10.41± 0.06), and in other places (8.19± 0.48). Obesity was associated with lower average breakfast quality scores based on breakfast location [mean quintile 3 compared with 1 difference: home 13.6 (P < 0.001), college 9.1 (P < 0.001), other 8.6 (P < 0.001)].

Conclusion:

The findings presented here indicated that a high percentage of students consume breakfast regularly. Students who had breakfast at home had high scores, which indicated good breakfast quality and a decreased risk of obesity. Further research on breakfast quality is needed in this area, as it affects the nutritional status and quality of life of the younger population.

Insufficient Sleep and Poor Sleep Quality Completely Mediate the Relationship between Financial Stress and Dietary Risk among Higher Education Students

The coronavirus disease 2019 (COVID-19) pandemic worsened financial stress for higher education students in the U.S. Financial stress is associated with poor dietary behaviors; however, factors that might influence this relationship are not well characterized. The present cross-sectional study investigated the associations between financial stress and dietary intake and dietary risk scores among higher education students (undergraduate and graduate students) in the U.S. and examined whether poor sleep quality and short sleep duration mediated the relationship between financial stress and dietary risk score. Validated tools were used to assess financial stress, sleep quality, sleep duration, dietary intake, and dietary risk. A total of 1280 students from three large U.S. universities completed the study. Results indicated that higher financial stress was associated with lower vegetable, fruit, fiber, and calcium intake, higher added sugar intake from sugar sweetened beverages, and higher dietary risk score. Further, the positive relationship between financial stress and dietary risk score was completely mediated by poor sleep quality among students who reported poor sleep quality and by short sleep duration among students who slept less than 7 h per night. These findings suggest that students might benefit from both financial management training and sleep education services to reduce undesirable dietary behaviors.

Effect of Breakfast Consumption and Meal Time Regularity on Nutrient Intake and Cardiometabolic Health in Korean Adults

Objective

Dietary factors are important contributors to obesity and related metabolic disorders. Few studies have evaluated the impact of dietary habits (e.g., breakfast consumption frequency and meal regularity) on metabolic health. We investigated the effects of breakfast consumption frequency and meal time regularity on nutrient intake and cardiometabolic status in Korean adults.

Methods

Participants without diagnosed diseases (n=217) were examined for anthropometric and biochemical parameters, lifestyle, dietary habits, and nutrient intake. They were categorized into 4 groups by breakfast consumption frequency (≥6 or <6 times/week) and meal time regularity (regular or irregular): breakfast ≥6 times/week and regular eating (HBRE), breakfast ≥6 times/week and irregular eating (HBIE), breakfast <6 times/week and regular eating (LBRE) and breakfast <6 times/week and irregular eating (LBIE).

Results

Participants in the LBIE group were the youngest, had higher waist circumference, body mass index, triglyceride levels, and inflammation, and consumed the highest daily total caloric intake (TCI), the highest proportion of fats, and the lowest proportion of carbohydrates. The LBIE group also had the lowest proportion of energy intake at breakfast and the highest proportion at dinner. The LBIE group consumed the lowest amounts of fiber, beta-carotene, vitamin K, folate, calcium and iron, and had the highest prevalence of inadequate nutrient intake for TCI, protein, vitamins A, C, B6, and B12, folate, calcium, iron, zinc, and copper.

Conclusion

Regular breakfast consumption and meal times are related to healthy lifestyle habits and adequate nutrient intake, which affect metabolic health, thereby helping prevent obesity and related metabolic disorders.

Breakfast Frequency Is Inversely Associated with Weight Gain in a Cohort of Mexican Women

BACKGROUND

Food timing affects circadian rhythms involved in weight control. Regular consumption of breakfast may affect body weight.

OBJECTIVE

We examined the relation between breakfast frequency with weight change in middle-age women over a 3-y period.

METHODS

We used data from 65,099 nonpregnant women aged >20 y participating in the Mexican Teachers' Cohort (MTC) who at baseline (2006-2008) were cancer free and for whom self-reported breakfast frequency at baseline was available. We analyzed body weight change between baseline and the first follow-up (2011) according to breakfast frequency. Participants were classified according to baseline breakfast frequency 0, 1-3, 4-6, or 7 d/wk and meal frequency 1-2, 3-4, or ≥5 meals/d. We used linear and modified Poisson regression to analyze body weight change as a continuous variable and for weight gain ≥5 kg (yes/no), respectively. Models were adjusted for sociodemographic and lifestyle confounders.

RESULTS

At baseline, 25% of participants were daily breakfast consumers and 18.4% of women increased ≥5 kg between 2008 and 2011. The prevalence of weight gain ≥5 kg among daily breakfast consumers was 7% lower than among those who skipped breakfast (prevalence ratio: 0.93; 95% CI: 0.89, 0.97; P-trend = 0.02). The association was stronger among normal-weight women at baseline with a corresponding estimate of 0.87 (95% CI: 0.79, 0.97; P-trend = 0.02).

CONCLUSION

Daily breakfast consumption was inversely associated with weight gain ≥5 kg over 3 y in middle-aged Mexican women. Regular breakfast may be an important dietary factor for body weight change.

Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review

BACKGROUND

There is an increasing global trend towards urbanization. In general, there are less food access issues in urban than rural areas, but this "urban advantage" does not benefit the poorest who face disproportionate barriers to accessing healthy food and have an increased risk of malnutrition.

OBJECTIVES

This systematic literature review aimed to assess urban poverty as a determinant of access to a healthy diet, and to examine the contribution of urban poverty to the nutritional status of individuals.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, our review included quantitative and qualitative studies published in English or in Spanish between 2000 and 2019. The articles were eligible if they focused on nutrition access (i.e. access to a healthy diet) or nutrition outcomes (i.e., anemia, overweight and obesity, micronutrient deficiency, micronutrient malnutrition) among urban poor populations. Articles were excluded if they did not meet pre-established criteria. The quality of the quantitative studies was assessed by applying Khan et al.'s methodology. Similarly, we assessed the quality of qualitative articles through an adapted version of the National Institute for Health and Care Excellence (NICE) methodology checklist. Finally, we systematically analyzed all papers that met the inclusion criteria based on a qualitative content and thematic analysis.

RESULTS

Of the 68 papers included in the systematic review, 55 used quantitative and 13 used qualitative methods. Through the analysis of the literature we found four key themes: (i) elements that affect access to healthy eating in individuals in urban poverty, (ii) food insecurity and urban poverty, (iii) risk factors for the nutritional status of urban poor and (iv) coping strategies to limited access to food. Based on the systematization of the literature on these themes, we then proposed a conceptual framework of urban poverty and nutrition.

CONCLUSIONS

This systematic review identified distinct barriers posed by urban poverty in accessing healthy diets and its association with poorer nutrition outcomes, hence, questioning the "urban advantage". A conceptual framework emerging from the existing literature is proposed to guide future studies and policies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO Registration number: CRD42018089788 .

Association between Breakfast Skipping and Body Weight-A Systematic Review and Meta-Analysis of Observational Longitudinal Studies

Globally, increasing rates of obesity are one of the most important health issues. The association between breakfast skipping and body weight is contradictory between cross-sectional and interventional studies. This systematic review and meta-analysis aims to summarize this association based on observational longitudinal studies. We included prospective studies on breakfast skipping and overweight/obesity or weight change in adults. The literature was searched until September 2020 in PubMed and Web of Science. Summary risk ratios (RRs) or β coefficients with a 95% confidence interval (CI), respectively, were estimated in pairwise meta-analyses by applying a random-effects model. In total, nine studies were included in the systematic review and three of them were included in the meta-analyses. The meta-analyses indicated an 11% increased RR for overweight/obesity when breakfast was skipped on ≥3 days per week compared to ≤2 days per week (95% CI: 1.04, 1.19, n = two studies). The meta-analysis on body mass index (BMI) change displayed no difference between breakfast skipping and eating (β = −0.02; 95% CI: −0.05, 0.01; n = two studies). This study provides minimal evidence that breakfast skipping might lead to weight gain and the onset of overweight and obesity.

Weight Gain After 20 Years of Age is Associated with Unfavorable Lifestyle and Increased Prevalence of Metabolic Disorders

PURPOSE

It is unclear what kind of modifiable lifestyle factors are associated with long-time weight gain in adulthood. To clarify the lifestyle behavior related to body weight gain since the age of 20 years, we explored the lifestyle risk factor, independently associated with excessive weight gain after 20 years of age as compared to those in subjects with a stable weight, with matching of age, gender, and the current body mass index (BMI).

PATIENTS AND METHODS

From baseline data of a general population-based cohort study, we designed a cross-sectional analysis collecting individual data of medical health check-ups and a questionnaire related to lifestyle, including amount of sleep, frequency of eating breakfast, average times per day engaged in walking and sitting in the prior year, and smoking habits. These data were compared between the subjects with weight gain ≥10kg (n=3601) and <10kg (n=3601) after age 20, matched by a propensity score model which included current BMI, age and gender. We used multivariable logistic regressions to assess the lifestyle factor's association with high weight gain.

RESULTS

Participants who gained ≥10 kg were significantly more likely to sleep <5 hours or ≥9 hours per night, skip breakfast, engage in walking <1 hour per day, and sit ≥5 hours per day than those who gained <10kg. Multivariable logistic regressions analyses showed that, with adjusting for potential confounder, the lifestyles with the positive association with high weight gain were skipping breakfast (OR 1.252; 95% CI 1.053-1.489, vs regularly), long sleeping duration (9 hours/day≤ OR 1.613; 95% CI 1.018-2.557 vs 5≤-<7 hours/day), and former smoker (OR 1.163; 95% CI 1.008-1.343 vs never smoker), while walking duration was negatively associated with high weight gain. Furthermore, despite similar current BMI, participants with weight gain ≥10kg had significantly higher values for waist circumference, blood pressure, HbA1c, LDL-C, triglycerides, and hepatic enzyme levels than those with weight gain <10kg. Similarly, the prevalence rates of hypertension, dyslipidemia, metabolic syndrome (MetS), and former smoker were higher in the participants with weight gain ≥10kg.

CONCLUSION

Major weight gain after 20 years of age was associated with unfavorable lifestyle factors and greater waist circumference, possibly leading to elevated risk for MetS and other non-communicable diseases. These findings highlight the importance of maintaining both weight at age 20 and a favorable lifestyle throughout adulthood.

Use of workplace foodservices is associated with reduced meal skipping in Korean adult workers: A nationwide cross-sectional study

Skipping meals is a poor eating behaviour known to result in poor diet quality and health outcomes. Nevertheless, it has become increasingly common over the past few decades in many countries. This study aimed to examine the potential association between the use of workplace foodservices and skipping meals among Korean adult workers using data from the Korea National Health and Nutrition Examination Survey 2016–2018, a nationwide cross-sectional survey of a representative Korean population. A total of 5,137 workers aged 20–64 years were included. Dietary assessment was conducted using a 24-hour dietary recall. In total, 41.2% participants skipped one meal or more per day. The percentage of workers who skipped meals was 43.1±1.0% among participants who did not use workplace foodservices compared to 31.8±1.9% among those who did (P<0.01). Skipping meals was significantly associated with not using workplace foodservices, after adjusting for other confounders including sociodemographic variables, health-related variables, and meal procurement source (odds ratio = 3.4; 95% confidence interval = 2.6–4.4; P<0.01). We found a significant association between using workplace foodservices and reduced skipping meals in Korean adult workers. This study suggests the importance of the provision of workplace foodservices for workers to potentially reduce poor eating behaviours such as skipping meals.

Improving sleep disturbances in obesity by nutritional strategies: review of current evidence and practical guide

Over the past decades, there has been an increase in overweight and obesity worldwide rates in both in adult and children. In parallel, it has been reported a worsening of sleep duration and quality. Some studies have shown an association between obesity and sleep disturbances (SD) vice versa, subjects with obesity have a greater risk of SD. As well as SD influences diet, also food choices have been shown to influence various sleep-related variables, such as duration and quality. For this reason, nutrition could represent an important tool not only to lose weight but also to improve sleep in patients with obesity and sleep disturbances. Thus, the aim of this review is to provide an overview of the studies that assessed the association between obesity and SD and vice versa, highlighting possible nutritional advices as a tool to improve sleep in patients with obesity and sleep disturbances.

Nutritional breakfast quality and cardiometabolic risk factors: Health Survey of São Paulo, a population-based study

OBJECTIVE

To evaluate the association between nutritional quality of breakfast and cardiometabolic risk factors.

DESIGN

Cross-sectional study, 2015 Health Survey of São Paulo (2015 ISA-Capital) with Focus on Nutrition Study (2015 ISA-Nutrition).

SETTINGS

Population-based study, with a representative sample of adults and elderlies living in São Paulo, Brazil.

PARTICIPANTS

The sample included 606 adults (aged 20-59 years) and 537 elderlies (aged ≥60 years) from the 2015 Health Survey of São Paulo. Dietary intake was assessed by at least one 24-h recall. Breakfast quality was evaluated using the proposed Brazilian Breakfast Quality Index (BQI), ranging scores from 0 to 10. BQI associations with sociodemographic, lifestyle, dietetic and cardiometabolic variables were estimated using survey-weighted multiple logistic regression models.

RESULTS

Being ≥60 years of age, self-identifying as White or Asian, having a per capita family income with ≥1 minimum wage, being sufficiently active at leisure time and non-smoker were associated with better scores of BQI. A higher BQI score was inversely associated with elevated blood pressure (OR 0·81, 95 % CI 0·70, 0·94), fasting glucose (OR 0·85, 95 % CI 0·73, 0·98), HOMA-IR (OR 0·86, 95 % CI 0·74, 0·98), total cholesterol (OR 0·87, 95 % CI 0·76, 0·99), LDL-C (OR 0·85, 95 % CI 0·74, 0·97), metabolic syndrome (OR 0·82, 95 % CI 0·72, 0·93) and being overweight (OR 0·87, 95 % CI 0·76, 0·99).

CONCLUSIONS

Breakfast quality of Brazilian adults needs improvement with disparities across some sociodemographic factors. BQI was associated with lower odds of cardiometabolic risk factors, suggesting a beneficial effect in this population and emphasising the role of breakfast in reducing the risk of CVD.

Association between Breakfast Skipping and the Metabolic Syndrome: The Korea National Health and Nutrition Examination Survey, 2017

Background and Objectives: Recently, the prevalence of metabolic syndrome in Korea has increased rapidly. Current knowledge reflects the importance of dietary control in relation to the metabolic syndrome. The objective of this study was to evaluate the influence of skipping breakfast on the metabolic syndrome. Materials and Methods: We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey 2017 for the second year. A total of 3864 adults aged 20 to 64 were included in the study. We stratified the study population into three groups, based on breakfast patterns: the regular group, irregular group, and skipping group. Multiple logistic regression analysis was used to analyze the association between skipping breakfast and the presence of metabolic syndrome. Results: We noted an increase in the proportion of metabolic syndrome cases as follows: skipping group (3.3%), irregular group (5.4%), and regular group (8.5%) (p < 0.001). The multivariate-adjusted odds ratios of metabolic syndrome in the skipping and irregular groups compared with the regular group were 0.68 (95% CI; 0.35 to 1.35) and 0.81 (95% CI; 0.51 to 1.28), respectively. In the 40-65-year-old age group, which had a high prevalence of metabolic syndrome, the multivariate-adjusted odds ratios of metabolic syndrome in the skipping group compared with regular group were 0.78 (95%CI, 0.39 to 1.62). Conclusions: There was no significant correlation between skipping breakfast and risk factors of metabolic syndrome (after adjusting for risk factors), but a tendency of skipping breakfast to lower the risk of metabolic syndrome was observed. A rationale for these results is proposed through the association between skipping breakfast and intermittent fasting.

Association of fruit and vegetable intake with meal skipping in children and adolescents: the CASPIAN-V study

BACKGROUND

There are few studies on the association of main meal consumption with fruit and vegetable intake. This study aims to assess the relation between skipping main meals and fruit and vegetable intake in children and adolescents.

METHODS

This multi-centric cross-sectional study was conducted in 30 provinces of Iran. This study was conducted in the framework of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease study (CASPIAN- V). 14,440 school students aged 7-18 years were assessed. Logistic regression analyses were used to evaluate the association between frequency of fruit and vegetable intake with skipping main meals.

RESULTS

Overall, 14,274 students completed the study (99% participation rate). Their mean (SD) age was 12.3 (3.2) (53% were aged 6-12), 50.6% of them were boys, and 71.3% lived in urban area. In multivariate logistic regression model, statistically significant associations were found between skipping main meals and low fruits and vegetables intake. Skipping breakfast was associated with vegetables intake [OR = 1.19(95% CI 1.02-1.38)] and fruits intake [OR = 5.33(95% CI 4.46-6.37)]. Skipping lunch was associated with vegetables intake [OR = 1.61(95% CI 1.29-1.96)] and fruit intake [OR = 9.11(95% CI 6.55-12.67)]. Skipping dinner was associated with vegetables intake [OR = 1.52 (95% CI 1.15-2.01)] and fruits intake [OR = 2.21(95% CI 1.64-2.97)].

CONCLUSIONS

In this study, low frequency of fruit and vegetable intake was associated with skipping main meals. The results highlight the importance of promoting regular meal consumption with increase in the intake of fruit and vegetables among children and adolescents.

LEVEL OF EVIDENCE

Level V.