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Yeo GS, Lee ST, Wong JE, Khouw I, Safii NS, Poh BK. Association of breakfast skipping on nutrient intake and adiposity in Malaysian children: Findings from SEANUTS II. Appetite 2024; 201:107607. [PMID: 39029531 DOI: 10.1016/j.appet.2024.107607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/26/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
Malaysian children often skip breakfast, an important meal providing essential nutrients for optimal growth and maintaining proper nutritional status. Therefore, this study aims to investigate the associations between breakfast skipping with dietary intake, diet quality, and adiposity indicators among primary schoolchildren aged 6.0-12.9 years. This study involved 1383 children from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia. Information collected through questionnaires included sociodemography and breakfast consumption, defined as the first meal before noon. Breakfast skipping was identified as skipping breakfast at least once a week. Anthropometric measures, including height, body weight, and waist circumference, as well as percentage of body fat, were collected. Body mass index (BMI) and waist-to-height ratio were calculated, and BMI-for-age-z-scores was determined using WHO (2007) growth reference. A one-day 24-hour dietary recall was employed to assess dietary intake, and diet quality was analyzed using Malaysian Healthy Eating Index. Binary logistic regression was applied to examine relationship between breakfast skipping on diet quality and adiposity indicators. Over one-third (36.0%) of children skipped breakfast at least once a week, resulting in lower intakes of energy, nutrients, cereals/grains, vegetables, and milk/dairy products, though not affecting total diet quality score. Breakfast skipping was associated with higher odds of overweight/obesity (aOR 2.04, 95%CI: 1.52-2.76) and central obesity (aOR 1.87, 95%CI 1.34-2.61). In conclusion, primary schoolchildren in Peninsular Malaysia who skipped breakfast tended to have lower consumption of nutrients and specific basic food groups, as well as increased body fat. This study highlights the importance of continuing to educate parents and children about healthy eating habits, especially the need to adhere to dietary recommendations, with an emphasis on breakfast consumption.
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Affiliation(s)
- Giin Shang Yeo
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Shoo Thien Lee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia; Faculty of Health and Life Sciences, Management and Science University, 40100, Shah Alam, Malaysia
| | - Jyh Eiin Wong
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia; Obesity-UKM Research Group, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia
| | - Ilse Khouw
- FrieslandCampina, Amersfoort, the Netherlands
| | - Nik Shanita Safii
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia; Obesity-UKM Research Group, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia.
| | - Bee Koon Poh
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia; Obesity-UKM Research Group, Universiti Kebangsaan Malaysia, 43600, Bangi, Malaysia.
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Bodepudi S, Hinds M, Northam K, Reilly-Harrington NA, Stanford FC. Barriers to Care for Pediatric Patients with Obesity. Life (Basel) 2024; 14:884. [PMID: 39063637 PMCID: PMC11277597 DOI: 10.3390/life14070884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
This review article emphasizes the challenges pediatric patients face during obesity treatment. Prior research has been compartmentalized, acknowledging that stigma, the ability to implement lifestyle changes, social health determinants, and healthcare accessibility are considerable impediments for obese children. These issues emerge at various levels, including the individual or family, the community and school, and even national policy. This suggests the need for a more comprehensive, team-based approach to tackle pediatric obesity. Understanding these barriers is the first step toward creating effective strategies and solutions to overcome these challenges.
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Affiliation(s)
- Sreevidya Bodepudi
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Kayla Northam
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
| | - Noreen A. Reilly-Harrington
- MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA; (K.N.); (N.A.R.-H.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA 02115, USA
- MGH Weight Center, Massachusetts General Hospital, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Boston, MA 02114, USA
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Fischer JAJ, Thomas J, van Zutphen‐Küffer KG, Ierodiakonou D, Kraemer K, Garcia‐Larsen V. PROTOCOL: Breakfast consumption, anthropometry, and nutrition-related outcomes in adolescents from low- and middle-income countries: Protocol for a systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1415. [PMID: 38808167 PMCID: PMC11131355 DOI: 10.1002/cl2.1415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/30/2024]
Abstract
Objectives This is the protocol for a Campbell systematic review. The objectives are as follows: The aim of this systematic review is to examine the scientific evidence available from low- and middle-income countries on the association of breakfast consumption habits and anthropometry/adiposity- and nutrition-related outcomes in adolescents aged 10-19 years old.
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Affiliation(s)
| | - Jonathan Thomas
- Sight and LifeBaselSwitzerland
- School of Medicine, Texas A&MBryanTexasUSA
| | | | - Despo Ierodiakonou
- Department of Primary Care and Population HealthUniversity of Nicosia Medical SchoolNicosiaCyprus
| | - Klaus Kraemer
- Sight and LifeBaselSwitzerland
- Program in Human Nutrition, Department of International HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Vanessa Garcia‐Larsen
- Program in Human Nutrition, Department of International HealthJohns Hopkins UniversityBaltimoreMarylandUSA
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Khan MSI, Paul T, Al Banna MH, Hamiduzzaman M, Tengan C, Kissi-Abrokwah B, Tetteh JK, Hossain F, Islam MS, Brazendale K. Skipping breakfast and its association with sociodemographic characteristics, night eating syndrome, and sleep quality among university students in Bangladesh. BMC Nutr 2024; 10:46. [PMID: 38439041 PMCID: PMC10913273 DOI: 10.1186/s40795-024-00860-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
INTRODUCTION Skipping breakfast has become more common, and it can significantly affect a person's health, performance, mood, and other physiological and psychological factors. In Bangladesh, university students often encounter unhealthy dietary habits, which raises questions about why many university students choose to skip breakfast. The purpose of this study was to investigate the prevalence of skipping breakfast among university students in Bangladesh and explore the contributing factors. METHODS Patuakhali Science and Technology University, Bangladesh was the location of this cross-sectional study. Breakfast consumption was measured with the single-question item, "How often do you eat breakfast?" (Almost every day, sometimes, rarely, or never). Skipping breakfast was classified as respondents selecting sometimes, rarely, or never having breakfast. Sociodemographic, behavioral, and sleep-related data were collected as key predictor variables. Multiple logistic regression models identified factors associated with skipping breakfast. RESULTS The prevalence of skipping breakfast among study participants (N = 502, 51.6% female and mean age 21.31 years) was 63.5%. Female students were more likely to skip breakfast compared to male students (adjusted odds ratio, AOR = 1.65, 95% CI: 1.06-2.55). Smoker participants had a higher likelihood of skipping breakfast compared to non-smokers (AOR = 3.92, 95% CI: 1.57-9.78). Students with night eating syndrome had a higher likelihood of skipping breakfast compared to their counterparts (AOR = 1.84, 95% CI: 1.06-3.22). Students with poor sleep quality were three times more likely to skip breakfast than their counterparts (AOR = 2.95, 95% CI: 1.93-4.51). Overweight/obese students were less likely to skip breakfast compared to their counterparts (AOR = 0.40, 95% CI: 0.20-0.82). CONCLUSION This study highlights a high prevalence of skipping breakfast among university students in Bangladesh. Specifically, students who are females, smokers, poor sleepers and who have night eating syndrome are more likely to skip breakfast compared to their counterparts. These findings underscore a need for targeted interventions and educational programs to promote healthy breakfast habits. Addressing these modifiable risk factors can have a positive impact on students' nutritional practices and their health and wellbeing.
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Affiliation(s)
- Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Trisha Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh.
- Nutrition Initiative, Kushtia, Bangladesh.
| | | | - Cornelius Tengan
- Department of Hospitality, Catering and Institutional Management, Bolgatanga Technical University, Sumbrugu, Ghana
| | | | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Faria Hossain
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Md Shajadul Islam
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
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Svendsen M, Forslund HB. Meal patterns, including intermittent fasting - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10505. [PMID: 38370117 PMCID: PMC10870972 DOI: 10.29219/fnr.v68.10505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/30/2022] [Accepted: 01/08/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction 'Meal patterns' refers to eating frequency, snacking, regularity, and timing. Here also including intermittent fasting. The effect of meal patterns on health is inconsistent and when updating the Nordic Nutrition Recommendations 2023 (NNR2023), summarizing the evidence is important. Aims To describe the evidence for the role of meal patterns on bodyweight, body composition, and cardiovascular risk factors (i.e. blood pressure and lipid- and glukose metabolism) in healthy people living with normal weight, overweight, or obesity in all age groups. Methods An initial search in PubMed found 481 reviews, of which 104 were identified based on titles. Of these, 47 were excluded based on title and abstracts. Of the remaining 57 reviews, 16 were included reporting search terms and inclusion/exclusion criteria. In addition, 8 reviews from reference list or known by authors were included. In total, 24 reviews were relevant. Cochrane Library was searched with no results. Results All reviews were rated low or critically low (AMSTAR 2). No consistent findings on eating frequency and body weight or composition were found in children/adolescents or adults. In snacking, mixed results were found, although among adults, some consistent results showed positive associations between snacking and body weight. In regularity, breakfast skipping showed mixed results in children/adolescents on body weight and composition. Among adults, randomized controlled trials on breakfast skipping showed a minor impact on improved weight loss. In prospective studies on timing, lower energy intake during late afternoon/evening was related to less body weight. Intermittent fasting reduced body weight but was not superior to continuous energy restrictions. Cardiovascular risk factors were assessed in a minority of the reviews, and despite some beneficial effects, the evidence was limited. Conclusion Given the overall low to critically low quality of the reviews, the evidence is limited and inconclusive. No consistent results providing evidence for setting recommendations for meal patterns were shown. In this regard, meal patterns may vary within the context of an energy balanced and nutritionally adequate diet.
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Affiliation(s)
- Mette Svendsen
- Department of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Heléne Bertéus Forslund
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Gibson-Moore H, Spiro A, Stanner S. No food for thought-How important is breakfast to the health, educational attainment and wellbeing of school-aged children and young people? NUTR BULL 2023; 48:458-481. [PMID: 37986635 DOI: 10.1111/nbu.12652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023]
Abstract
There have been reports from teachers of pupils in the United Kingdom arriving at school hungry. Poor nutritional intake during childhood can increase the risk of developing both short- and long-term health problems. Breakfast consumption has been associated with several outcomes including better diet quality and healthier weight status. Nevertheless, skipping breakfast is a frequent behaviour in young people, particularly adolescents, and those from lower socio-economic groups, who are less likely to meet dietary recommendations and nutritional targets. The aim of this narrative review is to explore the contribution of breakfast consumption at home or at school and the impact of breakfast skipping on nutrient intakes in school-aged children (aged 4-18 years), and their effect on weight and cardiometabolic health. We will also summarise evidence for a link with cognitive function and educational attainment. A broadly positive effect of breakfast intake on diet quality, weight status and school-related outcomes was found in the literature, although inconsistencies in findings and methodological limitations within the evidence base are notable. Further research is warranted to better understand impact of breakfast intake and school breakfast provision on longer-term learning, educational attainment and health outcomes. This also needs to consider the cost benefit, type of breakfast and any unintended consequences such as encouraging multiple breakfasts. Breakfast consumption could improve the nutritional intakes of the most vulnerable young people and may help to address inequalities in educational outcomes at least in the short term.
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Fiore G, Scapaticci S, Neri CR, Azaryah H, Escudero-Marín M, Pascuzzi MC, La Mendola A, Mameli C, Chiarelli F, Campoy C, Zuccotti G, Verduci E. Chrononutrition and metabolic health in children and adolescents: a systematic review and meta-analysis. Nutr Rev 2023:nuad122. [PMID: 37944081 DOI: 10.1093/nutrit/nuad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
CONTEXT Obesity has emerged as a global health issue for the pediatric population, increasing the need to investigate physiopathological aspects to prevent the appearance of its cardiometabolic complications. Chrononutrition is a field of research in nutritional sciences that investigates the health impact of 3 different dimensions of feeding behavior: regularity of meals, frequency, and timing of food intake. OBJECTIVE We carried out a systematic review and meta-analysis to investigate the association between chrononutrition in children and adolescents and the risk of overweight/obesity or a cluster of metabolic abnormalities related to glucose and lipid metabolism, blood pressure, and cardiovascular disease risk. DATA EXTRACTION A literature search was performed using PubMed, EMBASE, and The Cochrane Library for relevant articles published before August 2022. DATA ANALYSIS A total of 64 articles were included in the narrative synthesis (47 cross-sectional and 17 cohort studies), while 16 studies were included in the meta-analysis. Meta-analysis showed that non-daily breakfast consumers (≤6 d/wk) had a higher risk of overweight/obesity (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.08-1.82] compared with daily breakfast eaters (7 d/wk). Similarly, irregular breakfast consumption (only 0-to-3 times/wk) increased the risk of abdominal obesity (waist-to-height ratio ≥ 0.5) compared with regular consumption (5-to-7 times/wk) (OR, 1.38; 95% CI, 1.26-1.49). There was evidence to suggest that a regular frequency of meal consumption (≥4 times/d) is preventive against overweight/obesity development compared with fewer meals (≤3 times/d) (OR, 0.83; 95% CI, 0.70-0.97). In the narrative synthesis, snacking habits showed controversial results, while food timing was the most understudied dimension. CONCLUSION Overall, our data indicate a potential implication of chrononutrition in affecting pediatric metabolic health; however, the evidence of this association is limited and heterogeneous. Further prospective and intervention studies with a consistent approach to categorize the exposure are needed to elucidate the importance of chrononutrition for pediatric metabolic health.
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Affiliation(s)
- Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Serena Scapaticci
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Costanza R Neri
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Hatim Azaryah
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Mireia Escudero-Marín
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), San Cecilio University Hospital, Granada, Spain
- Neurosciences Institute Dr. Federico Oloriz, University of Granada, Granada, Spain
| | - Martina C Pascuzzi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Alice La Mendola
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Chiara Mameli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti "G. D'Annunzio", Chieti, Italy
| | - Cristina Campoy
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Pediatric Research, Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), San Cecilio University Hospital, Granada, Spain
- Neurosciences Institute Dr. Federico Oloriz, University of Granada, Granada, Spain
- Spanish Network of Biomedical Research in Epidemiology and Public Health (CIBERESP), Granada's Node, Institute of Health Carlos III, Madrid, Spain
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Elvira Verduci
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
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Wang K, Niu Y, Lu Z, Duo B, Effah CY, Guan L. The effect of breakfast on childhood obesity: a systematic review and meta-analysis. Front Nutr 2023; 10:1222536. [PMID: 37736138 PMCID: PMC10510410 DOI: 10.3389/fnut.2023.1222536] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
Objective Previous cohort trials have shown that skipping breakfast increases the risk of obesity or overweight in children. However, this finding remains controversial. Through a meta-analysis, this study systematically evaluated the effect of skipping breakfast on the prevalence of obesity or overweight in children. Methods We performed a literature search for studies published until March 19, 2023. using the Cochrane, PubMed, and Embase databases. Based on the inclusion and exclusion criteria, observational studies on the relationship between skipping breakfast and overweight/obesity in children and adolescents were analyzed. Three investigators independently screened the relevant literature, extracted the data, and assessed the risk of bias. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was used. The odds ratio (OR) with its 95% confidence interval (CI) was used to indicate the effect size. Results A total of 40 retrospective studies with 323,244 children ranging in age from 2 to 20 years were included in this study. The results of this meta-analysis showed that children and adolescents who skipped breakfast had a significantly higher prevalence of obesity or overweight than those who ate breakfast (OR, 1.59; 95% CI, 1.33-1.90; P < 0.001). Skipping breakfast was positively associated with overweight in children and adolescents (OR, 1.37; 95% CI, 1.23-1.54; P < 0.001). Similarly, skipping breakfast was positively associated with obesity in children and adolescents (OR, 1.51; 95% CI, 1.30-1.76; P < 0.001). The effect was also different by sex, with girls being the most affected (OR, 1.47; 95% CI, 1.23-1.76; P < 0.001). There was also a correlation between skipping breakfast and abdominal obesity in children (OR, 0.65; 95% CI, 0.55-0.77; P < 0.001). Conclusion This meta-analysis suggested that skipping breakfast is associated with an increased risk of overweight/obesity in children and adolescents. The findings provide support for a possible protective role of breakfast against excessive weight gain in children and adolescents. However, more rigorous study designs with validated and standardized measures of relevant variables are needed.
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Affiliation(s)
- Kun Wang
- Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yifan Niu
- Henan Medical School of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhenzhen Lu
- Henan Medical School of Zhengzhou University, Zhengzhou, Henan, China
| | - Boyang Duo
- Henan Medical School of Zhengzhou University, Zhengzhou, Henan, China
| | - Clement Yaw Effah
- General ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lina Guan
- Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Khusun H, Anggraini R, Februhartanty J, Mognard E, Fauzia K, Maulida NR, Linda O, Poulain JP. Breakfast Consumption and Quality of Macro- and Micronutrient Intake in Indonesia: A Study from the Indonesian Food Barometer. Nutrients 2023; 15:3792. [PMID: 37686824 PMCID: PMC10489646 DOI: 10.3390/nu15173792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Breakfast is an important meal that has been shown to have a positive effect on health. The current study aimed to assess the patterns of breakfast consumption among adult Indonesians and to estimate the contribution of breakfast to their nutrient intake and dietary quality. The study used 24-h recall data from the 2018 Indonesian Food Barometer study to assess breakfast intake among 1333 adults aged 18 and above from six provinces in Indonesia. Diet quality was measured using the Nutrient Rich Food index (NRF) 9.3, and the nutritional profile of breakfast was compared across tertiles of NRF 9.3. In total, 5.2% of adults in Indonesia skipped breakfast. Breakfast contributed 26% to daily energy intakes and 22-28% to intakes of all reported nutrients, except for total sugar (12%), vitamin C (8%) and vitamin D (7%). With respect to daily requirements, breakfast contributed approximately 20% to energy, protein, fat and sodium requirements, 26% to saturated fat but <15% to the requirements for most micronutrients and only 5% for fiber. Among breakfast consumers, a higher NRF score was associated with higher daily intakes of protein, dietary fiber and micronutrients and lower intakes of sodium from breakfast. This study suggests that a balanced breakfast in Indonesia should aim to lower fat and saturated fat intake while increasing fiber, potassium, calcium and vitamin C and D intake. These findings could inform the development of nutrient-based guidelines for breakfast consumption in Indonesia.
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Affiliation(s)
- Helda Khusun
- Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA, Jakarta 12130, Indonesia; (N.R.M.); (O.L.)
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
- Nutrition Department, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia
| | - Roselynne Anggraini
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
| | - Judhiastuty Februhartanty
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
- Nutrition Department, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia
| | - Elise Mognard
- Chair “Food Studies: Food, Cultures & Health”, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia; (E.M.)
- Centre for Asian Modernisation Studies (CAMS), Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Faculty of Social Sciences and Leisure Management, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Centre d’Études et de Recherche: Travail, Organisation, Pouvoir (CERTOP) UMR CNRS 5044, Université de Toulouse (France), 31000 Toulouse, France
| | - Khalida Fauzia
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
| | - Nursyifa Rahma Maulida
- Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA, Jakarta 12130, Indonesia; (N.R.M.); (O.L.)
| | - Ony Linda
- Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA, Jakarta 12130, Indonesia; (N.R.M.); (O.L.)
| | - Jean-Pierre Poulain
- Chair “Food Studies: Food, Cultures & Health”, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia; (E.M.)
- Centre for Asian Modernisation Studies (CAMS), Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Faculty of Social Sciences and Leisure Management, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Centre d’Études et de Recherche: Travail, Organisation, Pouvoir (CERTOP) UMR CNRS 5044, Université de Toulouse (France), 31000 Toulouse, France
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Lazzeri G, Ciardullo S, Spinelli A, Pierannunzio D, Dzielska A, Kelly C, Thorsteinsson EB, Qirjako G, Geraets A, Ojala K, Rouche M, Nardone P. The Correlation between Adolescent Daily Breakfast Consumption and Socio-Demographic: Trends in 23 European Countries Participating in the Health Behaviour in School-Aged Children Study (2002-2018). Nutrients 2023; 15:nu15112453. [PMID: 37299415 DOI: 10.3390/nu15112453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Breakfast is often considered the most important meal of the day and can benefit adolescent health in several ways. The aims of the present study were (1) to identify adolescents' socio-demographic (sex, family affluence and family structure) determinants of daily breakfast consumption (DBC) and (2) to describe trends in DBC among adolescents across 23 countries. Cross-sectional surveys of nationally representative samples of adolescents (aged 11, 13, and 15 years) (n = 589,737) participating in the Health Behaviour in School-aged Children (HBSC) survey from 2002 to 2018 were used. Multilevel logistic regression analyses modeled DBC over time, adjusted for family affluence, family structure and year of survey. Four countries showed an increased trend in DBC (the Netherlands, Macedonia, Slovenia, and England). A significant decrease in DBC was observed in 15 countries (Belgium-Fr, France, Germany, Croatia, Portugal, Spain, Hungary, Poland, Russian Federation, Ukraine, Denmark, Finland, Latvia, Lithuania and Sweden). In 4 countries no significant change was observed (Czech Republic, Scotland, Ireland and Norway). In most of the countries (n = 19), DBC was higher among the adolescents from high-affluence homes. In all the countries analysed, the adolescents living in two-parent households report higher DBC use than those in single-parent households. More than half of the countries showed a decrease in DBC. There is a need to implement key interventions by developing different strategies (education, incorporating educational curriculum and counselling programmes) to increase DBC. Comparing DBC patterns across HBSC countries is important for understanding regional and global trends, monitoring strategies, and developing health promotion programmes.
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Affiliation(s)
- Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Silvia Ciardullo
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Daniela Pierannunzio
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
| | - Anna Dzielska
- Department of Child and Adolescent Health, Institute of Mother and Child, 01-211 Warsaw, Poland
| | - Colette Kelly
- Health Promotion Research Centre, University of Galway, H91 TK33 Galway, Ireland
| | - Einar B Thorsteinsson
- Einar B. Thorsteinsson School of Psychology, University of New England, Armidale, NSW 2351, Australia
| | - Gentiana Qirjako
- Faculty of Medicine, University of Medicine, 8RRM+W7X Tirana, Albania
| | - Anouk Geraets
- Department of Social Sciences, University of Luxembourg, L-4365 Esch-sur-Alzette, Luxembourg
| | - Kristiina Ojala
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, FI-40014 Jyvaskyla, Finland
| | - Manon Rouche
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, CP598 Brussels, Belgium
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy
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11
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Iizuka K, Sato H, Kobae K, Yanagi K, Yamada Y, Ushiroda C, Hirano K, Ichimaru S, Seino Y, Ito A, Suzuki A, Saitoh E, Naruse H. Young Japanese Underweight Women with "Cinderella Weight" Are Prone to Malnutrition, including Vitamin Deficiencies. Nutrients 2023; 15:2216. [PMID: 37409654 DOI: 10.3390/nu15092216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
Undernutrition among young women at "Cinderella weight" is socially important in Japan. To determine the nutritional status of Cinderella-weight women, we conducted an exploratory cross-sectional study on the health examination results of employees aged 20 to 39 (n = 1457 and 643 for women and men, respectively). The percentage of underweight women was found to be much higher than that of men (16.8% vs. 4.5%, respectively). In underweight women (n = 245), handgrip strength (22.82 ± 5.55 vs. 25.73 ± 5.81 kg, p < 0.001), cholesterol level (177.8 ± 25.2 vs. 194.7 ± 31.2 mg/dL, p < 0.05), and lymphocyte count (1883 ± 503 vs. 2148 ± 765/μL, p < 0.001) were significantly lower than in overweight women (n = 116). Then, the BMI < 17.5 group (n = 44) was referred to the outpatient nutrition evaluation clinic. Lower prealbumin, cholesterol, and lymphocyte levels were also observed in 34%, 59%, and 32% of the patients, respectively. Regarding dietary characteristics, 32% of the underweight women in this study skipped breakfast, and 50% had low dietary diversity scores. Lower total energy intake, carbohydrate and fiber intake, and Ca and Fe intake were also observed in 90% of the patients. Deficiencies in vitamin B1, B12, D, and folate were diagnosed in 4.6%, 25%, 14%, and 98% of the patients, respectively. Thus, young underweight women may be prone to malnutrition.
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Affiliation(s)
- Katsumi Iizuka
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Hiroko Sato
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Kazuko Kobae
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Kotone Yanagi
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Yoshiko Yamada
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
| | - Chihiro Ushiroda
- Department of Clinical Nutrition, Fujita Health University, Toyoake 470-1192, Japan
| | - Konomi Hirano
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Satomi Ichimaru
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Yusuke Seino
- Department of Endocrinology, Diabetes, Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Akemi Ito
- Food and Nutrition Service Department, Fujita Health University Hospital, Toyoake 470-1192, Japan
| | - Atsushi Suzuki
- Department of Endocrinology, Diabetes, Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake 470-1192, Japan
| | - Hiroyuki Naruse
- Health Management Center, Fujita Health University, Toyoake 470-1192, Japan
- Department of Medical Laboratory Science, Fujita Health University Graduate School of Health Sciences, Toyoake 470-1192, Aichi, Japan
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12
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Grosjean E, Simonneaux V, Challet E. Reciprocal Interactions between Circadian Clocks, Food Intake, and Energy Metabolism. BIOLOGY 2023; 12:biology12040539. [PMID: 37106739 PMCID: PMC10136292 DOI: 10.3390/biology12040539] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
Like other biological functions, food intake and energy metabolism display daily rhythms controlled by the circadian timing system that comprises a main circadian clock and numerous secondary clocks in the brain and peripheral tissues. Each secondary circadian clock delivers local temporal cues based on intracellular transcriptional and translational feedback loops that are tightly interconnected to intracellular nutrient-sensing pathways. Genetic impairment of molecular clocks and alteration in the rhythmic synchronizing cues, such as ambient light at night or mistimed meals, lead to circadian disruption that, in turn, negatively impacts metabolic health. Not all circadian clocks are sensitive to the same synchronizing signals. The master clock in the suprachiasmatic nuclei of the hypothalamus is mostly synchronized by ambient light and, to a lesser extent, by behavioral cues coupled to arousal and exercise. Secondary clocks are generally phase-shifted by timed metabolic cues associated with feeding, exercise, and changes in temperature. Furthermore, both the master and secondary clocks are modulated by calorie restriction and high-fat feeding. Taking into account the regularity of daily meals, the duration of eating periods, chronotype, and sex, chrononutritional strategies may be useful for improving the robustness of daily rhythmicity and maintaining or even restoring the appropriate energy balance.
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Affiliation(s)
- Emma Grosjean
- Institute of Cellular and Integrative Neurosciences, CNRS UPR3212, University of Strasbourg, 67000 Strasbourg, France
| | - Valérie Simonneaux
- Institute of Cellular and Integrative Neurosciences, CNRS UPR3212, University of Strasbourg, 67000 Strasbourg, France
| | - Etienne Challet
- Institute of Cellular and Integrative Neurosciences, CNRS UPR3212, University of Strasbourg, 67000 Strasbourg, France
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13
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Prevalence of Breakfast Skippers among Tunisian Preschool and School Children and Association with Weight Status: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020392. [PMID: 36832521 PMCID: PMC9954857 DOI: 10.3390/children10020392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
Breakfast is considered the most important meal of the day. This study aimed to assess breakfast frequency and quality in Tunisian children and to determine the relationship between breakfast skipping and the weight status of the children. A total of 1200 preschool and school children aged 3 to 9 years were randomly selected under a cross-sectional design. Breakfast habits and socio-economic characteristics were collected using a questionnaire. Participants who consumed breakfast less than five times the previous week were categorized as breakfast skippers. The other breakfast consumers were considered as non-skippers. The overall prevalence of breakfast skipping in Tunisian children was 8.3% and 83% of them consumed breakfast all the weekdays. At least two out of three children had a poor breakfast quality. Only 1% of children consumed breakfast in accordance with the composition guidelines. No relationships between breakfast skipping and weight status were detected in this study after adjustment for age, sex and all socio-economic factors (OR = 1.16, 95% CI = 0.72-1.89, p = 0.541). Further school-based interventions should be implemented to improve breakfast quality and to promote a healthy weight in Tunisian children.
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14
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Geraets AFJ, Heinz A. The associations of dietary habits with health, well-being, and behavior in adolescents: A cluster analysis. Child Care Health Dev 2022; 49:497-507. [PMID: 36207786 DOI: 10.1111/cch.13064] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/06/2022] [Accepted: 09/30/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Dietary habits may be associated with adolescents' health and behavior. However, previous findings are inconsistent and often unadjusted for sociodemographic confounders. The aim of this study was to investigate (1) whether dietary habits (consumption of fruits, vegetables, sweets, soft drinks, breakfast, and family meals) cluster among adolescents and (2) how these clusters associate with a range of health, well-being, and behavior outcomes in a large population-based sample of adolescents. METHODS The study included adolescents (n = 7529; n = 3891 [51.7%] girls; mean [standard deviation] age = 14.9[2.1] years) from the 2018 Luxembourg Health Behaviour in School-aged Children study. We used cluster analysis to define clusters of dietary habits (consumption of fruits, vegetables, sweets, soft drinks, breakfast, and family meals) and logistic regression analyses to assess the cross-sectional associations of the clusters with health, well-being and behavior, adjusted for age, gender, family affluence, and migration background. RESULTS Cluster analysis yielded five clusters of dietary habits: (1) healthy, (2) family meal and breakfast skippers, (3) sugar consumption, (4) unbalanced diet, and (5) unhealthy. The healthy cluster was associated with better health and positive mental health and behavior, whereas the less healthy clusters were associated with worse health, mental health problems, and risk behavior. CONCLUSION Findings suggest that healthy dietary habits associate with positive health and behavior, whereas unhealthy dietary habits associate with health problems and risk behavior during adolescence. More research is needed to investigate the underlying mechanisms. Interventions should include dietary habits as a component of lifestyle modification to improve adolescents' health, well-being, and behavior.
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Affiliation(s)
| | - Andreas Heinz
- Department of Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Department of Health, IU Internationale Hochschule, Erfurt, Thüringen, Germany
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15
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Family Social Support and Weight-Related Behaviors of School-Age Children: An Exploratory Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148501. [PMID: 35886352 PMCID: PMC9318999 DOI: 10.3390/ijerph19148501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 01/27/2023]
Abstract
Families are a key provider of support that may encourage positive weight-related behaviors. Yet little is known about the relation of family support to children’s performance of weight-related behaviors. Mothers (N = 524) who completed an online survey were categorized as having low, moderate, or high family support for fruit/vegetable intake, breakfast intake, limiting sugar-sweetened beverage intake, physical activity, limiting sedentary screentime, and sleep. ANOVA revealed that children in families with high support for breakfast ate this meal significantly more often. Additionally, children in families with low support for limiting sugar-sweetened beverages had significantly greater intake. Surprisingly, families with moderate support for physical activity and sleep tended to have children with lower physical activity level, sleep duration, and sleep quality, and fewer days/week with set bedtimes than those with low and high support. Binomial logistic regression revealed that high family support for eating breakfast, limiting sugar-sweetened beverages, and getting sufficient sleep had greater odds of meeting recommendations for these behaviors. Findings suggest that greater family support for healthy weight-related behaviors tends to be associated with children’s performance of these behaviors. Future interventions should further examine the impact of different types of family support on weight-related behaviors to better understand this complex interplay.
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16
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Breakfast Consumption May Improve Fasting Insulin, HOMA-IR, and HbA1c Levels in Predominately Low-Income, Hispanic Children 7-12 Years of Age. Nutrients 2022; 14:nu14112320. [PMID: 35684120 PMCID: PMC9182585 DOI: 10.3390/nu14112320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/10/2022] Open
Abstract
Children from low-income households and minority families have high cardiometabolic risk. Although breakfast consumption is known to improve cardiometabolic health in children, limited randomized control trials (RCT) have explored this association in low-income and racial/ethnic U.S. minority families. This study conducted secondary analyses from TX Sprouts, a school-based gardening, cooking, and nutrition education RCT, to examine the intervention effect on breakfast consumption and how changes in breakfast consumption impact cardiometabolic risk in predominately low-income, multi-ethnic children. TX Sprouts consisted of 16 schools (8 intervention; 8 control) in greater Austin, TX. A total of 18 lessons were taught, including topics on breakfast consumption benefits and choosing healthy food options at school. Children completed clinical measures (e.g., anthropometrics, body composition via bioelectrical impedance), and the number of breakfast occasions (BO) per week (at home and school) was captured via validated survey at baseline and post-intervention. Post-study—Baseline changes in breakfast consumption were used to categorize students as: maintainers (BO −1 to 1 day/week), decreasers (BO ≤−2 day/week), and increasers (BO ≥2 day/week). Optional fasting blood draws were performed on a subsample. Generalized weighted linear mixed modeling tested differences between intervention and control, with schools as random clusters. Analysis of covariance and linear regression examined changes in breakfast consumption on cardiometabolic outcomes, controlling for age, sex, race/ethnicity, free and reduced-price school meal participation (FRL), school site, breakfast location, physical activity, baseline cardiometabolic measures, and BMI z-score. This study included 1417 children (mean age 9 years; 53% male; 58% Hispanic, 63% FRL; breakfast consumption patterns: 63% maintainers, 16% decreasers, and 21% increasers). There was no intervention effect on changes in breakfast consumption. Compared to decreasers, increasers had an increase in insulin (−0.3 µIU/mL vs. +4.1 µIU/mL; p = 0.01) and a larger increase in HOMA-IR (+0.4 vs. +1.5; p < 0.01). Every one-day increase in breakfast consumption decreased fasting insulin by 0.44 µIU/mL, HOMA-IR by 0.11, and hemoglobin A1c by 0.01% (p ≤ 0.03). Increased breakfast consumption was linked to improved glucose control, suggesting breakfast can mitigate risk in a high-risk population. To better understand underlying mechanisms linking breakfast consumption to improved metabolic health, RCTs focusing on breakfast quality and timing are warranted.
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17
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Nizami H, Su L, Jain R, Jain R. Effects of chronically skipping meals on atrial fibrillation risk. Future Cardiol 2022; 18:497-506. [PMID: 35360935 DOI: 10.2217/fca-2021-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Atrial fibrillation is the most common form of arrhythmia and can result in significant morbidity and mortality. While there are many potential causes of atrial fibrillation that have been well studied, this work considers the potential effect of chronically skipping meals on the development of atrial fibrillation. The authors discuss the various processes that skipping meals initiates in the body that may ultimately result in atrial fibrillation. Through a better understanding of the various disease pathophysiologies that can contribute to the development of atrial fibrillation, this narrative review may help lead to more advanced therapeutic and preventive approaches.
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Affiliation(s)
- Hamasah Nizami
- School of Medicine, American University of Integrative Sciences, #9 5th Avenue Belleville, St. Michael, Barbados
| | - Lilly Su
- School of Medicine, Pennsylvania State College of Medicine, 700 HMC Crescent Road, Hershey, PA 17033, USA
| | - Rahul Jain
- University Hospital, 1 Hospital drive, Columbia, MO 65212, USA
| | - Rohit Jain
- Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA
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Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes. Nutrients 2022; 14:nu14030596. [PMID: 35276957 PMCID: PMC8840273 DOI: 10.3390/nu14030596] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 01/01/2023] Open
Abstract
Our aim was to evaluate adherence to the Mediterranean diet (MedDiet) among children and adolescents with type 1 diabetes (T1D) in relation to metabolic control. Adherence to the MedDiet was assessed with the Mediterranean Diet Quality Index (KIDMED) questionnaire and physical activity by the International Physical Activity Questionnaire for Adolescent (IPAQ-A) on 65 subjects (32 males, 9–18 years) with T1D. Clinical and metabolic evaluation was performed (standardized body mass index (BMI-SDS), hemoglobin A1C (HbA1c), continuous glucose monitoring metrics when present, blood pressure, lipid profile). Parental characteristics (age, body mass index (BMI), socio-economic status) were reported. The adherence to the MedDiet was poor in 12.3%, average in 58.6%, and high in 29.1% of the subjects. Furthermore, 23.4% of patients were overweight/obese. The most impacting factors on BMI-SDS were skipping breakfast and their father’s BMI. HbA1c and time in range % were positively associated with sweets and fish intake, respectively. Additionally, the father’s socio-economic status (SES) and mother’s age were associated with glucose control. Blood pressure was associated with travelling to school in vehicles, extra-virgin olive oil intake and milk/dairy consumption at breakfast. The promotion of the MedDiet, mainly having a healthy breakfast, is a good strategy to include in the management of T1D to improve glucose and metabolic control. This research is valuable for parents to obtain the best results for their children with T1D.
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Individual Circadian Preference, Eating Disorders and Obesity in Children and Adolescents: A Dangerous Liaison? A Systematic Review and a Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020167. [PMID: 35204888 PMCID: PMC8870066 DOI: 10.3390/children9020167] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obesity and other eating disorders are an actual public health problem, especially in childhood and adolescents, and could be also related with chronotype. The aim of this systematic review was to determine the relationship between eating disorders, obesity and the different chronotypes in children and adolescents. METHODS A systematic review of observational studies evaluating young populations dealing with and evaluating chronotype was conducted. Electronic searches were performed in six international databases. A qualitative thematic-categorical analysis was carried out and a random-effects model was used for the quantitative analysis (meta-analysis). RESULTS Fifteen studies were included, but quantitative analysis was only carried out in three of them. Children and adolescents with an evening chronotype had higher body mass index, consumed more junk food or were more predisposed to suffer from food addiction and night eating syndrome. CONCLUSIONS Children and adolescents with evening chronotype had higher tendency to incorrect eating behaviors and were suffering from overweight/obesity. Environment but also lifestyle factors should be considered in the association between chronotype and eating disorders and obesity.
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Makri R, Katsoulis M, Fotiou A, Kanavou E, Stavrou M, Richardson C, Kanellopoulou A, Orfanos P, Benetou V, Kokkevi A. Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9010119. [PMID: 35053743 PMCID: PMC8774704 DOI: 10.3390/children9010119] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 01/22/2023]
Abstract
Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages.
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Affiliation(s)
- Rafaela Makri
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
| | - Michail Katsoulis
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London, London ΝW1 2DA, UK;
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, Faculty of Population Health Sciences, London WC1E 7HB, UK
| | - Anastasios Fotiou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Eleftheria Kanavou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Myrto Stavrou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
| | - Clive Richardson
- Department of Economic and Regional Development, Panteion University of Social and Political Sciences, 176-71 Athens, Greece;
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 451-10 Ioannina, Greece;
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115-27 Athens, Greece; (R.M.); (P.O.)
- Correspondence: ; Tel.: +30-210-7462074
| | - Anna Kokkevi
- University Mental Health, Neurosciences, & Precision Medicine Research Institute “Costas Stefanis” (UMHRI), 115-27 Athens, Greece; (A.F.); (E.K.); (M.S.); (A.K.)
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Adolescent Self-Efficacy for Diet and Exercise Following a School-Based Multicomponent Lifestyle Intervention. Nutrients 2021; 14:nu14010097. [PMID: 35010972 PMCID: PMC8746524 DOI: 10.3390/nu14010097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/17/2022] Open
Abstract
Self-efficacy is perhaps the most important parameter associated with behavioral changes. The main aim of this study was to provide insight into the diet and exercise self-efficacy of Greek adolescents and how they could be modified via a multilevel multicomponent school-based lifestyle intervention. Secondary aims were to study the associations of students’ dietary and exercise self-efficacy indices with their anthropometric and sociodemographic parameters. A representative sample of the adolescent population in Attica, consisting of 1610 adolescents aged 12–17 years, recruited from 23 public high schools in three municipalities of the Attica area in Greece, received a three-component lifestyle educational intervention for health promotion and underwent screening for characteristics of metabolic syndrome with the use of portable telemedicine. All assessments and anthropometric measurements were performed at baseline and after the 6-month intervention. Anthropometric measurements included body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Assessment tools included the Self-efficacy for Diet and the Self-efficacy for Exercise questionnaires, as well as the Mediterranean Diet Quality Index in Children and Adolescents (KIDMED). Analysis included 1020 adolescent students (421 males and 599 females), who completed the self-efficacy questionnaires pre- and post-intervention. Overall, the dietary (p < 0.001) and exercise (p < 0.001) self-efficacy increased significantly post-intervention. Post-intervention, all adolescents decreased their abdominal obesity indices (WC, WHtR, WHR), and this improvement was even more pronounced and significant (p = 0.019, p = 0.019, p = 0.023 respectively) in the adolescents with overweight/obesity. Post-intervention, the proportion of adolescents with normal weight increased from 73.9% to 78.6%, whereas the proportion of adolescents with overweight and obesity decreased from 20.4% to 15.9% and from 5.7% to 5.5%, respectively. Abdominal obesity also decreased from 10.4% to 9.0%. Female adolescents achieved significantly (p = 0.010) higher changes in diet self-efficacy than males. Other sociodemographic characteristics such as family structure, parental age, parental educational level and family income showed non-significant differences. Adolescents with higher KIDMED scores manifested significantly higher dietary and exercise self-efficacy than those with lower KIDMED scores. Both adolescents with normal weight and overweight/obesity manifested a reciprocal relation between diet and exercise self-efficacy. Multicomponent lifestyle interventions in the school environment may provide a first step in students’ behavior changes and provide grounds for future prevention programs in youth.
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