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Original Research
The Relationship of Breakfast Skipping and Type of Breakfast Consumption with Nutrient Intake and Weight Status in Children and Adolescents: The National Health and Nutrition Examination Survey 1999-2006

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Abstract

Background

National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited.

Objective

To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status.

Subjects

Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339).

Design

Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006.

Methods

Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferroni's correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers.

Results

Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index ≥95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05).

Conclusions

RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents.

Section snippets

Study Population

This study involved analyses of cross-sectional data from US children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339) participating in the 1999-2006 NHANES (21). Pregnant or lactating subjects (n=129) were excluded. Due to the nature of the analysis (secondary data analysis) and the lack of personal identifiers, this study was exempted by the Institutional Review Board of the Baylor College of Medicine.

Dietary Assessment

The dietary data collection procedures are described elsewhere (22

Demographic Characteristics

Twenty percent of children were breakfast skippers, 35.9% consumed RTE cereals, and 44% consumed other breakfast. A lower percentage of Mexican-American/Hispanic and white children were breakfast skippers (16.1% and 19.4%) than consumed RTE cereals (35.5% and 37.6%) or other breakfast (48.4% and 43.1%), respectively. A lower percentage of children from households with PIR >5 were breakfast skippers (15.4%) than consumed RTE cereal (30.4%) or other breakfast (54.2%), respectively (Table 1).

Discussion

Breakfast has been regarded as the most important meal of the day, in part because of its nutritional benefits (5, 7, 8, 9, 10, 11, 19). In this study spanning from 1999 to 2006, the prevalence of skipping breakfast was higher in adolescents, especially girls, than in children confirming results from previous studies (6, 7, 11, 34, 35). The percentage of those consuming RTE cereal was lower than those consuming other breakfast in all children/adolescents from this study.

A higher percent of

Conclusions

Dietetics practitioners need to reinforce the importance of not only eating breakfast, but also consumption of healthy breakfast choices, such as RTE cereal, by children/adolescents. More research is needed to examine the influence of type of breakfast consumption on nutrient intakes and adiposity status over time in a nationally representative longitudinal sample of children/adolescents and using multiple days of dietary assessment.

P. R. Deshmukh-Taskar is a research coordinator II, US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX

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  • Cited by (0)

    P. R. Deshmukh-Taskar is a research coordinator II, US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX

    T. A. Nicklas is a professor, US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX

    C. E. O'Neil is an alumni professor, Louisiana State University AgCenter, Baton Rouge, LA

    D. R. Keast is a statistician, Food and Nutrition Database Research Consulting, Okemos, MI

    J. D. Radcliffe is a professor, Department of Nutrition, Texas Woman's University, Houston

    S. Cho is a statistician, NutraSource Inc, Clarksville, MD

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