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Title: 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

Author
item DESHMUKH-TASKAR, PRIYA - Children'S Nutrition Research Center (CNRC)
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item O'NEIL, CAROL - LSU Agcenter
item KEAST, DEBRA - Food And Nutrition Database Research, Inc
item RADCLIFFE, JOHN - Texas Woman'S University
item CHO, SUSAN - Nutrasource

Submitted to: American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/7/2009
Publication Date: 5/22/2010
Citation: Deshmukh-Taskar, P.R., Nicklas, T.A., O'Neil, C.E., Keast, D.R., Radcliffe, J.D., Cho, S. 2010. 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. American Dietetic Association. 110(6): 869-878.

Interpretive Summary: Ready-to-eat (RTE) cereal consumers had higher intake of almost all vitamins and minerals, including B vitamins, shortfall minerals, and some antioxidants than breakfast skippers and other breakfast consumers. The increased intake of calcium among RTE cereal consumers may be attributed to the increased intake of milk that occurs with RTE cereal consumption, significant differences were found for BMI z scores, waist circumference, and the prevalence of obesity. The mean waist circumference was higher in breakfast skippers compared to RTE cereal consumers in children and adolescents. The prevalence of obesity was higher in breakfast skippers than RTE cereal consumers in children and adolescents and higher in other breakfast than RTE cereal consumers in adolescents. 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 and 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.

Technical Abstract: National data comparing nutrient intakes and anthropometric measures in children and adolescents in the United States who skip breakfast or consume different types of breakfasts are limited. The objective was to examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status. Children aged 9 to 13 years (n equal to 4,320) and adolescents aged 14 to 18 years (n equal to 5,339). The research design was cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006. 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. Resulting twenty percent of children and 31.5 percent of adolescents were breakfast skippers; 35.9 percent of children and 25.4 percent of adolescents consumed RTE cereal. In children and adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P less than 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 less than 0.05). In children and adolescents, breakfast skippers had higher body mass index-for-age z scores (P less than 0.05) and a higher waist circumference (P less than 0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index greater than or equal to 95th percentile) was higher in breakfast skippers than RTE cereal consumers (P less than 0.05) in children and adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P less than 0.05). In conclusion, RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children and adolescents.