Shannon Adair, Dietetic InternFebruary 11, 2013

Breakfast, BMI, and Nutritional Adequacy

Objectives

Be able to explain the relationship between breakfast and BMI.

Be able to explain the relationship between breakfast and nutritional adequacy of diet.

Be able to use research rather than dogma to explain why breakfast consumption is important for good nutrition.

Overweight and Obesity

In the last 20 years, overweight has doubled in children and tripled in adolescents.

2/3 adults are obese or overweight.

Obese individuals more likely to skip or eat less energy at breakfast.

Overweight and Obesity

Overweight and Obesity

Overweight and Obesity

Nutrient InadequacyWhat America's Missing: A 2011 Report on the Nation's Nutrient Gap

Used CDC and NHANES data to determine 11 gap nutrients:

CalciumVitamin DFiberPotassiumZincVitamin B12

Vitamin B6Vitamin AMagnesiumIronFolate

Project EAT

Collected anthropometric data and food frequency questionnaire from >4000 students

Five years later, recollected data

Higher frequency of breakfast consumption:

Higher carbohydrate and fiber intake

Higher socioeconomic status

Higher physical activity levels

Lower frequency of breakfast consumption:

Higher smoking and alcohol use

Higher dieting/weight control behaviors

After control for confounding variables:

Breakfast frequency has a dose-dependent relationship to BMI

More frequent breakfast = lower BMI

Project EAT

2010 Australian Study

Three, independent cross-sectional studies (1967, 1986, 2005)

Hypothesis: People who consume a substantial breakfast will have lower BMI than those who skip breakfast or consume small breakfasts.

2010 Australian Study

Results: In men, consuming a larger breakfast correlates with lower BMI

Independent of other lifestyle factors

Eating breakfast is associated with cereal, bread, fruit, and spread consumption.

Small breakfast and breakfast skipping associated with higher coffee intake.

NHANES IIIExamined BMI by breakfast category:

Ready-to-eat cereal

Cooked Cereal

Breads

Quick Breads

Fruits/vegetables

Dairy

Fats/Sweets

Beverages

NHANES III

Results:

RTEC, Cooked Cereal, and Quick Bread eaters had significantly lower BMI than Skippers and Meat and Egg eaters

Breakfast skippers and fruit/vegetable eaters had lowest daily energy intake

Meat and Egg eaters had highest daily energy intake and highest BMI

Health Outcomes

Moderately obese women have more success losing weight by consuming 70% of calories before noon.

Lean individuals lose weight on eating a 2000 calorie meal at breakfast, but gain weight if the same meal is eaten at dinner.

High energy breakfasts and cereal consumption are associated with higher vitamin and mineral intake and lower serum cholesterol in all ages.

Skipping breakfast can decrease cardiometabolic health.

Consumption of viscous water-soluble fibers found in cereal decrease glycemic response of a meal.

Omitting breakfast impairs postprandial insulin sensitivity and fasting lipids.

Glycemic Response

Children who regularly consume breakfast have better motor function skills and are less overweight than breakfast skippers.

School breakfast participation improves dietary intake, decreases risk of food insecurity, decreases BMI, and improves academic performance.

Pediatrics

Why People Skip Breakfast

Most common reasons listed for skipping breakfast:

Trying to lose weight

Not enough time

Not being hungry

Soaked OatsBlueberry Pecan

1/2 c oatmeal

1/4 c plain yogurt

1/4 c milk

1/4 c blueberries

1 T honey

1/4 c chopped pecans

Sprinkle with cinnamon

Sunrise

1/2 c oatmeal

1/4 c strawberry yogurt

1/4 c orange juice

1/4 c blueberries

Implications

School breakfast programs

Successful weight loss

Glycemic control for diabetics

Summary

Research shows that consuming breakfast results in lower BMI.

Certain breakfast foods help meet micronutrient needs of gap nutrients.

Children who eat breakfast have better motor and academic skills.

Overall: Research supports eating breakfast as part of a healthy lifestyle.

Questions?

Baldinger, Nina, Andreas Krebs, Roland Muller, and Isabelle Aeberli. "Swiss Children Consuming Breakfast Regularly Have Better Motor Functional Skills and Are Less Overweight Than Breakfast Skippers." Journal of the American College of Nutrition 31.2 (2012): 87-93. Web. 9 Feb. 2013. <http://www.jacn.org/content/31/2/87.abstract?sid=ee995b81-0ca3-495c-8833-fd7a37cce715>."Breakfast for Health." Food Research and Action Center, n.d. Web. 9 Feb. 2013. <http://frac.org/wp-content/uploads/2011/08/breakfastforhealth.pdf>.Cho, Sungsoo, Marion Dietrich, Coralie JP Brown, Celeste A. Clark, and Gladys Block. "The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index: Results from the Third National Health and Nutrition Examination Survey (NHANES III)." Journal of the American College of Nutrition 22.4 (2003): 296-302. Web. 9 Feb. 2013. <http://www.jacn.org/content/22/4/296.long>.Dow, Shireen, Kelly L. Pritchett, Susan Hawk, Stefanie J. Herrington, and David L. Gee. "Ultrahigh-Viscosity Hydroxypropylmethylcellulose Blunts Postprandial Glucose after a Breakfast Meal in Women." Journal of the American College of Nutrition 31.2 (2012): 94-99. Web. 9 Feb. 2013. <http://www.jacn.org/content/31/2/94.abstract?sid=ee995b81-0ca3-495c-8833-fd7a37cce715>.Farshchi, Hamid R., Moira A. Taylor, and Ian A. Macdonald. "Deleterious Effects of Omitting Breakfast on Insulin Sensitivity and Fasting Lipid Profiles in Healthy Lean Women." The American Journal of Clinical Nutrition 81.2 (2005): 388-96. Web. 9 Feb. 2013. <http://ajcn.nutrition.org/content/81/2/388.full?sid=b0964b18-c2ad-44e0-859b-f4f1c334f97f>.Kent, Lillian M., and Anthony Worsley. "Breakfast Size Is Related to Body Mass Index for Men, but Not Women." Nutrition Research 30.4 (2010): 240-45. Science Direct. Web. 9 Feb. 2013. <http://www.sciencedirect.com/science/article/pii/S0271531710000436>.Kral, Tanja VE, Linda M. Whiteford, Moonseong Heo, and Myles S. Faith. "Effects of Eating Breakfast Compared with Skipping Breakfast on Ratings of Appetite and Intake at Subsequent Meals in 8- to 10-y-old Children." The American Journal of Clinical Nutrition 93.2 (2011): 284-91. Effects of Eating Breakfast Compared with Skipping Breakfast on Ratings of Appetite and Intake at Subsequent Meals in 8- to 10-y-old Children. Web. 9 Feb. 2013. <http://ajcn.nutrition.org/content/93/2/284.full?sid=b0964b18-c2ad-44e0-859b-f4f1c334f97f>."New Study: Eating Breakfast More Frequently Means Lower BMI." Dietitian Center, n.d. Web. 9 Feb. 2013. <http://www.dietitiancenter.com/article.aspx?id=2>.Preziosi, Paul, Pilar Galan, Michele Deheeger, Nedra Yacoub, Adam Drewnowski, and Serge Hercberg. "The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index: Results from the Third National Health and Nutrition Examination Survey (NHANES III)." Journal of the American College of Nutrition 18.2 (1999): 171-78. The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index: Results from the Third National Health and Nutrition Examination Survey (NHANES III). Web. 9 Feb. 2013. <http://www.jacn.org/content/22/4/296.long>.Smith, Kylie J., Seana L. Gall, Sarah A. McNaughton, Leigh Blizzard, Terence Dwyer, and Alison J. Venn. "Skipping Breakfast: Longitudinal Associations with Cardiometabolic Risk Factors in the Childhood Determinants of Adult Health Study." The American Journal of Clinical Nutrition 92.6 (2010): 1316-325. Web. 9 Feb. 2013. <http://ajcn.nutrition.org/content/92/6/1316.full?sid=b0964b18-c2ad-44e0-859b-f4f1c334f97f>."What America's Missing: A 2011 Report on the Nation's Nutrient Gap." Dairy Research Institute, n.d. Web. <http://www.milkmustache.com/wp-content/uploads/2012/02/what_americas_missing.pdf>."When You Eat Matters." Massive Health. N.p., n.d. Web. 9 Feb. 2013. <http://data.massivehealth.com/>.

References