© 2012 Institute of Food Technologists

Heather J. Leidy, PhD

Dept. Nutrition & Exercise Physiology; University of Missouri; Columbia, MO

Siegra-Riz , 1998; AJCN; 67(supp): 748S-756S; Haines, 1996; JADA; 96(5): 464-470; Deshmukh-Taskar, 2010; JADA; 110(6): 869-878; McLynn, 2011; The NPD Group; Morning Mealscape

• Breakfast was a staple in the

American Diet 50y ago

• Gradual decline has

mirrored the rise in obesity

• Current trends: 30-60% of

young people skip breakfast

on a daily basis

Siegra-Riz , 1998; AJCN; 67(supp): 748S-756S; Haines, 1996; JADA; 96(5): 464-470; Deshmukh-Taskar, 2010; JADA; 110(6): 869-878; McLynn, 2011; Timlin, 2008; Pediatrics; 121: e638-e645

Cross-sectional Studies

• Overweight/Obese are 2x more likely to skip breakfast

• Breakfast Skippers have an increased

-Prevalence of being obese

-Higher BMI percentile

-Higher BMI z-score

5-yr Prospective Study in Young People

• 2,216 Adolescents

• Increased BMI (-) associated with

decreased breakfast frequency

(in a dose-dependent relationship)

• Cross-sectional studies in >5,000 young people

40% MORE Sweets (+60 kcal) 55% MORE Chips (+100 kcal) 55% MORE Soft Drinks (+200 kcal) 40% MORE White Bread

45% LESS Vegetables 30% LESS Fruit 60% LESS Milk (-100 kcal) 65% LESS Whole-grain

• Compared to breakfast consumers, skippers consume:

• Majority of breakfast was RTE cereals

Sjoberg, 2003; European J Clin Nutrition; 57: 1569-1578; Savige, 2007: Int J Behavioral Nutrition and Physical Activity; 4(36): 1-9; Haire-joshu, 2011; JADA: 111: 124-130

Deshmukh-Taskar PR, et al. 2010; J Am Diet Assoc; 110 (6) 869-878

NHANES Data (1999-2006)

Breakfast Skippers (n=2547)

RTE Cereal Breakfast (n=2,856)

Other Breakfast (n=4,256)

Prevalence of Obesity (%) 23 ± 1 15 ± 1 18 ± 1*

13 Micronutrients (MAR) 75 ± 2 88 ± 2 80 ± 2*

5 Shortfall Nutrients (MAR) 51 ± 2 59 ± 2 54 ± 2*

Dietary Fat (g) Cholesterol(mg)

85.4 ± 1 222 ± 7

78 ± 1 217 ± 6

85 ± 1* 287 ± 8*

Dietary CHO (g) Sugars (g)

297 ± 3 153 ± 3

316 ± 2* 165 ± 3*

297 ± 2 150 ± 3

Dietary Protein (g) 76 ± 1 78 ± 1 78 ± 1

*RTE vs. Other

Breakfast Foods 1960s

Breakfast Foods 2000s

Nutrition Reviews; 65(6): 268-281; FIC Review; 2011; Breakfast and Health; Moshfegh, 2005; What We Eat in America 2001-02; USDA.gov; Breakfast in America

High Protein

Low Protein

Westerterp-Plantenga, M.S., et al., Annu Rev Nutr, 2009; 21-41

11

• Randomized Crossover; Clinical Trial

• Healthy, but overweight/obese teen girls (13-19y)

Habitual breakfast skippers

• 3 Breakfast Patterns (6 d acclimation + 1 d testing/pattern)

Breakfast Skipping

Normal Protein Breakfast

Higher Protein Breakfast Participants were blinded to protein focus

13

Dietary Characteristics

Normal Protein Breakfast*

Protein-rich Breakfast*

Breakfast Skipping

Meal Characteristics RTE Cereals ‘Other Foods’ 0

Energy Content (kcal) 350 350 0

CHO/Protein/Fat (%) 65/15/20 40/40/20 0

PRO (g) 13 35 0

CHO (g) 57 35 0

Fat (g) 8 8 0

*Also matched for Energy Density (1.3g/kcal), Sugar (18g), & Fiber (6g)

• 10 h Testing Days for Each Breakfast Pattern

• Outcomes:

Appetite: Perceived Hunger; Hunger-hormone Ghrelin

Satiety: Perceived Fullness; Satiety-hormone PYY

Reward: Brain Scans in response to visual food stimuli before dinner

Snacking: Evening

Breakfast Skipping Normal Protein High Protein

Breakfast Skipping Normal Protein High Protein

Breakfast Skipping Normal Protein High Protein

Breakfast Skipping Normal Protein High Protein

• 13 blocks in 1 fMRI scan • 3 blocks of food, 3 blocks of animals, 7 blocks of blurred images • Each block is 30 sec

Breakfast Skipping vs. Breakfast

Normal vs. High Protein Breakfast

Breakfast Skipping Normal Protein High Protein

Breakfast Skipping Normal Protein High Protein

Snack Foods BS NP HP

Desserts (g) 110 ± 23 104 ± 24 87 ± 20

Candy (g) 33 ± 13a 37 ± 12a 16 ± 6b

Salty (g) 45 ± 15 58 ± 17 51 ± 18

High Fat (g) 164 ± 29a 142 ± 28b 105 ± 24b

Chocolate (g) 94 ± 22 99 ± 24 82 ± 20

Heather J. Leidy, PhD

Assistant Professor; Dept. of Nutrition & Exercise Physiology

University of Missouri

573-825-2620; leidyh@missouri.edu

© 2012 Institute of Food Technologists