Irregular breakfast habits are associated with children's increased adiposity and children's and parents' lifestyle-related behaviors: a population-based cross-sectional study

ABSTRACT

BACKGROUND: Skipping meals, especially breakfast, is related to an increase in adiposity indicators, and this behavior is related to metabolic changes that predispose to the development of chronic diseases, recognized as major causes of death worldwide. The objective of the present paper was estimated the association between irregular breakfast habits with adiposity indices in schoolchildren and other lifestyle factors. METHODS: A population-based cross-sectional study was conducted in 2009­2010, including schoolchildren (n=10,243) between 6 and 9 years old (51.3 % girls) from 18 districts of mainland Portugal. Breakfast habits were as certained by asking a yes/no question ("Does your child eat breakfast regularly?"). An index estimated by performing principal component analysis was used to assess body adiposity from three different adiposity indicators (body mass index (BMI), waist circumference (WC), and the triceps, subscapular, and supra iliac skinfolds (used to estimate body fat percentage (BFP))). Multivariate logistic regression and multiple linear regression models were used to estimate the association of irregular breakfast habits with anthropometric indicators (BMI, BMI z score, WC, BFP, and adiposity index) and with children's and parents' lifestyle and socioeconomic characteristics. RESULTS: A total of 3.5 % of the children did not have breakfast regularly (girls 3.9 %; boys 3.1 %; P= 0.02). Among boys, irregular breakfast habits were associated with lower fathers' education level, television time≥2 h/day, and soft drink consumption≥2 times/week. For girls, irregular breakfast habits were associated with lower mothers' education level and physical inactivity, soft drink consumption≥2 times/week, and <1 portion of milk/day. Multivariate linear models revealed a positive association between irregular breakfast habits with increased adiposity indicators among boys (BMI (kg/m2)ß= 1.33; BMI z scoreß= 0.48; WC (cm)ß= 2.00; BFP (%)ß= 2.20; adiposity indexß= 0.37;P< 0.01 for all). No significant association was found for girls. CONCLUSIONS: Irregular breakfast habits were positively associated with boys' increased global adiposity and were significantly affected by children's and parents' lifestyle-related behaviors.