Prevalence of consumption and nutritional content of breakfast meal among adolescents from the Brazilian National Dietary Survey / Prevalência de consumo e teor nutricional da refeição do café da manhã entre adolescentes da Pesquisa Nacional de Consumo Alimentar

Abstract Objective: To estimate the prevalence of breakfast consumption and describe the foods and nutrients consumed at this meal and throughout the day by Brazilian adolescents. Method: A total of 7276 adolescents aged 10-19 years were evaluated in the Brazilian National Dietary Survey 2008-9, a population-based cross-sectional study. Individuals' information was collected at home. Dietary data were obtained by two food records. Breakfast was defined as the first eating occasion of the day that occurred between 6 and 9:59 am. Differences between breakfast consumers, occasional consumers, and skippers were tested through Pearson's chi-squared test or F-test of regression analysis. Results: Breakfast was consumed by 93% of adolescents and it was associated with age, income, geographic region and household area. The most frequently consumed foods at breakfast were white bread, coffee, butter/margarine, refined cookies and crackers, and whole milk. The mean daily intakes of total energy, sugar, and calcium were higher among occasional consumers and skippers. Breakfast consumers had higher intake of vitamins B12, C, and D. Breakfast contributed more to total intake of calcium, phosphorus, thiamin, riboflavin, and vitamins A, B6, and D (17-32%), trans fat and sodium (about 30%) and less to folate, vitamin C, iron, zinc, and fiber (8-12%) and energy intake (16%). Conclusions: Although the prevalence of breakfast consumption among Brazilian adolescents was high, the overall nutritional quality of this meal is suboptimal, highlighting the need to support adolescents and their families to make more nutrient-dense food choices.

Resumo Objetivo: Estimar a prevalência de consumo de café da manhã e descrever os alimentos e nutrientes consumidos nessa refeição e durante todo o dia por adolescentes brasileiros. Método: Foram avaliados 7.276 adolescentes entre 10-19 anos no Inquérito Nacional de Alimentação 2008-2009, um estudo transversal de base populacional. As informações dos indivíduos foram coletadas nos domicílios. Os dados alimentares foram obtidos por dois registros alimentares. O café da manhã foi definido como a primeira refeição do dia entre 6h e 9h59. As diferenças entre os consumidores de café da manhã, consumidores ocasionais e aqueles que não tomam café da manhã foram testadas por meio do teste de qui-quadrado ou teste F para análise de regressão. Resultados: O café da manhã foi consumido por 93% dos adolescentes e seu consumo foi associado à idade, renda, região geográfica e área residencial. Os alimentos mais frequentemente consumidos foram pão branco, café, manteiga/margarina, biscoitos e bolachas refinados e leite integral. A ingestão média diária de energia total, açúcar e cálcio foi maior entre os consumidores ocasionais e aqueles que não tomam café da manhã. Aqueles que tomam café da manhã apresentam maior ingestão de vitaminas B12, C e D. O café da manhã contribuiu mais para a ingestão total de cálcio, fósforo, tiamina, riboflavina e vitaminas A, B6 e D (17%-32%), gordura trans e sódio (cerca de 30%) e menos para a ingestão de ácido fólico, vitamina C, ferro, zinco e fibras (8%-12%) e energia (16%). Conclusões: Apesar de a prevalência de consumo de café da manhã entre os adolescentes brasileiros ter sido alta, a qualidade nutricional dessa refeição está abaixo do ideal, destaca a necessidade de apoio aos adolescentes e suas famílias para possibilitar a escolha de alimentos mais densos em nutrientes.

Prevalence of consumption and nutritional content of breakfast meal among adolescents from the Brazilian National Dietary Survey.

OBJECTIVE: To estimate the prevalence of breakfast consumption and describe the foods and nutrients consumed at this meal and throughout the day by Brazilian adolescents. METHOD: A total of 7276 adolescents aged 10-19 years were evaluated in the Brazilian National Dietary Survey 2008-9, a population-based cross-sectional study. Individuals' information was collected at home. Dietary data were obtained by two food records. Breakfast was defined as the first eating occasion of the day that occurred between 6 and 9:59am. Differences between breakfast consumers, occasional consumers, and skippers were tested through Pearson's chi-squared test or F-test of regression analysis. RESULTS: Breakfast was consumed by 93% of adolescents and it was associated with age, income, geographic region and household area. The most frequently consumed foods at breakfast were white bread, coffee, butter/margarine, refined cookies and crackers, and whole milk. The mean daily intakes of total energy, sugar, and calcium were higher among occasional consumers and skippers. Breakfast consumers had higher intake of vitamins B12, C, and D. Breakfast contributed more to total intake of calcium, phosphorus, thiamin, riboflavin, and vitamins A, B6, and D (17-32%), trans fat and sodium (about 30%) and less to folate, vitamin C, iron, zinc, and fiber (8-12%) and energy intake (16%). CONCLUSIONS: Although the prevalence of breakfast consumption among Brazilian adolescents was high, the overall nutritional quality of this meal is suboptimal, highlighting the need to support adolescents and their families to make more nutrient-dense food choices.

Proposal for a breakfast quality index for brazilian population: Rationale and application in the Brazilian National Dietary Survey.

Breakfast has been related to positive nutrition and health outcomes, but criteria for an optimal composition of this meal are not well established. The aim of this study was to propose a breakfast quality index (BQI) for the Brazilian population, and to describe the relationship between breakfast quality, socio-demographic factors, dietary intake at breakfast and for the total day. BQI was constructed based on individual dietary data of 22,279 breakfast consumers, aged 20+ years from the Brazilian National Dietary Survey, a population-based cross-sectional study. The BQI was comprised of food components (cereals, fruit/vegetables, dairy products), and nutrient criteria (energy, fiber, free sugar, saturated fat, calcium and sodium). Mean, percentage and 95% CIs were estimated for variables according to BQI categories. The mean BQI was 4.2, with 71% of individuals falling into medium BQI category and 6% in high category. Individuals in urban areas, in higher categories of income and education and women had higher BQI means. Consumers with high BQI had higher intake of fruits/vegetables and higher breakfast and total daily intake of energy, carbohydrates, fiber, total sugar, sodium, potassium, phosphorus, thiamin, riboflavin, niacin, folate and vitamins B6, A, C, and D, and lower trans fatty acids compared to those in low and medium BQI groups. Promoting a high-quality breakfast may contribute to a better nutrient intake and achievement of daily requirements.

Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001-2012.

BACKGROUND: The purpose of this study was (1) to describe intakes of total grain and whole grain in the United States over the past 12 years and major dietary sources, and (2) to determine the relationship between whole grain intake and adiposity measures for children and adults. METHODS: Cross-sectional dietary data from the continuous National Health and Nutrition Examination Survey 2001-12 (6 2-year cycles) for children 6-18 years (n = 15,280) and adults 19+ years (n = 29,683) were linked to the My Pyramid and Food Patterns Equivalents Databases to assess daily intake of total grain and whole grain. These populations were classified into groups based on average whole grain intake: 0 ounce equivalents (oz eq)/day, > 0 and <1 oz eq/day, and ≥1 oz eq/day. Within these classifications, body mass index, waist circumference, and percent overweight/obese were identified. Regression and logistic regression analyses were used to assess associations between these dependent variables and whole grain intake. RESULTS: Adults consumed a mean 0.72 whole grain oz eq/day in 2001-02 and 0.97 oz eq/day in 2011-12 and children consumed a mean 0.56 whole grain oz eq/day in 2001-02 and 0.74 oz eq/day in 2011-12. While over 70 % of children and 60 % of adults met daily intake recommendations for total grain, less than 1.0 and 8.0 % percent of children and adults, respectively, met whole grain recommendations in 2011-12. Adults and children who consumed whole grain had significantly better intakes of nutrients and dietary fiber compared to non-consumers. From 2001 to 2012, grain mixed dishes and yeast breads were the leading sources of total grain, while yeast breads and ready to eat cereals were the leading sources of whole grain for both children and adults. Multiple regression analysis showed a significant, inverse relationship between body mass index and waist circumference with respect to whole grain intake after adjustment for covariates in both children and adults (p < 0.05). Similarly, logistic regression analysis showed a significant inverse relationship between percent overweight/obese and whole grain intake (p < 0.05). CONCLUSIONS: Although most children and adults meet daily intake goals for grain foods overall, whole grain as a portion of total grain intake continues to be consumed at levels well below recommendations. The data from the current study suggest that greater whole grain consumption is associated with better intakes of nutrients and healthier body weight in children and adults. Continued efforts to promote increased intake of whole grain foods are warranted.

An energy-reduced dietary pattern, including moderate protein and increased nonfat dairy intake combined with walking promotes beneficial body composition and metabolic changes in women with excess adiposity: a randomized comparative trial.

Moderate protein and nonfat dairy intake within an energy-reduced diet (ERD) may contribute to health benefits achieved with body weight (BW) loss. The current study examined the effectiveness of a weight-loss/weight-loss maintenance intervention using an ERD with moderate dietary protein (30% of kcals) and increased nonfat dairy intake (4-5 svg/d), including yogurt (INT group) and daily walking compared to an ERD with standard protein (16-17% of kcals) and standard nonfat dairy intake (3 svg/d) (COM group) with daily walking. A randomized comparative trial with 104 healthy premenopausal women with overweight/obesity was conducted in a university setting. Women were randomized to INT group or COM group. Anthropometric measurements, as well as dietary intake, selected vital signs, resting energy expenditure, blood lipids, glucose, insulin, and selected adipose-derived hormones were measured at baseline, and weeks 2, 12, and 24. Targets for dietary protein and nonfat dairy intake, while initially achieved, were not sustained in the INT group. There were no significant effects of diet group on anthropometric measurements. Women in the INT group and COM group, respectively, reduced BW (-4.9 ± 3.2 and -4.3 ± 3.3 kg, P < 0.001) and fat mass (-3.0 ± 2.2 and -2.3 ± 2.3 kg, P < 0.001) during the 12-week weight-loss phase and maintained these losses at 24 weeks. Both groups experienced significant decreases in body mass index, fat-free soft tissue mass, body fat percentage, waist and hip circumferences and serum triglycerides, total cholesterol, and leptin (all P < 0.001). Healthy premenopausal women with excess adiposity effectively lost BW and fat mass and improved some metabolic risk factors following an ERD with approximately 20% protein and 3 svg/d of nonfat dairy intake.

Associations between yogurt, dairy, calcium, and vitamin D intake and obesity among U.S. children aged 8-18 years: NHANES, 2005-2008.

The aim of this study was to investigate associations of yogurt and dairy consumption with energy, macronutrient, calcium, and vitamin D intakes, and associations with indicators of overweight/obesity in U.S. children in the National Health and Nutrition Examination Survey (NHANES 2005-2008). Using 24-hour recall data, children 8-18 years of age were classified to dairy consumption groups of <1, 1 to <2, or 2+ dairy servings, and yogurt consumers were those who reported eating yogurt during at least one of two dietary intake interviews. NHANES anthropometric measurements were used, and BMI and BMI-for-age percentiles were calculated. Yogurt and dairy consumption were associated with higher intakes of calcium, vitamin D and protein. Yogurt intake was associated with lower total fat and saturated fat intakes and body fat as measured by subscapular skinfold thickness. This study supports consumption of yogurt and higher amounts of dairy as eating patterns associated with greater intake of specific shortfall nutrients, and lower body fat in U.S. children.

Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods.

OBJECTIVE: Weight loss and consumption of viscous fibers both lower low-density lipoprotein (LDL) cholesterol levels. We evaluated whether or not a whole-grain, ready-to-eat (RTE) oat cereal containing viscous fiber, as part of a dietary program for weight loss, lowers LDL cholesterol levels and improves other cardiovascular disease risk markers more than a dietary program alone. DESIGN: Randomized, parallel-arm, controlled trial. SUBJECTS/SETTING: Free-living, overweight and obese adults (N=204, body mass index 25 to 45) with baseline LDL cholesterol levels 130 to 200 mg/dL (3.4 to 5.2 mmol/L) were randomized; 144 were included in the main analysis of participants who completed the trial without significant protocol violations. INTERVENTION: Two portions per day of whole-grain RTE oat cereal (3 g/day oat b-glucan) or energy-matched low-fiber foods (control), as part of a reduced energy ( approximately 500 kcal/day deficit) dietary program that encouraged limiting consumption of foods high in energy and fat, portion control, and regular physical activity. MAIN OUTCOME MEASURES: Fasting lipoprotein levels, waist circumference, triceps skinfold thickness, and body weight were measured at baseline and weeks 4, 8, 10, and 12. RESULTS: LDL cholesterol level was reduced significantly more with whole-grain RTE oat cereal vs control (-8.7+/-1.0 vs -4.3+/-1.1%, P=0.005). Total cholesterol (-5.4+/-0.8 vs -2.9+/-0.9%, P=0.038) and non-high-density lipoprotein-cholesterol (-6.3+/-1.0 vs -3.3+/-1.1%, P=0.046) were also lowered significantly more with whole-grain RTE oat cereal, whereas high-density lipoprotein and triglyceride responses did not differ between groups. Weight loss was not different between groups (-2.2+/-0.3 vs -1.7+/-0.3 kg, P=0.325), but waist circumference decreased more (-3.3+/-0.4 vs -1.9+/-0.4 cm, P=0.012) with whole-grain RTE oat cereal. Larger reductions in LDL, total, and non-high-density lipoprotein cholesterol levels and waist circumference were evident as early as week 4 in the whole-grain RTE oat cereal group. CONCLUSIONS: Consumption of a whole-grain RTE oat cereal as part of a dietary program for weight loss had favorable effects on fasting lipid levels and waist circumference.