Associations between breakfast frequency and adiposity indicators in children from 12 countries.

OBJECTIVES: Reports of inverse associations between breakfast frequency and indices of obesity are predominantly based on samples of children from high-income countries with limited socioeconomic diversity. Using data from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the present study examined associations between breakfast frequency and adiposity in a sample of 9-11-year-old children from 12 countries representing a wide range of geographic and socio-cultural variability. METHODS: Multilevel statistical models were used to examine associations between breakfast frequency (independent variable) and adiposity indicators (dependent variables: body mass index (BMI) z-score and body fat percentage (BF%)), adjusting for age, sex, and parental education in 6941 children from 12 ISCOLE study sites. Associations were also adjusted for moderate-to-vigorous physical activity, healthy and unhealthy dietary patterns and sleep time in a sub-sample (n=5710). Where interactions with site were significant, results were stratified by site. RESULTS: Adjusted mean BMI z-score and BF% for frequent breakfast consumers were 0.45 and 20.5%, respectively. Frequent breakfast consumption was associated with lower BMI z-scores compared with occasional (P<0.0001, 95% confidence intervals (CI): 0.10-0.29) and rare (P<0.0001, 95% CI: 0.18-0.46) consumption, as well as lower BF% compared with occasional (P<0.0001, 95% CI: 0.86-1.99) and rare (P<0.0001, 95% CI: 1.07-2.76). Associations with BMI z-score varied by site (breakfast by site interaction; P=0.033): associations were non-significant in three sites (Australia, Finland and Kenya), and occasional (not rare) consumption was associated with higher BMI z-scores compared with frequent consumption in three sites (Canada, Portugal and South Africa). Sub-sample analyses adjusting for additional covariates showed similar associations between breakfast and adiposity indicators, but lacked site interactions. CONCLUSIONS: In a multinational sample of children, more frequent breakfast consumption was associated with lower BMI z-scores and BF% compared with occasional and rare consumption. Associations were not consistent across all 12 countries. Further research is required to understand global differences in the observed associations.

The oxygen uptake kinetic response to moderate intensity exercise in overweight and non-overweight children.

OBJECTIVE: To compare the phase II oxygen uptake time constant (τV'O(2)) and V'O(2) mean response time (V'O(2)MRT) in overweight (OW) and non-OW (NO) children during moderate intensity exercise. DESIGN: Between subjects where participants completed a maximal ramp exercise test on an electromagnetically braked cycle ergometer to determine peak V'O(2) (V'O(2peak)) and gas exchange threshold (GET). Gas exchange was measured breath-by-breath using a mass spectrometer. On subsequent visits, 6 square-wave transitions (2 per day) from 0 W to 90% GET were completed. Individual phase II τV'O(2) and V'O(2)MRTs were estimated from time aligned average V'O(2) traces. SUBJECTS: Eleven OW (11.8±0.4 years) and 12 NO (11.9±0.4 years) children were recruited to the study. The OW group was significantly heavier (62.9±9.7 vs 39.4±5.8 kg, P<0.001), taller (1.58±0.05 vs 1.47±0.07 m, P<0.001) and had a higher body mass index (25.8±3.4 vs 18.3±1.8 kg m(-2), P<0.001). RESULTS: Both τV'O(2) (30.2±9.6 vs 22.8±7.1 s, P<0.05) and V'O(2)MRT (43.5±10.7 vs 36.3±5.3 s, P<0.05) were significantly slower in OW compared with NO children; absolute V'O(2peak) was higher in the OW compared with NO group (2.23±0.04 vs 1.74±0.04 l min(-1), P<0.05); mass relative V'O(2peak) was lower in OW compared with NO children (35.9±8.3 vs 43.8±6.2 ml kg(-1) min(-1), P<0.05); allometrically scaled V'O(2peak) was similar between OW and NO groups whether relative to body mass(0.67) (139.8±29.1 vs 147.2±23.9 ml kg(-67) min(-1)) or stature(3) (576.0±87.2 vs 544.9±84.9 ml m(-3) min(-1)) (P>0.05); absolute V'O(2) at GET was similar between OW and NO groups (0.94±0.24 vs 0.78±0.27 l min(-1), P>0.05); GET expressed as percentage of V'O(2peak) was similar between the groups (42.0±0.1 vs 44.8±0.1%, P>0.05). CONCLUSION: These findings demonstrate impairment in the factors determining V'O(2) kinetics in OW children at a relatively young age. Furthermore, assessment of cardiorespiratory fitness using peak exercise values is likely to be misleading and not useful when designing exercise programmes for OW children.

Effect of breakfast glycemic index on metabolic responses during rest and exercise in overweight and non-overweight adolescent girls.

BACKGROUND/OBJECTIVES: The metabolic responses to mixed breakfast meals with different glycemic indexes (GI) and their effects on substrate metabolism during exercise in adolescent girls have not been examined. The interaction with weight status also warrants investigation. This study investigated the effect of mixed breakfast meals containing high GI (HGI) or low GI (LGI) carbohydrates on metabolic responses and fat oxidation during rest and exercise in overweight (OW) and non-overweight (NO) adolescent girls. SUBJECTS/METHODS: A total of 8 OW and 12 NO adolescent girls consumed an isoenergetic HGI (GI=73) or LGI (GI=44) breakfast 120 min before completing a 30-min treadmill walk at 50% \[Vdot]O(2peak). RESULTS: Peak blood glucose concentration was higher for HGI compared with LGI in OW (P=0.023), but not NO (P>0.05) girls. Blood glucose total area under the curve (TAUC) was 13% higher in HGI compared with LGI in OW (P=0.006), but only 4% higher in NO (P=0.072) girls. Plasma insulin data were log(e) transformed (lninsulin). Plasma lninsulin concentrations were not different between HGI and LGI (P>0.05). Peak plasma lninsulin concentration (P=0.016) and TAUC (P=0.001) were greater in OW than NO girls. Fat oxidation during postprandial rest and exercise was not different between breakfasts (P>0.05). CONCLUSIONS: The elevated glycemic response in HGI compared with LGI was more pronounced in OW girls, suggesting a reduced ability to cope with the metabolic demands of the HGI, but not LGI, breakfast. Manipulation of breakfast GI did not alter fat oxidation during rest or subsequent moderate intensity exercise in OW and NO adolescent girls.