Association between breakfast consumption, breakfast quality, mental health and quality of life in Turkish adolescents: A high school-based cross-sectional study.

This study aimed to determine the frequency of breakfast consumption and breakfast quality among adolescents and to evaluate the relationships between breakfast consumption, breakfast quality, mental health, and health-related quality of life. This cross-sectional study included 449 students from 17 high schools between December 2022 and May 2023. A face-to-face questionnaire measuring the frequency of breakfast consumption, Mediterranean diet quality index (KIDMED), health-related quality of life (KIDSCREEN), and depression, anxiety and stress scales (DASS-21) was performed. Of the students, 54.1% skipped breakfast 2 or more times a week and 75.9% had poor breakfast quality. There were significant differences in breakfast quality classification according to the frequency of breakfast consumption (p = 0.003). Breakfast consumption ≤1 time/week or 2-5 times/week was associated with depression, anxiety and low adherence to the Mediterranean diet. No relationship was observed between breakfast quality and stress, depression or anxiety (p = 0.620, p = 0.586, p = 0.539, respectively) or between breakfast quality and the KIDSCREEN-27 subscales (p > 0.05). However, those eating poor-quality breakfasts had better results in physical wellbeing (p = 0.022), psychological wellbeing (p = 0.024), autonomy and parent relations (p = 0.017) than breakfast-skippers and also scored lower for depression, stress and anxiety (all p < 0.001). In conclusion, the frequency of breakfast consumption had a stronger association with reduced symptoms of stress, depression and anxiety, as well as improvements in all dimensions of health-related quality of life, compared to the quality of breakfast consumed. Given the association of breakfast consumption with mental health outcomes in adolescents, our findings are of great importance, especially to parents, clinicians and nutritional educators.

Breakfast quality and its sociodemographic and psychosocial correlates among Italian children, adolescents, and adults from the Italian Nutrition & HEalth Survey (INHES) study.

BACKGROUND: Breakfast quality, together with regularity of breakfast, has been suggested to be associated with cardiometabolic health advantages. We aimed to evaluate the quality of breakfast and its socioeconomic and psychosocial correlates in a large sample of the Italian population. METHODS: Cross-sectional analyses on 7,673 adult and 505 children/adolescent regular breakfast eaters from the Italian Nutrition & Health Survey (INHES; 2010-2013). Dietary data were collected through a single 24-h dietary recall. Breakfast quality was assessed through the Breakfast Quality Index (BQI) combining intake of ten food groups, energy, and nutrients of public health concern, and potentially ranging from 0 to 10. The association of sociodemographic and psychosocial factors with BQI were analyzed by multivariable-adjusted linear regression models. RESULTS: The average BQI was 4.65 (SD ± 1.13) and 4.97 (SD ± 1.00) in adults and children/adolescents, respectively. Amongst adults, older age (ß = 0.19; 95%CI 0.06 to 0.31 for > 65 vs. 20-40 years) and having a high educational level (ß = 0.13; 0.03 to 0.23; for postsecondary vs. up to elementary) were independent predictors of better breakfast quality, while men reported lower BQI (ß = -0.08; -0.14 to -0.02 vs. women). Perceived stress levels at home and work and financial stress were inversely associated with BQI. Children/adolescents living in Central and Southern Italian regions had lower BQI compared to residents in Northern Italy (ß = -0.55; -0.91 to -0.19 and ß = -0.24; -0.47 to -0.01, respectively). CONCLUSIONS: In adults, breakfast quality was associated with age, sex, and educational level. Perceived stress levels were inversely associated with the quality of breakfast. In children/adolescents, a north-south gradient in breakfast quality was observed.

Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors.

BACKGROUND: Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors. METHODS: Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA). RESULTS: Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: -3.28, 95% C.I.: -5.7 to -0.86), diastolic blood pressure (b: -1.85, 95% C.I.: -3.34 to -0.36), augmentation index (b: -3.17, 95% C.I.:-4.98 to 1.35) and left carotid intima media thickness (b: -0.03, 95% C.I.:-0.06 to -0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10-20% of daily total energy intake (dTEI) was inversely associated with Aix (b: -2.31, 95% C.I.:-4.05 to -0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90). CONCLUSION: SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.

Time-related meal patterns and breakfast quality in a sample of Iranian adults.

BACKGROUND: Some evidence shows that meal timing is associated with diet quality. We aimed to investigate the relationship between meal timing and breakfast quality in a sample of Iranian adults. METHODS: This cross-sectional study was conducted on 850 men and women living in Tehran, Iran. Dietary data was recorded by three non-consecutive 24-h dietary recalls. The Breakfast Quality Index (BQI) was calculated. Time-related meal patterns included the interval between the first and last meal (eating and fasting window), frequency of meals, length of sleep, and time of first and last eating occasion. The multiple linear regression analysis was used to identify the relationships between time-related meal patterns and BQI. RESULTS: The mean (95% CI) of BQI was 4.52 (4.45-4.65) and the maximum was 8. Bread, cheese, vegetables, fruits, energy, and carbohydrate intake showed positive associations with BQI scores. Longer fasting time showed a positive association with fruits (ß (CI 95%)) (0.11 (0.0003-0.005), and vegetable consumption (0.12 (0.009-0.07)) and BQI score (0.39 (0.001-0.06)). Time of first eating occasions indicated a negative association with protein and fat intake and BQI score. Time of last eating occasions showed a positive association with vegetables consumption and BQI score. The longer length of sleep was associated with a higher BQI score. The frequency of meals was significantly and positively related to energy and macronutrients intake and BQI. CONCLUSION: Earlier first and last meal, longer sleep length, longer fasting window, and a greater meal frequency were associated with a better breakfast quality.

Breakfast Quality and Insulin Resistance in Spanish Schoolchildren: A Cross-Sectional Study.

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8−13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01−0.77], p < 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.

Breakfast Quality of Preschool-aged Canadian Children.

Purpose: To investigate the breakfast quality of preschool-aged children through a comparison of their energy and nutrient intakes at breakfast to published benchmarks for a balanced breakfast.Methods: Dietary data were collected for 163 children aged 3-5 years enrolled in the Guelph Family Health Study using one parent-reported online 24-hour recall and analyzed for energy and nutrient intakes. Breakfast quality was assessed by tallying the frequency of participants whose nutrient and energy intakes at their breakfast meal met the recommendations for a balanced breakfast established by the International Breakfast Research Initiative (IRBI).Results: Almost all participants (98%) consumed breakfast, and most participants (82.5%) met the energy IRBI recommendation. However, the majority of participants did not meet the IRBI recommendations for breakfast intakes of most macronutrients and micronutrients. In particular, fewer than 25% of participants met the IRBI recommendations for breakfast intakes of dietary fibre, niacin, folate, vitamin C, calcium, potassium and zinc.Conclusions: Almost all preschool-aged children in this study consumed breakfast, but the nutritional quality of their breakfast did not meet recommendations for most nutrients. These results can inform nutrition education and intervention programs for children that aim to improve the nutritional quality of breakfast.

Evaluación de la calidad y frecuencia de consumo del desayuno en estudiantes secundarios de las ciudades de Arequito y Gálvez (Santa Fe) / Assessment of breakfast quality and frequency of consumption in high school students from Arequito and Gálvez (Santa Fe)

Resumen Introducción: se considera al desayuno como la comida más importante del día a través de la cual se vehiculizan nutrientes sustanciales. Es difícil conseguir una alimentación diaria correcta si éste se omite. El objetivo de la presente investigación fue evaluar la frecuencia y calidad del desayuno de los adolescentes de entre 16 y 18 años que asisten a una escuela en el turno mañana, en relación a aquellos que asisten a una escuela en el turno tarde. Objetivo: evaluar la frecuencia y la calidad del desayuno de adolescentes escolarizados en una escuela secundaria pública de Arequito y en una escuela privada de Gálvez (provincia de Santa Fe). Materiales y método: se realizó un estudio de tipo observacional, descriptivo y transversal. Se encuestaron un total de 177 estudiantes de ambos sexos (16-18 años) utilizando un cuestionario auto-administrado elaborado por las autoras para conocer los alimentos ingeridos en el desayuno y evaluar su calidad. Se consideró un desayuno de buena calidad aquel que incluía al menos un alimento del grupo de los lácteos, cereales y frutas. Los resultados se presentan en forma tabular con frecuencias absolutas y porcentuales. Resultados: 60,9% (n=28) del total de encuestados en el turno mañana realizaban el desayuno siempre de lunes a viernes, un 32,6% (n=15) lo hacía entre 2 y 4 veces por semana y un 6,9% (n=3) lo hacía menos de 2 veces. En relación al turno tarde, un 41,3% (n=45) desayunó todos los días, el 50,5% (n=55) entre 2 y 4 veces y 8,2% (n=9) lo hacía menos de 2 veces. Un 74% (n=34) de los alumnos del turno mañana que desayunó al menos una vez en la semana, consumió un desayuno de calidad buena o mejorable, mientras que en el 26% (n=12) fue de calidad insuficiente o mala. La mayoría de los adolescentes del turno tarde (83,5%, n= 91) consumió un desayuno de calidad buena o mejorable y sólo el 16,5% (n=18) evidenció una calidad de desayuno insuficiente o mala. Conclusión: no se hallaron diferencias estadísticamente significativas en la frecuencia de realización del desayuno según turno. Tanto para el turno mañana como para el turno tarde, lo más usual fue que los alumnos desayunaran siempre.

Abstract Introduction: breakfast is considered the most important meal of the day, through which substantial nutrients are conveyed. It is difficult to get a correct daily diet if it is omitted. The objective of this research was to evaluate the frequency and quality of breakfast in adolescents between 16 and 18 years old who attend school in the morning shift, in relation to those who attend school in the afternoon shift. Objective: to evaluate the frequency and quality of breakfast for adolescents enrolled in a state secondary school in Arequito and in a private school in Gálvez (Santa Fe). Materials and Method: an observational, descriptive and cross-sectional study was carried out. A total of 177 students of both sexes (16-18 years) were surveyed using a self-administered questionnaire prepared by the authors to know the food eaten at breakfast and assess its quality. A good quality breakfast was considered one that included at least one food from the group of dairy, cereal and fruit group. The results are presented in tabular form with absolute and percentage frequencies. Results: 60.9% (n=28) of the total number of respondents in the morning shift always had breakfast from Monday to Friday, 32,6% (n=15) did it between 2 and 4 times a week and 6,9% (n=3) did so less than 2 times. In relation to the afternoon shift, 41,3% (n=45) ate breakfast every day, 50,5% (n=55) between 2 and 4 times and 8,2% (n=9) had it less than 2 times. 74% (n=34) of the students on the morning shift who ate breakfast at least once a week, consumed a breakfast of good or improvable quality, while in 26% (n=12) it was of insufficient or bad quality. The majority of the adolescents on the afternoon shift (83,5%, n=91) consumed a breakfast of good or improvable quality, and only 16.5% (n=18) showed insufficient or poor quality of breakfast. Conclusion: no statistically significant differences were found in the frequency of breakfast according to shift. For both the morning shift and the afternoon shift, the most common thing was that the students always had breakfast.

Dietary Patterns of Breakfast Consumption Among Chilean University Students.

Breakfast is one of the most important meals of the day. A good quality breakfast must include dairy products, cereals, and fruits. The aim of this study is to determine breakfast dietary patterns and their nutritional quality among Chilean university students. A cross-sectional non-probabilistic study was conducted in 200 university students between 18 and 27 years in Santiago, Chile. To identify dietary patterns and breakfast quality, a breakfast food survey was conducted. Patterns were identified by factor analysis. Most of the subjects (53%) ate breakfast daily, with a higher prevalence among females (60.2% vs. 43.7%, p < 0.05); 68% did not consume fruits and 17.5% had good breakfast quality, with no differences by sex. Four breakfast dietary patterns were identified: "dairy & cereals", "healthy", "traditional salty" and "traditional sweet" that together explained 35.6% of the total variance. There was no sex difference in predominant dietary patterns. The "dairy & cereals" and "traditional sweet" patterns were associated with regularly eating breakfast (ß: -0.47, p = 0.001; ß: -0.32, p = 0.020) and the "healthy" pattern with BMI ≥25 kg/m2 (ß: 0.35, p = 0.024). In conclusion, breakfast quality was inadequate due to low fruit consumption and energy intake. The four identified patterns included cereals, bread, dairy, fats and sugars. Results may be usual in the planning of future interventions aimed at improving breakfast consumption and quality in university students.

Association of Breakfast Quality and Energy Density with Cardiometabolic Risk Factors in Overweight/Obese Children: Role of Physical Activity.

There is a general belief that having breakfast is an important healthy lifestyle factor; however, there is scarce evidence on the influence of breakfast quality and energy density on cardiometabolic risk in children, as well as on the role of physical activity in this association. The aims of this paper were (i) to examine the associations of breakfast quality and energy density from both solids and beverages with cardiometabolic risk factors, and (ii) to explore whether physical activity levels may attenuate these relationships in children with overweight/obesity from two projects carried out in the north and south of Spain. Breakfast consumption, breakfast quality index (BQI) score, BEDs/BEDb (24 h-recalls and the KIDMED questionnaire), and physical activity (PA; accelerometry) were assessed, in 203 children aged 8⁻12 years who were overweight or obese. We measured body composition (Dual X-ray Absorptiometry), uric acid, blood pressure, lipid profile, gamma-glutamyl-transferase (GGT), glucose, and insulin, and calculated the HOMA and metabolic syndrome z-score. The BQI score was inversely associated with serum uric acid independently of a set of relevant confounders (ß = -0.172, p = 0.028), but the relationship was attenuated after further controlling for total PA (p < 0.07). BEDs was positively associated with total and HDL cholesterol, and systolic blood pressure regardless of confounders (all p < 0.05), while BEDb was positively associated with HOMA in either active/inactive children (all p < 0.03). In conclusion, higher breakfast quality and lower breakfast energy density should be promoted in overweight/obesity children to improve their cardiometabolic health.

Association of bisphenol A exposure with dietary quality indices in Spanish schoolchildren.

Young children, whose growth and development are highly dependent on the endocrine system, are particularly vulnerable to endocrine disruptor exposure. The main objectives of this study were to measure BPA migration levels from cans, fruit juice bottles/packs, and microwave containers used for food/drinks consumed by a sample of 6- to 8-year old schoolchildren in Spain and to estimate the relationship between their resulting BPA exposure and diet quality index scores (Mediterranean Diet Score and Breakfast Quality Index). The mean BPA concentration was 11.8 ng/mL for vegetable cans, 22.1 ng/mL for pulse cans, 3.6 ng/mL for juice bottles/packs, and 1.2 ng/mL for microwave containers. Results revealed a significant association between the Mediterranean Diet Score and low BPA exposure of the children. BPA exposure below the median level was significantly associated with a higher score in both the first-grade (P = 0.030) and second-grade (p = 0.0001) groups. However, no association was found between BPA exposure and the Breakfast Quality Index. In conclusion, children with a stronger adherence to a Mediterranean-like diet appear to be less exposed to BPA migrating from food packaging and microwave containers. Further research is warranted on the inadvertent exposure of children to endocrinedisrupting chemicals from these sources.

Hábito y calidad del desayuno en alumnos de dos escuelas primarias públicas de la ciudad de Santa Fe / Breakfast habit and quality in students from two public primary schools in the city of Santa Fe

Introducción. El desayuno proporciona la energía y los nutrientes necesarios que permiten un óptimo rendimiento físico e intelectual. Objetivo. Conocer la frecuencia del desayuno, los factores que condicionan el hábito y su omisión, la calidad del desayuno y la colación en los niños de escuelas públicas de la ciudad de Santa Fe. Población y métodos. Estudio descriptivo transversal. Se evaluaron 637 alumnos mediante una encuesta estructurada de respuestas cerradas. Resultados El 75% de los niños desayunaban diariamente; solo 1,6% realizaban un desayuno de buena calidad. Consumir el desayuno todos los días o a veces no dependía de la compañía de un familiar. De 1°a 5° grado la frecuencia semanal dependió de que algún familiar lo preparara (p= 0,04). La causa principal de omisión del desayuno fue la falta de tiempo. El 23% de los alumnos de 6°-7° grado manifestaron sentir malestar al desayunar. Más del 50% de los niños miraban televisión mientras desayunaban. La mayoría de los alumnos de 1° a 3er grado consumieron un desayuno de mejorable (41%) e insufciente calidad (41%). En los alumnos de 4° y 5° grado predominó el de insufciente calidad (50%). En el grupo de 6° y 7° grado fue notable el consumo de desayuno de mala calidad (16%). En muy pocos niños la colación resultó apropiada para completar la calidad fnal del desayuno. Conclusiones. Si bien se encontró un alto porcentaje de escolares que tienen el hábito de desayunar, la mayoría lo hacen de forma incompleta. Muy pocos logran completar la calidad del desayuno con los alimentos ingeridos a media mañana.(AU)

Introduction. Breakfast provides the necessary energy and nutrients to achieve an optimal physical and mental performance. Objective. To fnd out breakfast frequency, factors that influence breakfast habit and skipping, breakfast quality and snack intake in children from public schools in the city of Santa Fe. Population and Methods. Descriptive, cross-sectional study. A total of 637 students were assessed using a closed-ended question survey. Results. Seventy fve percent of children had breakfast on a daily basis; only 1.6% had a good quality breakfast. Eating breakfast every day or some days did not depend on having the company of a family member. In the case of frst to ffth grade children, the weekly frequency depended on having a family member who made it (p= 0.04). The main cause for skipping breakfast was lack of time. Twenty-three percent of children in sixth and seventh grade indicated feeling unwell when having breakfast. More than 50% of children watched television while having breakfast. Most students in frst to third grade had breakfast that could be improved (41%) and which was insufficient (41%). An insufficient quality breakfast was more common among fourth and ffth grade students (50%). A remarkable piece of information is the number of sixth and seventh grade children who had a poor quality breakfast (16%). Very few children had a snack that was appropriate to supplement the fnal quality of breakfast. Conclusions. Although a high percentage of school-aged children are used to having breakfast, most have an incomplete breakfast. Very few manage to supplement their breakfast with snacks at mid-morning.(AU)

Hábito y calidad del desayuno en alumnos de dos escuelas primarias públicas de la ciudad de Santa Fe / Breakfast habit and quality in students from two public primary schools in the city of Santa Fe

Introducción. El desayuno proporciona la energía y los nutrientes necesarios que permiten un óptimo rendimiento físico e intelectual. Objetivo. Conocer la frecuencia del desayuno, los factores que condicionan el hábito y su omisión, la calidad del desayuno y la colación en los niños de escuelas públicas de la ciudad de Santa Fe. Población y métodos. Estudio descriptivo transversal. Se evaluaron 637 alumnos mediante una encuesta estructurada de respuestas cerradas. Resultados El 75% de los niños desayunaban diariamente; solo 1,6% realizaban un desayuno de buena calidad. Consumir el desayuno todos los días o a veces no dependía de la compañía de un familiar. De 1°a 5° grado la frecuencia semanal dependió de que algún familiar lo preparara (p= 0,04). La causa principal de omisión del desayuno fue la falta de tiempo. El 23% de los alumnos de 6°-7° grado manifestaron sentir malestar al desayunar. Más del 50% de los niños miraban televisión mientras desayunaban. La mayoría de los alumnos de 1° a 3er grado consumieron un desayuno de mejorable (41%) e insufciente calidad (41%). En los alumnos de 4° y 5° grado predominó el de insufciente calidad (50%). En el grupo de 6° y 7° grado fue notable el consumo de desayuno de mala calidad (16%). En muy pocos niños la colación resultó apropiada para completar la calidad fnal del desayuno. Conclusiones. Si bien se encontró un alto porcentaje de escolares que tienen el hábito de desayunar, la mayoría lo hacen de forma incompleta. Muy pocos logran completar la calidad del desayuno con los alimentos ingeridos a media mañana.

Introduction. Breakfast provides the necessary energy and nutrients to achieve an optimal physical and mental performance. Objective. To fnd out breakfast frequency, factors that influence breakfast habit and skipping, breakfast quality and snack intake in children from public schools in the city of Santa Fe. Population and Methods. Descriptive, cross-sectional study. A total of 637 students were assessed using a closed-ended question survey. Results. Seventy fve percent of children had breakfast on a daily basis; only 1.6% had a good quality breakfast. Eating breakfast every day or some days did not depend on having the company of a family member. In the case of frst to ffth grade children, the weekly frequency depended on having a family member who made it (p= 0.04). The main cause for skipping breakfast was lack of time. Twenty-three percent of children in sixth and seventh grade indicated feeling unwell when having breakfast. More than 50% of children watched television while having breakfast. Most students in frst to third grade had breakfast that could be improved (41%) and which was insufficient (41%). An insufficient quality breakfast was more common among fourth and ffth grade students (50%). A remarkable piece of information is the number of sixth and seventh grade children who had a poor quality breakfast (16%). Very few children had a snack that was appropriate to supplement the fnal quality of breakfast. Conclusions. Although a high percentage of school-aged children are used to having breakfast, most have an incomplete breakfast. Very few manage to supplement their breakfast with snacks at mid-morning.

SURVEY OF BREAKFAST BEHAVIORS AMONG PRIMARY AND SECONDARY STUDENTS IN SEVEN CITIES OF CHINA / 营养学报

Objective To investigate the breakfast behaviors and nutritional quality among primary and secondary students,and to provide scientific evidence for developing intervention strategies.Method Random three-stage clustering sampling method was employed in the study.A questionnaire survey was conducted among 9194 primary and secondary students aged 6-17y,from seven cities in China.Results The rates of primary and secondary students having breakfast everyday were 97.0%,92.4%,and 93.4%,Most of the students had their breakfast within 30 min after getting up,the rates being 75.4%,74.7%,and 68.6% respectively.Mothers primarily cook breakfast for the students,the rates being 53.1%,49.9%,and 49.7% respectively.In most cases,they had breakfast at home,the rates being 71.8%,67.0%,and 63.8% respectively.The rates of students having poor quality breakfast were above 80%.Conclusion Primary and secondary students are one of the focal target people for preventing unhealthy dietary behaviors due to shortcomings of eating breakfast.It is necessary to improve the nutritional quality of breakfast for better health of students.