Background

Literature suggests that breakfast consumption (BC) in children is inversely associated with adiposity; however, these findings are inconsistent. Even so, those with frequent BC have superior diet quality, regardless of adiposity. This study examined associations of BC with adiposity and dietary intake in children.

Methods

This analysis used baseline data from TX Sprouts, a gardening, cooking, and nutrition intervention in 16 elementary schools across Austin, TX. Measurements included height, weight, BMI, body fat percent via bioelectrical impedance, waist circumference, and two 24-hour dietary recalls. Breakfast was defined as a meal consumed before 10am, accounting for ≥15% of daily energy. Breakfast consumption groups (BCG) included: breakfast skippers (BS; no breakfast both days), intermittent breakfast eaters (IBE; breakfast one day), and regular breakfast eaters (RBE; breakfast both days). Multivariate linear regression was used to evaluate associations between BCG, adiposity parameters, and dietary intake, controlling for age, sex, ethnicity, free/reduced lunch (FRL) status, daily energy, and clustering effect by schools.

Results

This study included 640 children (mean age 9 y; 54% female, 59% Hispanic, 66% FRL) with a BCG composition of 17% BS, 37% IBE, and 46% RBE. BCG were unrelated to adiposity measures. Compared to BS, IBE and RBE were associated with a 9- and 8-gram higher intake of added sugar/day (p<0.01), with RBE having a 0.4 serving/day increase in 100% fruit juice (p<0.03) and IBE having a 0.2 serving/day increase in sugar-sweetened beverages/flavored milk (SSBFM; p=0.03). Compared to BS, IBE and RBE were associated with a 28-unit and 51-unit increase in Glycemic Index (GI; p<0.0001).

Conclusions

BC was associated with higher GI and intake of added sugar, fruit juice, and SSBFM; however, there was no protective effect on adiposity, suggesting that interventions and food policies should focus on breakfast quality and limit intake of high-sugar breakfasts to decrease adiposity.