The Relationship of Breakfast Skipping and Type of Breakfast Consumption with Nutrient Intake and Weight Status in Children and Adolescents: The National Health and Nutrition Examination Survey 1999-2006

Background National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited. Objective To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status. Subjects Children aged 9 to 13 years (n=4,320) and adolescents aged 14 to 18 years (n=5,339). Design Cross-sectional data from the National Health and Nutrition Examination Survey 1999-2006. Methods Breakfast consumption was self-reported. A 24-hour dietary recall was used to assess nutrient intakes. Mean adequacy ratio (MAR) for micronutrients and anthropometric indexes were evaluated. Covariate-adjusted sample-weighted means were compared using analysis of variance and Bonferroni's correction for multiple comparisons among breakfast skippers (breakfast skippers), ready-to-eat (RTE) cereal consumers, and other breakfast (other breakfast) consumers. Results Twenty percent of children and 31.5% of adolescents were breakfast skippers; 35.9% of children and 25.4% of adolescents consumed RTE cereal. In children/adolescents, RTE cereal consumers had lower intakes of total fat and cholesterol and higher intakes of total carbohydrate, dietary fiber, and several micronutrients (P<0.05 for all) than breakfast skippers and other breakfast consumers. RTE cereal consumers had the highest MAR for micronutrients, and MAR was the lowest for breakfast skippers (P<0.05). In children/adolescents, breakfast skippers had higher body mass index-for-age z scores (P<0.05) and a higher waist circumference (P<0.05) than RTE cereal and other breakfast consumers. Prevalence of obesity (body mass index >= 95th percentile) was higher in breakfast skippers than RTE cereal consumers (P<0.05) in children/adolescents and was higher in other breakfast consumers than RTE cereal consumers only in adolescents (P<0.05). Conclusions RTE cereal consumers had more favorable nutrient intake profiles and adiposity indexes than breakfast skippers or other breakfast consumers in US children/adolescents. J Am Diet Assoc. 2010;110:869-878.