Within-person comparison of eating behaviors, time of eating, and dietary intake on days with and without breakfast: NHANES 2005-2010

Background: Breakfast omission is known to be associated with lower 24-h energy intake. However, little is known about downstream eating behaviors subsequent to skipping breakfast in free-living individuals. Objective: We replicated the traditional crossover design of nutrition studies in a naturalistic setting to compare within-person differences in self-reported eating behaviors, energy intake, and other dietary characteristics of individuals on a day that included breakfast with a day that omitted breakfast. Design: We used cross-sectional dietary data for 2132 adult respondents who reported breakfast in only one of 2 dietary recalls in the NHANES 2005-2010. Dietary outcomes examined included meal-and snack-eating behaviors, clock time of eating episodes, and intakes of energy, macronutrients, and food groups. Regression methods accounted for replicate diet measurements, covariates, and survey-design characteristics. Results: The breakfast meal provided a mean of 508 kcal in men and 374 kcal in women, but differences in 24-h energy intakes between the breakfast and no-breakfast day were 247 and 187 kcal, respectively. Energy intakes at the lunch meal were higher on the no-breakfast day (202 kcal in men and 121 kcal in women), and the reported time of lunch was similar to 35 min earlier. The energy contribution of dinner or its reported time did not differ. A higher number of energy-adjusted servings of fruit and whole grains were reported on the breakfast day, but the energy and macronutrient density of reported foods were not different. Conclusions: In free-living American adults, the eating time for lunch was earlier, and the lunch meal provided more energy on the no-breakfast day than on the breakfast day. Although the quality of dietary selections reflected in the energy and macronutrient density of a day's intake did not differ between the breakfast and the no-breakfast day, breakfast skippers may need encouragement to consume fruit and whole grains at other eating episodes.