US researchers have found that teenagers who ate breakfast every day were more likely to have a healthier diet, exercise regularly and have a lower Body Mass Index (BMI) five years later compared to same age counterparts who skipped breakfast.
The study is the work of epidemiologists working on the University of Minnesota School of Public Health Project Eating Among Teens (EAT) at the University of Minnesota in Minneapolis and is published in the March online issue of the journal Pediatrics.
Body Mass Index is the ratio of a person’s weight in kilos to their height in metres squared.
Cross sectional studies looking at teenagers of different ages have already linked skipping breakfast with higher BMI, but there have been few studies that follow groups of children as they get older.
Study author Dr Mark Pereira said this study makes an important contribution in this less examined area because of its duration and size.
“The dose-response findings between breakfast frequency and obesity risk, even after taking into account physical activity and other dietary factors, suggests that eating breakfast may have important effects on overall diet and obesity risk, but experimental studies are needed to confirm these observations,” said Pereira.
The past 20 years have seen a doubling in American childhood obesity rates, and for teens the rate has nearly tripled.
57 per cent of adolescent girls and 33 per cent of adolescent boys frequently use unhealthy approaches to control weight, and the researchers said estimates show between 12 and 24 per cent of children and teenagers regularly skip breakfast. And the number who do so goes up with age.
The researchers examined the link between breakfast eating frequency and change in body weight after 5 years in 2,216 teenagers.
Project EAT (Eating Among Teens) was a 5-year longitudinal study that looked at teenagers’ eating patterns and weight concerns.
Participants completed questionnaires during 1998 and 1999 (first round) and then again during 2003 and 2004 (second round, five years later).
Using statistical linear regression analysis the researchers explored the link between how often the teenagers had breakfast and their change in BMI. The figures were adjusted for age, race, physical activity, socio-economic group, their BMI in round 1, and other diet and weight factors at the start of the study.
The results showed that:
- At the start of the study, the teenagers who ate breakfast more frequently were more likely to be white, physically active, have the highest carbohydrate and fibre intake, and have higher socio-economic status.
- On the other hand, the teenagers who ate breakfast less frequently were the ones who were most likely to smoke, drink alcohol, and use dieting and other ways to control their weight.
- Cross sectional analyses of data taken at the start and at the end of the study showed that the link between less frequent breakfast eating and higher BMI was mostly independent of all the potential confounders.
- Factors related to weight, such as concerns, behaviours and pressures, did not explain the link between breakfast eating and BMI.
- Prospective analyses (where the group is followed), showed that frequency of breakfast eating was inversely linked with BMI in a dose-response pattern.
Pereira and colleagues concluded that these findings:
“Support the importance of promoting regular breakfast consumption among adolescents.”
“Future studies should further examine the role of breakfast habits among youth who are particularly concerned about their weight,” they added.
They also pointed out that because the study was not an experimental design, they cannot say that skipping breakfast caused the higher BMI. An experimental study would have to be done to establish a causal link, they said.
However, principal investigator of Project EAT, Dr Dianne Neumark-Sztainer, said this study confirmed the importance of helping teenagers learn to start the day “right” by eating breakfast. Although they may think:
” That skipping breakfast seems like a good way to save on calories, findings suggest the opposite,” she said.
“Eating a healthy breakfast may help adolescents avoid overeating later in the day and disrupt unhealthy eating patterns, such as not eating early in the day and eating a lot late in the evening,” explained Neumark-Sztainer.
“Breakfast Eating and Weight Change in a 5-Year Prospective Analysis of Adolescents: Project EAT (Eating Among Teens).”
Maureen T. Timlin, Mark A. Pereira, Mary Story, and Dianne Neumark-Sztainer.
Pediatrics 2008; 121: e638-e645.
March 2008, Volume 121, Issue 3.
DOI:10.1542/peds.2007-1035
Sources: University of Minnesota Press Release, journal abstract.
Written by: Catharine Paddock, PhD