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The Relationship of Breakfast and Cereal Consumption to Nutrient Intake and Body Mass Index: The National Heart, Lung, and Blood Institute Growth and Health Study

https://doi.org/10.1016/j.jada.2005.06.003Get rights and content

Abstract

Objective

To describe changes in breakfast and cereal consumption of girls between ages 9 and 19 years, and to examine the association of breakfast and cereal intake with body mass index (BMI) and consumption of nutrients.

Design

Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal biracial observational cohort study with annual 3-day food records.

Subjects/Setting

The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 black), ages 9 and 10 years at baseline, from locations in the Berkeley, CA; Cincinnati, OH; and Washington, DC, areas.

Main Outcome Measures

Frequency of consumption of breakfast (including cereal vs other foods) and cereal; BMI; and dietary fat, fiber, calcium, cholesterol, iron, folic acid, vitamin C, and zinc.

Statistical Analyses

Generalized estimating equations methodology was used to examine differences in the frequency of breakfast and cereal eating by age. Generalized estimating equations and mixed models were used to examine whether breakfast and cereal consumption were predictive of BMI and nutrient intakes, adjusting for potentially confounding variables.

Results

Frequency of breakfast and cereal consumption decreased with age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. After adjusting for energy intake, cereal consumption was related to increased intake of fiber, calcium, iron, folic acid, vitamin C, and zinc, and decreased intake of fat and cholesterol. Days eating cereal was predictive of lower BMI.

Conclusions

Cereal consumption as part of an overall healthful lifestyle may play a role in maintaining a healthful BMI and adequate nutrient intake among adolescent girls.

Section snippets

Materials and Methods

As previously reported, the National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study is a 10-year longitudinal study of 2,379 girls who were 9 or 10 years old at study entry (Table 1) (16). Girls were recruited from three study sites: University of California at Berkeley; University of Cincinnati/Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and Westat Inc/Group Health in Rockville, MD. The study protocol was approved by the Institutional Review Boards of all

Age Trends in Breakfast and Cereal Consumption

The number of days of breakfast consumption and the number of days of cereal consumption were computed for each girl at each age (Objective 1). Detailed data on days of breakfast consumption by age in the same cohort of girls used in the present analysis were presented by Affenito and colleagues (7). Days of breakfast consumption decreased significantly as girls grew older [repeated-measures Mantel-Haenzel test of nonzero correlation: χ2(10)=1,603.09, P<.0001]. Similar to the pattern for

Discussion

The objective of this research was to investigate the role of breakfast and cereal consumption on BMI as girls matured through adolescence. The longitudinal analysis clearly demonstrated that cereal consumption was predictive of lower BMI in these girls. Previous research has documented several negative behaviors associated with overweight or obesity in youth, including lack of physical activity, unhealthful weight-control measures, unhealthful food choices or poor diet, and skipping breakfast (

Conclusions

Cereal consumption may be one component of a healthful lifestyle that helps adolescent girls to maintain adequate nutrient intake and a healthful BMI. Cereal consumption may form part of an overall eating pattern that promotes maintenance of healthful body weights.

B. Barton is president and chief executive officer, Maryland Medical Research Institute, Baltimore.

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      The cumulative effect of such campaigns could well be the basis for a form of ‘cognitive stereotyping’ (Booth, 1994) – namely associating breakfast with health. Relevant here, in terms of breakfast, foods such as cereals, have long been marketed as offering a healthy start to the day (Severson, 2016), this despite the fact that many breakfast cereals are anything but healthy (e.g., Environmental Working Group, 2011, 2014; Pombo-Rodrigues, Hashem, He, & MacGregor, 2017; see also Barton et al., 2005; Lee & Lee, 2007). Much the same criticism can also be levelled at orange juice (e.g., Bachmann, 2013; Braun, 2014).

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    B. Barton is president and chief executive officer, Maryland Medical Research Institute, Baltimore.

    D. Thompson is a senior research scientist, Maryland Medical Research Institute, Baltimore.

    A. Eldridge is manager, Nutrition Science, Bell Institute of Nutrition, Minneapolis.

    A. Albertson is a senior nutrition scientist, Bell Institute of Nutrition, Minneapolis.

    S. Crockett is senior director, General Mills, Bell Institute of Nutrition, Minneapolis, MN.

    S. Affenito is an assistant professor, Department of Nutrition and Family Studies, Saint Joseph College, West Hartford, CT.

    R. Striegel-Moore is a professor, Department of Psychology, Wesleyan University, Middletown, CT.

    D. Franko is a professor, Department of Counseling and Educational Psychology, Northeastern University, Boston, MA.

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