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Breakfast in relation to overall diet quality in UK children and adolescents

Published online by Cambridge University Press:  06 September 2018

S. Gaal ,
M.B.E. Livingstone ,
H. McNulty ,
M. Ward  and
M.A. Kerr
S. Gaal
Affiliation:
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA.
M.B.E. Livingstone
Affiliation:
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA.
H. McNulty
Affiliation:
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA.
M. Ward
Affiliation:
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA.
M.A. Kerr
Affiliation:
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, BT52 1SA.
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Abstract

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Information
Proceedings of the Nutrition Society , Volume 77 , Issue OCE3: Irish Section Meeting, 20–22 June 2018, Targeted approaches to tackling current nutritional issues , 2018 , E80
Copyright
Copyright © The Authors 2018 

Evidence suggests that regular breakfast consumption is associated with higher overall micronutrient intake(Reference Coulthard, Palla and Pot1), dietary adequacy(Reference Barr, DiFrancesco and Fulgoni2) and quality(Reference Polonsky, Davey and Bauer3) in children and adolescents but this has not been fully explored in a UK cohort(Reference Llaurado, Albar and Giralt4). The objective of this study was therefore to investigate the relationship between breakfast and overall diet quality in UK children and adolescents aged 5–17 years. Data from the most recent National Diet and Nutrition Survey (NDNS, 2008–2014) were accessed to provide a representative sample of UK children and adolescents (n = 3283). Dietary intake was assessed by a 4-day estimated food diary. As meal occasions were not specified in NDNS, breakfast was defined for the current study as all food and drink items consumed between 6 am – 11 am. Average energy, macro- and micronutrient intakes from breakfast were calculated based on consumption days only. Overall diet quality (DQ) was assessed by applying the Nutrient Rich Food Index (NRF) 9·3 method(Reference Maillot, Ferguson and Drewnowski5) which subtracts the sum of three negative nutrients (saturated fat, added sugar and salt) from that of nine positive nutrients (protein, fibre, vitamin A, C, D, calcium, iron, potassium, magnesium) expressed as a multiple of 100 (∑ sub-scores positive × 100)−(∑ sub-scores negative × 100). The algorithm was adjusted based on an 8·4 MJ energy intake. Statistical analyses were carried out by SPSS (Version 24) software.

Table 1.

Tertile 1: Low DQ; Tertile 2: Medium DQ; Tertile 3: High DQ. P* unadjusted (ANOVA) P** adjusted for National Statistics Socio-economic Classification (housing, employment, education) (ANCOVA). ¥ Nutrient values were Square-root transformed for normalisation purposes prior to analysis; data shown as absolute values. Macronutrients expressed as percentage contribution to breakfast energy. P < 0·05 is considered significant. Abbreviations: AOAC American Association of Analytical Chemists; SFA saturated fat; NMES non-milk extrinsic sugars.

Table 1 shows dietary intake at breakfast according to tertiles of NRF score. Average breakfast energy intake did not differ by tertile of DQ. However, average breakfast intakes of fibre, folate, calcium, iodine, iron, magnesium and potassium progressively and significantly increased from the lowest to the highest tertile of DQ. In contrast, average breakfast intakes of total fat, saturated fat, added sugar and sodium showed the opposite trend. These results highlight an important role for breakfast in relation to overall diet quality. The development of nutrient based breakfast recommendations for children and adolescents may be warranted.

This study was funded by Cereal Partners Worldwide as part of the International Breakfast Research Initiative.

References

1.Coulthard, JD, Palla, L & Pot, GK (2017) Br J Nutr 118, 280–90.Google Scholar
2.Barr, SI, DiFrancesco, L & Fulgoni, VL 3rd. (2014) Br J Nutr 112, 1373–83.Google Scholar
3.Polonsky, HM, Davey, A, Bauer, KW et al. (2018) J Nutr Educ Behav 50, 190–197.Google Scholar
4.Llaurado, E, Albar, SA, Giralt, M et al. (2016) Eur J Nutr 55, 1789–97.Google Scholar
5.Maillot, M, Ferguson, EL, Drewnowski, A et al. (2008) J Nutr 138, 1107–13.Google Scholar
Figure 0

Table 1.