Dataset Information

Regular breakfast consumption and type 2 diabetes risk markers in 9- to 10-year-old children in the child heart and health study in England (CHASE): a cross-sectional analysis.

ABSTRACT:

Background

Regular breakfast consumption may protect against type 2 diabetes risk in adults but little is known about its influence on type 2 diabetes risk markers in children. We investigated the associations between breakfast consumption (frequency and content) and risk markers for type 2 diabetes (particularly insulin resistance and glycaemia) and cardiovascular disease in children.

Methods and findings

We conducted a cross-sectional study of 4,116 UK primary school children aged 9-10 years. Participants provided information on breakfast frequency, had measurements of body composition, and gave fasting blood samples for measurements of blood lipids, insulin, glucose, and glycated haemoglobin (HbA1c). A subgroup of 2,004 children also completed a 24-hour dietary recall. Among 4,116 children studied, 3,056 (74%) ate breakfast daily, 450 (11%) most days, 372 (9%) some days, and 238 (6%) not usually. Graded associations between breakfast frequency and risk markers were observed; children who reported not usually having breakfast had higher fasting insulin (percent difference 26.4%, 95% CI 16.6%-37.0%), insulin resistance (percent difference 26.7%, 95% CI 17.0%-37.2%), HbA1c (percent difference 1.2%, 95% CI 0.4%-2.0%), glucose (percent difference 1.0%, 95% CI 0.0%-2.0%), and urate (percent difference 6%, 95% CI 3%-10%) than those who reported having breakfast daily; these differences were little affected by adjustment for adiposity, socioeconomic status, and physical activity levels. When the higher levels of triglyceride, systolic blood pressure, and C-reactive protein for those who usually did not eat breakfast relative to those who ate breakfast daily were adjusted for adiposity, the differences were no longer significant. Children eating a high fibre cereal breakfast had lower insulin resistance than those eating other breakfast types (p for heterogeneity <0.01). Differences in nutrient intakes between breakfast frequency groups did not account for the differences in type 2 diabetes markers.

Conclusions

Children who ate breakfast daily, particularly a high fibre cereal breakfast, had a more favourable type 2 diabetes risk profile. Trials are needed to quantify the protective effect of breakfast on emerging type 2 diabetes risk. Please see later in the article for the Editors' Summary.

SUBMITTER: Donin AS

PROVIDER: S-EPMC4151989 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundObservational studies show associations between breakfast skipping, reduced satiety, and poor sleep quality; however, intervention studies are lacking.ObjectiveThe purpose of this study was to examine the effects of consuming breakfast compared with breakfast skipping on appetitive, hormonal, and neural markers of appetite and satiety; ad libitum food intake; and exploratory measures of sleep health in young adults.MethodsThirteen adults [aged 23.5 ± 0.9 y (mean ± SEMs); body mass index (kg/m2): 23.6 ± 0.6] completed the following randomized crossover-design study. Participants consumed a high-protein breakfast ("Breakfast"; 340 kcal, 30 g protein, 36 g carbohydrate, 9 g fat) or skipped breakfast ("Skip") for 7 d/treatment. On day 7, an 8-h clinical testing day was completed including assessments of hunger, fullness, desire to eat, prospective food consumption (PFC), related hormones, food cue-stimulated functional magnetic resonance imaging brain scans, and ad libitum evening food intake. Sleep quantity and quality were assessed with 7-d actigraphy, 7-d sleep diaries, and sleep-related hormones.ResultsMorning and daily hunger, desire to eat, PFC, and ghrelin decreased, whereas fullness increased after the Breakfast pattern compared with after the Skip pattern (all, P < 0.05). No difference in peptide YY (PYY) concentrations were detected. Hippocampal, parahippocampal, and middle frontal gyrus activations were reduced after the Breakfast pattern compared with the Skip pattern (all, P < 0.01). Although no differences in daily food intake were observed, the Breakfast pattern reduced evening intake of high-carbohydrate and high-fat foods (P < 0.05), whereas evening sugar intake tended to be reduced compared with the Skip pattern (P = 0.085). Although Breakfast led to shorter total sleep time (TST) compared with Skip (P < 0.05), no difference in sleep efficiency (TST/sleep period) was detected. Perceived sleep quality and sleep onset tended to improve after Breakfast compared with after Skip (P = 0.060 and P = 0.07, respectively).ConclusionBreakfast consumption improved appetite, satiety, and diet quality and may support some aspects of sleep health in healthy young adults. This trial was registered at clinicaltrials.gov as NCT03031132.