Dietary macronutrient composition and its effect on 24-h substrate oxidation: A study of diurnal variations in carbohydrate and fat intake.

BACKGROUND & AIMS: In recent times, the complexity of food styles and meal content has increased, leading to significant variations in macronutrient composition between meals. This phenomenon has coincided with a rise in obesity rates. We aimed to determine whether a large variation in macronutrient composition between meals results in reduced fat oxidation. METHODS: A cross-over study was conducted with 13 healthy young men, using whole-body indirect calorimetry to test 24-h energy metabolic responses under three conditions: regular meals (R), high-carbohydrate breakfast (CB), or high-fat breakfast (FB), each with different macronutrient contents. The R condition included three meals daily with the same macronutrient composition. The CB condition included a high-carbohydrate meal at breakfast, high-fat meal at lunch, and high-carbohydrate meal at dinner. The FB condition included a high-fat meal at breakfast, high-carbohydrate meal at lunch, and high-carbohydrate meal at dinner. The daily macronutrient compositions were similar across the three conditions, except that CB and FB had larger variations in carbohydrate-fat balance between meals than R. The participants were tested in random order. During the dietary intervention, we compared 24-h whole-body metabolic parameters, including substrate oxidation (e.g., 24 h respiratory quotient [RQ]). RESULTS: No significant differences were observed in the measures of energy expenditure among the three conditions. However, after adjusting for the sleeping RQ on a preceding day, the estimated 24hRQ was lower under the FB condition (0.845) than under the R (0.854, P = 0.0077 vs. FB) and CB conditions (0.853, P = 0.016 vs. FB). No difference was observed in the magnitude of the 5-h RQ change from lunch to dinner under the CB condition and in the magnitude of change from breakfast to lunch under the FB condition. CONCLUSIONS: A large variation in the carbohydrate-fat balance between meals does not decrease daily fat oxidation. An FB may increase daily fat oxidation compared to a CB when the daily food quotient is constant, but this increase may not be owing to the upregulation of fat burning on a daily basis.

Body Mass Index, Adherence to a Healthy Lifestyle, and Breakfast Consumption Associated with Religious Affiliation in Peruvian University Students: A Cross-Sectional Study.

BACKGROUND: Despite evidence suggesting a relationship between religiosity and health habits, there is a paucity of studies specifically examining this association in the context of Peruvian university students. This study compared body mass index (BMI), adherence to a healthy lifestyle, and breakfast consumption in Peruvian university students of four religious denominations: Seventh Day Adventists (SDA), Catholics, Baptists, and Evangelicals. METHODS: A cross-sectional study was conducted online among 4557 students from a Peruvian university. The BMI and the frequency of breakfast consumption were evaluated, and the Diet and Healthy Lifestyle Scale (DEVS) was applied. The variables studied were associated using simple and multiple linear regression and Poisson models with robust variance. RESULTS: Baptist (B = 0.44, 95% CI: 0.10-0.78; p = 0.011), Catholic (B = 0.3, 95% CI: 0.12-0.47; p = 0.001), and Evangelical (B = 0.32, 95% CI: 0.09 to 0.64; p = 0.014) students had a significantly higher BMI compared to SDA. Baptist (B = -0.2, 95% CI: -0.37--0.05; p = 0.017) and Evangelical (B = -0.13, 95% CI: -0.28--0.03; p = 0.012) students exhibited a lower mean score on the measure of healthy lifestyles compared to SDA students. Additionally, Baptist (PR = -0.32, 95% CI: -0.92--0.12; p = 0.035) and Catholic (PR = -0.3, 95% CI: -0.99--0.19; p = 0.016) students exhibited a lower probability of eating breakfast regularly compared to SDA students. CONCLUSIONS: Health professionals should consider these findings when designing and implementing health promotion programs that are culturally sensitive and respectful of the beliefs and practices of all religious groups in university settings.

The association between breakfast frequency and diabetes incidence in middle-aged women: Results from the MTC study.

BACKGROUND AND AIMS: Breakfast consumption could have a synchronizer role in chronobiological functions. Across observational studies, the assessment of breakfast frequency consumption is heterogeneous, therefore consensus on the relation between of weekly frequency of breakfast consumption and the risk of diabetes is unclear. We examined the relation between weekly breakfast frequency consumption and the incidence of diabetes in middle-age women. METHODS AND RESULTS: Since baseline (2006-2008) we prospectively followed 71,373 women from the Mexican Teachers' Cohort. Participants were classified according to breakfast consumption frequency of 0, 1-3, 4-6, or 7 days/week. Diabetes was identified by self-report and clinical-administrative databases. We used Cox proportional hazards multivariable models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for breakfast frequency and diabetes adjusting for covariates. Stratified analyses were performed for age, birth weight, ethnicity, and physical activity. We identified 3613 new diabetes cases between baseline and 2014. The prevalence of daily breakfast consumers was 25%. The median follow-up was 2.2 years, interquartile range 1.8-3.8 years. Relative to women who skipped breakfast, those who consumed breakfast every day had a 12% lower risk of diabetes (multivariable HR = 0.88; 95% CI 0.78, 0.99; p-trend = 0.0018). One additional day per week of breakfast was associated with a lower risk of diabetes (HR = 0.98; 95% CI 0.97, 0.99). In stratified analysis, the observed inverse relation appeared to be stronger in women aged ≥40 years and in indigenous women. CONCLUSIONS: Breakfast frequency was inversely associated with the incidence of diabetes independently of lifestyle factors. Regular breakfast consumption may be a potential component of diabetes prevention.

Breakfast Frequency and Smoking Initiation in University Students: A Retrospective Cohort Study.

Smoking causes various health problems. Limited studies have reported a clinical effect of skipping breakfast on smoking initiation among adolescents. This retrospective cohort study aimed to assess the dose-dependent association between skipping breakfast and smoking initiation in university students. This study included 17,493 male and 8880 female students aged 18-22 years at a national university in Japan. The association between breakfast frequency (eating every day and skipping occasionally, often, and usually) and smoking initiation was evaluated using Cox proportional hazards models adjusted for clinically relevant factors. Smoking initiation was observed in 2027 (11.6%) male and 197 (2.2%) female students over the median observational period of 3.0 and 3.1 years. Skipping breakfast was significantly associated with smoking initiation in a dose-dependent fashion in male students (the adjusted hazard ratios [95% confidence interval] of eating breakfast every day and skipping occasionally, often, and usually: 1.00 [reference], 1.30 [1.15, 1.46], 1.47 [1.21, 1.79], and 1.77 [1.40, 2.25], respectively). Female students skipping breakfast occasionally and often were more vulnerable to smoking initiation than those who ate breakfast every day (1.00 [reference], 1.86 [1.24, 2.78], 2.97 [1.66, 5.32], and 1.76 [0.55, 5.64], respectively). Breakfast frequency may be useful to identify university students at risk of smoking initiation who need improvement in their health literacy.

The Association between the Planetary Health Diet with a Regular Consumption of Breakfast and a Well-Balanced Diet: A Cross-Sectional Analysis Involving Japanese Male Engineering Students at a University in Hyogo Prefecture.

Few young Japanese adults regularly consume a well-balanced diet composed of staples, main courses, and sides. We hypothesised that adopting the recommended planetary health diet with regular breakfast consumption would promote well-balanced diets among young Japanese male undergraduates. This study aimed to examine the structural association between the planetary health diet with regular breakfast consumption and a well-balanced diet intake. This cross-sectional study included 142 male engineering undergraduates who completed a 2022 online questionnaire via Google Forms at a public university in Hyogo Prefecture. The planetary health diet comprises the consumption of the recommended eight items. A covariance structure analysis was performed in a hypothetical model with factors (regular breakfast consumption and eight items) potentially associated with the intake of a well-balanced diet at least twice daily. After excluding chicken dishes and nuts from the eight recommended items of the planetary health diet, goodness-of-fit became acceptable. Frequent consumption of the remaining six recommended items (fish, eggs, soybeans/soybean products, dairy foods, vegetables, and fruits) was significantly positively correlated with regular breakfast consumption and a significant positive path to a well-balanced diet. Among male university students, regular breakfast consumption and the planetary health diet may lead to a well-balanced diet.

Association of breakfast skipping on nutrient intake and adiposity in Malaysian children: Findings from SEANUTS II.

Malaysian children often skip breakfast, an important meal providing essential nutrients for optimal growth and maintaining proper nutritional status. Therefore, this study aims to investigate the associations between breakfast skipping with dietary intake, diet quality, and adiposity indicators among primary schoolchildren aged 6.0-12.9 years. This study involved 1383 children from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia. Information collected through questionnaires included sociodemography and breakfast consumption, defined as the first meal before noon. Breakfast skipping was identified as skipping breakfast at least once a week. Anthropometric measures, including height, body weight, and waist circumference, as well as percentage of body fat, were collected. Body mass index (BMI) and waist-to-height ratio were calculated, and BMI-for-age-z-scores was determined using WHO (2007) growth reference. A one-day 24-hour dietary recall was employed to assess dietary intake, and diet quality was analyzed using Malaysian Healthy Eating Index. Binary logistic regression was applied to examine relationship between breakfast skipping on diet quality and adiposity indicators. Over one-third (36.0%) of children skipped breakfast at least once a week, resulting in lower intakes of energy, nutrients, cereals/grains, vegetables, and milk/dairy products, though not affecting total diet quality score. Breakfast skipping was associated with higher odds of overweight/obesity (aOR 2.04, 95%CI: 1.52-2.76) and central obesity (aOR 1.87, 95%CI 1.34-2.61). In conclusion, primary schoolchildren in Peninsular Malaysia who skipped breakfast tended to have lower consumption of nutrients and specific basic food groups, as well as increased body fat. This study highlights the importance of continuing to educate parents and children about healthy eating habits, especially the need to adhere to dietary recommendations, with an emphasis on breakfast consumption.

Association between Circadian Rhythm-Disturbing Factors and Metabolic Syndrome in Korean Adults: Korea National Health and Nutrition Examination Survey (2016-2020).

Background: Circadian misalignment is associated with metabolic syndrome. This study aimed to examine the association between circadian rhythm-disturbing factors and metabolic syndrome. Methods: We used data from the 7th and 8th Korea National Health and Nutrition Examination Survey conducted between 2016 and 2020, which surveyed 16,253 individuals. Circadian rhythm-disturbing factors were defined as follows: sleep duration outside the reference group (6-8 hours), irregular breakfast, shift work, and physical inactivity. The adjusted odds ratio (aOR) for metabolic syndrome was calculated based on the number of circadian rhythm-disturbing factors present in adults over the age of 19 years. Results: Among a total of 16,253 participants (mean age 48.2±15 years), metabolic syndrome was found in 5,237 participants (29.3 %). The participants were classified into three categories based on the number of circadian rhythm-disturbing factors as follows: 2,627 (15.6%) did not have any factors, 6,406 (38.13%) had one factor, and 7,220 (46.3%) had two or more factors. Participants with a single circadian rhythm-disturbing factor were 21% more likely to have metabolic syndrome (aOR, 1.21; 95% confidence interval [CI], 1.08-1.36), and participants with two or more factors were 27% more likely to have metabolic syndrome (aOR, 1.27; 95% CI, 1.12-1.43). Conclusion: Circadian rhythm-disturbing factors were significantly associated with the prevalence of metabolic syndrome in Korean adults. This finding has potential clinical implications for maintaining circadian rhythms by avoiding certain factors to prevent metabolic syndrome. Further studies are required to confirm these findings.

The International Breakfast Research Initiative-Evaluation and Comparison of Breakfast Nutrient Intakes in Indonesia, Malaysia and the Philippines with a View to Proposing a Harmonised Nutrient-Based Breakfast Recommendation.

The International Breakfast Research Initiative is a global study of breakfast nutrition, involving 17 countries in four continents, aiming to derive nutrient-based regional recommendations for breakfast. This study aimed to propose a harmonised recommendation for three South-East Asian countries: Indonesia, Malaysia, and the Philippines. For each country, data from nationally representative dietary surveys on the contribution of breakfast to daily nutrient intakes at both the adult population level and at the level of the upper tertile of daily nutrient density using the Nutrient Rich Food (NRF) Index were collated and examined. Energy intakes at breakfast ranged from 26 to 27% of daily energy intake. In all three countries, breakfast was carbohydrate-rich, providing 52 to 72% of breakfast energy intake, while it was higher in total and saturated fat in Malaysia and Indonesia. Intakes of fibre and vitamin C were low in all countries, while Malaysia tended to have higher intakes of most minerals, including sodium. Daily and breakfast nutrient intakes (at the population level and in the upper tertile of the NRF Index) were compared to the Codex Alimentarius nutrient reference values (NRVs) to assess adequacy. A decision tree was established based on these data to guide the development of recommendations for nutrient intakes at breakfast across the three countries.

Association between Breakfast Consumption Frequency and Chronic Inflammation in Korean Adult Males: Korea National Health and Nutrition Examination Survey 2016-2018.

Background: Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker. Methods: A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016-2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely "0-2 breakfasts per week" and "3-7 breakfasts per week"; hs-CRP concentrations were measured through blood tests. Results: Comparing between the "infrequent breakfast consumption (0-2 breakfasts per week)" and "frequent breakfast consumption (3-7 breakfasts per week)" groups, the mean hs-CRP was found to be significantly higher in the "infrequent breakfast consumption" group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036). Conclusion: Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Evaluation of the nutritional quality of French children breakfasts according to the Breakfast Quality Score (BQS).

Background: Breakfast meals provide essential nutrients and energy to children and adolescents. Based on recommendations from the International Breakfast Research Initiative (IBRI), the Breakfast Quality Score (BQS) was developed to assess breakfast nutritional value among the French adult population. However, its application to children remains unexplored. Objective: This study aimed to evaluate the BQS in assessing the nutritional quality of breakfasts consumed by French children aged 4-17 years. Methods: A total of 4,015 breakfasts, obtained from dietary recalls provided by 1,448 children participating in the French representative dietary survey (INCA3), were analyzed. As for adults, the performance of the BQS was tested through correlations with other nutritional indicators and comparison of nutrients and dietary components between tertiles of scores. The study examined the regularity of breakfast consumption and compared the BQS of children's breakfasts across socio-demographic modalities and breakfast categories distinguished by their primary grain component. Additionally, a predictive modeling using Partial Least Squares (PLS) regression identified influential INCA3 food groups. Results: The majority of children consumed solid breakfasts regularly. Socio-professional category, household income and food insecurity influenced BQS, revealing contradictory disparities. Ready-to-eat cereal (RTEC) breakfasts had the highest BQS (73.5% for children and 73.1% for adolescent), while biscuits and viennoiseries scored the lowest (52% for children and 49.1% for adolescent). PLS highlighted RTECs, milk, and hot beverages (mainly containing chocolate milk) as being positively associated with BQS, while sweet beverages and viennoiseries were negatively associated. Conclusion: The study demonstrates the effectiveness of the BQS in assessing children's breakfast quality, with RTEC breakfasts showing the highest nutritional value. The findings provide insights into factors influencing breakfast nutritional quality and underscore the importance of promoting healthier breakfast choices among all children.

Skipping Breakfast and Progression of Chronic Kidney Disease in the General Japanese Population: The Iki City Epidemiological Study of Atherosclerosis and Chronic Kidney Disease (ISSA-CKD).

INTRODUCTION: Breakfast-skipping habits are associated with adverse health outcomes including coronary heart disease, metabolic syndrome, and diabetes mellitus. However, it remains uncertain whether skipping breakfast affects chronic kidney disease (CKD) risk. This study aimed to examine the association between skipping breakfast and progression of CKD. METHODS: We retrospectively conducted a population-based cohort study using the data from the Iki City Epidemiological Study of Atherosclerosis and Chronic Kidney Disease (ISSA-CKD). Between 2008 and 2019, we included 922 participants aged 30 years or older who had CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or proteinuria) at baseline. Breakfast skippers were defined as participants who skipped breakfast more than 3 times per week. The outcome was CKD progression defined as a decline of at least 30% in the estimated glomerular filtration rate (eGFR) from the baseline status. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD progression, adjusted for other CKD risk factors. RESULTS: During a follow-up period with a mean of 5.5 years, CKD progression occurred in 60 (6.5%) participants. The incidence rate (per 1,000 person-years) of CKD progression was 21.5 in the breakfast-skipping group and 10.7 in the breakfast-eating group (p = 0.029), respectively. The multivariable-adjusted HR (95% CI) for CKD progression was 2.60 (95% CI: 1.29-5.26) for the breakfast-skipping group (p = 0.028) compared with the group eating breakfast. There were no clear differences in the association of skipping breakfast with CKD progression in subgroup analyses by sex, age, obesity, hypertension, diabetes mellitus, baseline eGFR, and baseline proteinuria. CONCLUSION: Skipping breakfast was significantly associated with higher risk of CKD progression in the general Japanese population.

Breakfast consumption, saturated fat intake, and body mass index among medical and non-medical students: a cross-sectional analysis.

Changes in dietary patterns and body weight have become a focus of research in undergraduate students. This study compared breakfast consumption, intake of foods high in saturated fat, and BMI between medical and non-medical students. A comparative cross-sectional study was conducted in 4,561 Peruvian university students, of whom 1,464 (32.1%) were from the medical field and 3,097 (67.9%) from the non-medical field. We compared the frequency of breakfast consumption (categorized as regular: 6 to 7 days/week; occasional: 3 to 5 days/week; and rarely or never: 0 to 2 days/week) and the frequency of consumption of foods high in saturated fat. We created simple and multiple linear and Poisson regression models with robust variance to evaluate the association of the mentioned variables with academic fields. Non-medical students (Adjusted Prevalence Ratio [PR] = 0.92, 95% CI 0.86-0.99; p = 0.008) were less likely to eat breakfast regularly compared to medical students. Likewise, consumption of foods high in saturated fats was higher in non-medical students (B = 1.47, 95% CI 0.91-2.04; p < 0.001) compared to medical students. Similarly, the mean BMI of these students was significantly higher than that of medical students (B = 0.33, 95% CI 0.12-0.53; p = 0.002). Although medical students reported relatively healthy eating habits and a lower BMI, there is a widespread need to promote improved diet and lifestyle among the entire university population to reduce the risks of communicable diseases and improve quality of life.

A healthy breakfast each and every day is important for students' motivation and achievement.

Breakfast is often cited as the most important meal of the day and vital for students' academic functioning at school. Although much research has linked students' breakfast consumption to better achievement, there has been debate about why and how breakfast has academic benefits. The present study of 648 Australian high school students investigated (a) the role of breakfast consumption and breakfast quality in students' self-reported motivation and their achievement in a science test, (b) the role of motivation in mediating the link between breakfast consumption and quality and students' achievement, and (c) the extent to which breakfast consumption effects are moderated by the quality of breakfast (e.g., more vegetables, fruit, dairy/protein, wholegrains, cereals, water; less sugary drinks, processed meat, fast take-away, unhealthy snack foods). Findings indicated that beyond the effects of personal, home, and classroom factors, breakfast consumption predicted higher adaptive motivation (p < .05), breakfast quality predicted lower maladaptive motivation (p < .05), and in turn, students' adaptive (positively, p < .01) and maladaptive (negatively, p < .01) motivation predicted their achievement. Moreover, adaptive motivation significantly mediated the relationship between breakfast consumption and achievement (p < .05). The effect of breakfast consumption was moderated by the quality of breakfast such that consuming a high-quality breakfast in the morning was associated with the highest levels of adaptive motivation (p < .01) and achievement (p < .05) later in the day. Findings have implications for educational practice and policy seeking to promote a healthy start to the school day to optimize students' motivation and achievement.

Associations of Eating Habits with Self-Rated Health and Life Satisfaction in Adolescents: A 42-Country Cross-Sectional Study.

OBJECTIVE: The aim of this study was to explore the associations of eating habits with self-rated health and life satisfaction in adolescents using a multiple-country sample. METHODS: Cross-sectional data from the Health Behavior in School-Aged Children (HBSC) 2013/2014 wave was used in this study. A self-reported questionnaire was used to collect data on independent variables including breakfast on weekdays, breakfast at weekends, and consumption of fruits, vegetables, sweets, and soft dirks. Outcomes included self-rated health and life satisfaction. Regression models were used to assess the associations between the independent variables and the two outcomes, separately, after controlling for covariates. Results were presented using odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Of all the study participants (aged 11-15 years), 50.8% were girls. Compared with no consumption of breakfast on weekdays, eating breakfast for five days had 1.22 times greater likelihood for improved self-rated health (OR = 1.22, 95% CI: 1.19-1.25, p < 0.001). Participants who ate breakfast for both days (OR = 1.41, 95% CI: 1.36-1.46, p < 0.001) and one day (OR = 1.12, 95% CI = 1.08-1.17, p < 0.001) were more likely to experience improved self-rated health compared to never eating breakfast at weekends. Five or more days for fruit and vegetable consumption resulted in better self-rated health (all p < 0.001). Similar results were found in terms of the associations of breakfast, fruit, and vegetable consumption with life satisfaction. For example, a higher frequency of fruit intake was associated with enhanced self-rated health (e.g., OR for more than once daily = 1.42, 95% CI: 1.34-1.51, p < 0.001) compared to no fruit consumption. Similarly, a higher-frequency vegetable intake, such as more than once daily (OR = 1.33, 95% CI: 1.26-1.39, p < 0.001), was associated with improved self-rated health. CONCLUSIONS: Healthy eating habits, especially regular breakfast and a higher consumption of vegetables and fruit, are associated with better self-rated health and life satisfaction in school-aged children. Of note, the consumption of fruit would have the greatest impact on health and wellbeing outcomes. This study offers evidence that healthy eating habits can play a vital role in school-aged children's health and wellbeing, highlighting the practical significance of educating adolescents to develop healthy eating habits.

Modifiable factors influencing attention performance in healthy children: insights from a comprehensive school nutrition study.

BACKGROUND: There is inconclusive evidence for the effects of various leisure activities on attention performance in children. The literature reports inconsistent associations between activities such as physical activities or media use. To date, no study has thoroughly examined the various factors influencing attentional performance in a larger cohort of healthy children. This study aims to close this research gap. METHODS: From 2018 to 2019, the Leipzig School Nutrition Study collected data from 1215 children and their families. The children report their dietary behavior (using CoCu- Questionnaire), especially their participation in school lunch and their breakfast habits, through a paper questionnaire. Furthermore, attention performance was assessed using a validated test (FAIR-2) at school. Data on physical activity, media consumption, family eating habits and socio-economic status (SES) were collected from parents using questionnaires. Associations between attention and influencing factors were estimated using hierarchical linear regression. Analyses were adjusted for age, SES, and school type. RESULTS: Attending upper secondary schools (ßadj= 23.6, p < 0.001) and having a higher SES (ß= 1.28, p < 0.001) was associated with higher attention performance. Children doing leisure-time sports (ßadj= 4.18, p = 0.046) or reading books for at least one hour/weekday showed better attention performance (ßadj= 3.8, p = 0.040). Attention performance was also better in children having no electronic devices in the bedroom (ßadj= 13.0, p = 0.005) and in children whose parents limited their children's Internet access (ßadj= 5.2, p = 0.012). We did not find any association between nutritional habits and attention performance. CONCLUSIONS: We found that fostering modifiable habits such as reading and physical activity could enhance attention performance. These findings have substantial implications for the development of prevention and intervention programs that aim to improve attention in schoolchildren. It is important to note, however, that social status as a hardly modifiable factor also impacts attention performance. Therefore, interventions should address personal habits in a systemic approach considering the child's social status. TRIAL REGISTRATION: The study is retrospectively registered with the German Clinical Trials Register (DRKS00017317, registration: 05-29-2019).

The mediating role of sugar and lipid metabolism and systemic inflammation in the association between breakfast skipping and periodontitis: A population-based study.

BACKGROUND: This study investigated the association between breakfast skipping and periodontitis and the mediating role of sugar and lipid metabolism and systemic inflammation in this association using data from the Korea National Health and Nutrition Examination Survey 2016-2018. METHODS: This study included 11,953 participants, representing an estimated 33.9 million people. Complex sample logistic regression was used to assess the independent association between breakfast skipping and periodontitis. Subgroup analysis was conducted with modifiers including age, sex, body mass index (BMI), urban residence, education level, marital status, and diabetes. Structural equation modeling assessed potential mediation by biomarkers related to glucose and lipid metabolism along with systemic inflammation. RESULTS: The fully adjusted logistic regression model indicated a positive association between breakfast skipping and periodontitis (odds ratio [OR] = 1.234 (1.026-1.483), p = 0.025). This association was highlighted in middle-aged (40-60 years), female, highly educated, married individuals with BMI < 25 kg/m2, and those in urban areas without diabetes. Blood glucose (ß ± SE = 0.006 ± 0.002, p = 0.014), triglycerides (ß ± SE = 0.004 ± 0.002, p = 0.033), and white blood cell count (ß ± SE = 0.011 ± 0.003, p = 0.003) were identified as partial mediators. CONCLUSIONS: A new, independent association between breakfast skipping, and periodontitis has been discovered, which is partially mediated by sugar and lipid metabolism, and systemic inflammation. The findings provide new insights into the benefits of chrononutrition for periodontal health.

Effect of recommendations of breakfast and late-evening snack habits on body composition and blood pressure: A pilot randomized trial.

Breakfast skipping and late-evening snack are prevalent in young adults. This randomized controlled intervention aimed to evaluate the influence of meal habit recommendations on young adults' body composition and blood pressure. Nonpregnant adults (≥20 y old) who were eligible for bioelectrical impedance analysis examination (neither pacemaker installed nor medications that would affect body composition, like diuretics or corticosteroids) were enrolled after they provided informed consent (n = 125). Subjects were randomized into three groups, every group receiving one of the following recommendations: (a) daily breakfast consumption (within 2 h after waking up), (b) avoidance of late-evening snacks (after 21:00h or within 4 h before sleep, with the exception of water), and (c) both recommendations. Body composition and blood pressure were measured before randomization at baseline and at the follow-up 1 y later. Intent-to-treat analysis showed that the recommendation of daily breakfast may contribute to a lower increment of diastolic blood pressure by 3.23 mmHg (95% CI: 0.17-6.28). Receiving the breakfast recommendation was associated with more reduction of total body fat percent by 2.99% (95% CI: 0.23-5.74) and percent trunk fat by 3.63% (95% CI: 0.40-6.86) in inactive youths. Recommendation of avoiding late-evening snack did not significantly affect the outcome measures (ClinicalTrials.gov Identifier: NCT03828812).

Chrono-nutrition and sleep: lessons from the temporal feature of eating patterns in human studies - A systematic scoping review.

An emerging field of research has revealed a bidirectional relationship between sleep and diet, highlighting the potential role of a healthy diet in improving sleep. However, the impact of chrono-nutrition on sleep remains less explored. Here we conducted a systematic scoping review, considering the multiple dimensions of chrono-nutrition, to describe the extent, range, and nature of the existing literature in this area (PROSPERO: CRD42021274637). There has been a significant increase in the literature exploring this topic over the past six years (almost 67 % of the evolving literature). A breakdown of the included studies was performed according to three major chrono-nutritional dimensions: meal timing [n = 35], irregular eating patterns [n = 84], and frequency of eating occasions [n = 3]. Meal timing included three sub-dimensions: breakfast skipping [n = 13], late eating [n = 16], and earlier vs later meals schedules [n = 6]. Irregular meal patterns included three sub-dimensions: diurnal fasting [n = 65], intermittent fasting [n = 16], and daily meal patterns [n = 3]. Frequency was the least studied dimension (n = 3). We provided a synthetic and illustrative framework underlining important preliminary evidence linking the temporal characteristics of eating patterns to various facets of sleep health. Nonetheless, much work remains to be done to provide chrono-nutrition guidelines to improve sleep health in the general population.

Association between breakfast skipping and blood levels of lead and cadmium in children and adolescents aged 6-17 years: Results from the National Health and Nutrition Examination Survey 2013-2018.

INTRODUCTION: Previous research suggests that fasting increases lead absorption in the gastrointestinal tract, and that regularly eating meals may reduce blood lead. However, there is insufficient evidence linking breakfast status and blood-metal levels in children. We assessed the cross-sectional association between breakfast consumption status and children and adolescent's blood levels of lead and cadmium. We also explored blood hemoglobin, serum ferritin, and age group as potential effect modifiers of these associations. METHODS: This analysis included children and adolescents aged 6-17 years who participated in the National Health and Nutrition Examination Survey (NHANES) cycles 2013-2018 with complete data on breakfast consumption status (consumers vs. skippers), blood metals, and covariates (N=3722). Blood metal variables were log-transformed. Crude and covariate-adjusted, survey-weighted linear regression models were conducted for each blood metal outcome. Potential effect modification was explored using stratification. RESULTS: Overall fewer participants reported skipping breakfast (n=719) than eating breakfast (n=3003). Mean (SE) concentrations of blood lead and cadmium (µg/L) were 0.63 (0.01) µg/dL and 0.13 (0.00) µg/L, respectively. Children and adolescents who skipped breakfast were more likely to be female (51.2%), older (mean 12.2 years, SE = 0.1), have a higher body mass index (mean 22.8 kg/m2, SE = 0.2), and a lower income-poverty ratio (mean 1.7, SE = 0.1) than breakfast consumers. No associations between breakfast consumption and any of the blood metals were found. When stratified by age (≤ 10, 11-13, and 14-17 years), children aged 11-13 years who consumed breakfast had lower log-transformed blood lead levels [ß = -0.14 µg/L; 95% CI: (-0.25, -0.03)] compared to children of the same age who skipped breakfast. CONCLUSION: Children 11-13 years-old who were breakfast consumers had lower blood lead levels compared to children of the same age who skipped breakfast. Our results support that encouraging breakfast consumption among school-age children may contribute to lower blood lead levels.

In Vitro Digestion and Intestinal Absorption of Mycotoxins Due to Exposure from Breakfast Cereals: Implications for Children's Health.

Breakfast cereals play a crucial role in children's diets, providing essential nutrients that are vital for their growth and development. Children are known to be more susceptible than adults to the harmful effects of food contaminants, with mycotoxins being a common concern in cereals. This study specifically investigated aflatoxin B1 (AFB1), enniatin B (ENNB), and sterigmatocystin (STG), three well-characterized mycotoxins found in cereals. The research aimed to address existing knowledge gaps by comprehensively evaluating the bioaccessibility and intestinal absorption of these three mycotoxins, both individually and in combination, when consumed with breakfast cereals and milk. The in vitro gastrointestinal method revealed patterns in the bioaccessibility of AFB1, ENNB, and STG. Overall, bioaccessibility increased as the food progressed from the stomach to the intestinal compartment, with the exception of ENNB, whose behavior differed depending on the type of milk. The ranking of overall bioaccessibility in different matrices was as follows: digested cereal > cereal with semi-skimmed milk > cereal with lactose-free milk > cereal with soy beverage. Bioaccessibility percentages varied considerably, ranging from 3.1% to 86.2% for AFB1, 1.5% to 59.3% for STG, and 0.6% to 98.2% for ENNB. Overall, the inclusion of milk in the ingested mixture had a greater impact on bioaccessibility compared to consuming the mycotoxins as a single compound or in combination. During intestinal transport, ENNB and STG exhibited the highest absorption rates when ingested together. This study highlights the importance of investigating the combined ingestion and transport of these mycotoxins to comprehensively assess their absorption and potential toxicity in humans, considering their frequent co-occurrence and the possibility of simultaneous exposure.