Breakfast intake is associated with nutritional status, Mediterranean diet adherence, serum iron and fasting glucose: the CYFamilies study

Objective: To assess the association of breakfast intake with Mediterranean diet adherence, physical activity levels, obesity, selected cardiovascular risk markers and Fe status. Design: Cross-sectional study. BMI, body fat percentage and waist circumference were assessed. Physical activity was assessed using a pedometer and diet quality was evaluated by applying the KIDMED index. Blood tests to assess blood lipids, high-sensitivity C-reactive protein, fasting glucose, serum Fe and ferritin, as well as Hb, were performed. Setting: Primary-school children of the Troodos mountainous area in Cyprus. Subjects: Eighty-three Cypriot children (mean age 9.2 (SD 1.7) years). Results: Compared with breakfast skippers, regular breakfast eaters were 40 % more likely to have a KIDMED score higher by one point on average (OR=1.41; 95 % CI 1.08, 1.84) after accounting for obesity levels and other confounders. Breakfast skippers, on the other hand, were by about 14 % more likely to have a body fat percentage value higher by one unit, as well as higher values for both BMI and waist circumference. The relationship was significantly strengthened when combining body fat percentage and waist circumference into a composite variable (OR = 0.20; 95 % CI 0.06, 0.69). Fasting glucose was inversely correlated to breakfast intake in descriptive analyses, whereas serum Fe was positively correlated to breakfast intake after considering age, gender and diet quality. The latter relationship disappeared, however, after considering physical activity levels. Conclusions: Cypriot children who take breakfast regularly exhibit a higher adherence to the Mediterranean diet and have higher serum Fe concentrations and lower BMI, waist circumference, body fat percentage and fasting glucose levels, compared with children who skip breakfast. Public health professionals, educators and parents should prioritize on actions that will motivate children to regularly eat breakfast.