Breakfast Dietary Patterns among Mexican Children Are Related to Total-Day Diet Quality

Abstract

Mexico has experienced shifts in food availability and consumption patterns over the past few decades from traditional diets to those containing more high-energy density foods, resulting in the development of unhealthful dietary patterns among children and adults. However, to our knowledge it is not known whether breakfast consumption patterns contribute to the overall daily diet of Mexican children. We examined total-day diet among breakfast consumers compared with breakfast skippers, identified and investigated breakfast dietary patterns in relation to energy and nutrient intakes at breakfast and across the day, and examined these patterns in relation to sociodemographic characteristics. With the use of nationally representative dietary data (one 24-h recall) from the 2012 Mexican National Health and Nutrition Survey, 3760 children aged 4-13 y were categorized into mutually exclusive breakfast patterns with the use of cluster analysis. The association between breakfast patterns and breakfast skippers with dietary intake at breakfast and for the total day was investigated with the use of multivariate linear regression. Most children (83%) consumed breakfast. Six breakfast dietary patterns were identified (milk and sweetened breads, tortillas and beans, sweetened beverages, sandwiches and quesadillas, eggs, and cereal and milk) and reflected both traditional and more Westernized dietary patterns. Sugar-sweetened beverages were consumed across all patterns. Compared with all breakfast dietary patterns, breakfast skippers had the lowest intake of several nutrients of public health concern. Nutrients to limit that were high at breakfast tended to be high for the total day and vice versa for nutrients to encourage. There was not a single pattern that complied perfectly with the Mexican School Breakfast Guidelines, but changes such as increasing dietary fiber by encouraging more whole grains, fruits, vegetables, and beans and reducing sodium and sugar-sweetened beverages could support compliance with these targets and improve overall diet quality.

Sugar Content and Nutritional Quality of Child Orientated Ready to Eat Cereals and Yoghurts in the UK and Latin America; Does Food Policy Matter?

“…In the UK, cereals are the main sources of micronutrients in children aged 1.5 to 10 years, while yogurts provide 5% of protein and 8% of calcium intake in children aged 1.5 to 10 years [11]. Similar findings are reported for REBCs in Guatemala [12], Mexico [8] and Ecuador [13]. However, there is a well-established body of evidence that consistently highlights concerns about the nutritional quality of REBCs and yoghurts marketed to children, in particular the high sugar content, while other nutrients of concern are fat, sodium, protein and fibre [9,[14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”

“…Furthermore, a large proportion of REBCs and yoghurts in all countries were classified as "less healthy" according to the Ofcom NPM, but more products were classified as "less healthy" in Latin America. This is important as the market of these products is expanding in Latin America, and surveys show they are important contributors to the dietary intake of children [8,12,13,44]. Pervasive child-orientated marketing is associated with brand recognition and increased consumption; thus, stronger advocacy and political will is needed at a global level to reduce the promotion of less healthful foods to children [45].…”

“…We focused on REBCs and yoghurts because they are important contributors to children's nutrient intake in both the UK and Latin America. REBCs have become part of the diet patterns of children in Latin America [8,9], while yoghurt sales are projected to grow [10]. In the UK, cereals are the main sources of micronutrients in children aged 1.5 to 10 years, while yogurts provide 5% of protein and 8% of calcium intake in children aged 1.5 to 10 years [11].…”

Breakfast Skipping and overweight/obesity among European adolescents, a cross-sectional analysis of the HELENA dataset: a DEDIPAC study.

“…The association of overweight/obesity among adolescents with mothers of lower education is consistent with existing work 45 , including that from the ENERGY study 31 , which suggests this relationship may be attributed to the poorer dietary and physical activity patterns observed in those with parents of lower education. Previous work also shows breakfast skipping appears to cluster with other unhealthy dietary behaviours 5,21 and that skippers may have lower intake of several important nutrients 46 . The lower diet quality, and lower intake of fruit and fibre identified among male and female skippers in the current study may suggest that adolescents who habitually skip breakfast are missing key nutritional elements through skipping the breakfast meal, or, alternatively, that the breakfast skipping behaviour may be a marker of irregular dietary behaviours.…”

The Association Between Maternal Factors and Preadolescent Breakfast Skipping: The Mediating Role of Preadolescent Attitudes Toward Breakfast

“…In fact, breakfast was found to be the most frequently missed meal among adolescents (Demissie, Eaton, Lowry, Nihiser, & Foltz, ). Breakfast‐skipping rates were reported to be 17% among Mexican children (Afeiche, Taillie, Hopkins, Eldridge, & Popkin, ); 8.9% among Chinese children and adolescents (Li et al., ); and 27.4%–62.2% among adolescents in 31 European and North American countries between 2002 and 2010 (Lazzeri et al., ). This worldwide increase in the rate of breakfast skipping has raised the issue of irregular breakfast consumption among children to an international level.…”