London School of Hygiene & Tropical Medicine

Led by King’s College London and conducted with the London School of Hygiene & Tropical Medicine, the study showed that children who ate breakfast every day were deemed to have overall superior nutritional profiles compared to those who didn’t. These children were found to have higher daily intakes of key nutrients such as folate (important for the development of genetic material), calcium, iron and iodine (key in the development of thyroid function) than children who skipped breakfast.

The research team used food diaries collected for the National Diet and Nutrition Survey Rolling programme between 2008 and 2012 from a group of 802 children aged 4 – 10 years and 884 children aged 11 – 18 years. Nutrient intake was assessed using a food composition databank from the Department of Health. Breakfast was considered as consumption of over 100 calories between 6am and 9am.

Key findings include:

• 31.5% of those who skipped breakfast did not meet even the lower recommended nutrient intake (LRNI) of iron compared to only 4.4% of breakfast consuming children
• 19% did not meet LRNI for calcium, compared to 2.9% of breakfast consuming children
• 21.5% did not meet lower levels for iodine, compared to 3.3% of breakfast consuming children
• No children who consumed breakfast daily had a folate intake below their LRNI compared to 7.3% of those who skipped breakfast

The study also compared breakfast habits and nutrients within individual participants. This analysis showed that on days when breakfast was consumed, younger children (4-10 years old) had higher intakes of folate, calcium, vitamin C and iodine compared to their breakfast-skipping days. Out of these same nutrients, for older children (11-18 years old) only calcium intakes were higher on breakfast-consuming days.

Authors have attributed these findings to higher levels of parental control over eating habits at a young age. There is also the possibility of mis-reporting in food diaries, particularly in older children who reported their own intakes. Some analyses were repeated to omit implausible levels of energy intake where possible.

Dr Luigi Palla, Assistant Professor in Medical Statistics and Epidemiology at the London School of Hygiene & Tropical Medicine and co-author who supervised the statistical design and analysis of the study, said: “Our study highlights that breakfast is an important meal for children, providing key nutrients for their growth and development. We noticed that eating breakfast is associated with better dietary quality but not with lower daily energy intake. This warrants further studies investigating the effect of eating at different times of the day on health issues such as obesity and metabolic disorders.

“A strength of this study was that we were able to compare whether a child reached the recommended nutrient intakes in days when they have breakfast to days when they don’t. This helped to reveal a compelling link between nutrient intakes and breakfast consumption within a child as it reduced the potential effect of unmeasured confounders.”

Dr Gerda Pot, senior author of the study and Lecturer in Nutritional Sciences at King’s College London, said: “This study provides evidence that breakfast is key for parents to ensure that their children are getting the nutrition they need. Further studies that investigate specific foods and dietary quality would help to identify if the differences are due to the different types of breakfast being eaten by different age groups, as well as provide more insight into the impact of breakfast on dietary quality overall.”

The study also showed that only 6.5% of 4 – 10 year olds missed breakfast every day, compared with nearly 27% of 11- 18 year olds. Data also suggested that girls were more likely to miss breakfast than boys and household income was found to be higher in the families of children eating breakfast every day.

Publication

Janine D. Coulthard, Luigi Palla and Gerda K. Pot. Breakfast consumption and nutrient intakes in 4–18-year-olds: UK National Diet and Nutrition Survey Rolling Programme (2008–2012). British Journal of Nutrition. DOI:10.1017/S0007114517001714P