Investigators from the Department of Public Health and Clinical Medicine in Umea, Sweden conducted a study to assess whether poor breakfast habits in adolescence are associated with metabolic syndrome in adulthood. Participants were enrolled in the Northern Swedish Cohort, a longitudinal population-based cohort, and were assessed when they were 16 and 43 years old. At age 16, participants completed questionnaires about breakfast contents from that day. Questions included “What did you have for breakfast this morning?” with food items divided into 7 food groups. “Poor breakfast habits” were defined as skipping breakfast or only drinking or eating something sweet. At age 43, participants were assessed for metabolic syndrome with measures of waist circumference, triglycerides, high density lipoprotein, fasting glucose, and blood pressure. Metabolic syndrome was defined using the International Diabetes Federation criteria as increased risk of cardiometabolic diseases and early death resulting from central obesity, hypertension, dyslipidemia, and impaired glucose regulation. Logistic regression was used to identify associations between adolescent breakfast habits and adult metabolic syndrome, adjusting for socioeconomic status, body mass index at age 16, alcohol and tobacco use, physical activity level, gender, and family history of diabetes. The results were reanalyzed after including data on participants’ reported fruit and vegetable consumption and physical activity as adults.
Data from 889 participants were analyzed. At age 16, 88 individuals (9.9%) were classified as having poor breakfast habits: 66 reported skipping breakfast, while 22 only ate or drank something sweet. The prevalence of metabolic syndrome at age 43 was 27.0%. The adjusted odds ratio (aOR) for metabolic syndrome at age 43 years was 1.68 (95% CI, 1.01–2.78) for those with poor breakfast habits at age 16 compared to those with more nutritious breakfast habits. Poor breakfast habits at age 16 were also associated with significantly increased risk of central obesity and high fasting glucose at age 43. However, when reported adult fruit and vegetable consumption and physical activity were added to the logistic regression model, the association between adolescent breakfast habits and adult metabolic syndrome was no longer statistically significant (aOR = 1.53; 95% CI, 0.91–2.57).
The investigators conclude that poor breakfast habits in adolescence were associated with metabolic syndrome in adulthood.
Dr Wong has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
The increasing prevalence of metabolic syndrome in adulthood, as well as risk factors such as obesity that develop in childhood, have been long established (see AAP Grand Rounds, April 2002;7:42–431 ). The investigators in the current study aimed to explore a childhood factor that could be used as an early target for preventing the development of metabolic syndrome later in life – eating a nutritious breakfast during adolescence. Eating breakfast has been...