Association between breakfast omission and abdominal adiposity in low-income adolescents

RIBEIRO, Ana Raquel de Andrade Barbosa; CARVALHO, Danielle Franklin de; CANTALICE, Anajás da Silva Cardoso; SIMÕES, Mônica Oliveira da Silva; TEIXEIRA, Alessandra; MEDEIROS, Carla Campos Muniz

doi:10.1590/1678-9865202134e190245

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Sumário

Original • Rev Nutr 34 • 2021 • https://doi.org/10.1590/1678-9865202134e190245 copy

Association between breakfast omission and abdominal adiposity in low-income adolescents

Associação entre a omissão do desjejum e a adiposidade abdominal em adolescentes de baixa renda

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To assess the association between breakfast omission, overweight/obesity, abdominal adiposity, and unhealthy lifestyle of low-income adolescents.

Methods

A cross-sectional population study involving 571 public school students aged between 15 and 19 years old. The habit of having breakfast was assessed using a form, checking the weekly frequency of a given meal and considered as breakfast omission when these adolescents did not have breakfast for at least 5 days in the past week. Sociodemographic and lifestyle variables (sedentarism, physical activity level, and sleep duration) were also assessed. Overweight/obesity was defined as a body mass index above a Z-score of +1, and the presence of abdominal adiposity was determined by a waist circumference/height ratio greater than 0.5. The association between breakfast omission and lifestyle variables was assessed using the chi-square test and a multivariate logistic regression of the anthropometric indicators.

Results

The omission of breakfast was found in 31% of the adolescents and was associated with physical inactivity (p<0.001). Regarding anthropometric indicators, breakfast omission was an independent factor for determining abdominal adiposity, with a 1.8 times greater chance of having this condition among those who omitted breakfast (p=0.037).

Conclusions

Omitting breakfast was frequent among the students assessed, and was associated with abdominal adiposity, a cardiometabolic risk factor. Investigation and early intervention are fundamental to change this behavior.

Keywords
Adolescent; Breakfast; Nutritional status; Obesity

Variables				Breakfast omission				p-value	PR
		Total n=571		Yes		No
		n	%	n	%	n	%
Sex							0.167	1.31	0.89-1.92
	Female	380	66.5	125	32.9	255	67.1
	Male	191	33.5	52	27.2	139	72.8
Age group (years)							0.459	1.14	0.79-1.64
	15-17	342	59.9	102	29.8	240	70.2
	18-19	229	40.1	75	32.8	154	67.2
Social class							0.128	1.34	0.91-1.95
	C, D, and E	396	69.4	115	29.9	281	71.1
	A, B	175	30.6	62	35.4	113	64.6
Maternal educational level (years of schooling)^* * Seven were unwilling or unable to answer; CI: Confidence Interval; PR: Prevalence Ratio.							0.738	0.94	0.65-1.35
	0-8	328	58.2	103	31.4	225	68.6
	>8	236	41.8	71	30.1	165	69.9
Physical activity (minutes/week)							<0.001	2.11	1.44-3.10
	<300	342	59.9	127	37.1	215	62.9
	≥300	229	40.1	50	21.8	179	78.5
Sedentary time (hours/day)							0.347	0.83	0.56-1.22
	≥2	381	66.7	54	28.4	136	71.6
	<2	190	33.3	123	32.3	258	67.7
Hours of sleep (hours/day)							0.081	1.91	1.23-2.97
	<8	422	73.9	32	21.5	117	78.5
	≥8	149	26.1	145	34.4	277	65.6
Nutritional status							0.003	1.49	0.95-2.31
	Overweight/obesity	102	17.9	39	38.2	63	61.8
	Eutrophic/low weight	469	82.1	138	29.4	331	70.6
Waist-to-Height Ratio							0.027	1.86	1.06-3.24
	>0.5	57	10.0	152	29.6	362	70.4
	≤0.5	514	90.0	25	43.9	32	56.1

Variables		Abdominal adiposity				Univariate analysis	p-value	^* * Hosmer-Lemeshow Test p=1.00; Multivariate analysis	p-value
		Yes		No		Univariate analysis		^* * Hosmer-Lemeshow Test p=1.00; Multivariate analysis
		n	%	n	%	PR (95%CI)		PR (95%CI)
Sex
Female		18	9.4	173	90.6	1	0.752
	Male	39	10.3	341	89.7	1.10 (0.61-1.98)	0.752
Age group (years)
	15-17	31	9.1	311	90.9	1	0.372
	18-19	26	11.4	203	88.6	1.29 (0.74-2.23)	0.372
Maternal educational level (years of schooling)^ Seven were unwilling or unable to answer; 1: Group considered as a reference for comparison and calculation of PR. CI: Confidence Interval; PR: Prevalence Ratio.
	0-8	24	10.1	212	89.9	1	0.966
	>8	33	10.2	293	89.8	1.01 (0.58-1.76)	0.966
Social class
	C, D, and E	34	8.6	362	91.4	1	0.096	1	0.127
	A, B	23	13.1	152	86.9	1.61 (0.92-2.83)	0.096	1.55 (0.33-2.73)	0.127
Breakfast Omission
	No	25	8.1	362	91.9	1	0.029	1	0.037
	Yes	32	14.1	152	85.9	1.86 (1.07 – 3.25)	0.029	1.81 (1.04-3.17)	0.037
Sedentary time (hours/day)
	≥2	344	90.3	37	10.7	1	0.760
	<2	170	89.5	20	10.5	1.09 (0.62-1.96)	0.760
Physical activity (minutes/week)
	<300	24	10.5	205	89.5	1	0.745
	≥300	33	9.6	309	90.4	1.10 (0.63-1.91)	0.745
Hours of sleep (hours/day)
	<8	133	89.3	16	10.7	1	0.720
	≥8	381	90.3	41	9.7	0.90 (0.49-1.65)	0.720

Variables		Overweight/obesity				Univariate analysis	p-value	^* * Hosmer-Lemeshow Test p=0.804; Multivariate analysis	p-value
		Yes		No		Univariate analysis		^* * Hosmer-Lemeshow Test p=0.804; Multivariate analysis
		n	%	n	%	PR (CI95%)		PR (CI95%)
Sex
	Female	32	16.8	159	83.2	1	0.624
	Male	70	18.4	310	81.6	1.12 (0.71-1.78)
Age group (years)
	15-17	64	18.7	278	81.3	1	0.571
	18-19	38	16.6	191	83.4	0.86 (0.56-1.34)
Maternal educational level (years of schooling)^ Seven were unwilling or unable to answer; 1: Group considered as a reference for comparison and calculation of PR; CI: Confidence Interval; PR: Prevalence Ratio.
	0-8	60	18.3	268	81.7	1	0.779
	>8	41	17.4	195	82.6	0.94 (0.61-1.46)
Social class
	C, D, and E	60	15.2	336	84.8	1	0.012	1	0.015
	A, B	42	24.0	133	76.0	1.72 (1.14-2.75)		1.73 (1.11-2.70)
Breakfast omission
	No	63	16.0	331	84.0	1	0.082	1	0.144
	Yes	39	22.0	138	78.0	1.49 (0.95-2.32)		1.44 (0.92-2.25)
Sedentary time (hours/day)
	≥2	70	18.4	311	81.6	1	0.653
	<2	32	16.8	158	83.2	0.90 (0.57-1.43)
Physical activity (minutes/week)
	<300	41	17.9	188	82.1	1	0.983
	≥300	61	17.8	281	82.2	0.90 (0.64-1.54)
Hours of sleep (hours/day)
	<8	29	19.5	120	80.5	1	0.553
	≥8	72	17.3	346	82.7	0.87 (0.54-1.40)

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[1] Correspondence to: C.C.M. MEDEIROS. E-mail: carlamunizmedeiros@hotmail.com.