Breakfast habits and their relation to diet quality and health-related quality of life in an urban, socioeconomically diverse sample of African American and white adults
Date
2017
Authors
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Publisher
University of Delaware
Abstract
Background – Observational studies have documented decreased diet quality and health-related quality of life with breakfast skipping. These outcomes may be connected to the increased risk of obesity and chronic disease compared to breakfast consumers. Away from home (AFH) foods have also been correlated with lower diet quality; however, the relationship between away from home foods and health-related quality of life is unknown. AFH breakfasts have a larger impact on diet quality than other meals; however, to our knowledge no one has compared the effects of eating away versus not eating breakfast at all or has assessed the relationship between health-related quality of life and breakfast location. ☐ Objective – To characterize the breakfast habits of a diverse, urban population and to compare diet quality and health-related quality of life when breakfasts are eaten at home, eaten away from home, or skipped. ☐ Subjects – Participants of the prospective cohort Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Participants were African American and White adults residing in Baltimore, MD. ☐ Methods – Dietary data (two 24-hour recalls) from Wave 3 of the HANDLS study were used to divide participants into three groups: home breakfast consumers, AFH breakfast consumers, and breakfast skippers. Those who reported different breakfast habits across the two days were labeled ‘breakfast switchers’ and were not included. The Healthy Eating Index (HEI)-2010 was used as a diet quality measure. The Short Form 12 (SF-12) Health Survey was the measure of health-related quality of life. This survey gives two composite scores: the Mental Component Summary (MCS) score and the Physical Component Summary (PCS) score. ☐ Statistical Analysis – Only subjects who completed two 24-hour recalls and reported either no breakfast or consumption of breakfast at home or AFH were eligible (n=2115). Descriptive statistics were calculated for demographic and dietary data. After removing ‘breakfast switchers,’ 1834 cases remained. One-way ANOVA and Chi-square tests were used to compare dietary and demographic data among the three groups. Independent samples T-tests were used to compare breakfast nutrient intake among home and AFH breakfast consumers. Three regression models were run to examine the relationship between the outcome measures (HEI-2010, MCS score, and PCS score) and breakfast group after controlling for covariates (age, sex, race, poverty status, BMI, marital status, employment, education, smoking, literacy, and income). ☐ Results – 2115 subjects were included in analysis of breakfast characteristics; 60.8% were breakfast consumers. When divided into breakfast groups, 41.2% of subjects ate breakfast at home both days, 6.3% of subjects ate both breakfasts AFH, and 13.3% were breakfast switchers. For the HEI analysis, 1834 subjects were included. The home breakfast consumers had the highest HEI-2010 scores, whereas eating breakfast AFH or skipping breakfast was associated with a decrease of 3.59 and 4.66 HEI points, respectively. After adjustment, neither mental nor physical HRQoL scores were associated with breakfast group. ☐ Conclusion – When counseling clients, dietitians should consider breakfast habits and recommend eating breakfast at home; however, if clients cannot eat at home, eating breakfast away from home was related to higher diet quality than skipping breakfast. In meal pattern research, location of meals should be considered. HRQoL, as a long-term measure of health, did not appear to be related to daily breakfast habits.
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Keywords
Social sciences, Health and environmental sciences, Breakfast, Diet quality, Health-related quality of life