Association between breakfast frequency and physical activity and sedentary time: a cross-sectional study in children from 12 countries

Abstract

Background: Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites.

Methods: This multinational, cross-sectional study included 6228 children aged 9-11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time.

Results: Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found.

Conclusions: In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance.

Trial registration: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500 ).

Keywords: Exercise; Fasting; Health; International; Nutrition; Youth.

Conflict of interest statement

Ethics approval and consent to participate

The Pennington Biomedical Research Center Institutional Review Board approved the ISCOLE protocol with Ethical Review Boards at each site approving local protocols (Australia: University of South Australia Human Research Ethics Committee; Brazil: The Research Ethics Committee (REC) of the Municipal Health of Sao Caetano do Sul – Prima; Canada: Children’s Hospital of Eastern Ontario Research Ethics Board; China Biomedical Ethics Committee of Tianjin Women’s and Children’s Health Center; Colombia: Universidad de los Andes Committee on Research Ethics; Finland: The Ethics Committee of the Hospital District of Helsinki and Uusimaa; India: St. John’s Medical College & Hospital Institutional Ethical Review Board; Kenya: Kenyatta University Ethics Review Committee; Portugal: Ethics Committee University of Porto; South Africa: University of Cape Town Faculty of Health Sciences Human Research Ethics Committee; U.K: University of Bath Research Ethics Committee for Health; U.S: Pennington Biomedical Research Center Institutional Review Board for Research with Human Subjects). Written informed consent was obtained from parents or legal guardians, and child assent was obtained as required by local Ethical Review Boards before participation in the study.

Consent for publication

Not applicable.

Competing interests

Dr. Fogelholm has received a research grant from Fazer Finland. Dr. Kurpad is a member of the Advisory Board of McCain Foods. Dr. Matsudo is a member of the Scientific Advisory Board of Actigraph. Gang Hu is a member of the editorial board for BMC Public Health. The authors report no other potential competing interests.

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Figures

Fig. 1

Participant flow chart

Fig. 2

Total and morning time spent sedentary (a and b), in light physical activity (PA) (c and d) and in moderate- to vigorous-intensity physical activity (MVPA) (e and f) in rare (breakfast on 0–2 days per week), occasional, (breakfast on 3–5 days per week) and frequent (breakfast on 6–7 days per week) breakfast consumers stratified by site. Values are least squares means (error bars indicate the standard error of the mean) adjusted for age, sex, highest level of parental education, body mass index z-score and accelerometer wear time. *Significant main effect of breakfast (p ⩽ 0.05); #significant difference between rare and frequent after Bonferonni adjustment (p ⩽ 0.02). No interactions with study site were found (p > 0.05)