Breakfast intake among adults with type 2 diabetes: influence on daily energy intake

Objective: To assess the association between breakfast energy and total daily energy intake among individuals with type 2 diabetes. Design: Cross-sectional study. Daily energy intake was computed from a 24 h dietary recall. Multiple regression models were used to estimate the association between daily energy intake (dependent variable) and quartiles of energy intake at breakfast (independent variable), expressed in either absolute or relative (percentage of total daily energy intake) terms. Orthogonal polynomial contrasts were used to test for linear and quadratic trends. Models were controlled for sex, age, race/ethnicity, BMI, physical activity and smoking. In addition, we used separate multiple regression models to test the effect of quartiles of absolute and relative breakfast energy on energy intake at lunch, dinner and snacks. Setting: The 1999-2004 National Health and Nutrition Examination Survey (NHANES). Subjects: Participants aged >= 30 years with self-reported history of diabetes (n 1146). Results: Daily energy intake increased as absolute breakfast energy intake increased (linear trend, P < 0.0001; quadratic trend, P = 0.02), but decreased as relative breakfast energy intake increased (linear trend, P < 0.0001). In addition, while higher quartiles of absolute breakfast intake had no associations with energy intake at subsequent meals, higher quartiles of relative breakfast intake were associated with lower energy intake during all subsequent meals and snacks (P < 0.05). Conclusions: Consuming a breakfast that provided less energy or comprised a greater proportion of daily energy intake was associated with lower total daily energy intake in adults with type 2 diabetes.