What's for breakfast? Nutritional implications of breakfast habits: insights from the NDNS dietary records

Studies suggest that eating breakfast (as opposed to skipping breakfast) has nutrition and health benefits. However, it is not altogether clear whether these benefits are attributes of breakfast as a meal or meals that include breakfast cereals. To explore associations with nutrient intakes according to the type of breakfast chosen, we extracted data on all foods consumed at breakfast time (0600-1000 h) from the individual weighed food records of respondents in the National Diet and Nutrition Survey of adults aged 19-to-64-years. Seven days of data were available for each person, giving a total of 12 068 potential breakfast-eating occasions. Our hypotheses were: (1) that adults who skip breakfast have lower-quality diets on that day than those who eat breakfast and (2) that a meal containing breakfast cereal has enhanced nutritional benefits over other types of breakfast. Approximately 1 in 5 adults consumed no solid food between the hours of 0600 and 1000 h, one-third ate a breakfast that included ready-to-eat cereal or porridge, and 45% consumed a non-cereal breakfast. Overall, eating breakfast was associated with a lower fat and higher carbohyrate intake over 24 h compared with breakfast skipping. However, 'cereal' breakfasts (containing a ready-to-eat cereal or porridge, usually consumed with milk) were associated with signficantly better macronutrient composition [lower in fat, saturated fatty acids (SFAs), and non-milk extrinsic sugars (NMES) and higher in protein and carbohydrate] compared with other breakfasts. Compared with skipping breakfast, micronutrient intakes were marginally higher on days when noncereal breakfast was consumed but 30-90% higher on days where cereal was consumed. In terms of public health recommendations, the results suggest that a cereal breakfast should be encouraged as part of a healthy lifestyle not only in helping to meet nutritional guidelines for fat, SFA, NMES and dietary fibre, but just as importantly in enhancing micronutrient intakes. Given the substantial reductions in sodium content achieved by reformulation since 2000, cereal breakfasts are not high in salt. Other studies have generally demonstrated a favourable impact of a breakfast habit on metabolism, body weight and some aspects of cognitive function, and this study further highlights the special significance of breakfast cereal,rather than breakfast as a meal occasion, to help consumers meet nutritional guidelines.