Background Prevention of type 2 diabetes and one of its precursor obesity are important public health priorities both in adults and in children. In adults, not eating breakfast regularly has been associated with increased risks of obesity and possibly type 2 diabetes. However, little information is available on the influence of breakfast consumption on type 2 diabetes risk markers in children. We therefore examined the relations between self-reported breakfast consumption, type 2 diabetes risk markers and dietary energy and nutrient intakes in childhood.
Methods Information was collected on usual breakfast frequency in a multi-ethnic population of primary school children in London, Birmingham and Leicester. Children provided detailed 24 hour recalls, measurements of body composition and fasting blood samples which enabled fasting blood lipids, glucose, HbA1c and insulin resistance to be measured.
Results Among 4283 children studied, 26% did not eat breakfast every day; these children had higher insulin resistance, HbA1c, glucose, triglycerides, systolic BP, C-reactive protein, skinfold sum and fat mass index than children who reported eating breakfast daily. Differences in insulin resistance, HbA1c, glucose persisted after adjustment for adiposity. Children who did not eat breakfast every day had lower total energy intakes but higher energy density and total fat% energy (particularly mono unsaturated fat% energy). They also had lower intakes of carbohydrates, total non-starch polysaccharides; all micronutrient intakes were also much lower including vitamin B12, folate, vitamin C, calcium and iron. However, adjustment for these differences in diet could not fully account for the differences in type 2 diabetes markers observed.
Conclusion Children who did not eat breakfast had an adverse type 2 diabetes risk profile and higher body fat. These patterns could not be fully explained by observed differences in diet. Breakfast consumption may protect against emerging diabetes risk in childhood, but the underlying reasons for this have still to be established.
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