Search Results (418)

Background: Skipping breakfast, a prevalent issue among children and adolescents, has been reported to be associated with academic performance and long-term health. However, less attention has been given to the types of breakfast foods consumed. Therefore, our study aims to investigate the association between breakfast variety and dietary knowledge, attitude, and practice (KAP) among preadolescents. Methods: The study included 1449 students in grades 4–6 from Zhongshan city, Guangdong province. Data were collected through face-to-face field investigation using a validated questionnaire. The questionnaire encompassed sociodemographic characteristics, as well as dietary KAP. Results: Among all participants, 1315 reported consuming breakfast daily. Dietary diversity varied significantly: 8.8% consumed only 1 type of food, 52.9% consumed 2–4 types, and 38.3% consumed ≥5 types. Students who consumed a greater variety of breakfast foods exhibited more favorable dietary and lifestyle patterns. Specifically, those who consumed ≥5 types of food showed statistically significant associations with healthier practices, including reduced intake of sugary beverages and night snacks, stronger adherence to dietary guidelines, more positive attitudes toward improving eating habits, longer sleep durations, increased participation in meal preparation, greater dish variety in meals, and higher engagement in daily physical activity. Conclusions: Breakfast variety was associated with KAP, particularly when breakfast types ≥ 5, providing more sufficient and favorable evidence for breakfast consumption. Full article

Background: Anxiety and depression are among the most common mental health disorders affecting adolescents worldwide. Skipping breakfast is a prevalent dietary behaviour linked to inadequate nutrient intake, which may contribute to the development or exacerbation of mental health issues in this age group. Despite growing interest, a comprehensive synthesis of evidence on the association between breakfast omission and adolescent anxiety or depression remains limited. Objectives: This scoping review aimed to synthesise existing research on the association between skipping breakfast and the risk of anxiety and/or depression in adolescents. Methods: A systematic scoping review was conducted using the Joanna Briggs Institute (JBI) methodological framework. A comprehensive search of PubMed, ProQuest, and EBSCOhost databases was performed, focusing on studies published in English between 2014 and 2024. Keywords included “skipping breakfast,” “risk,” “anxiety,” “depression,” and “adolescen*.” Studies were screened and selected based on predefined inclusion and exclusion criteria. Results: Out of 1671 initially identified studies, 12 met the inclusion criteria. The majority were cross-sectional (n = 9), with one prospective cohort study, one secondary data analysis, and one systematic review with meta-analysis. Most studies reported a significant association between breakfast skipping and increased risk of anxiety and depression in adolescents. Only one study reported no significant relationship between the two variables. Conclusions: This review underscores a consistent association between skipping breakfast and elevated risk of anxiety and depression among adolescents. While causality remains to be established, breakfast omission emerges as a modifiable lifestyle factor with potential public health implications. These findings highlight the need for prospective research, as well as the importance of community- and school-based health promotion strategies that advocate for regular and nutritious breakfast consumption as part of broader mental health support efforts. Full article

Background/Objectives: Imposed sleep restriction leads to increased feelings of appetite and hedonic eating behaviors (or food rewards). No study to date has assessed home-based measures of sleep with appetite and food rewards exclusively in Black emerging adults (ages 18–28 years), despite higher risks of short sleep and obesity in this population. We examined associations between 6-month changes in sleep with changes in appetite and food reward in Black emerging adults. Methods: Fifteen Black emerging adults (12 females; age, 21 ± 2.5 years; body mass index, 25.7 ± 4.5 kg/m²; body fat, 25.8 ± 11.9%) completed two identical 7-day measurement bursts at baseline and 6 months. Sleep (duration, efficiency, and architecture) was captured via 7 days of actigraphy and 2 nights of in-home polysomnography. During a laboratory visit, participants completed appetite measures (desire to eat, hunger, fullness, and prospective food consumption) via visual analog scales before and for 3 h following standard breakfast intake. The food reward for the fat and sweet categories of food was measured before lunch with the Leeds Food Preference Questionnaire. Results: Fasting fullness scores decreased from baseline to 6 months (−8.9 mm, p < 0.01) despite increases in body weight (2.6 kg, p < 0.01) and waist circumference (2.4 cm, p = 0.03). Increases in actigraph-measured sleep duration were associated with decreases in fasting desire to eat (r = −0.58, p = 0.04). Increases in actigraph-measured sleep efficiency were also associated with decreases in explicit liking for sweet foods (r = −0.60, p = 0.03). Conclusions: Our findings suggest that improvements in sleep duration and sleep efficiency may lead to decreased feelings of appetite and food reward in Black emerging adults. Full article

Background/Objectives: Chrononutrition highlights the significance of temporal consumption behavior for a healthy dietary pattern. This study investigated the relationship between dietary fatty acid (FA) intake timing and type 2 diabetes mellitus (T2DM) risk. Methods: A total of 14,518 participants in the China Health and Nutrition Survey (1991–2015) were recruited. Dietary intake and mealtime were collected via three consecutive 24 h dietary recalls. Multivariable Cox proportional hazard models were employed to estimate the association between FA intake at meals and T2DM risk. Differences in FA intake between dinner and breakfast (Δ = dinner-breakfast) were calculated for each type of FA intake. Sensitivity analyses considering the effects of snacks, the sum of different types of FAs, and other confounding factors were performed. The isocaloric substitution model was used to view the risk changes according to the shifted mealtime. Results: During an average of 10.1-year follow-up, 1048 T2DM cases occurred. T2DM risk was inversely associated with n-3 polyunsaturated FAs (n-3 PUFAs) (p trend = 0.032) and plant-sourced monounsaturated FAs (P-MUFAs) (p trend = 0.002) intake at dinner versus breakfast. The highest category of Δ n-3 PUFAs and Δ P-MUFAs were respectively linked to a 19% and 29% reduced T2DM risk. Unanimous associations were found for the difference between lunch and breakfast rather than dinner and lunch. Isocalorically switching 1 standard deviation (SD) of n-3 PUFAs or MUFAs intake at breakfast with the corresponding type of FAs at dinner was associated with a 22% and 20% lower risk of T2DM, respectively. Conclusions: Timely consumption of dietary FAs, particularly n-3 PUFAs and plant-based MUFAs at dinner versus breakfast, is crucial for T2DM prevention. Full article

Adolescence is a critical period for growth and development, yet research on dietary quality and its influencing factors among Senegalese adolescent girls is limited. This study aims to assess dietary quality, with a focus on dietary diversity (DD), and identify its determinants in a nationally representative sample of adolescent girls in Senegal. A cross-sectional study was conducted in 2023 among 600 girls aged 10–19 years. Food intake was assessed over a seven-day period to evaluate DD. Household food security and sociodemographic data were gathered through face-to-face interviews. Half the sample had adequate DD. As for consumption, 80% had breakfast daily, while the same proportion consumed one snack per day. Fruits and vegetables, meat/poultry/fish, and dairy were consumed daily by less than 25% of the sample. Sweet foods, sweet beverages, and salty and fried food were consumed by less than 10% every day. Not having been sick in the past two weeks (Odds ratio (OR): 1.53, Confidence Interval (CI): 1.05–2.22), taking breakfast daily (OR: 1.89, CI: 1.23–2.93) and micronutrients (OR: 2.75, CI: 1.54–4.92), listening to the radio at least once a week (OR: 1.66, CI: 1.05–2.63), and living in a household with access to an improved source of water (OR: 4.13, CI: 2.28–7.49) were positively associated with adequate DD. Overall, the diet of adolescent girls is of poor quality. Potential determinants of their dietary quality should be considered in future nutrition programs and policies to ensure their optimal growth and development. Full article

Background: Ultra-processed foods (UPFs) represent a substantial part of modern diets, with a growing prevalence in food environments worldwide. Their unfavourable nutritional composition and adverse health effects present growing public health concerns. Methods: This study examines the prevalence of UPFs in the Slovenian food supply, their nutritional quality and the use of different food symbols and labelling schemes on food packaging. A cross-sectional analysis was conducted using the representative Slovenian branded foods database. A total of 23,173 prepacked foods and beverages were categorised into levels of processing according to the NOVA classification system. The nutritional composition of UPFs was compared to less processed products within 16 narrow subcategories. Additionally, the prevalence in the use of front-of-package nutrition labelling (FOPNL) and subjectively nutrition-related elements (SNREs) (such as EU Organic, Vegan labels etc.) were assessed across different food categories and processing levels. Results: Results show that UPFs represent 54.5% of the available products in the Slovenian food supply, with the highest prevalence in Confectionery (93%), Bread and bakery products (83%), Meat, meat products and alternatives (77%) and Convenience foods (74%). Comparison of nutritional composition indicated that UPFs had significantly poorer nutritional composition compared to less processed counterparts, including higher levels of sugar, salt and saturated fats, and a lower protein content. Breakfast cereals, Snack foods, Meat alternatives and Pre-prepared salads and sandwiches showed the most significant differences between UPFs and less processed counterparts. Analysis of the prevalence of symbols and labelling schemes revealed that 33.8% of products carried at least one FOPNL (15.0%) or SNRE (19.1%), with SNREs being more prevalent on less processed products and FOPNL predominantly used on UPFs (p < 0.05). The most prevalent SNRE was the EU Organic logo (12.7%), followed by the Vegan (4.7%) and Non-GMO (3.1%) logos, whereas the most frequent FOPNL was Reference Intakes (RI), presenting only energy value RI-Energy (12.5%), followed by nutrient-specific RI (1.6%), while other FOPNL were scarce and limited to certain categories. An additional comparison of visual presentation highlighted the potentially selective use of voluntary FOPNL to improve product framing. This raises concerns about their role in guiding consumer choices versus serving as marketing tools, especially when it comes to UPFs. Conclusions: Our findings highlight the need for monitoring UPFs in the food supply together with harmonised, mandatory labelling regulations to ensure transparency and empower consumers to make healthier choices. Full article

Background: Ready-to-eat cereals (RTECs) are a large, heterogeneous category of cereals designed to fit into busy lifestyles with minimal preparation time. Methods: This systematic review evaluated nutrient intake data from seven national surveys. Using PubMed and Science Direct (1 January 2004 until 16 September 2024), we investigated RTECs in relation to their contributions to macro, micronutrient and food group intakes, breakfast/diet quality and effects on health with focus on non-communicable disease (NCD) prevention. The search was restricted to Systematic Reviews (SRs), meta-analyses (MAs), randomised controlled trials (RCTs) and observational studies. Fifty-one publications were obtained. Studies related to health outcomes and NCD risk were graded using an updated Scottish Intercollegiate Guidelines Network approach. Results: Grade A evidence: Based on high-quality MA, SRs, or RCTs, this showed that RTEC consumption was associated with improved nutrient intakes (particularly fibre and micronutrients), reduced cardiovascular disease and mortality. One good-quality Grade A meta-analysis showed that total whole grain intake which included cereals was associated with a reduced risk of total cancer. Grade B evidence: Based largely on observational evidence, this showed that RTEC consumption was associated with reduced risk of overweight and obesity, body mass index and composition improvements and type 2 diabetes risk. For food group intakes, breakfast/diet quality and lipid profiles, more well-designed studies were needed (Grade D evidence). Conclusions: There is consistent evidence that RTECs generally have positive or neutral effects on nutritional status and NCD prevention. Strongest evidence exists for RTEC and micronutrient intakes, reduced risk of cardiovascular diseases (CVDs), body weight regulation, and reduced type 2 diabetes risk. Public health messaging should recognise that RTECs, especially whole-grain, higher-fibre and lower-sugar varieties, may help to reinforce micronutrient intakes and a range of health outcomes. Full article

Background/Objectives: Although a healthy dietary pattern is a modifiable lifestyle factor in the prevention of chronic kidney disease (CKD), studies that investigate the association between a healthy diet and prevalent CKD in patients with diabetes, using the Korean Healthy Eating Index (KHEI), are lacking. Methods: This cross-sectional study included 1991 patients with diabetes from the eighth Korean National Health and Nutrition Examination Survey 2019–2021. A higher KHEI indicated healthier eating habits. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m² or urine albumin–creatinine ratio ≥ 30 mg/g. The risk of prevalent CKD was evaluated according to the median KHEI value using logistic regression analysis adjusted for various clinicodemographic characteristics. Each KHEI component score was compared between those with and those without CKD, using the Student’s t-test. Results: Participants with a higher KHEI were older, with higher proportions of women, non-smokers, and non-alcoholics. A higher KHEI was significantly associated with a lower risk of prevalent CKD (adjusted odds ratio [aOR], 0.73 [0.58–0.93]). Subgroup analysis revealed stronger associations in those without hypertension status (aOR, 0.57 [0.37–0.87]) with at least high school education (aOR, 0.56 [0.38–0.81]). Moreover, patients with diabetes and CKD had significantly lower KHEI, particularly in the adequacy category components, including breakfast consumption, total fruit intake, and dairy product intake. Conclusions: A healthier dietary pattern was associated with a lower risk of prevalent CKD in patients with diabetes. Dietary intervention, which recommends the intake of breakfast, fruits, and dairy products, may be an effective strategy for CKD prevention. Full article

According to the 2022 Korean Society of Lipidology and Atherosclerosis, in Korea, dyslipidemia is a common disease that occurs in 40.2% of adults aged 20 or older, and its prevalence increases with age. Although dyslipidemia has a high prevalence of 47.8% in adults aged 30 or older, it is known to be preventable and manageable through lifestyle improvements in areas including eating habits, alcohol consumption, smoking, and physical activity. In this study, we propose a model for predicting age-specific dyslipidemia risk factors according to adult health behavior characteristics and diet. By analyzing the correlation between age-specific health behaviors and diet and the presence or absence of dyslipidemia, we aimed to predict dyslipidemia risk factors through a combination of multiple factor variables. This study utilized data from the 8th National Health and Nutrition Examination Survey, and selected 12,028 adults who received a doctor’s diagnosis of dyslipidemia as the subjects. In order to compare the characteristics of the dyslipidemia diagnosis group and the non-diagnosed group, a Rao–Scott χ² test was performed, and machine learning-based logistic regression and decision tree analyses were performed to predict the dyslipidemia risk factors. Analyzing the difference in the dyslipidemia prevalence according to the general characteristics and health status showed no significant difference between the men and women in the 19–34, 35–49, and 50–64 age groups, but there was a significant difference in the dyslipidemia prevalence in the 65 and older group. It was found that the dyslipidemia risk also increased with age. In terms of health behavior characteristics, the alcohol intake frequency and aerobic exercise frequency were found to have statistically significant effects and, in terms of eating habits, the breakfast frequency and dining out frequency were found to be significant factor variables in the dyslipidemia prevalence. As a result of the decision tree analysis, the most important dyslipidemia predictive factor showed differences according to the age group. The most important predictive variable for the presence or absence of dyslipidemia in the 19–34 age group was the BMI; for the 35–49 age group, it was gender and subjective health perception; for the 50–64 age group, it was subjective health perception and the BMI; and for the 65 and older group, it was the BMI. This suggests that healthy eating habits and behaviors such as aerobic exercise are very important for preventing and managing dyslipidemia as age increases. Full article

Background: Though evidence is limited, animal products like pork sausages and cheese may affect satiety differently due to their distinct protein, fat, and calcium content. This study therefore compared their acute effects on breakfast using appetite-related markers. Methods: A total of 11 women and 13 men, with a mean age of 23.0 ± 2.6 years and mean BMI of 24.5 ± 2.6 kg/m², participated in this crossover design study. Concentrations of active ghrelin, glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), cholecystokinin (CCK), insulin, glucose, leptin, and blood lipids were measured. Subjective feelings of appetite using visual analogue scales were analyzed (0–4 h) as a response to two test breakfasts meals with a similar energy and macronutrient content. Appetite feelings and energy intake from an ad libitum buffet lunch were subsequently measured. Data were analyzed using two different ANOVA methods. Results: The pork sausage breakfast was characterized by an earlier triglyceride (TG) peak than the cheese. A slower TG clearance was seen with the cheese breakfast. Ghrelin suppression was longer in the pork sausage breakfast. Active GLP-1 concentration was higher following the cheese breakfast and active GIP declined slower. The two ANOVA methods disagreed regarding the insulin effect. Subjective feelings of hunger before buffet and ad libitum energy intake were higher in males (791 ± 64 kcal) compared with females (344 ± 32 kcal), but did not differ between breakfast types. Conclusions: Acute consumption of pork and cheese of the same energy, fat, and protein content provided detectable differences in appetite-related hormones and lipid responses. Appetite and lipid metabolism were affected by the major differentiators of the test meals, namely calcium, fatty acids and amino acids compositions. Full article

Background: Arabinoxylan (AX) concentrates from wheat can be produced from co-products from the starch and gluten industries. These fractions are rich in AX, have high solubility, can be incorporated into bread and breakfast cereals, and have the potential to enhance functional and nutritional effects beyond what is possible with cereal species. Methods: The aim of this review is to summarize the available literature on AX concentrates from wheat in terms of production, incorporation in breads, and influence on glucose homeostasis in human subjects and animals. Results: Breads enriched in AX fiber have been found to increase the viscosity of digesta from the small intestine but with no effect on the digestibility of starch. In the large intestine, AX is, to a large extent, degraded, producing short-chain fatty acids. Across acute human and animal studies, the intake of AX concentrates has been shown to reduce the rate and extent of glucose absorption and insulin responses in a dose-dependent fashion. No general influence of AX on incretins has been identified, and the role of AX-enriched diets in appetite sensation is unclear. Medium- and long-term human and animal intervention studies demonstrated improved glucose homeostasis (fructosamine and glycated hemoglobin A1c) during the consumption of AX-enriched diets compared to placebo. Although AX concentrates across studies improved glucose homeostasis, a confounding factor to be further investigated is to what extent protein being present in relatively high concentrations in some of the produced AX-rich wheat fractions, partly or fully, is responsible for the observed homeostatic effects. Full article

Background/Objectives: Early intervention combining nutrition optimisation with exercise can potentially prevent frailty progression and reverse pre-frailty in older adults. Methods: This 4-month study examined the effectiveness of nutrition education (without oral nutrition supplement use) as part of a multi-domain intervention on the nutritional status and intake of pre-frail community-dwelling older adults and its relationship with sarcopenia markers. Results: Amongst 172 participants (≥55 years), 5.8% were malnourished, with no significant change in nutritional status throughout the study. Post-intervention, participants consumed significantly higher daily calories, protein, protein per body weight (BW), and calcium (p < 0.001); protein intake at lunch (p = 0.001) and dinner (p = 0.004) also increased. However, 6-month post-intervention daily protein (p = 0.025), protein per BW (p = 0.039), and calcium (p = 0.015) decreased significantly. Sarcopenia markers (handgrip strength (HGS), five-time chair stand test (5STS), and short physical performance battery score (SPPB)) showed no significant difference post-intervention. Well-nourished participants had better HGS (p = 0.005), 5STS (p = 0.026), and SPPB (p = 0.039). Practical nutrition education effectively improved nutritional intake, but the effect was not sustained 6-months post-intervention. Conclusions: Optimising nutritional status with a focus on improving protein intake, especially at breakfast, to meet minimal intake to stimulate muscle protein synthesis can help prevent sarcopenia and frailty. Future studies should examine factors driving sustainable improvement to prevent frailty progression in this population. Full article

Objectives: This study explored the impact of physical activity (PA) participation on the lifestyle habits and school life of Korean elementary school students. Methods: We collected survey data from 28,514 elementary school students participating in the 2023 Student Health Examination conducted by the Korea Ministry of Education. PA participation was the independent variable, defined as whether elementary school students participate in exercise that makes them out of breath or sweat more than three times a week. The variables related to lifestyle habits included breakfast intake, amount of sleep, TV viewing, gaming/Internet use, thoughts about running away from home, perceived body image, and body mass index. The variables for school life included experiences of being bullied, the need for counseling regarding school life problems, and the need for counseling for distress. The collected data were analyzed using frequency analysis, chi-squared tests, and multivariate logistic regression analyses. Results: PA was significantly associated with regular breakfast intake, sufficient sleep, limited television viewing, reduced gaming/Internet use, and a positive perception of body image. Specifically, regarding breakfast intake, the average odds ratio (OR) was 1.160 for always having it. Regarding the amount of sleep, the average OR was 0.836 for less than 6 h, 0.692 for 6–7 h, and 0.767 for 7–8 h. Regarding TV viewing, the average OR was 0.831 for yes. For gaming, the average OR was 0.770 for yes. Regarding perceived body image, the average OR was 1.429 for slightly thin, 1.487 for normal, and 1.400 for slightly fat. Conclusions: These results suggest that children’s PA facilitates the formation of good lifestyle habits; therefore, it should be actively encouraged in children. Full article

Background/Objectives: Sleep is a fundamental physiological function that plays a crucial role in maintaining health and well-being. The aim of this study was to assess dietary and lifestyle factors associated with adequate sleep duration in children and adolescents living in five Mediterranean countries. Methods: Parents of children and adolescents taking part in an initial survey for the DELICIOUS project were examined to assess their children’s dietary and eating habits (i.e., meal routines), as well as other lifestyle behaviors (i.e., physical activity levels, screen time, etc.) potentially associated with adequate sleep duration (defined as 8–10 h according to the National Sleep Foundation). The youth healthy eating index (Y-HEI) was used to assess the diet quality of children and adolescents. Multivariate logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs), indicating the level of association between variables. Results: A total of 2011 individuals participated in the survey. The adolescents and children of younger parents reported being more likely to have inadequate sleep duration. Among eating behaviors, having breakfast (OR = 2.23, 95% CI: 1.62, 3.08) and eating at school (OR = 1.33, 95% CI: 1.01, 1.74) were associated with adequate sleep duration. In contrast, children eating alone, screen time, and eating outside of the home were less likely to have adequate sleep duration, although these findings were only significant in the unadjusted model. After adjusting for covariates, a better diet quality (OR = 1.63, 95% CI: 1.24, 2.16), including higher intake of fruits, meat, fish, and whole grains, was associated with adequate sleep duration. Conclusions: Adequate sleep duration seems to be highly influenced by factors related to individual lifestyles, family and school eating behaviors, as well as diet quality. Full article

Background/Objectives: Vitamin D deficiency (VDD) is a global health concern associated with metabolic disease and immune dysfunction. Despite known risk factors like limited sun exposure, diet, and lifestyle, few studies have explored these factors comprehensively on a large scale. This cross-sectional study aimed to identify VDD-associated factors in South Korea via an integrative approach of machine learning and statistical analyses using Korea National Health and Nutrition Examination Survey (KNHANES) IX-1 data. Methods: Using the KNHANES dataset, six machine learning algorithms were applied to evaluate VDD (serum 25[OH]D3 < 20 ng/mL)-associated factors through feature importance scores. Thereafter, multivariate linear and logistic regression models were applied to the dataset—stratified by sex and age. Results: Among 583 variables, 17 VDD-associated factors were identified using the CatBoost model, which achieved the highest F1 score. When these factors were assessed through statistical analysis, dietary supplement use emerged as a consistent factor associated with VDD across all subgroups (younger men, younger women, older men, and older women). In younger adults, HDL cholesterol, blood and urinary creatinine, water intake, urban residence, and breakfast frequency were significantly associated with VDD. Additionally, blood urea nitrogen and fasting plasma glucose in men and urinary sodium in women showed sex-specific associations with serum 25(OH)D levels. Conclusions: This study identified key VDD-associated factors in the South Korean population, which varied by age or sex. These findings highlight the multifaceted nature of VDD, influenced by dietary, lifestyle, and biochemical factors and underscore the need for strategies integrating machine learning and statistical analysis. Full article