Within-person comparison of eating behaviors, time of eating, and dietary intake on days with and without breakfast: NHANES 2005-2010

Abstract

Background: Breakfast omission is known to be associated with lower 24-h energy intake. However, little is known about downstream eating behaviors subsequent to skipping breakfast in free-living individuals.

Objective: We replicated the traditional crossover design of nutrition studies in a naturalistic setting to compare within-person differences in self-reported eating behaviors, energy intake, and other dietary characteristics of individuals on a day that included breakfast with a day that omitted breakfast.

Design: We used cross-sectional dietary data for 2132 adult respondents who reported breakfast in only one of 2 dietary recalls in the NHANES 2005-2010. Dietary outcomes examined included meal- and snack-eating behaviors, clock time of eating episodes, and intakes of energy, macronutrients, and food groups. Regression methods accounted for replicate diet measurements, covariates, and survey-design characteristics.

Results: The breakfast meal provided a mean of 508 kcal in men and 374 kcal in women, but differences in 24-h energy intakes between the breakfast and no-breakfast day were 247 and 187 kcal, respectively. Energy intakes at the lunch meal were higher on the no-breakfast day (202 kcal in men and 121 kcal in women), and the reported time of lunch was ∼35 min earlier. The energy contribution of dinner or its reported time did not differ. A higher number of energy-adjusted servings of fruit and whole grains were reported on the breakfast day, but the energy and macronutrient density of reported foods were not different.

Conclusions: In free-living American adults, the eating time for lunch was earlier, and the lunch meal provided more energy on the no-breakfast day than on the breakfast day. Although the quality of dietary selections reflected in the energy and macronutrient density of a day's intake did not differ between the breakfast and the no-breakfast day, breakfast skippers may need encouragement to consume fruit and whole grains at other eating episodes.

Keywords: NHANES; breakfast; chrononutrition; eating behaviors; eating frequency; energy density; food pattern equivalents; main meals; obesity; time of eating.

FIGURE 1

Within-person differences in distribution of 24-h energy intake into named eating episodes on the breakfast day and no-breakfast day reported by adults in the NHANES 2005–2010. (A) Total, breakfast, lunch, dinner, and snack energy intakes reported in the 24-h recall of a breakfast day and no-breakfast day. Estimates are predicted margins from linear regression models that included each dependent variable as a continuous outcome and the mention or omission of breakfast, day of the week of recall (Monday to Thursday and Friday to Sunday), and recall type (i.e., in-person or telephone recall) as independent variables along with a separate intercept term for each individual in the study. (Men, n = 1095 on the breakfast day and n = 1095 on the no-breakfast day; women, n = 1037 on the breakfast day and n = 1037 on the no-breakfast day.) *Significantly different from that reported on the breakfast day within each sex, P < 0.001. (B) Compensated and uncompensated breakfast energy intake on the no-breakfast day in men and women. Estimates are predicted margins from linear regression models that included each dependent variable as a continuous outcome and the mention or omission of breakfast, day of the week of recall (Monday to Thursday and Friday to Sunday), and recall type (i.e., in-person or telephone recall) as independent variables along with a separate intercept term for each individual in the study.

FIGURE 2

Reported time of day for eating events on the breakfast day and no-breakfast day in adult men and women, NHANES 2005–2010. Estimates are predicted margins from linear regression models that included each dependent variable as a continuous outcome and the mention or omission of breakfast, day of the week of recall (Monday to Thursday and Friday to Sunday), and recall type (i.e., in-person or telephone recall) as independent variables along with a separate intercept term for each individual in the study. (Men, n = 1095 on the breakfast day and n = 1095 on the no-breakfast day; women, n = 1037 on the breakfast day and n = 1037 on the no-breakfast day.) *Significantly different from that reported on the breakfast day within each sex, P < 0.001. HH:MM, hours:minutes.