Breakfast in the United States: Food and Nutrient Intakes in Relation to Diet Quality in National Health and Examination Survey 2011⁻2014. A Study from the International Breakfast Research Initiative

Abstract

The contribution of breakfast to diet quality (DQ) can inform future dietary guidelines. This study examined breakfast nutrition in relation to overall DQ, using dietary data from the first reported day of the National Health and Examination Survey (NHANES) 2011⁻2014 (n = 14,488). Relative DQ was assessed using the Nutrient Rich Foods Index (NRF9.3) and the USDA Healthy Eating Index 2015 (HEI 2015). The sample was stratified by NRF9.3 tertiles and by age and socioeconomic groups. Four out of 5 NHANES participants had breakfast on the day of the interview. Breakfast provided 19⁻22% of dietary energy depending on age. Breakfast intakes of complex carbohydrates and total sugars were proportionately higher and intakes of protein and fats were lower relative to breakfast energy intakes. Breakfast provided more that 20% of daily intakes of B vitamins, vitamins A and D, folate, calcium, iron, potassium and magnesium. Eating breakfast was associated with higher NRF9.3 DQ scores. Breakfasts associated with the top tertile of NRF9.3 scores had less added sugars and fats than those associated with the bottom tertile. Such breakfasts had more fruit and juices, more whole grain products, more milk and yogurt and less meat and eggs. Breakfast patterns and food choices that favored fruit, whole grains and dairy were associated with healthiest diets.

Keywords: NRF9.3 index; USDA HEI 2015 index; breakfast; dietary intake; dietary quality; nutrition.

Figure 1

Percent contribution of breakfast to macronutrient intakes relative to energy intakes among breakfast consumers. PUFA stands for Polyunsaturated fatty acids, MUFA stands for Monounsaturated fatty acids, SFA stands for Saturated fatty acids. The 20% cutoff is indicated by a vertical line.

Figure 2

Percent contribution of breakfast to micronutrient intakes relative to energy intakes among breakfast consumers. The 20% cut point is indicated by the vertical line.

Figure 3

Nutrient subscores of the Nutrient Rich Index (NRF9.3) by age group and by tertiles of total NRF9.3 scores.

Figure 4

Distribution of breakfast macronutrients by tertiles of NRF9.3 diet quality score. PUFA stands for Polyunsaturated fatty acids, MUFA stands for Monounsaturated fatty acids, SFA stands for Saturated fatty acids.

Figure 5

Percent consumers at breakfast for selected food groups by NRF9.3 tertiles. MPF stands for Meat, Poultry, Fish.

Figure 6

Percent consumers of specific food groups at breakfast by age group (data for breakfast consumers only). RTEC stands for Ready to eat cereals.