Application of digital transformations of dietary microdata and factor analysis to study the nutritional patterns of breakfast and its significance in providing the nutritional value of the diet of adults
Abstract
Eating disorders with skipping meals are considered as a risk factor for chronic non-communicable diseases. Frequent skipping of meals is associated with the risk of developing metabolic syndrome, type 2 diabetes, and obesity. Breakfast is considered to be the most important meal of the day. However, studies on the impact of skipping breakfast on the risk of overweight and obesity are highly controversial.
The aim of this study was to analyze the prevalence of skipping the morning breakfast meal and its impact on the actual daily intake of nutrients and energy in the Russian adult population.
Material and methods. The data from a sample survey of dietary intake conducted in 2013 by the Russian Federal State Statistics Service have been used. The analysis included adult respondents (19 years and older) in the amount of 163 000 people in 2 stages of the survey (in April and September). The dietary intake of all members of the surveyed households was studied using the 24-hour recall method. Since the survey questionnaires did not contain information about type of meals, therefore, with the help of binning in thзe SPSS program, time intervals of the maximum food energy intake by the respondents were established, which were taken as evidence of the main meals and snacks.
Results. Of the main meals, the largest proportion of respondents skipped dinner (23.1%), then breakfast (13.0%), and the smallest proportion skipped lunch (5.7%).The proportion of men and women who skipped breakfast was 12.6 and 13.3%, respectively, a greater frequency of skipping breakfast was observed at a young age (19–30 years, 19.3%) and at an old age (75 years and older, 16.1%). With an increase in the average monthly income of a family, the percentage of those who skip breakfast increases. Adult members of families with many children (3 or more children), whose average per capita income is lower than those in families with 2 children, skip breakfast less frequently. The smallest share of people skipping breakfast was found in the North Caucasian and Southern districts, and the maximum in the Siberian and Far Eastern districts. Adults who skipped breakfast had a higher percentage of malnourished (BMI <18.5 kg/m2) and normal nutritional status (BMI 18.5–24.9 kg/m2). At the same time, the proportion of people who consumed breakfast was significantly higher in overweight people (25.0–29.9 kg/m2), and no differences were found among obese people. It is shown that skipping breakfast is accompanied by a decrease in the energy value of the daily diet by an average of 200 kcal. Despite the increase in the caloric content of the 2nd breakfast, afternoon snack and evening snack in absolute terms (р<0.01), there was no compensation for the loss of energy value in the absence of breakfast. A decrease in the absolute values of nutrient intake associated with a decrease in energy consumption was established. However, skipping breakfast showed a decrease in added sugar intake as a per cent of total calorie intake (12.1±8.6 vs 13.2±9.1%, р<0.01), while the contribution of other macronutrients to energy intake did not change significantly. In connection with the heterogeneity of the actual dietary intake of the population, factor analysis was used to describe the main food models of the breakfast using the principal component method. 6 factors were identified that determine the eating patterns of breakfasts and correlate with 2–4 individual food items of actual dietary intake.
Conclusion. The results obtained are consistent in a number of positions with the literature data, in particular, indicating a decrease in daily energy consumption when skipping breakfast.
Keywords:adults; diet; skipping meals; breakfast; breakfast food patterns
Funding. The research was carried out at the expense of the state budget for the implementation of the state task on the topic of the fundamental scientific research № FGMF 2022-0001.
Conflict of interest. The authors declare no conflict of interest.
Сontribution. Concept and design of the study – Martinchik A.N., Baturin A.K.; collecting and statistical processing the material – Mikhailov N.A. Peskova E.V.; text writing – Martinchik A.N.; editing, approval of the final version of the article, responsibility for the integrity of all parts of the article – all authors.
For citation: Martinchik A.N., Mikhailov N.A., Peskova E.V., Baturin A.K. Application of digital transformations of dietary microdata and factor analysis to study the nutritional patterns of breakfast and its significance in providing the nutritional value of the diet of adults. Voprosy pitaniia [Problems of Nutrition]. 2023; 92 (5): 48–59. DOI: https://doi.org/10.33029/0042-8833-2023-92-5-48-59 (in Russian)
References
1. Bonnet J.P., Cardel M.I., Cellini J., Hu F.B., Guasch-Ferré M. Breakfast skipping, body composition, and cardiometabolic risk: a systematic review and meta-analysis of randomized trials. Obesity (Silver Spring). 2020; 28 (6): 1098–109. DOI: https://doi.org/10.1002/oby.22791
2. Chen L., Li X., Du X., Liu W., Du J., Guo L., et al. Cross-sectional association of meal skipping with lipid profiles and blood glucose in Chinese adults. Nutrition. 2021; 90: 111245. DOI: https://doi.org/10.1016/j.nut.2021.111245
3. Sierra-Johnson J., Undén A.L., Linestrand M., Rosell M., Sjogren P., Kolak M., et al. Eating meals irregularly: a novel environmental risk factor for the metabolic syndrome. Obesity (Silver Spring). 2008; 16 (6): 1302–7. DOI: https://doi.org/10.1038/oby.2008.203
4. Niki A., Baden M.Y., Kato S., Mitsushio K., Horii T., Ozawa H., et al. Consumption of two meals per day is associated with increased intrapancreatic fat deposition in patients with type 2 diabetes: a retrospective study. BMJ Open Diabetes Res Care. 2022; 10 (5): e002926. DOI: https://doi.org/10.1136/bmjdrc-2022-002926
5. Ballon A., Neuenschwander M., Schlesinger S. Breakfast skipping is associated with increased risk of type 2 diabetes among adults: a systematic review and meta-analysis of prospective cohort studies. J Nutr. 2019; 149 (1): 106–13. DOI: https://doi.org/10.1093/jn/nxy194
6. Aguzzi F., Salleber S., Gigante B., De Faire U. Irregular eating behavior and incidence of cardiovascular disease: results from a Swedish 60-year-old cohort of men and women. Eur Heart J. 2019; 40 (suppl 1): ehz746-0018. DOI: https://doi.org/10.1093/eurheartj/ehz746.0018
7. Pendergast F.J., Livingstone K.M., Worsley A., McNaughton S.A. Correlates of meal skipping in young adults: a systematic review. Int J Behav Nutr Phys Act. 2016; 13 (1): 125. DOI: https://doi.org/10.1186/s12966-016-0451-1
8. St-Onge M.P., Ard J., Baskin M.L., Chiuve S.E., Johnson H.M., Kris-Etherton P., et al. Meal timing and frequency: implications for cardiovascular disease prevention: a scientific statement from the American Heart Association. Circulation. 2017; 135 (19): e96–121. DOI: https://doi.org/10.1161/CIR.0000000000000476
9. Ma X., Chen Q., Pu Y., Guo M., Jiang Z., Huang W., et al. Skipping breakfast is associated with overweight and obesity: a systematic review and meta-analysis. Obes Res Clin Pract. 2020; 14 (1): 1–8. DOI: https://doi.org/10.1016/j.orcp.2019.12.002
10. Kahleova H., Lloren J.I., Mashchak A., Hill M., Fraser G.E. Meal frequency and timing are associated with changes in Body Mass Index in Adventist Health Study 2. J Nutr. 2017; 147 (9): 1722–8. DOI: https://doi.org/10.3945/jn.116.244749
11. LeCheminant G.M., LeCheminant J.D., Tucker L.A., Bailey B.W. A randomized controlled trial to study the effects of breakfast on energy intake, physical activity, and body fat in women who are nonhabitual breakfast eaters. Appetite. 2017; 112: 44–51. DOI: https://doi.org/10.1016/j.appet.2016.12.041
12. Baranauskas M, Kupčiūnaitė I, Stukas R. The association between rapid weight loss and body composition in elite combat sports athletes. Healthcare (Basel). 2022; 10 (4): 665. DOI: https://doi.org/10.3390/healthcare10040665
13. Todorović N., Ranisavljev M., Tapavički B., Zubnar A., Kuzmanović J., Štajer V., et al. Principles of rapid weight loss in female sambo athletes. Int J Environ Res Public Health. 2021; 18, N 21; 11356. DOI: https://doi.org/10.3390/ijerph182111356
14. Federal State Statistics Service. Selective observation of the diet of the population in 2013. URL: www.gks.ru (in Russian)
15. Diet of the population. 2013: Statistical compendium. In: Rosstat. Moscow: Statistika Rossii, 2016: 220 p. ISBN 978-5-4269-0058-5 (in Russian)
16. Guidelines for assessing the amount of food consumed by the method of 24-hour recall. Approved Deputy Chief State Sanitary Doctor of the Russian Federation, No. С1-19/14-17 February 26, 1996. (in Russian)
17. Nikityuk D.B., Martinchik A.N., Baturin A.K., A method for assessing individual food intake by the method of 24-hour recall: Guidelines. 2016 [Electronic resource]. URL: http://web.ion.ru/files/ (in Russian)
18. Martinchik A.N., Baturin A.K., Baeva V.S., Peskova E.V., Larina T.I., Zaburkina T.G. Album of portion size of foods and dishes. Moscow: Institut pitaniia RAMN, 1995: 64 p. (in Russian)
19. Ergin I., Hassay H., Kunst A. Socio-economic inequalities in overweight among adults in Turkey: a regional evaluation. Public Health Nutr. 2012; 15 (1): 58–66.
20. Martinchik A.N., Baturin A.K., Mikhaylov N.A., Keshabyants E.E., Kambarov A.O. Development and assessment of the reliability of the basic healthy eating index for the Russian population. Voprosi pitaniia [Problems of Nutrition]. 2019; 88 (6): 34–44. DOI: https://doi.org/10.33029/0042-8833-2021-90-5-77-86 (in Russian)
21. Goyal R., Julka S. Impact of breakfast skipping on the health status of the population. Indian J Endocrinol Metab. 2014; 18 (5): 683–7. DOI: https://doi.org/10.4103/2230-8210.139233
22. McCrory A., Campbell W.W. Effects of eating frequency, snacking, and breakfast skipping on energy regulation: symposium overview. J Nutr. 2011; 141 (1): 144–7. DOI: https://doi.org/10.3945/jn.109.114918
23. Thomas E.A., Higgins J., Bessesen D.H. Usual breakfast eating habits affect response to breakfast skipping in overweight women. Obesity (Silver Spring). 2015; 23 (4): 750–9. DOI: https://doi.org/10.1002/oby.21049
24. Blondin S.A., Anzman-Frasca S., Djang H.C., Economos C.D. Breakfast consumption and adiposity among children and adolescents: an updated review of the literature. Pediatr Obes. 2016; 11: 333–48. DOI: https://doi.org/10.1111/ijpo.12082
25. Wu C.H., Lin C.Y., Hsieh Y.P., Strong C, Meshki C, Lin Y.C., et al. Dietary behaviors mediate the association between food insecurity and obesity among socioeconomically disadvantaged youth. Appetite. 2019; 132: 275–81. DOI: https://doi.org/10.1016/j.appet.2018.10.013
26. Betts J.A., Richardson J.D., Chowdhury E.A., Holman G.D., Tsintzas K. Thompson D. The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr. 2014; 100 (2): 539–47. DOI: https://doi.org/10.3945/ajcn.114.083402
27. Wicherski J., Schlesinger S., Fischer F. Association between breakfast skipping and body weight – a systematic review and meta-analysis of observational longitudinal studies. Nutrients. 2021; 13 (1): 272. DOI: https://doi.org/10.3390/nu13010272
28. Sudharsanan N., Romano S., Cunningham S.A. School breakfast receipt and obesity among American fifth- and eighth-graders. J Acad Nutr Diet. 2016; 116 (4): 599–607. DOI: https://doi.org/10.1016/j.jand.2015.08.021
29. Dhurandhar E.J. True, true, unrelated? A review of recent evidence for a causal influence of breakfast on obesity. Curr Opin Endocrinol Diabetes Obes. 2016; 23 (5): 384–8. DOI: https://doi.org/10.1097/MED.0000000000000281
30. Chung S.-J., Lee Y., Lee S., Choi K. Breakfast skipping and breakfast type are associated with daily nutrient intakes and metabolic syndrome in Korean adults. Nutr Res Pract. 2015; 9: 288. DOI: https://doi.org/10.4162/nrp.2015.9.3.288
31. Wronska M.D., Coffey M., Robins A. Determinants of nutrition practice and food choice in UK construction workers. Health Promot Int. 2022; 37 (5): daac129. DOI: https://doi.org/10.1093/heapro/daac129
32. Sievert K., Hussain S.M., Page M.J., Wang Y., Hughes H.J., Malek M., et al. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019; 364: l42. DOI: https://doi.org/10.1136/bmj.l42
33. Levitsky D.A., Pacanowski C.R. Effect of skipping breakfast on subsequent energy intake. Physiol Behav. 2013; 119: 9–16. DOI: https://doi.org/10.1016/j.physbeh.2013.05.006
34. Sun Y., Rong S., Liu B., Du Y., Wu Y., Chen L., et al. Meal skipping and shorter meal intervals are associated with increased risk of all-cause and cardiovascular disease mortality among US adults. J Acad Nutr Diet. 2023; 123 (3): 417–26.e3. DOI: https://doi.org/10.1016/j.jand.2022.08.119
35. Rong S., Snetselaar L.G., Xu G., Sun Y., Liu B., Wallace R.B., et al. Association of skipping breakfast with cardiovascular and all-cause mortality. J Am Coll Cardiol. 2019; 73 (16): 2025–32. DOI: https://doi.org/10.1016/j.jacc.2019.01.065
36. Ofori-Asenso R., Owen A.J., Liew D. Skipping breakfast and the risk of cardiovascular disease and death: a systematic review of prospective cohort studies in primary prevention settings. J Cardiovasc Dev Dis. 2019; 6 (3): 30. DOI: https://doi.org/10.3390/jcdd6030030
37. Liu T., Wang Y., Wang X., Liu C., Zhang Q., Song M., et al. Habitually skipping breakfast is associated with the risk of gastrointestinal cancers: evidence from the Kailuan Cohort Study. J Gen Intern Med. 2023; 38 (11): 2527–36. DOI: https://doi.org/10.1007/s11606-023-08094-7