Breakfast is the Lowest Fat Meal for Young Adult Women

R E S E A R CAHR T I C L E

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Breakfast Is the Lowest Fat Meal for Young Adult Women YA-LI H U A N G , S H A R O N L. H O E R R , A N D W O N 0. S O N G Department of Food Science & Human Nutrition, College of Human Ecology, Michigan State University, East Lansing, Michigan 48824

ABSTRACT Breakfast consumption and the contribution of breakfast foods to the daily fat and fiber intakes of young adults were evaluated in a sample of 2628 young adults (mean k SD age = 19.6 k 3.0 years).The subjects (males = 817, females = 1811) completed 24-hour dietary records for a college introductory nutrition class. The 1-day dietary intake data were analyzed for the following: (1) differences in daily fat and fiber intake between breakfast eaters (80%) and skippers (20%) by gender; (2) fat and fiber content of breakfast compared to other meals; and (3) foods most frequently consumed for breakfast by gender. More women who ate breakfast had daily fat intakes 130% energy from fat compared to the women who skipped breakfast (40% vs. 28%, p < .001). For both genders, the breakfast meal contained the lowest mean percent energy from fat compared to other eating occasions (p < .05).The ratio of fat to fiber was lowest for the breakfast meal, although fiber intakes were low overall. For men, the major sources of fat for breakfast were milk, eggs, sausage/ham, cream cheese, and butter/margarine; cereal, bread, and bagels were the major sources of fiber for both genders. Eating breakfast, especially breads and cereals and skim and 1% fat milk, can reduce fat intake and h e l ~increase fiber intakes of vounp. u adults. 2

UNE 29:184-188, 1997)

INTRODUCTION National surveys show that the U.S. population consumes too much fat and too little fiber for optimal health.'-* A few studies have reported daily total fat and/or fiber intake in relation to breakfast consumptiony-" and a positive impact of breakfast ~ ' ~ - ' ~ educators need to on nutritional a d e q u a ~ y . ~ . ' ~Nutrition look for food messages to help people reduce fat and increase fiber intakes1with information about specific food items that contribute significantly to daily fat and fiber intake.15J6 What young adults eat for breakfast and how this relates to their daily fat and fiber intakes are of interest to nutrition educators for several reasons. First, a limited number of studies on .......................................... The development of the MSU NutriGuide was supported by the W.K. Kellogg Foundation as part of the Healthy U program, a campus-wide health promotion program at MSU.This project was funded In part by a Healthy U grant for dissemination of findings by the Michigan Agricultural Experiment Station and Regional Project NC200. Address for correspondence: Sharon L. Hoerr, R.D., Ph.D., Department of Food Science & Human Nutrition, College of Human Ecology, Michlgan State University, East Lansing, MI 48824;Tel: (517) 355-7701; Fax: (517) 353-1633. 01997 SOCIETY FOR NUTRITION EDUCATION

what college students eat has been published mostly in an abstract form. Second, young adults in college have increased responsibility for food selection, while adapting to a new environment and lifestyle outside of their homes.17Third, college life presents an opportunity for nutrition educators to help young people develop healthy lifestyles and food habits. A recent phone survey, however, found that a higher percentage of young adults (18-34 years) had less knowledge of food composition and less belief in the diet-cancer connection than did middle-aged adults.'* Finally, adolescent females, especially those who diet, are also the most likely to omit breakfast.13 Zirnmerman reported that college women who ate breakfast tended to have lower intakes of fat without differences in total daily calorie^.'^ Because of the frequent selection of breads and cereals as breakfast food^,'^^" we hypothesized that young adults who ate breakfast would consume less fat and more fiber daily than those who did not. The purpose of this study was to examine the daily intake of fat and fiber in a large sample of young adults who ate or skipped breakfast.We also examined the foods most fiequently consumed for breakfast by gender to target specific nutrition education messages to young adults.When the nutrition composition differs among meals, nutrition education messages for specific meals should improve efficacy of intervention. METHODS Subjects were 2628 young adults (males = 817, females = 1811;mean age = 19.6 k 3.0 years) enrolled in a large undergraduate introductory nutrition class between 1988-1991. Data presented are for all four seasons; previous analysis indicated no seasonal differences in food intakes.20An exception to the seasonal invariability was summer when men consumed more beer and women skipped breakfast more.20 N o women in this study were pregnant or lactating. This study was approved by the University Committee on Research Involving Human Subjects as part of a campus-wide health promotion pr0gram.A~a class assignment, each subject completed a 24-hour dietary record for one "typical"weekday. class instructors gave students detailed instructions on keeping complete records including methods of food preparation, mixed and estimation of portion sizes. dishes, beverages, Students entered and evaluated their own dietary intake information using a nutrition software package, MSU NutriGuide

Journal of Nutrition EducationVolume 29 Number 4

(Song WO, Nutritional Analysis Computer Program,Version 1.5, Michigan State University, East Lansing, MI, 1988).Using the s o h a r e , the subjects themselves identified the mealtime in one of four categories:breakfast, lunch, supper, or snacks.Food and nutrient analysis was then evaluated by the subject-identified meal.Additionally, subjects reported age, height, weight, and hours spent in different categories of activity. Race/ethnicity and type of residence were not asked because these data were not relevant to the students' assignment. After the students completed the entries using the MSU NutriGuide software, investigators collected the raw dietary records in ASCII format for batch data analysis. The final sample size of 2628 records was from an original data pool of 2810 records after elimination of incomplete and multiple dietary records for an individual, records with unreasonable serving size, and diets with energy intakes varying more Estimathan 50% from the estimated energy expendit~res.~' tion of daily energy expenditure was calculated based on selfreported physical activity plus the basal metabolic rate calculated using the Harris-Benedict equation for age, height, gender, and thermic effect of food.2' The 953 foods in the MSU NutriGuide database include those frequently consumed by the college students, such as fast-food items and recipes obtained from campus residence halls. The list is expanded and revised regularly according to the food intake of the study population.The food composition database for MSU NutriGuide came originally from and was Michigan State University's main-frame databa~e*~ supplemented with USDA's food composition data, information from food manufacturers, McCance and Widdowson,2' and P e n n i n g t ~ n Ninety-eight .~~ percent of the foods in the MSU NutriGuide database are complete for fat composition and 99% for dietary fiber. Data were analyzed using the Statistical Package for the Social Sciences,Version 6.0 (SPSS Inc., Chicago, IL, 1990).For comparison of daily fat and fiber intakes, data were examined by breakfast eating or slupping patterns and separated by gender. Fat and fiber intake was examined for each meal and for the entire day. Fiber density for each meal was calculated as grams per 1000 calories and compared to the nutrition labeling goal of 12.5 g/1000 kcaLZ5Finally, the 20 foods most frequently consumed at breakfast were identified and sorted into food groups. Comparisons between genders for breakfast eaters or skippers were made using the student's t-test for means and chi-square for proportions.

July

August 1997

185

Comparisons between breakfast eaters and skippers and by meals were made separately for men and women. Women who ate breakfast were more likely than skippers to meet the dietary guideline of 130% energy from fat (chi-square, p < .0001,Table 2), although there were no differences in fat or fiber intakes evaluated by either grams or by density (g/1000 kcal) (see Table 1). More men who ate breakfast tended to meet the recommendation for fat than those who skipped breakfast, but the difference was not significant (30% vs. 23%, p = .07, seeTable 2).A higher percentage of women than men had daily fiber density 212.5 g/1000 kcal(12% vs. 4%, p < .0001, see Table 3). Breakfast eaters did not differ from breakfast skippers, however, in meeting the dietary fiber density recommendation. Figure 1 shows the percentage of energy from fat and the fiber density of each meal for men and women. Breakfast eaters of both genders consumed 12% of their total daily fat from breakfast, 34% from lunch, 40% to 42% from dinner, and 13% to 14% from snacks. There were no gender differences with the breakfast eaters for percentage fat and fiber contributions by meal for a day. Breakfast provided 16% of the daily fiber intake, only 12% of daily fat intake, and 16% of the total daily energy intake. Breakfast was the eating occasion with the lowest fat to fiber ratio. For the total sample,breakfast and snacks were the only eating occasions with 530% energy derived from fat. (This was 21% energy for breakfast and 28% energy for snacks;Table 3). The 20 foods consumed most fi-equently for breakfast by the young adults who consumed breakfast (males:n = 657,females: n = 1426) showed clear gender differences (Table 4). Higher percentages of women than men chose slum milk, frozen yogurt, and cream cheese with bagels. Higher percentages of men ate eggs and ham/sausage/hot dogs at breakfast. Gender Merences were also found for selection of foods within the grain and fruit groups. More men ate cereal and bread, but more women ate bagels, muffins, and biscuits.The three major food sources for dietary fiber at breakfast were cereal,bread, and bagels. Orange juice was by far the favorite fruit choice for breakfast, selected by 34.2% of males and 19.6% of females. Juice of any type was selected much more 6equently for breakfast than was whole h i t by both genders. Only small percentages of the young adults reported consumption of nondairy or nonfruit beverages for breakfast,with almost equal numbers reporting soft drinks and coffee consumption. DISCUSSION

RESULTS Twenty percent of the men and 22% of the women in this study skipped breakfast on the day reported.There were no differences in age, body mass index (BMI = kg/m2), physical activity, energy output, and energy intake between breakfast eaters and skippers (Table 1).The energy intakes estimated from the self-reported food intake did not differ significantly from energy outputs, calculated based on selfreported physical activities.This suggests that subjects did not greatly overestimate or underestimate their daily intakes.

Our hypothesis that breakfast eaters would have lower fat and higher fiber diets than the breakfast skippers as a group was not supported in this study.We did find, however, that young adult women who ate breakfast were more likely to get 130% energy from fat than those who did not. Breakfast was the only meal for which the ratio of fat to fiber contribution to the daily intake (%/% for a day) was less than 1.O. Similar to , ~ diets of these young adults were low in national s ~ r v e y sthe fiber, even at breakfast. All subgroups had only about half or less than the 12.5 g/1000 kcal fiber density r e ~ o m m e n d e d . ~ ~

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Huang et al./BREAKFAST A N D Y O U N G ADULT W O M E N

Table 1.

General and dietary characteristics of breakfast eaters and breakfast skippers by gender." Males (n

=

817)

Eater (n

=

Female (n

Skipper

657)

(n

=

=

Eater

160)

(n

=

1811) Skipper

1426)

(n

=

385)

Age (yr) BMI (kg/m2) Physical activities ( h r l d a ~ ) ~ Light Moderate Heavy Energy outputC(kcallday) Energy intake (kcallday) Nutrient Intakes Fat Glday % kcal

Cholesterol (mglday) Fiber Glday GI1000 kcal Carbohydrate (glday) Mean i SD. "Differences between breakfast eaters and skippers for all variables were nonsignificant by t-test or chi-square. bExamplesof physical activities: light-studying,

driving, walking; moderat-dancing,

fast walking; and heavy-aerobics,

running, cycling.

CEstimatesby the Harris-Benedict Equation based on Basal Metabolic Rate, physical activity, and thermic activity.20

Young adults in this study reported eating breakfast (80%) and a high percentage of subjects being first and second year (62% were 18-19 years old) who live mostly in cammore often than those in other reports of college s t ~ d e n t s . ~ ~ , ~ students ' A recent report from a national dietary survey reported that pus residence halls with prepaid meal plans. Reasons for conyoung adults under 30 years were more likely to skip breaksumption or omission of breakfast were not probed, although fast than were older adults and that only 75% of adults consome have hypothesized that young adults are motivated by sumed breakfast in 1991.28The high percentage of breakfast concern for sleep and/or weight loss.2yInterestingly, the findeaters in the present study might have resulted from class ings of two studies wherein children and adults who skipped breakfast consumed greater amounts of high-fat snacks than instructions to report a food record for a "typical" weekday, those who ate breakfastI3.l6were not confirmed in this sample of young adults. Table 2. Percent of breakfast eaters and breakfast skippers by gender whose diets met the dietary recommendationsfor fat and fiber for the day. Percent Energy

Fiber Density

from Fat

(g/1000 kcal)

s30

130

c12.5g

212.59

Females Eaters (n = 1426)

40*

60

88

12"

Skippers (n = 385)

28*

72

90

10

30"

70

96

4**

23

77

98

2

Males Eaters (n = 657) Skippers (n

=

160)

More female breakfast eaters than skippers met fat recommendation (chi-square, p < ,0001); "more women than men breakfast

BREAKFAST

LUNCH

DINNER

SNACKS

eaters met the fiber recommendation (chi-square, p < .0001). a

Nonsignificant (chi-square, p

=

.07).

Figure 1. Percentage of daily total fat and fiber contribution by meal.

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Journal of Nutrition Education Volume 29 Number 4 Table 3.

August 1997

187

Percentage of energy from fat for meals (energy from fat at meal1 total energy at meal) by breakfast eating and by gender. Breakfast

Lunch

Dinner

Snacks

Males (n = 817) Eaters (n = 657) Skippers (n = 160) Females (n = 1811) Eaters (n = 1426) Skippers (n = 385)

20.6 + 17.7 20.6 17.7 NA

35.8 35.2 37.9

*

+ 16.6

* 16.9 + 15.2

34.7 34.5 35.3

* 14.3 * 15.3 * 14.9

27.2 27.2 27.3

* 19.6

* 19.7 * 19.6

*

Mean SD. There were no significant differences between breakfast eaters and skippers or among the eating occasions.

In this study, all of the meat group foods consumed frequently by men were high in fat. Block et al.,15who examined the NHANES 11, reported that eggs and ham/hot dogs/lunch meats contributed 5% and 6% of total daily fat intake, respectivelyWomen in this study consumed breakfasts with the same percent energy from fat as men (21% and 22%, respectively), although from different foods.The lack of gender differences in percentages of daily energy from fat and in Table 4. Foods most frequently consumed for breakfast by young adults. % of Students Who Consumede

Food

Males

Females

(n = 657)

(n = 1426)

Dairv Low-fat (2%, 1%) milk Skim milk Whole milk Yogurt, frozen Meat and Alternatives

Eggs Ham, sausage, hot dog Peanut butter Grain Cereal, all types Bread Bagel Muffin, biscuits Fruits and Fruit Juices Orange juice Apple juice Grape juice Banana

Apple Beverages: nondairy, nonfruit juice Carbonated beverage Coffee Other Cream cheese Butterlmargarine

'Chi-square p < .05 between genders. Only students who consumed breakfast were included.

a

fiber density by meal (see Fig. 1) and in percentage of energy from fat for each meal (seeTable 3) was interesting, given the gender differences in foods selected and in total energy intakewomen chose notably more bagels, cream cheese, and skim milk than did men.Whether this observation in gender differences in food selection is a regional or national trend is not known from this present study. Findings from earlier studies suggest that consumption of certain breakfast foods is associated with lower daily fat intakes. Albertson andTobelmanl' found that children who ate readyto-eat (RTE) cereals had less fat in their diets compared to those who did not. Morgan et al. concluded from the 1977-78 National Food Consumption Survey that people who ate RTE cereals had lower daily fat and cholesterol intakes than those who ate other foods at breakfast (e.g., combinations of bread, eggs, and mdk or bread and coffee).1° Resnicow reported lower plasma cholesterol concentration in children who consumed breakfast compared to those who did The percentage of daily energy intake from fat and the fiber densities of young adults in this study are in the ranges reported by national surveys. In the NHANES I11 Survey (Phase I 1988-91, which was done at the same time as our study), fat provided about 34% of daily energy intake in the U.S. diet,6 and the population consumed only about half of the recommended 25 g/day for fiber.' The fiber density of students' diets in our study was consistently inadequate. Reasons for this low fiber intake and ways to improve the diet quality for fiber are yet to be investigated.We suspect that the low fiber intake of this group might be related to lack of knowledge about the connection between fiber and health as well as not knowing the fiber composition of foods. O f the breakfast foods offered in residence hall cafeterias, three types of bran muffins and 29% of 78 cereals had 22 g fiber per serving. N o breads, rolls, or pastas had 22 g fiber per serving. Our study was not a random sample of young adults, and as such is not generalizable.The study was carried out recently and the sample is the largest reported for this age group. Even though college students do not represent all young adults, 63% of 18 to 19 year olds in the U.S. are reported to begin postsecondary education.30Food frequency data, or several days' intake, are considered desirable to estimate usual food intakes of individuals.15One-day records have also long been accepted for descriptions of a large group's food intake.31The database - -

188

Huang et al./BREAKFAST A N D Y O U N G ADULT W O M E N

of 953 foods used for nutrient analysis is considered small by some, but has been developed for college students and recently updated from students' 24-hour recalls to reflect foods currently selected at this university. Finally, the failure to find significant differences between the reported caloric intakes and the estimated expenditures does not necessarily rule out underestimation or overestimation of both. Our observation is in contrast to the findings of validity studies in which underestimation of energy intake and overestimation of activity level have been reported.32

11. Albertson AM,Tobelman RC. Impact of ready-to-eat cereal consumption on the diets of children, 7-12 years old. Cereal Food World 1993; 38:428-434. 12. NicklasTA, Bao W,Webber GS. Nutrient contribution of the breakfast meal classified by source in 10-year-old children, home versus school. Res Rev 1993;17:125-32. 13. Ruxton CH, Kirk T R , Belton N R , Holmes MA. Breakfast habits in children. Nutr Food Sci Edinburgh 1993;4:17-20. 14. Hanes S,Vermeesch J, Gale %The national evaluation of school nutrition programs: program impact on dietary intake. Am J Clin Nutr 1984;40:390-413,

CONCLUSION

15. Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient sources in the American diet: quantitative data from the NHANES I1 survey.Am

Breakfast is the meal lowest in fat and moderate in fiber content compared to other meals consumed by young adults. For young adults in college, breakfast might be a good target to increase dietary fiber intake, although all meals need attention. Advice for selection of breakfast foods low in fat and high in fiber should be gender specific. Men might be encouraged to replace whole milk and 2% fat milk with lower fat milk choices and increase intake of high-fiber cereals.Women might be encouraged to consume high-fiber cereals and bagels along with reduced-fat cream cheese.

J Epidemiol 1985;122:27-40. 16. Gorbach SL, Morrill-LaBrode A, Woods MN, et al. Changes in food patterns during a low-fat dietary intervention in women. J Am Diet Assoc 1990;90:802-9. 17. Lau R R , Quadrel MJ, Hartman KA. Development and change of young adults' preventive health beliefs and behavior: influence of parents and peers. J Health Soc Behav 1990;31:240-59. 18. Patterson RE, Kristal AR, Lynch JC, White E. Diet-cancer related beliefs, knowledge, norms and their relationships to healthful diets. J Nutr Educ 1995;27:86-92. 19. Zimmerman DC. The relation of weight history to weight control

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