Breakfast Consumption May Improve Fasting Insulin, HOMA-IR, and HbA1c Levels in Predominately Low-Income, Hispanic Children 7–12 Years of Age

Abstract

Children from low-income households and minority families have high cardiometabolic risk. Although breakfast consumption is known to improve cardiometabolic health in children, limited randomized control trials (RCT) have explored this association in low-income and racial/ethnic U.S. minority families. This study conducted secondary analyses from TX Sprouts, a school-based gardening, cooking, and nutrition education RCT, to examine the intervention effect on breakfast consumption and how changes in breakfast consumption impact cardiometabolic risk in predominately low-income, multi-ethnic children. TX Sprouts consisted of 16 schools (8 intervention; 8 control) in greater Austin, TX. A total of 18 lessons were taught, including topics on breakfast consumption benefits and choosing healthy food options at school. Children completed clinical measures (e.g., anthropometrics, body composition via bioelectrical impedance), and the number of breakfast occasions (BO) per week (at home and school) was captured via validated survey at baseline and post-intervention. Post-study—Baseline changes in breakfast consumption were used to categorize students as: maintainers (BO −1 to 1 day/week), decreasers (BO ≤−2 day/week), and increasers (BO ≥2 day/week). Optional fasting blood draws were performed on a subsample. Generalized weighted linear mixed modeling tested differences between intervention and control, with schools as random clusters. Analysis of covariance and linear regression examined changes in breakfast consumption on cardiometabolic outcomes, controlling for age, sex, race/ethnicity, free and reduced-price school meal participation (FRL), school site, breakfast location, physical activity, baseline cardiometabolic measures, and BMI z-score. This study included 1417 children (mean age 9 years; 53% male; 58% Hispanic, 63% FRL; breakfast consumption patterns: 63% maintainers, 16% decreasers, and 21% increasers). There was no intervention effect on changes in breakfast consumption. Compared to decreasers, increasers had an increase in insulin (−0.3 µIU/mL vs. +4.1 µIU/mL; p = 0.01) and a larger increase in HOMA-IR (+0.4 vs. +1.5; p < 0.01). Every one-day increase in breakfast consumption decreased fasting insulin by 0.44 µIU/mL, HOMA-IR by 0.11, and hemoglobin A1c by 0.01% (p ≤ 0.03). Increased breakfast consumption was linked to improved glucose control, suggesting breakfast can mitigate risk in a high-risk population. To better understand underlying mechanisms linking breakfast consumption to improved metabolic health, RCTs focusing on breakfast quality and timing are warranted.

Effect of skipping breakfast on cardiovascular risk factors: a grade-assessed systematic review and meta-analysis of randomized controlled trials and prospective cohort studies

“…In the potential sequence caused by skipping breakfast, glucose homeostasis may occur before energy balance ( 29 , 79 ). Glucose status was improved if breakfast was added among those who habitually skip breakfast, including FBG and HOMA-IR ( 80 , 81 ).…”

Timing of energy intake and BMI in children: differential impacts by age and sex

“…In addition, a randomised cross-over study demonstrated that postprandial metabolic processes have shown higher energy expenditure (resting metabolic rate) in the morning compared with the evening (35) . Research has also suggested protective factors against overweight of earlier, rather than later, food intake throughout the day (8,17) , with more recent evidence highlighting improved glycaemic control with increased breakfast consumption in children (36) . Consuming a larger breakfast may suppress appetite and improve satiety and diet quality (10) .…”

Exploring twitter discussions on healthy food: inspiring, access to healthy food for young, and nutritional economics in focus

“…This is a critical community from the perspective of those interested in increasing the health of the whole population because communities that focus on promoting healthy foods and healthy lifestyles have a high potential to improve the nutritional composition of the foods consumed by the population exposed to these messages (Love et al, 2018). Overall, it has been shown (Jean et al, 2019) that social media influencers play a crucial role in stimulating positive attitudes among consumers, which can subsequently impact their purchase intentions.…”

“…The goal of interest groups is a healthy society. In the context of research showing that daily breakfast consumption is associated with maintaining a healthy body weight (Dubois et al, 2009), reduces stress and depression in adolescents (Ferrer-Cascales et al, 2018), improves carbohydrate metabolism and insulin levels (Maki et al, 2016;Jeans et al, 2022), and positively correlates with cognitive and emotional engagement (Moller et al, 2022), consumption of a high-quality breakfast plays a critical role in promoting both mental and physical health.…”