Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older Spanish adults

Abstract

Aims: To explore the associations between breakfast energy intake and quality and time trajectories of cardiometabolic traits in high cardiovascular risk. Methods: 383 participants aged 55-75 from the PREDIMED-Plus cohort were included. Longitudinal averages of breakfast energy intake and quality were calculated. Three categories were defined for energy intake: 20-30% (reference), <20% (low), and >30% (high). Quality was estimated using the Meal Balance Index; categories were above (reference) or below the median score (low). Smoothed cubic spline mixed effects regressions described trajectories of cardiometabolic indicators (anthropometry, blood pressure, lipids, glucose, glycated hemoglobin, and estimated glomerular filtration rate) at breakfast groups. Inter-group differences in predicted values were estimated by linear regressions. Results: At 36 months, compared to the reference, low- or high-energy breakfasts were associated with differences in: body mass index (low: 0.62 kg/m2 [95% confidence interval: 0.28; 0.96]; high: 1.17 kg/m2 [0.79; 1.56]), waist circumference (low: 2.24 cm [1.16; 3.32]; high: 4.55 cm [3.32; 5.78]), triglycerides (low: 18.3 mg/dL [15.3; 21.4]; high: 34.5 cm [31.0; 38.1]), and HDL cholesterol (low: -2.13 mg/dL [-3.40; -0.86]; high: -4.56 mg/dL [-6.02; -3.10]). At 36 months, low-quality breakfast was associated with higher waist circumference (1.49 cm [0.67; 2.31]), and triglycerides (3.46 mg/dL [1.13; 5.80]) and less HDL cholesterol (-1.65 mg/dL [-2.61; -0.69]) and glomerular filtration rate (-1.21 mL/min/1.73m2 [-2.01; -0.41]). Conclusions: Low- or high-energy and low-quality breakfasts were associated with higher adiposity and circulating triglycerides, and lower HDL cholesterol in high-risk older adults. Low-quality breakfasts were also linked to poorer kidney function.