Kostarellou Panayiota, Anastasiou Costas A, Karaglani Eva, Iotova Violeta, Usheva Natalya, Tankova Tsvetalina, Rurik Imre, Liatis Stavros, Legarre Natalia Giménez, Moreno Luis A, Lindstrom Jaana, Wikström Katja, Cardon Greet, Makrilakis Konstantinos, Manios Yannis
Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Kallithea, Athens, Attica, Greece.
Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
Eur J Clin Nutr. 2025 May;79(5):427-434. doi: 10.1038/s41430-025-01570-9. Epub 2025 Jan 25.
The long-term effects of breakfast on childhood z-BMI remain inconclusive.
To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries.
Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Feel4Diabetes study were used. Children's lifestyle behaviors, including breakfast frequency, were assessed through parent-reported questionnaires. Weight and height were objectively measured and converted to z-BMI. Participants were categorized into trajectories combining breakfast consumption habit (i.e., regular consumption, irregular consumption or omission) at baseline and follow up. Logistic regression analyzed the prospective association between breakfast trajectories and z-BMI increase, with adjustment for demographic and lifestyle variables.
A statistically significant effect of breakfast trajectories was observed in z-BMI, both at baseline and follow up. Stable skippers was the only trajectory that showed a significant increase in BMI z-score from baseline to follow up (0.891 ± 1.058 vs. 1.034 ± 1.072 respectively, p < 0.05). BMI z-score at follow up of regular eaters (0.615 ± 0.967) was significantly lower, compared to both irregular eaters (1.229 ± 0.890) and stable skippers (both p < 0.05). Stable regular consumption and transition from omission to regular consumption were independently associated with significantly lower risk of z-BMI gain, compared to stable omission [OR, 95% CI: 0.55 (0.31, 0.97), p = 0.039 and 0.43 (0.21, 0.88), p = 0.021 respectively].
Stable regular breakfast consumption or transition from omission to regular consumption seem to contribute to superior weight regulation in children and to independently protect against z-BMI gain, compared to stable omission. Further studies are warranted to extend the evidence on the breakfast habit-BMI association among children.
早餐对儿童标准化体重指数（z-BMI）的长期影响尚无定论。
前瞻性评估六个欧洲国家学龄儿童稳定和改变的早餐消费习惯对两年内z-BMI变化的影响。
使用了来自“感受糖尿病”（Feel4Diabetes）研究的6528名儿童（8.2±1.0岁，48.9%为男性）的数据。通过家长报告的问卷评估儿童的生活方式行为，包括早餐频率。客观测量体重和身高并转换为z-BMI。参与者根据基线和随访时的早餐消费习惯（即规律消费、不规律消费或不吃早餐）组合分为不同轨迹。逻辑回归分析了早餐轨迹与z-BMI增加之间的前瞻性关联，并对人口统计学和生活方式变量进行了调整。
在基线和随访时，z-BMI均观察到早餐轨迹有统计学显著影响。从基线到随访，稳定不吃早餐组是唯一z-BMI得分显著增加的轨迹（分别为0.891±1.058和1.034±1.072，p<0.05）。规律吃早餐者随访时的z-BMI得分（0.615±0.967）显著低于不规律吃早餐者（1.229±0.890）和稳定不吃早餐组（均p<0.05）。与稳定不吃早餐相比，稳定规律消费以及从不吃早餐转变为规律消费与z-BMI增加风险显著降低独立相关[比值比（OR），95%置信区间（CI）：分别为0.55（0.31，0.97），p=0.039和0.43（0.21，0.88），p=0.021]。
与稳定不吃早餐相比，稳定规律的早餐消费或从不吃早餐转变为规律消费似乎有助于儿童更好地控制体重，并独立预防z-BMI增加。有必要进一步开展研究以扩展关于儿童早餐习惯与BMI关联的证据。
