Objective: An association between weight gain and breakfast skipping has been reported, but breakfast location was rarely considered. We investigated the prospective associations between breakfast location, breakfast skipping and body mass index (BMI) change in a large cohort of Chinese children.
Design: Our baseline cohort consisted of 113,457 primary 4 (US grade 4) participants of the Hong Kong Department of Health Student Health Service in 1998-2000. Of these, 68,606 (60.5%) had complete records and were successfully followed-up 2 years later. Data on breakfast consumption and location were collected at both time points along with other lifestyle characteristics. BMI was derived from objectively measured height and weight. Associations between breakfast habits and BMI change were assessed by multivariable linear regression, adjusting for demographic, socioeconomic and lifestyle characteristics.
Results: At baseline, 85.3, 9.4 and 5.2% of children had breakfast at home, away from home and skipped breakfast, respectively. Prospectively, having breakfast away from home (vs at home) predicted a greater BMI increase over two years (β = 0.15; 95% CI: 0.11-0.18). Breakfast skipping had a comparable, slightly smaller effect (0.13; 0.09-0.18).
Conclusion: Both breakfast skipping and eating breakfast away from home predict greater increases in BMI during childhood, the effect being slightly stronger in the latter. Having breakfast, particularly at home, could have important implications for weight management and reducing obesity in children. Further research is required to gain insight into potential underlying mechanisms.