A paper published in Scientific Reports describes how researchers affiliated with the University of São Paulo s Medical School (FM-USP) in Brazil and colleagues at institutions in Europe evaluated behaviors leading to weight gain in adolescents. Childhood obesity can favor the premature emergence of health issues such as type 2 diabetes and cardiovascular disease.
The main finding is that skipping breakfast, a common habit among teenagers, correlates directly with increased waist circumference and body mass index in this age group.The habit can lead to an unbalanced diet and other unhealthy behaviors, potentially making the adolescents vulnerable to weight gain.
"We found that skipping breakfast is associated with adiposity markers in adolescents regardless of where they live and how much sleep they get, or whether they re male or female," said epidemiologist Elsie Costa de Oliveira Forkert, a member of the Youth/Child Cardiovascular Risk and Environmental (YCARE) Research Group in FM-USP s Preventive Medicine Department.
"By skipping breakfast, millions of children and adolescents around the world are probably replacing a more healthy homemade meal including dairy products, whole-grain cereal and fruit with fast food at an venue on the way to school, or at the school itself," Forkert said.
"This typically means consuming industrialized hypercaloric foods of low nutritional value, such as deep-fried snacks, pastries, sodas and other sugary drinks, which are all directly associated with the development of obesity."
The study was part of Forkert s postdoctoral research, supported by São Paulo Research Foundation - FAPESP. Scientists at institutions in Austria, Belgium, Germany, Greece, Italy and Spain collaborated.
The European data came from the "Healthy Lifestyle in Europe by Nutrition in Adolescence" cross-sectional study (HELENA-CSS, 2006-07), which involved 3,528 adolescents in ten major cities. The subjects were between 12.5 years and 17.5 years of age and were stratified by age, gender, region, and socioeconomic status. Males and females accounted for roughly half of the study population each (47.7% and 52.3%, respectively). The principal investigator was Luis Alberto Moreno, a professor at the University of Zaragoza s Health Science School in Spain.
The principal investigator for this survey was Augusto Cesar Ferreira de Moraes, a professor in the Epidemiology Department of the University of São Paulo s Public Health School (FSP-USP).
The new study analyzed weight, height and body mass index data as indicators of overall obesity and waist circumference and waist-height ratios as indicators of abdominal obesity.
According to Forkert, sedentary behaviors were analyzed in terms of habitual screen time (television, computer, video games), and subjects were asked to specify how many hours they usually slept on weekdays and weekends.
A separate questionnaire was applied to explore attitudes and concerns regarding food choices, preferences, healthy eating habits and lifestyle, and included a specific question about breakfast that asked subjects to agree or disagree (more or less strongly on a scale from 1 to 7) with the statement "I often skip breakfast."
The scientists used the data from these surveys to investigate whether adolescents who skipped breakfast had higher adiposity markers on average than those who did not.
Sedentary habits and more calories
Data from both the European and Brazilian surveys showed that male adolescents were heavier and taller on average and had larger waist circumferences than females.
"For boys who skipped breakfast, the average waist circumference was 2.61 cm larger in Europe and 2.13 cm larger in Brazil than those of boys who usually ate breakfast," Forkert said.
"On the other hand, when we looked at how sleep time influenced the association between the other behaviors and the obesity markers, we found that the average body mass index for European and Brazilian boys who skipped breakfast was 1.29 kg/m² and 1.69 kg/m² higher, respectively, than those who ate breakfast, even when they got sufficient sleep [eight hours or more per day]."
In Brazil, girls were more sedentary than boys. In Europe, sedentary habits prevailed less among girls than among boys, but girls were also less physically active, although they were more active than Brazilian boys. The sedentary behaviors of these girls (more than two hours per day) resulted in an increased waist circumference (1.20 m on average), even when sleep time was adequate.
"However, among Brazilian boys who slept less than eight hours per day, less sleep was protective for total obesity, which fell by 0.93 kg/m² on average," Forkert said.
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Fundação de Amparo à Pesquisa do Estado de São Paulo. "Adolescents who skip breakfast may develop obesity." ScienceDaily. ScienceDaily, 22 July 2019. .
Fundação de Amparo à Pesquisa do Estado de São Paulo. "Adolescents who skip breakfast may develop obesity." ScienceDaily. www.sciencedaily.com/releases/2019/07/190722154603.htm (accessed July 22, 2019).