• To assess the nutrients provided to Australian adults by the breakfast meal
• To compare the food and nutrient intakes and health of regular breakfast eaters and breakfast skippers.

A nationally representative sub-sample (adult Australians, aged 19 or more years) of the National Health Survey.

National Health Survey participants younger than 19 years old.

Recruitment

 A nationally representative sample of 10,851 Australians, aged 19 years and older, from the 1995 Australian National Nutrition Survey (NNS), during the period between February 1995 and March 1996. 

 Design

 Cross-sectional study (population-based data).

Dietary Intake/Dietary Assessment Methodology

• A 24-hour recall: Indicated the intake of food items on the day prior to the interview (i.e., the day of recall) 
• A food frequency questionnaire (FFQ): Used to assess the intake of selected foods, including nutrient supplements, over the previous 12 months
• A series of questions: Asked and included self-reported health status on a five-point scale and "How many days per week do you usually have something to eat at breakfast?"

Blinding Used

Physical measurements were taken of height, weight, waist and hip circumference and blood pressure.

Statistical Analysis

The Student T-test was used to calculate statistical significance of differences between breakfast eaters and breakfast skippers and between eaters and non-eaters of breakfast cereal.

Timing of Measurements

Data collected from the 1995 Australian NNS during the period between February 1995 and March 1996.

Dependent Variables

• Nutrient intake: Calculated using the 24-hour recall data in the Confidential Unit Record File, which included food intakes for each individual surveyed. A food composition database developed by the Australia New Zealand Food Authority (1999) was used to calculate nutrient intakes
• Food and nutrient intakes: Compared with current recommended dietary intakes (RDI) for use in Australia (National Health and Medical Research Council 1991) or other dietary target recommendations
  • The recommended target of 30g dietary fibre per day for adults aged 19 years or older
  • Servings of cereal foods calculated by dividing the food intake (grams) by the standard cereal serves defined for the Australian Core Food Groups (30g for bread, 20g for RTEC and 90g for cooked rice, pasta or porridge)
  • Intakes compared with the target of seven serves per day for adults aged 19 years or older
  • The dietary target of 55% of energy from carbohydrate taken from the recommendations of the Food and Agriculture Organization/World Health Organization (WHO) expert consultation on carbohydrates
• Health status: Self-reported on a five-point scale. 

Independent Variables

• Eaters and skippers: Participants were asked how many days per week they usually had something to eat at breakfast
• Those who indicated they ate breakfast five or more days a week were classified as regular breakfast eaters; those who responded "rarely or never" were classified as breakfast skippers.

Control Variables

• Age:
  • 19 to 24 years
  • 25 to 44 years
  • 45 to 54 years
  • 45 to 64 years
  • 55 or more years
  • 65 or more years
• Gender: Male and female. 

• Initial N: 13,858 National Health Survey participants aged two years and over from urban and rural areas in all States and Territories from Australia
• Attrition (final N): After applying for the exclusion criteria, 10,851 individuals aged 19 years or older were included in the analysis
• Age: 19 years or older
• Anthropometrics: People from urban and rural areas
• Location: All States and Territories from Australia.

Other Findings

• Figures showed that a significantly higher proportion of eaters than skippers met the RDI or dietary target on the day of the survey for every nutrient
• The differences between eaters and skippers were particularly significant for thiamin, riboflavin, folate, calcium and magnesium, and also (for women only) iron, greater for older adults among whom the risk of an inadequate diet was significantly greater in breakfast skippers
• The proportion of skippers in the oldest age groups consuming less than 70% of the RDI was more than twice that of breakfast eaters for almost every nutrient, including protein
• Figures also showed for every nutrient, a higher proportion of breakfast cereal eaters had daily intakes above 70% of RDI than did those who did not eat breakfast cereal. Women (but not men) over the age of 25 years who included ready-to-eat cereal (RTEC) in their diets were also more likely to meet the dietary target of 30% energy from fat, than those who did not eat breakfast cereal (62% vs. 54%, P<0.05).

• The study showed that the typical breakfast among Australian adults was low in fat, high in carbohydrate and a good source of thiamin, riboflavin, niacin, calcium and magnesium.
• The NNS showed that regular breakfast eaters had more adequate diets overall, particularly those aged 65+ years.
• People who did not eat breakfast cereal were much more likely to have inadequate nutrient intakes, especially of thiamin, riboflavin, calcium, magnesium and iron.
• Regular breakfast eaters were more likely to rate their health as excellent or good than those who skip breakfast, but there was no difference between the fat intake or the body mass index of regular breakfast eaters compared with breakfast skippers.
• Generally, regular breakfast consumption was associated with better diets for adults.

• It was possible that the NNS results from 1995/1996 overestimated the current total vitamin A intakes and underestimate the folate and zinc intakes since there had been some significant changes to the fortification of Australian breakfast cereals since the NNS was carried out
• The results from the cross-sectional study suggested an association between breakfast consumption and better diet quality and health, but to determine whether it was the effect of breakfast per se, or other factors related to lifestyle, would need a controlled clinical trial.