title: Regular breakfast consumption and type 2 diabetes risk markers in 9- to 10-year-old children in the child heart and health study in England (CHASE): a cross-sectional analysis.
abstract: BACKGROUND
  Regular breakfast consumption may protect against type 2 diabetes risk in adults but little is known about its influence on type 2 diabetes risk markers in children. We investigated the associations between breakfast consumption (frequency and content) and risk markers for type 2 diabetes (particularly insulin resistance and glycaemia) and cardiovascular disease in children.
  
  
  RESULTS
  We conducted a cross-sectional study of 4,116 UK primary school children aged 9-10 years. Participants provided information on breakfast frequency, had measurements of body composition, and gave fasting blood samples for measurements of blood lipids, insulin, glucose, and glycated haemoglobin (HbA1c). A subgroup of 2,004 children also completed a 24-hour dietary recall. Among 4,116 children studied, 3,056 (74%) ate breakfast daily, 450 (11%) most days, 372 (9%) some days, and 238 (6%) not usually. Graded associations between breakfast frequency and risk markers were observed; children who reported not usually having breakfast had higher fasting insulin (percent difference 26.4%, 95% CI 16.6%-37.0%), insulin resistance (percent difference 26.7%, 95% CI 17.0%-37.2%), HbA1c (percent difference 1.2%, 95% CI 0.4%-2.0%), glucose (percent difference 1.0%, 95% CI 0.0%-2.0%), and urate (percent difference 6%, 95% CI 3%-10%) than those who reported having breakfast daily; these differences were little affected by adjustment for adiposity, socioeconomic status, and physical activity levels. When the higher levels of triglyceride, systolic blood pressure, and C-reactive protein for those who usually did not eat breakfast relative to those who ate breakfast daily were adjusted for adiposity, the differences were no longer significant. Children eating a high fibre cereal breakfast had lower insulin resistance than those eating other breakfast types (p for heterogeneity <0.01). Differences in nutrient intakes between breakfast frequency groups did not account for the differences in type 2 diabetes markers.
  
  
  CONCLUSIONS
  Children who ate breakfast daily, particularly a high fibre cereal breakfast, had a more favourable type 2 diabetes risk profile. Trials are needed to quantify the protective effect of breakfast on emerging type 2 diabetes risk. Please see later in the article for the Editors' Summary.
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Donin
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Nightingale
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Chris G
authors.initials: CG
authors.lastname: Owen
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Perkin
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Jebb
authors.affiliation: Medical Research Council Human Nutrition Research, Cambridge, United Kingdom.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Stephen
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow School of Medicine, Glasgow, United Kingdom.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
authors.affiliation: Population Health Research Institute, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D062408:Breakfast / Q000208:ethnology* / Q000502:physiology; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology* / Q000517:prevention & control*; D004739:England / Q000208:ethnology; D005247:Feeding Behavior / Q000208:ethnology* / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose