title: Associations between breakfast eating habits and health-promoting lifestyle, suboptimal health status in Southern China: a population based, cross sectional study.
abstract: BACKGROUND
  Suboptimal health status (SHS) is the intermediate health state between health and disease, refers to medically undiagnosed or functional somatic syndromes, and has been a major global public health challenge. However, both the etiology and mechanisms associated with SHS are still unclear. Breakfast eating behavior is a dietary pattern marker and previous studies have presented evidence of associations between failure to consume breakfast and increased diseases. Accordingly, in view of the significance of breakfast eating behaviors with respect to health status, the associations between breakfast eating habits and healthy lifestyle, SHS require further elucidation.
  
  
  METHODS
  A cross-sectional survey was conducted within a clustered sample of 24,159 individuals aged 12-80 years in 2012-13 within the population of Southern China. Breakfast eating habits were categorically defined by consumption frequency ('scarcely, sometimes or always'). Health-promoting lifestyle was assessed via the health-promoting lifestyle profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0).
  
  
  RESULTS
  Of the 24,159 participants, the prevalence rates for the 'health' , 'SHS' , and 'disease' were 18.8%, 46.0%, and 35.2%, respectively. Overall, 19.6% of participants reported 'scarce' breakfast eating habits, with frequent breakfast eaters scoring higher on both HPLP-II and SHMS V1.0. After demographic adjustment, regression analyses revealed a significant association between breakfast eating habits and healthy lifestyle (p <0.001). There were lower levels of breakfast consumption regularity amongst individuals with SHS than those with disease. Categorically 'scarce' breakfast eaters were approximately three times more likely to be assigned SHS (OR: 2.745, 95% CI: 2.468-3.053), while infrequent breakfast eaters ('sometimes') were just less than twice as likely to be assessed as being of SHS (OR: 1.731, 95% CI: 1.595-1.879).
  
  
  CONCLUSIONS
  Breakfast eating habits are significantly associated with a healthy lifestyle, and appear to be a useful predictor of a healthy lifestyle. Irregular breakfast eating habits are related to an increased risk of SHS; increased breakfast eating frequency may contribute to lowering the prevalence of SHS in Southern China.
authors.forename: Jieyu
authors.initials: J
authors.lastname: Chen
authors.forename: Jingru
authors.initials: J
authors.lastname: Cheng
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Liu
authors.forename: Yang
authors.initials: Y
authors.lastname: Tang
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Sun
authors.forename: Tian
authors.initials: T
authors.lastname: Wang
authors.forename: Ya
authors.initials: Y
authors.lastname: Xiao
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.forename: Lei
authors.initials: L
authors.lastname: Xiang
authors.forename: Pingping
authors.initials: P
authors.lastname: Jiang
authors.forename: Shengwei
authors.initials: S
authors.lastname: Wu
authors.forename: Liuguo
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China. luoren2014@126.com.
authors.forename: Ren
authors.initials: R
authors.lastname: Luo
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000328:Adult; D002681:China; D003430:Cross-Sectional Studies; D004435:Eating; D005260:Female; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male