Nutritional breakfast quality and cardiometabolic risk factors: Health Survey of São Paulo, a population-based study

Objective: To evaluate the association between nutritional quality of breakfast and cardiometabolic risk factors. Design: Cross-sectional study, 2015 Health Survey of Sao Paulo (2015 ISA-Capital) with Focus on Nutrition Study (2015 ISA-Nutrition). Settings: Population-based study, with a representative sample of adults and elderlies living in Sao Paulo, Brazil. Participants: The sample included 606 adults (aged 20-59 years) and 537 elderlies (aged >= 60 years) from the 2015 Health Survey of Sao Paulo. Dietary intake was assessed by at least one 24-h recall. Breakfast quality was evaluated using the proposed Brazilian Breakfast Quality Index (BQI), ranging scores from 0 to 10. BQI associations with sociodemographic, lifestyle, dietetic and cardiometabolic variables were estimated using survey-weighted multiple logistic regression models. Results: Being >= 60 years of age, self-identifying as White or Asian, having a per capita family income with >= 1 minimum wage, being sufficiently active at leisure time and non-smoker were associated with better scores of BQI. A higher BQI score was inversely associated with elevated blood pressure (OR 0 center dot 81, 95 % CI 0 center dot 70, 0 center dot 94), fasting glucose (OR 0 center dot 85, 95 % CI 0 center dot 73, 0 center dot 98), HOMA-IR (OR 0 center dot 86, 95 % CI 0 center dot 74, 0 center dot 98), total cholesterol (OR 0 center dot 87, 95 % CI 0 center dot 76, 0 center dot 99), LDL-C (OR 0 center dot 85, 95 % CI 0 center dot 74, 0 center dot 97), metabolic syndrome (OR 0 center dot 82, 95 % CI 0 center dot 72, 0 center dot 93) and being overweight (OR 0 center dot 87, 95 % CI 0 center dot 76, 0 center dot 99). Conclusions: Breakfast quality of Brazilian adults needs improvement with disparities across some sociodemographic factors. BQI was associated with lower odds of cardiometabolic risk factors, suggesting a beneficial effect in this population and emphasising the role of breakfast in reducing the risk of CVD.