BREAKFAST PATTERNS IN BRAZILIAN ADOLESCENTS AND BODY MASS INDEX: NATIONAL DIETARY SURVEY 2008-2009

Introduction: Quality of breakfast has been recognized as a relevant component to achieve adequate health growth and development in adolescence. The relationship between breakfast patterns and body mass index (BMI) in this age group needs further investigation. Objectives: We aimed to describe breakfast patterns and its relationship with BMI in Brazilian adolescents. Methods: A representative sample (n = 7,425) of adolescents aged 10-19 years was examined from the Brazilian National Dietary Survey (2008–2009). Food consumption was obtained by two non-consecutive food records. Dietary patterns of adolescents who had breakfast were analyzed (n = 4,991). The occurrence of breakfast was defined as an eating occasion of at least 50 kcal (209.2kJ) from any source of food between 5 and 10 a.m. Breakfast dietary patterns were derived by principal component factor analysis of 18 food groups. Factor loadings over 0.25 were considered representative of each pattern. Varimax rotation was conducted after definition of factors. We performed linear regressions for the association between factor scores and BMI considering the survey design, and controlling for confounders (sex, age, region of the country and per capita income). Results: Three breakfast patterns were identified for Brazilian adolescents, which explain 44.8% of data variability. The named regional pattern had positive adherence of cookies, meats, dairy products, preparations with corn, eggs, fruit juices/fruit drinks/soy-based drinks, tubers/roots/potatoes and cereals, and negative adherence of cold cut meat and savory snacks/crackers. The protein diet pattern had positive loadings for cold cut meat, milk and cheese, and negative for cookies, fruit juices/fruit drinks/soybased drinks, tubers/roots/potatoes and cereals. Traditional Brazilian pattern was characterized by cakes, coffee/tea, bread, fruit juices/fruit drinks/soy-based drinks, chocolate/desserts, savory snacks/crackers. The first and second patterns were both inversely associated with BMI. Conclusions: Brazilian adolescents presented three dietary patterns for breakfast. The group fruit juices/fruit drinks/soy-based adhered to two patterns while the group fruits did not adhere to any. The quality of breakfast may play a role in BMI in adolescents. Few studies focused on dietary patterns at the meal level and this is the first to address breakfast patterns in adolescents with population-based data.