The old phrase "breakfast is the most important meal of the day" has taken on new meaning for teenagers. A new study suggests that as teens enter adulthood, they are more likely to skip breakfast and increase their fast food consumption, and that both behaviors lead to an increased risk of weight gain. This is the finding of an article appearing in the December 2006 issue of the Journal of Adolescent Health by researchers at The Weight Control and Diabetes Research Center at The Miriam Hospital and Brown Medical School.
"Since the transition from adolescence to adulthood appears to be a particularly high-risk period for weight gain, we wanted to investigate what role skipping breakfast and fast food consumption had on weight during this important time," says lead author Heather Niemeier, PhD, a psychologist at The Miriam Hospital.
Researchers analyzed data drawn from Add Health, a school-based study of over 20,000 adolescents in grades 7 through 12 in the United States. The current study used information from two "Waves" of data that consisted of a total of 9,919 adolescents. Wave 2 data was collected from the adolescents (ages 11 to 21) during the period of April to August 1996. Wave 3 data was collected from the same group of adolescents from August 2001 to April 2002, when they were between the ages of 18 and 27. Fast food and breakfast consumption was measured throughout both waves, in addition to Body Mass Index (BMI).
"We found that both fast food consumption and breakfast skipping significantly increased between Waves 2 and 3. More importantly, both behaviors were associated with increased weight gain during this time," says Niemeier.
During the five-year interval between Waves 2 and 3, signifying the transition from adolescence to adulthood, the number of participants considered overweight increased from 29 percent to 47 percent. Fast food consumption increased from 2 days a week as adolescents to about 2.5 days per week as young adults, and although participants reported that they consumed breakfast 4 to 5 days per week during adolescence - this decreased to 3 days per week by young adulthood.
The increase in fast food and breakfast skipping could be due to the increased independence and responsibility for food preparation that adolescents face during this developmental transition the authors note.
"Fast food is a quick, easy, and tasty option for aging adolescents who may be used to relying on Mom or Dad to prepare their meals," says Niemeier. "As adolescents enter the workforce or college, breakfast may be looked at as an unnecessary hassle and easily skipped. However, skipping breakfast can lead to greater levels of hunger later in the day, causing overeating, or the choosing of heavy foods that fill you up faster, but may not be very nutritious."
The authors write that since adolescent obesity is a significant predictor of overweight status in adulthood and poses a risk for adult morbidity and mortality, it is important to identify dietary behaviors early on that are associated with unhealthy weight gain in order to create effective interventions.
"This study highlights the importance of encouraging adolescents who are entering adulthood to eat breakfast regularly and to make healthy food choices, limiting their fast food consumption," says Niemeier.
The prevalence of obesity in adolescents and adults in the United States has increased dramatically over the past decade with the Surgeon General referring to it as a public health epidemic. Unhealthy weight increases during adolescence have been associated with fasting insulin, increased levels of HDL-cholesterol and risk factors for heart disease, and systolic blood pressure in young adulthood.
Future research should look at obtaining more detailed dietary information to better understand the mechanisms by which they influence weight gain.
"Including measures about specific types of fast food or breakfast alternatives consumed, and how they relate to the adolescent's overall energy intake and the percent of energy from fat -- may be able to help create targeted interventions aimed at prevention of weight gain in this age group, "says Niemeier.
Additional authors include Hollie Raynor, PhD, RD; Elizabeth Lloyd-Richardson, PhD; Michelle Rogers, PhD; and Rena Wing, PhD; of the Weight Control and Diabetes Research Center at The Miriam Hospital and Brown Medical School.
The Add Health research project was funded by a grant from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding from 17 other agencies.
The Miriam Hospital, established in 1926 in Providence, RI, is a not-for-profit hospital affiliated with Brown Medical School. Nationally recognized as a top hospital in cardiovascular care, The Miriam Hospital (http://www.miriamhospital.org) offers particular expertise in cardiac catheterization, angioplasty and women's cardiac care. One of 20 designated Center for AIDS Research (CFAR) sites, The Miriam is a leader in the treatment, research and prevention of HIV/AIDS, attracting $17 million of the world's HIV/AIDS research dollars. The Miriam Hospital has been awarded Magnet Recognition for Excellence in Nursing Services three times and is committed to excellence in patient care, research and medical education. The Miriam is a founding member of the Lifespan health system.
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