@article{01K59D90DXJQ5EWC0VQ6QA298A,
  abstract     = {{BACKGROUND: The long-term effects of breakfast on childhood z-BMI remain inconclusive.
OBJECTIVE: To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries.

METHODS: Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Feel4Diabetes study were used. Children’s lifestyle behaviors, including breakfast frequency, were assessed through parent‐reported questionnaires. Weight and height were objectively measured and converted to z-BMI. Participants were categorized into trajectories combining breakfast consumption habit (i.e., regular consumption, irregular consumption or omission) at baseline and follow up. Logistic regression analyzed the prospective association between breakfast trajectories and z-BMI increase, with adjustment for demographic and lifestyle variables.

RESULTS: A statistically significant effect of breakfast trajectories was observed in z-BMI, both at baseline and follow up. Stable skippers was the only trajectory that showed a significant increase in BMI z-score from baseline to follow up (0.891 ± 1.058 vs. 1.034 ± 1.072 respectively, p < 0.05). BMI z-score at follow up of regular eaters (0.615 ± 0.967) was significantly lower, compared to both irregular eaters (1.229 ± 0.890) and stable skippers (both p < 0.05). Stable regular consumption and transition from omission to regular consumption were independently associated with significantly lower risk of z-BMI gain, compared to stable omission [OR, 95% CI: 0.55 (0.31, 0.97), p = 0.039 and 0.43 (0.21, 0.88), p = 0.021 respectively].
CONCLUSION: Stable regular breakfast consumption or transition from omission to regular consumption seem to contribute to superior weight regulation in children and to independently protect against z-BMI gain, compared to stable omission. Further studies are warranted to extend the evidence on the breakfast habit-BMI association among children.}},
  author       = {{Kostarellou, Panayiota and Anastasiou, Costas A. and Karaglani, Eva and Iotova, Violeta and Usheva, Natalya and Tankova, Tsvetalina and Rurik, Imre and Liatis, Stavros and Legarre, Natalia Giménez and Moreno, Luis A. and Lindstrom, Jaana and Wikström, Katja and Cardon, Greet and Makrilakis, Konstantinos and Manios, Yannis and Schwarz, Peter and Annemans, Lieven and Ko, Winne and Karatzi, Kalliopi and Androutsos, Odysseas and Moschonis, George and Kanellakis, Spyridon and Mavrogianni, Christina and Tsoutsoulopoulou, Konstantina and Katsarou, Christina and Qira, Irini and Skoufas, Efstathios and Maragkopoulou, Konstantina and Tsiafitsa, Antigone and Sotiropoulou, Irini and Tsolakos, Michalis and Argyri, Effie and Nikolaou, Mary and Vampouli, Eleni-Anna and Filippou, Christina and Apergi, Kyriaki and Filippou, Amalia and Katerina, Gatsiou and Dimitriadis, Efstratios and Laatikainen, Tiina and Kivelä, Jemina and Valve, Päivi and Levälahti, Esko and Virtanen, Eeva and Pennanen, Tiina and Olli, Seija and Nelimarkka, Karoliina and Van Stappen, Vicky and Huys, Nele and Willems, Ruben and Shadid, Samyah and Timpel, Patrick and Dafoulas, George and Lambrinou, Christina-Paulina and Giannopoulou, Angeliki and Karuranga, Ernest and Civeira, Fernando and Bueno, Gloria and De Miguel-Etayo, Pilar and Gonzalez-Gil, Esther Mª and Miguel-Berges, María L. and Giménez-Legarre, Natalia and Flores-Barrantes, Paloma and Ayala-Marín, Alelí M. and Seral-Cortés, Miguel and Baila-Rueda, Lucia and Cenarro, Ana and Jarauta, Estíbaliz and Mateo-Gallego, Rocío and Tsochev, Kaloyan and Chakarova, Nevena and Galcheva, Sonya and Dimova, Rumyana and Bocheva, Yana and Radkova, Zhaneta and Marinova, Vanya and Bazdarska, Yuliya and Stefanova, Tanya and Ungvari, Timea and Jancsó, Zoltán and Nánási, Anna and Kolozsvári, László and Semánova, Csilla and Bíró, Éva and Antal, Emese and Radó, Sándorné and Martinez, Remberto and Tong, Marcos and Feel4Diabetes-Study Grp, [missing]}},
  issn         = {{0954-3007}},
  journal      = {{EUROPEAN JOURNAL OF CLINICAL NUTRITION}},
  keywords     = {{BODY-MASS INDEX,SKIPPING BREAKFAST,PHYSICAL-ACTIVITY,MEAL PATTERNS,WEIGHT STATUS,OVERWEIGHT,ADOLESCENTS,CHILDHOOD,HEALTH,TRENDS}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{427--434}},
  title        = {{Prospective association between breakfast consumption frequency and BMI z-score among European school-aged children : the Feel4Diabetes study}},
  url          = {{http://doi.org/10.1038/s41430-025-01570-9}},
  volume       = {{79}},
  year         = {{2025}},
}

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