Background: Breakfast quality has been linked with overall dietary quality and may influence childhood obesity risk. However, breakfast quality in early childhood remains understudied. This study described the changes in breakfast quality index (BQI) (i.e. trajectory) among Australian children from ages 1.5 to 5.0 years and assessed the association between BQI trajectories and obesity outcomes at ages 5.0 years.
Methods: Data of children who participated in the Melbourne InFANT Program were used (n=328). Dietary intakes were assessed at ages 1.5, 3.5, and 5.0 years using three 24-hour recalls. Multiple Sources Method1) was used to obtain usual intakes. BQI was calculated using a revised 9-item BQI tool2) based on dietary recommendations for Australian young children in. Group-based trajectory modelling identified BQI trajectory groups. Multivariable linear or logistic regression examined the associations between identified BQI trajectory groups and obesity outcomes age 5 years.
Results: Mean BQI (mean±SD) at age 1.5, 3.5, and 5.0 years was 4.8±0.9, 4.8±0.8, 2.7±1.6 points, respectively (total 9 points). Two BQI trajectory groups were identified, and both showed a decline in BQI from 1.5 to 5.0 years. The BQI of most children (74%) decreased from 5.0 to 4.0 points from 1.5 to 5.0 years (referred as “High BQI” group). The remaining children (26%) had a mean BQI of 4.8 points at 1.5 years to 1.2 points at 5.0 years (referred as “Low BQI” group). The “Low BQI” group showed higher BMI z-score and higher risk of overweight at 5 years than the “High BQI” group, but the difference was not statistically significant.
Conclusions: Two BQI trajectory groups were found in early childhood. Both trajectory groups showed a decline in breakfast quality from 1.5 to 5.0 years. Our study highlights the need for early health promotion interventions and strategies to improve breakfast quality in early childhood.