The addition of a protein-rich breakfast tot improve appetite control and combat obesity Heather J. Leidy, PhD IFT 2012 (with permission of H.J. Leidy)

1. Heather J. Leidy, PhD
Dept. Nutrition & Exercise Physiology; University of Missouri; Columbia, MO
© 2012 Institute of Food Technologists

4. • Breakfast was a staple in the
American Diet 50y ago
• Gradual decline has
mirrored the rise in obesity
• Current trends: 30-60% of
young people skip breakfast
on a daily basis
Siegra-Riz , 1998; AJCN; 67(supp): 748S-756S; Haines, 1996; JADA; 96(5): 464-470; Deshmukh-Taskar, 2010; JADA; 110(6): 869-878; McLynn, 2011; The NPD Group; Morning Mealscape

5. Cross-sectional Studies
• Overweight/Obese are 2x more likely to skip breakfast
• Breakfast Skippers have an increased
-Prevalence of being obese
-Higher BMI percentile
-Higher BMI z-score
5-yr Prospective Study in Young People
• 2,216 Adolescents
• Increased BMI (-) associated with
decreased breakfast frequency
(in a dose-dependent relationship)
Siegra-Riz , 1998; AJCN; 67(supp): 748S-756S; Haines, 1996; JADA; 96(5): 464-470; Deshmukh-Taskar, 2010; JADA; 110(6): 869-878; McLynn, 2011; Timlin, 2008; Pediatrics; 121: e638-e645

6. • Cross-sectional studies in >5,000 young people
• Compared to breakfast consumers, skippers consume:
45% LESS Vegetables
30% LESS Fruit
60% LESS Milk (-100 kcal)
65% LESS Whole-grain
40% MORE Sweets (+60 kcal)
55% MORE Chips (+100 kcal)
55% MORE Soft Drinks (+200 kcal)
40% MORE White Bread
• Majority of breakfast was RTE cereals
Sjoberg, 2003; European J Clin Nutrition; 57: 1569-1578; Savige, 2007: Int J Behavioral Nutrition and Physical Activity; 4(36): 1-9; Haire-joshu, 2011; JADA: 111: 124-130

7. NHANES Data Breakfast RTE Cereal Other
(1999-2006) Skippers Breakfast Breakfast
(n=2547) (n=2,856) (n=4,256)
Prevalence of Obesity (%) 23 ± 1 15 ± 1 18 ± 1*
13 Micronutrients (MAR) 75 ± 2 88 ± 2 80 ± 2*
5 Shortfall Nutrients (MAR) 51 ± 2 59 ± 2 54 ± 2*
Dietary Fat (g) 85.4 ± 1 78 ± 1 85 ± 1*
Cholesterol(mg) 222 ± 7 217 ± 6 287 ± 8*
Dietary CHO (g) 297 ± 3 316 ± 2* 297 ± 2
Sugars (g) 153 ± 3 165 ± 3* 150 ± 3
Dietary Protein (g) 76 ± 1 78 ± 1 78 ± 1
*RTE vs. Other
Deshmukh-Taskar PR, et al. 2010; J Am Diet Assoc; 110 (6) 869-878

8. Breakfast Foods Breakfast Foods
1960s 2000s
High Protein Low Protein
Nutrition Reviews; 65(6): 268-281; FIC Review; 2011; Breakfast and Health; Moshfegh, 2005; What We Eat in America 2001-02; USDA.gov; Breakfast in America

9. Westerterp-Plantenga, M.S., et al., Annu Rev Nutr, 2009; 21-41

11. 11

12. • Randomized Crossover; Clinical Trial
• Healthy, but overweight/obese teen girls (13-19y)
Habitual breakfast skippers
• 3 Breakfast Patterns (6 d acclimation + 1 d testing/pattern)
Breakfast Skipping
Normal Protein Breakfast Participants were blinded to protein focus
Higher Protein Breakfast

13. Dietary Characteristics Normal Protein Protein-rich Breakfast
Breakfast* Breakfast* Skipping
Meal Characteristics RTE Cereals ‘Other Foods’ 0
Energy Content (kcal) 350 350 0
CHO/Protein/Fat (%) 65/15/20 40/40/20 0
PRO (g) 13 35 0
CHO (g) 57 35 0
Fat (g) 8 8 0
*Also matched for Energy Density (1.3g/kcal), Sugar (18g), & Fiber (6g)
13

14. • 10 h Testing Days for Each Breakfast Pattern
• Outcomes:
Appetite: Perceived Hunger; Hunger-hormone Ghrelin
Satiety: Perceived Fullness; Satiety-hormone PYY
Reward: Brain Scans in response to visual food stimuli before dinner
Snacking: Evening

15. Breakfast Skipping
Normal Protein
High Protein

16. Breakfast Skipping
Normal Protein
High Protein

17. Breakfast Skipping
Normal Protein
High Protein

18. Breakfast Skipping
Normal Protein
High Protein

19. • 13 blocks in 1 fMRI scan
• 3 blocks of food, 3 blocks of animals, 7 blocks of blurred images
• Each block is 30 sec

20. Breakfast Skipping vs. Breakfast

21. Normal vs. High Protein Breakfast

22. Breakfast Skipping
Normal Protein
High Protein

23. Snack Foods BS NP HP
Desserts (g) 110 ± 23 104 ± 24 87 ± 20
Breakfast Skipping
Normal Protein Candy (g) 33 ± 13a 37 ± 12a 16 ± 6b
High Protein
Salty (g) 45 ± 15 58 ± 17 51 ± 18
High Fat (g) 164 ± 29a 142 ± 28b 105 ± 24b
Chocolate (g) 94 ± 22 99 ± 24 82 ± 20

26. Heather J. Leidy, PhD
Assistant Professor; Dept. of Nutrition & Exercise Physiology
University of Missouri
573-825-2620; leidyh@missouri.edu
© 2012 Institute of Food Technologists