Associations of breakfast skipping with obesity and health-related quality of life: evidence from a national survey in Taiwan.

Abstract

This study investigated the associations of breakfast skipping with obesity and health-related quality of life (QOL). We also tested the hypothesis that there is a dose-dependent relationship between frequency of breakfast consumption and prevalence of obesity. This cross-section study used a national representative sample (n=15 340) from the 2005 Taiwan National Health Interview Survey. Breakfast skippers were defined as those who ate breakfast about once a week or less often and those who never ate breakfast. Individuals were classified as 'obese' if their body mass index was >or=27. Health-related QOL was assessed using the Medical Outcome Studies 36-Item Short-Form (SF-36) Health Survey. Logistic regression was used to examine the odds ratio of obesity and associated 95% confidence intervals (CIs) in breakfast skippers compared with breakfast eaters. Multivariable logistic regression modeling was used to adjust all risk estimates for covariates. The unadjusted odds ratio of obesity in breakfast skippers was 1.23 (95% CI: 1.06, 1.43). The odds of developing obesity for breakfast skippers was 1.34 (95% CI: 1.15, 1.56) controlling for age, sex, marital status, educational level, monthly income, smoking, alcohol, betel nut chewing and exercise habit. The Cochran-Armitage trend test revealed that the prevalence rate of obesity decreased as the frequency of breakfast consumption increased (P=0.005). Breakfast skippers had significantly worse health-related QOL than breakfast eaters (P<0.001). Moreover, breakfast skippers had significantly lower scores in 5 out of 8 domain scores of the SF-36, namely general health perceptions (P<0.001), vitality (P<0.001), social functioning (P=0.036), emotional role (P<0.001) and mental health (P<0.001). The findings from this study add support to the potential role of breakfast eating in obesity prevention.