Breakfast consumption among children and adolescents in the netherlands.

Abstract
BACKGROUND: The Netherlands Nutrition Centre (NNC) recommends eating a daily breakfast preferably including products from five food groups. The aims of this study were to examine to what extent breakfast consumption among Dutch youngsters attending primary and secondary education (aged 10-19 years) is in accordance with these recommendations and whether breakfast habits differ among demographic subgroups. METHODS: A cross-sectional study was conducted among 2404 youngsters at 71 schools in the Netherlands. All Dutch schools were stratified by educational level and province, and randomly ordered within the strata. Participants completed an online questionnaire at school including food frequency items and a 24-h recall. RESULTS: The percentage of participants reporting to consume breakfast every day varied between 62.9 and 95.5 in different subgroups. Skipping breakfast was associated with being older, being a girl, attending vocational or senior general education and being of non-Dutch origin. Of the participants, <9% consumed products from five food groups as recommended. Participants especially ate products from the 'grain group', followed by the 'dairy group', the 'fats group', 'the liquids group' and the 'fruit/fruit juice group'. Bread, butter and milk were the most frequently consumed products and the majority chose healthy (i.e. low-fat) variants within food groups (i.e. wholemeal bread). CONCLUSION: Health promotion efforts should aim to stimulate breakfast consumption, particularly among vocational school students and adolescents of non-Dutch origin. Special attention should be given to breakfast quality. Future research should investigate whether better adherence to the recommendations of the NNC results in enhanced nutrient intake at breakfast.