Breakfast in Latin America: evaluation of nutrient and food group intake towards a nutrient-based recommendation.

Abstract Background Little is known about breakfast habits of the Latin American (LA) population to support nutritional recommendations for a balanced breakfast in this region. Objective To evaluate the nutritional composition of breakfast in LA and to propose recommendations for a balanced breakfast. Design This multicenter cross-sectional study evaluated food and nutrient intake of nationally representative samples of urban populations of eight LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015. Participants/setting The sample comprised 8,714 participants from the Latin American Study of Nutrition and Health (ELANS), aged 15–65 years, randomly recruited according to geographical location, sex, age, and socioeconomic level. Main outcome measures Two 24-hour recalls were used to examine dietary intake. Breakfast consumers were stratified by tertiles of Nutrient-Rich Foods Index 9.3 (NRF9.3) to assess the overall diet quality of individuals. Nutrient intake at breakfast of those in the upper tertile of NRF9.3 pooled for the 8 countries was used as a reference for the development of recommendations for LA adolescents and adults. Statistical analyses:Comparison of food and nutrient intake of breakfast across NRF9.3 tertiles were analyzed using the Kruskal-Wallis rank sum test. Results Overall breakfast was an important contributor to protein, carbohydrate and B vitamin intakes, but also to added sugar, total and saturated fat intakes relative to daily intakes. Individuals in the upper NRF9.3 tertile had higher intake of key micronutrients such as calcium and potassium at breakfast when compared to other tertiles. White breads/rolls/tortillas were the most consumed food group (60%), followed by butter/margarine (40%) and coffee/tea without milk (34%-50%). Conclusions Breakfast contributed to the daily intake of B vitamins, protein and carbohydrates but also added sugar, and total and saturated fat intakes for all countries. The proposed recommendations support the nutrient density of existing highest-quality breakfast in the LA population while addressing concerns about nutrients to be encouraged or reduced.