Breakfast regularity across participants’ characteristics

Table 1 shows that 96–98% are breakfast consumers. Only 2% of the younger age groups (6–12 yo and 13–18 yo) were breakfast skippers while for both adults and elderly groups, the percentage slightly increased to 4%. Almost all participants were breakfast consumers across demographic characteristics and nutritional statuses (male 95–98%, female 96–98%). There was a significant association between breakfast consumption and gender among adults only. Proportion of female breakfast consumers (96%) was higher compared to males (95%). In contrast to urban areas, higher percentage of breakfast skippers were significantly observed in rural areas among adolescents (2.3%), adults (4.7%) and elderly (4.8%) groups. It appears that proportions of breakfast consumers across wealth quintile was almost equivalent for all age groups. Educational attainment was significantly associated to breakfast consumption among adults and elderly group. For adults, the proportion of breakfast consumers who have an elementary and college level education was 94% and 97%, respectively. On the other hand, the proportion of breakfast consumers among the elderly with elementary level and college level education was 95% and 98%, respectively. Nutritional status of the children and adolescents was not associated to breakfast status. Elderly with chronic energy deficiency (CED) (94%) has the lowest proportion of breakfast consumers (94%), while overweight (97%) and obese (98%) elderly has the highest proportion of breakfast consumers.

Table 1 Breakfast regularity across demographics and nutritional statusConsumption of commonly consumed food at breakfast by NRF9.3 tertiles

Tables 2, 3, 4 and 5 presents the average consumption of the top 10 mostly consumed food groups. The NFR 9.3 tertiles are also shown for the age groups including the percentage consumption of each food group. The analyses showed that consumption of all top 10 food groups were associated to NRF tertiles. The highlight of this result explains that individuals with the Tertile 3 consumed more vegetables, fresh meat and fish, and eggs but less in rice, sugar and coffee.

In Table 2, children with poorest quality diets (Tertile 1) have a higher percentage consumption of cereal products (51%) and sugars (27%) while having lower consumption of powdered milk (11%), other vegetables (2%), green leafy vegetables (0.4%), fresh fish (2%), chicken eggs (6%), cacao and chocolate-based beverages (1%), and rice (49%). For adolescent group in Table 3, results show that Tertile 1 has a higher percentage consumption of coffee (57%), sugars (30%), and cereals products (52%) while having the lowest percentage consumption of green leafy vegetables (0.4%), other vegetables (3%), cacao and chocolate-based beverages (0.3%), chicken egg (6%), fresh fish (2%), and rice (43%) compared to T2 and T3. Consumption of coffee seems to increase as age increases with tertile 1 having the highest consumption including sugars. This is evident in the analysis for the adults and elderly group. In Table 4, results showed that adults aged 19–59 years old in Tertile 1 has the highest percentage consumption of coffee (85%), and cereal products (47%), while having the lowest percentage consumption of green leafy vegetables (0.4%), other vegetables (2%), and chicken egg (7%), fresh fish (2%), fresh meat (1%) and rice (29%) compared to T2 and T3. On the other hand, results shown in Table 5 for the elderly group aged 60 years old and above shows that Tertile 1 has the highest percentage consumption of coffee (88%), and cereal products (48%) while having the lowest percentage consumption of green leafy vegetables (0.4%), other vegetables (2%), powdered milk (3%), chicken egg (8%), fresh fish (3%), and rice (29%) compared to T2 and T3. For all age groups, Tertile 3 has the highest mean consumption of fresh fish, green leafy vegetables and other vegetables while having a moderate consumption of rice, chicken egg, and cooking oil. Younger age groups such as school age children and adolescents who belong to T3 had the highest consumption of chocolate-based beverages. While older adults and elderly in T3 had the highest consumption of rice and the least consumption of coffee.

Table 2 Mean food group intake and percentage consumers at breakfast for Children by NRF 9.3 Tertiles, Philippines, 2018Table 3 Mean food intake and percentage consumer at breakfast for Adolescents by NRF 9.3 Tertiles, Philippines, 2018Table 4 Mean food intake and percentage consumer at breakfast for Adults by NRF 9.3 Tertiles, Philippines, 2018Table 5 Mean food intake and percentage consumer at breakfast for Elderly by NRF 9.3 Tertiles, Philippines, 2018Usual energy and nutrient intakes at breakfast and NRF9.3 scores by age group

Table 6 presents the average NRF 9.3 scores and mean habitual intake of energy and nutrients at breakfast per age group. Children age 6–12 years has the highest NRF 9.3 average score with 417 which reflects to a healthier diet at breakfast compared to elderly with 347, adolescent (340) and also for adult (330) age groups which had the lowest scores. In all the age groups, breakfast contributed approximately 328 kcal to 440 kcal of their daily intake with the significant highest mean intakes of energy among adolescents (440 kcal) and adults (426 kcal). In terms of macronutrients, the highest mean intakes for total carbohydrates at breakfast were significantly observed among adults (77 g) followed by adolescents (77 g), elderly (64 g) and lastly, school-aged children (54 g). Mean protein intakes were also considerably highest in adolescents (13 g) and lowest in children (10 g). This similar trend is also observed with other nutrients such as fiber, niacin, vitamin D, magnesium, and potassium. With regards to total fat, saturated fat, monounsaturated fat (MUFA), polyunsaturated fat (PUFA), cholesterol, sodium, and iron, mean intakes were significantly highest among adolescents and lowest in the elderly. Highest mean intakes of total sugar and calcium were seen among the elderly while vitamin A intake was significantly higher among adults.

Table 6 Mean NRF9.3 score and usual energy and nutrients at breakfastUsual energy and nutrient intakes at breakfast by NRF9.3 tertiles

Tables 7, 8, 9 and 10 showed the mean intake of usual energy and nutrients across NRF9.3 tertiles. In Table 7, results showed cumulative trend of energy intake at breakfast across NRF9.3 tertiles. There was a significant trend in all nutrients across NRF9.3 tertiles at breakfast among children except for total fat and saturated fat. Also, increasing consumption were observed across NRF9.3 tertiles for energy, protein, carbohydrates, fiber, thiamin, riboflavin, niacin, vitamin C, vitamin A, vitamin D, calcium, phosphorus, iron, magnesium, potassium, and cholesterol, while a decreasing trend was seen for MUFA, PUFA, total sugar and sodium intake. In Table 8, consumption of all nutrients among adolescents showed significant trends including energy intake. Moreover, consumption of total fat, saturated fat, MUFA, PUFA, total sugar and sodium declined across NFR tertiles while other nutrients significantly increased. For adults and elderly groups in Tables 9 and 10, both groups had the same results which was all nutrients including energy intake showed significant increasing trends across NRF tertiles. Total sugar and sodium intake decreases from tertile 1 to tertile 3. Results emphasize that the consumption of the population group in Tertile 3 consumed more essential nutrients such as vitamins and minerals and less intake of sodium, total sugar and total fat.

Table 7 Mean energy and nutrient intakes at breakfast of Children by NRF9.3 Score in TertilesTable 8 Mean energy and nutrient intake from breakfast of Adolescents by NRF 9.3 Score in TertilesTable 9 Mean energy and nutrient intake at breakfast of Adults by NRF 9.3 Score in TertilesTable 10 Mean energy and nutrient intakes at breakfast of Elderly by NRF 9.3 Score inContribution of energy and nutrients at breakfast to the total daily intake

Figure 2 shows the energy and nutrient contribution of breakfast to the total daily intake. Breakfast must consist at least 20–25% of the total daily energy and nutrients. Overall, energy and nutrients coming from breakfast reached more than the 20% of the total daily intake of energy and nutrients. On the other hand, total sugar, cholesterol, and sodium contributed to more than 30% at breakfast for all age groups. Total sugar accounted for 40% of daily consumption at breakfast for adults aged 19–49 years old and goes up to approximately 45% for the elderly. Contribution of vitamin C at breakfast seems to be low especially for adults aged 19–59 years old which means that vitamin C intake was low during breakfast.

Fig. 2

Energy and nutrient contribution of breakfast to the total daily intake. *PUFA stands for polyunsaturated fatty acids, MUFA stands for Monounsaturated fatty acids, SatFat stands for saturated fatty acids. The 20% cutoff is indicated by a vertical line with color green bar

Contribution of breakfast to the daily recommended intakes

Figure 3 showed that children with the healthiest breakfast diets met the 20% recommendation for intake of protein (32%), iron (24%), vitamin D (22%), vitamin A (31%) and magnesium (37%) but fall short in energy (19%), calcium (14%), fiber (7%), vitamin C (17%) and potassium (14%) intakes at breakfast. On a daily basis, intake of magnesium and protein were more than adequate but there were deficiencies in calcium, fiber, iron, vitamin D, vitamin C, and potassium. There were no recorded excessive intakes of total sugar, saturated fat, and sodium intake at breakfast, same was observed in the results for daily consumption. Results also showed that there is a low nutrient consumption at breakfast.

Fig. 3

Contribution of breakfast to the daily recommendation among children NOTE: Daily Intake = All meals; Intake at breakfast of healthiest individuals = intake from breakfast only of participants that were categorized in Tertile 3 which represent the individual with healthiest diet; 20% Benchmark = 20% of the recommended intake of each nutrient (based on the PDRI), 100% Benchmark = the total recommendation per day

Adolescents with the healthiest breakfast diets met the 20% recommended intake of protein (26%), vitamin D (29%), vitamin A (22%) and magnesium (24%). Only 7% of fiber at breakfast was consumed. Poor intakes of calcium (12%), iron (15%), and vitamin C (12%) were observed at breakfast for adolescents. There is a slightly low contribution (11%) of total sugar, saturated fat (17%), and sodium (13%) for this group. Overall, it is noticeable that most micronutrients were inadequate especially calcium, fiber and vitamin C (Fig. 4).

Fig. 4

Contribution of breakfast to the daily recommendation among adolescent. NOTE: Daily Intake = 24 h food recall (All meals); Intake at breakfast of healthiest individuals = intake from breakfast only of participants that were categorized in Tertile 3 which represent the individual with healthiest diet; 20% Benchmark = 20% of the recommended intake of each nutrient (based on the PDRI), 100% Benchmark = the total recommendation per day

Adults with the healthiest breakfast diets (Tertile 3) were adequate in energy (23%), protein (27%), iron (20%), vitamin D (28%), vitamin A (20%), potassium (23%) and magnesium (28%) at breakfast. However, contribution of calcium (17%), vitamin C (12%), and fiber (9%) at breakfast is low, which is an unceasing problem up until this age group (Fig. 5).

Fig. 5

Contribution of breakfast to the daily recommendation among adults. NOTE: Daily Intake = 24 h food recall (All meals); Intake at breakfast of healthiest individuals = intake from breakfast only of participants that were categorized in Tertile 3 which represent the individual with healthiest diet; 20% Benchmark = 20% of the recommended intake of each nutrient (based on the PDRI), 100% Benchmark = the total recommendation per day

Among the elderly with the healthiest breakfast diets, their breakfast consumption reached more than the 20% recommended intake of energy (21%), protein (21%), iron (23%), and magnesium (23%). However, the composition of their breakfast was inadequate in fiber (10%), vitamin D (9%), vitamin C (15%), and calcium (17%). There was only 1% excessiveness of total sugar (21%), and no excessiveness of saturated fat and sodium. On a daily basis, they were inadequate of calcium, fiber, vitamin D, and vitamin C (Fig. 6).

Fig. 6

Contribution of breakfast to the daily recommendation among elderly. NOTE: Daily Intake = 24 h food recall (All meals); Intake at breakfast of healthiest individuals = intake from breakfast only of participants that were categorized in Tertile 3 which represent the individual with healthiest diet; 20% Benchmark = 20% of the recommended intake of each nutrient (based on the PDRI), 100% Benchmark = the total recommendation per day