Sample characteristics for both demographic and potential confounding measures are presented in , summarized by total sample and across breakfast consumption frequency groupings. The mean age of our eligible participants was 17.5±1.3 years. Roughly 47% of the sample represented a minority, 91% were using WIC, and 14.2% had graduated high school, indicative of the high-risk demographic that PAT Teen Programs were designed to support. Half of the sample were either overweight or obese (49.3%) and approximately six months postpartum (187±98 days). The majority of teen mothers (56.9%) reported an attempt to lose weight prior to survey administration, with a combination of both exercise and diet being the most popular approach. Forty-two percent of teen mothers reported consuming breakfast zero to two days per week. No relationship was found between age, education, race/ethnicity, or percent using WIC and breakfast consumption frequency in postpartum teens.
Baseline Characteristics of Postpartum Teens: Parents as Teachers Teen Program (n=904)
presents BMI-for-age percentile and daily beverage and snack intake by breakfast consumption frequency groupings, controlled for potential confounding factors. After controlling for BMI-for-age percentile and weight loss attempts, participants reporting at least six to seven days of breakfast consumption consumed fewer calories from sweetened beverages, salty snacks, sweet snacks, and consumed fewer total calories from snacks and beverages than participants reporting zero to two days of breakfast consumption. Conversely, fruit and vegetable, cereal, milk, and water consumption were highest among the regular breakfast consumers. BMI-for-age percentile remained associated with breakfast consumption frequency after controlling for those reporting an attempt to lose weight.
Baseline Breakfast Consumption Frequency for Postpartum Teens: Parents as Teachers Teen Program (n=904)
There are several findings from this study that contribute to the growing literature on teen dietary intake. First, 42% of our postpartum teens skipped breakfast, compared to other studies that have shown 10–30% of adolescents skipped breakfast (34
). Affenito et al. found race impacted breakfast frequency, with 19.1% of white and 24.2% of African American girls skipping breakfast by age 19 (15
). However, African American and Hispanic teen girls in this study ate breakfast with the same frequency as white girls. This might be explained by the fact that a greater proportion of this sample reported skipping breakfast, which could have lessened the racial disparities. Reasons that adolescents skip breakfast (i.e., lack of time, lack of hunger, prefer to sleep, and attempting to lose weight) may be more prevalent in postpartum teens who are also juggling the demands of parenting (35
The second finding provides further evidence of the relationship between breakfast consumption and beverage intake, and how it might impact weight retention among postpartum teens. Teen mothers who ate breakfast most days of the week consumed over 1,300 fewer calories per week from sweetened drinks than those who skipped breakfast. This is consistent with findings among teens in general, where sweetened drinks are associated with increased energy intake and BMI (11
). Therefore, it is not surprising that those who regularly consumed breakfast had a lower BMI and consumed 1,477 fewer calories per week from snacks and beverages than those who skipped breakfast.
Similar to other studies (37
), findings of this study suggest those who regularly consume breakfast have an overall healthier diet. Those who ate breakfast frequently consumed more fruits and vegetables and drank more milk and water (38 more ounces/day) than those who skipped breakfast. Also, those who ate breakfast most days of the week snacked more on cereal and less on sweet and salty snacks. Given the frequent intake of unhealthy snacks and beverages in adolescents (10
), encouraging regular breakfast consumption holds promise as a means to help this population improve their overall diet.
Finally, these data have particular relevance not only for addressing weight retention in teen mothers, but in their children. Numerous studies have documented the importance of the parent as a model to their child (24
). Teen mothers now take on that responsibility and control the food environment for their child. Thus patterns exhibited by the mothers, including lack of breakfast and high risk sweetened drink and snacking behavior, might influence the intake of their young child. Over time and left unchanged, these behaviors are reinforced as the child observes that parent and has access to high risk foods in their environment. Early intervention is needed to encourage appropriate nutritional patterns that can be passed from teen mother to child, and prevent intergenerational obesity (44
Despite a large diverse sample size, there are some limitations worth noting. There was reliance on self-reported data for dietary intake and breakfast consumption. The teen mothers’ reported intake may not reflect a usual week’s intake. Measurement errors, such as underreporting, are often seen when using an FFQ (45
). In addition, a modified FFQ was used that asks about specific foods and only looked at beverage and snack intake. Teen mothers may consume beverages and snacks that do not appear on the FFQ.