Association between Frequency of Ready-to-Eat Cereal Consumption, Nutrient Intakes, and Body Mass Index in Fourth- to Sixth-Grade Low-Income Minority Children

Published:February 27, 2013DOI:



      The consumption of non-ready-to-eat cereal and ready-to-eat cereal (RTEC) breakfasts have been associated with increased nutrient intakes and lower body mass index (BMI). These relationships have not been examined in low-income minority children.


      To evaluate, in low-income minority children, whether there is a relationship among the frequency of RTEC consumption and nutrient intakes measured at baseline, and whether there is a relationship between the frequency of RTEC and BMI controlling for age, sex, ethnicity, and energy intake.


      A longitudinal study design where a cohort was followed for 3 years.


      Participants were 625 fourth- through sixth-grade, low-income children living in San Antonio, Texas, and enrolled in the control arm of the Bienestar Diabetes Prevention Program's cluster randomized trial. Three multiple-pass 24-hour dietary recalls were collected at the beginning of their fourth-grade year and at the end of their fifth- and sixth-grade years. Children's age, sex, ethnicity, and height and weight (used to calculate BMI) were collected between August 2001 and May 2004.

      Statistical analyses performed

      Descriptive and inferential statistical analyses were performed. The frequency of breakfast consumption was examined using a 6×4 cross-tabulation table with χ2 test to establish categorical differences. The degree of association between BMI percentile and frequency of RTEC consumption adjusted for age, sex, ethnicity, and nutrition-related parameters were calculated using a partial correlation multivariate linear model analysis.


      There was a significant positive relationship between the frequency of RTEC consumption and nutrient intakes measured at baseline. There was also a significant inverse relationship between frequency of RTEC consumption and BMI percentile over the cumulative 3-year period controlling for age, sex, ethnicity, and energy intake.


      Children who frequently consumed RTEC had greater intakes of essential nutrients at baseline and significantly lower BMI over a 3-year period.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • World Health Organization
        Diet, nutrition and the prevention of chronic diseases. Report of a joint WHO/FAO consultation.
        (Accessed December 24, 2012)
        • Ogden C.L.
        • Carroll M.D.
        • Curtin L.R.
        • Lamb M.M.
        • Flegal K.M.
        Prevalence of high body mass index in US children and adolescents, 2007-2008.
        JAMA. 2010; 303: 242-249
        • Kumanyika S.K.
        • Obarzanek E.
        • Stettler N.
        • et al.
        Population-based prevention of obesity. The need for comprehensive promotion of healthful eating, physical activity, and energy balance. A scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention.
        Circulation. 2008; 118: 428-464
        • Daniels S.
        • Arnett D.
        • Eckel R.
        • Williams C.L.
        Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment.
        Circulation. 2005; 111: 1999-2012
        • De Ferranti S.D.
        • Gauvreau K.
        • Ludwig D.
        • Neufeld E.J.
        • Newburger J.W.
        • Rifai N.
        Prevalence of the metabolic syndrome in American adolescents. Findings from the Third National Health and Nutrition Examination Survey.
        Circulation. 2004; 110: 2494-2497
        • Cruz M.L.
        • Goran M.I.
        The metabolic syndrome in children and adolescents.
        Curr Diab Rep. 2004; 4: 53-62
        • Hedley A.A.
        • Ogden C.L.
        • Johnson C.L.
        • Carroll M.D.
        • Curtin L.R.
        • Flegal K.M.
        Prevalence of overweight and obesity among US children, adolescents, and adults.
        JAMA. 2004; 291: 2847-2850
        • Lutfiyya M.N.
        • Garcia R.
        • Dankwa C.M.
        • Young T.
        • Lipsky M.S.
        Overweight and obese prevalence rates in African American and Hispanic children: An analysis of data from the 2003-2004 National Survey of Children's Health.
        J Am Board Fam Med. 2008; 21: 191-199
        • Barton B.A.
        • Eldridge A.L.
        • Thompson D.
        • et al.
        The relationship of breakfast and cereal consumption to nutrient intake and body mass index: The National Heart, Lung and Blood Institute Growth and Health Study.
        J Am Diet Assoc. 2005; 105: 1383-1389
        • Berkey C.S.
        • Rockett H.R.H.
        • Gillman M.W.
        • Field A.E.
        • Colditz G.A.
        Longitudinal study of skipping breakfast and weight change in adolescents.
        Int J Obes Relat Metab Disord. 2003; 27: 1258-1266
        • Niemeier H.M.
        • Raynor H.A.
        • Lloyd-Richardson E.E.
        • Rogers M.L.
        • Wing R.R.
        Fast food consumption and breakfast skipping: Predictors of weight gain from adolescence to adulthood in a nationally representative sample.
        J Adolesc Health. 2006; 39: 842-849
        • Roseman M.G.
        • Yeung W.K.
        • Nickelsen J.
        Examination of weight status and dietary behaviors of middle school students in Kentucky.
        J Am Diet Assoc. 2007; 107: 1139-1145
        • Affenito S.G.
        • Thompson D.R.
        • Barton B.A.
        • et al.
        Breakfast consumption by African American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index.
        J Am Diet Assoc. 2005; 105: 938-945
        • Albertson A.M.
        • Anderson G.H.
        • Crockett S.J.
        • Goebel M.T.
        Ready-to-eat cereal consumption: Its relationship with BMI and nutrient intake of children aged 4 to 12 years.
        J Am Diet Assoc. 2003; 103: 1613-1619
        • Kafatos A.
        • Linardakis M.
        • Bertsias G.
        • Mammas I.
        • Fletcher R.
        • Bervanaki F.
        Consumption of ready-to-eat cereals in relation to health and diet indicators among school adolescents in Crete, Greece.
        Ann Nutr Metab. 2005; 49: 165-172
        • Albertson A.M.
        • Thompson D.
        • Franko D.L.
        • Kleinman R.E.
        • Barton B.A.
        • Crockett S.J.
        Consumption of breakfast cereal is associated with positive health outcomes: Evidence from the National Heart, Lung, and Blood Institute Growth and Health Study.
        Nutr Res. 2008; 28: 744-752
        • Wiecha J.M.
        • Fink A.K.
        • Wiecha J.
        • Hebert J.
        Differences in dietary patterns of Vietnamese, white, African-American, and Hispanic adolescents in Worcester, Mass.
        J Am Diet Assoc. 2001; 101: 248-251
        • Treviño R.P.
        • Fogt D.L.
        • Wyatt T.J.
        • Leal-Vasquez L.
        • Sosa E.
        • Woods C.
        Diabetes risk, low fitness, and energy insufficiency levels among children from poor families.
        J Am Diet Assoc. 2008; 108: 1846-1853
        • Treviño R.P.
        • Yin Z.
        • Hernandez A.
        • Hale D.E.
        • Garcia O.A.
        • Mobley C.
        Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on fasting capillary glucose levels.
        Arch Pediatr Adolesc Med. 2004; 158: 911-917
        • Carter R.I.
        • Sharbaugh C.O.
        • Stapeli C.A.
        Reliability and validity of the 24-hour recall.
        J Am Diet Assoc. 1981; 79: 542-547
        • Frank G.C.
        • Berenson G.S.
        • Schilling P.E.
        • Moore M.C.
        Adapting the 24-hour recall for epidemiological studies of school children.
        J Am Diet Assoc. 1977; 71: 26-31
        • Centers for Disease Control and Prevention
        National Health and Nutrition Examination Survey: MEC in-person dietary interviewer procedures manual.
        (Accessed January 20, 2012)
      1. Definition of ready-to-eat cereal.
        (Accessed January 20, 2012)
        • Siega-Riz A.M.
        • Popkin B.M.
        • Carson T.
        Trends in breakfast consumption for children in the United States from 1965-1991.
        Am J Clin Nutr. 1998; 67: 748S-756S
        • Nutrition and Your Health: Dietary Guidelines for Americans, 2010
        (Updated March 14, 2012. Accessed January 20, 2012)
        • Rampersaud G.C.
        Benefits of breakfast for children and adolescents: Update and recommendations for practitioners.
        Am J Lifestyle Med. 2009; 3: 86-103
      2. Fulgoni III VL, Keast DR, Quann EE, Auestad N. Food sources of calcium, phosphorus, vitamin D, and potassium in the U.S. Paper presented at: Experimental Biology, Anaheim, CA, April 24-29, 2010.

        • Greer F.R.
        • Krebs N.F.
        • American Academy of Pediatrics Committee on Nutrition
        American Academy of Pediatrics, Optimizing bone health and calcium intakes of infants, children, and adolescents.
        Pediatrics. 2006; 117: 578-585
        • Menu planning in the School Breakfast Program
        US Department of Agriculture, Food and Nutrition Service website.
        (Accessed October 30, 2012)
        • Utter J.
        • Scragg R.
        • Mhurchu C.N.
        • Schaaf D.
        At-home breakfast consumption among New Zealand children: Associations with body mass index and related nutrition behaviors.
        J Am Diet Assoc. 2007; 107: 570-576
        • Sampson A.E.
        • Dixit S.
        • Meyers A.F.
        • Houser R.
        The nutritional impact of breakfast consumption on the diets of inner-city African-American elementary school children.
        J Natl Med Assoc. 1995; 87: 195-202
        • Williams P.
        Breakfast and the diets of Australian children and adolescents: An analysis of data from the 1995 National Nutrition Survey.
        Int J Food Sci Nutr. 2007; 58: 201-216
        • Albertson A.M.
        • Affenito S.G.
        • Bauserman R.
        • et al.
        The relationship of ready-to-eat cereal consumption to nutrient intake, blood lipids, and body mass index of children as they age through adolescence.
        J Am Diet Assoc. 2009; 109: 1557-1565
        • Rosado J.L.
        • Arrellano M.R.
        • Montemayor K.
        • Garcia O.P.
        • Caamano M.C.
        An increase of cereal intake as an approach to weight reduction in children is effective only when accompanied by nutrition education: A randomized controlled trial.
        Nutr J. 2008; 7: 28-36
        • Kosti R.
        • Panagiotakos D.
        • Zampelas A.
        • et al.
        The association between consumption of breakfast cereals and BMI in school-children aged 12-17 years: The VYRONAS study.
        Public Health Nutr. 2008; 11: 1015-1021
        • McNulty H.
        • Eaton-Evans J.
        • Cran G.
        • et al.
        Nutrient intakes and impact of fortified breakfast cereals in schoolchildren.
        Arch Dis Child. 1996; 75: 474-481
        • Ortega R.M.
        • Requejo A.M.
        • Redondo R.
        • et al.
        Influence of the intake of fortified breakfast cereals on dietary habits and nutritional status of Spanish schoolchildren.
        Ann Nutr Metab. 1996; 40: 146-156
        • Nicklas T.A.
        • O'Neil C.E.
        • Berenson G.S.
        Nutrient contribution of breakfast, secular trends, and the role of ready-to-eat cereals: A review of the data from the Bogalusa Heart Study.
        Am J Clin Nutr. 1998; 67: 757S-763S
        • Stanton J.L.
        • Keast D.R.
        Serum cholesterol, fat intake, and breakfast consumption in the United States adult population.
        J Am Coll Nutr. 1989; 8: 567-572
        • Albertson A.M.
        • Tobelmann R.C.
        The impact of ready-to-eat cereal consumption on the diets of primary school-aged children, 7-12 years old.
        Cereal Foods World. 1992; 36: 428-434
        • National Health and Nutrition Examination Survey data
        Centers for Disease Control and Prevention, National Center for Health Statistics website.
        (Accessed January 17, 2012)
        • Dietary Guidelines for Americans, 2010
        (Updated March 14, 2012. Accessed January 20, 2012)
        • Cotton P.A.
        • Subar A.F.
        • Friday J.E.
        • Cook A.
        Dietary sources of nutrients among US adults, 1994 to 1996.
        J Am Diet Assoc. 2004; 104: 921-930
        • Song W.O.
        • Chun O.K.
        • Kerver J.
        • Cho S.
        • Chung C.E.
        • Chung S.J.
        Ready-to-eat breakfast cereal consumption enhances milk and calcium intake in the US population.
        J Am Diet Assoc. 2006; 106: 1783-1789
        • Timlin M.T.
        • Pereira M.A.
        • Story M.
        • Neumark-Sztainer D.
        Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating Among Teens).
        Pediatrics. 2008; 121: e638-e645
        • Gleason P.M.
        • Dodd A.H.
        School breakfast program but not school lunch program participation is associated with lower body mass index.
        J Am Diet Assoc. 2009; 109: S118-S128
        • Willett W.
        Nutritional Epidemiology.
        2nd ed. Oxford University Press, New York, NY1998
        • Bandini L.G.
        • Schoeller D.A.
        • Cyr H.N.
        • Dietz W.H.
        Validity of reported energy intake in obese and nonobese adolescents.
        Am J Clin Nutr. 1990; 52: 421-425
        • Butte N.F.
        • Cai G.
        • Cole S.A.
        • Comuzzie A.G.
        Viva la Familia study: Genetic and environmental contributions to childhood obesity and its comorbidities in the Hispanic population.
        Am J Clin Nutr. 2006; 84: 646-654
        • Pontiroli A.E.
        Type 2 diabetes is becoming the most common type of diabetes in school children.
        Acta Diabetol. 2004; 41: 85-90
        • Strauss R.S.
        • Pollack H.A.
        Epidemic increase in childhood overweight, 1986-1998.
        JAMA. 2001; 286: 2845-2848


      L. Balvin Frantzen is vice president, health and wellness, Dairy MAX, San Antonio, TX.


      R. P. Treviño is director, Social and Health Research Center, San Antonio, TX.


      R. M. Echon is director, evaluation and data management, Social and Health Research Center, San Antonio, TX.


      O. Garcia-Dominic is assistant professor of Public Health Sciences, and Biobehavioral Health, College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA.


      N. DiMarco is a professor, Department of Nutrition and Food Sciences, and director, Institute for Women's Health, Texas Woman's University, Denton.