1 Instituto Pensi - Hospital Infantil Sabará e Pediatria - Escola Paulista de Medicina - UNIFESP, São Paulo, Brazil; 2 Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
Introduction: Breakfast consumption is an important dietary habit and a proxy of healthy lifestyles in developed nations. However, in developing countries, little is known about breakfast consumption patterns and their associations with social health determinants. Objective: To identify the breakfast consumption patterns and investigate their associations with social health determinants. Methods: A total of 30,938 breakfast consumers (subjects whose first eating occasion occurred between 06:00am and 09:00am) evaluated in the National Dietary Survey conducted in Brazil, between 2008- 2009, were included. Two non-consecutive food records assessed individual food consumption. Foods consumed at breakfast were collapsed into 42 food groups for factor analysis. A number of six breakfast patterns were derived by principal component factor and the VARIMAX rotation. The significant food items on each factor were identified by factor loading cut-off ≥|0.25|. Linear regression models were fitted to estimate effects of social health determinants on adherence to breakfast patterns. Results: The breakfast patterns were: “Breads and margarine” (breads, butter/margarine, cold cuts and cheese); “Rice and beans” (rice, beans, vegetables and meats); “Cereals and proteins” (cereals/grains, eggs, meats, roots/tubers and processed meats); “Coffee with milk”; “Fast-food” (fruit juices, soda pop, pizza, hot dog, sandwiches, salty snacks); and “Dairy and fruits” (milk, chocolate powder, fruits, cheese, yogurt, coffee). Age was positively associated with adherence to “Breads and margarine” and negatively with “Dairy and fruits”. Living in the urban area was negatively associated with “Rice and beans” and “Cereals and proteins”. White ethnicity was negatively associated with “Cereals and protein” and positively with “Coffee with milk”, “Fast-food” and “Dairy and fruits”. “Coffee with milk”, “Fast-food” and “Dairy and fruits” were also associated with higher family income and education. Conclusion: Ethnicity, income and education are the main social health determinants affecting the adherence to a variety of breakfast patterns with different nutritional qualities in Brazil.