Breakfast Skipping Is Associated with Vitamin D Deficiency among Young Adults entering Initial Military Training.

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 606 words

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Keywords Diet quality; Micronutrient; Military nutrition; Vitamin deficiency; Meal skipping Abstract Background Vitamin D deficiency (VDD), defined as serum 25-hydroxyvitamin D (25[OH]D) levels Objectives This study aimed to determine whether breakfast skipping is associated with odds of VDD among recruits entering initial military training (IMT), and with changes in serum 25(OH)D during IMT. In addition, whether diet quality and vitamin D intake mediated these associations was determined. Design Secondary analysis of individual participant data collected during five IMT studies. Breakfast skipping ([greater than or equal to] 3 times/week) was self-reported. Dietary intake was determined using food frequency questionnaires, and vitamin D status was assessed using circulating 25(OH)D concentrations pre- and post-IMT. Participants and setting Participants were healthy US Army, US Air Force, and US Marine recruits (N = 1,569, 55% male, mean [plus or minus] standard deviation age 21 [plus or minus] 4 years) entering military service between 2010 and 2015 at Fort Jackson, SC; Fort Sill, OK; Lakeland Air Force Base, TX; or the Marine Corps Recruit Depot, Parris Island, SC. Main outcome measures Primary outcomes were VDD pre-IMT and change in 25(OH)D from pre- to post-IMT. Statistical analysis performed Associations were determined using multivariate-adjusted logistic and linear regression and mediation models. Results Forty-six percent of military recruits were classified as breakfast skippers pre-IMT, and 30% were VDD. Breakfast skipping was associated with a higher odds of pre-IMT VDD (odds ratio 1.5, 95% CI 1.1 to 1.9), and lower vitamin D intake and diet quality were partial mediators of the association. Serum 25(OH)D concentrations improved (P = 0.01) among habitual breakfast skippers versus nonskippers during IMT; however, regression to the mean could not be ruled out. Neither change in diet quality nor vitamin D intake were associated with change in 25(OH)D concentrations during IMT. Conclusions Breakfast skipping is prevalent among incoming military recruits and is associated with VDD. This relationship may be mediated by lower diet quality and vitamin D intake. Author Affiliation: (1) US Army Research Institute of Environmental Medicine, Natick, Massachusetts (2) Oak Ridge Institute of Science and Education, Belcamp, Maryland (3) Combat Capabilities Development Command--Soldier Center, Natick, Massachusetts * J. Philip Karl, PhD, RD, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760. Article History: Received 3 February 2021; Accepted 24 September 2021 (footnote) Supplementary materials: and are available at (footnote) STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. (footnote) FUNDING/SUPPORT Research funded by the US Army Medical Research and Development Command, Military Operational Medicine Research Program. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Army or the Department of Defense. Any citations of commercial organizations and trade names in this report do not constitute an official Department of the Army endorsement or approval of the products or services of these organizations. Approved for public release; distribution is unlimited. Byline: Heather S. Fagnant, MS, MPH, RD (1), Laura J. Lutz, MS, RD (1), Anna T. Nakayama, MSc, RD (1,2), Erin Gaffney-Stomberg, PhD, RD (3), James P. McClung, PhD (1), J. Philip Karl, PhD, RD [] (1,*)

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Gale Document Number: GALE|A704126104