The role of breakfast consumption on metabolism, body size and chronic disease risk amongst healthy adults. Angelica Quatela, BSc (Hons) Nut A thesis submitted for the degree of PhD (Nutrition and Dietetics) University of Newcastle, NSW, Australia 16 November 2017 This research was supported by an Australian Government Research Training Program (RTP) Scholarship 1 Statements I hereby certify that the work embodied in the thesis is my own work, conducted under normal supervision. The thesis contains published scholarly work of which I am a co-author. For each such work a written statement, endorsed by my supervisor, attesting to my contribution to the joint work has been included. This thesis contains no material which has been accepted for the award of any other degree or diploma in any university or other tertiary institution and, to the best of my knowledge and belief, contains no material previously published or written by another person, except where due reference has been made in the text. I give consent to the final version of my thesis being made available worldwide when deposited in the University’s Digital Repository, unless an embargo has been approved for a determined period, subject to the provisions of the Copyright Act 1968. Angelica Quatela 15-11-17 Dr Lesley MacDonald-Wicks 15-11-17 2 Acknowledgments I would like to express my gratitude to the following people for their contribution towards the completion of my PhD: • Firstly, I wish to thank the participants of the typical Aussie Bloke project for their time and for kindly volunteering to take part in the study. • I would like to deeply thank my dear supervisors, Dr Lesley MacDonald-Wicks, Dr Amanda Patterson and Prof Robin Callister. Thanks you for your precious guidance, patience and professionalism that allowed me to fulfil my dream to complete this PhD journey. I will be forever grateful to you all. • A special thank to A/Prof Mark McEvoy (HMRI) for his precious time and outstanding statistical support during the ‘Australian Longitudinal Study on Women’s Health longitudinal analyses. It has been a real pleasure working with you and thanks for everything you have taught me. • I wish to show my sincere gratitude to A/Prof Leanne Brown for her precious help in facilitating data collection for the Typical Aussie Bloke study in Tamworth Education Centre (Tamworth, NSW, Australia). • I would also like to acknowledge my deepest gratitude to: Prof Robert Callister (Head of the Faculty of Health of Medicine); A/Prof Shane Dempsey (Head of School, Health Sciences); Ms Shirley Savy (Research Training Officer). Also, thanks to all the School of Health Sciences Team, particularly to: Mr David Rambaldi, Mrs Alli Johns, Ms Brooke Allars, Ms Tara Magnay, Ms Sally Goodchap, Ms Fiona Whyte, Mrs Sharni Greenwood, Ms Clare Eley-Smith, Mrs Sandra Fitness and Mrs Ashely Gleeson for their administrative support over these years. Furthermore, thanks to all the technical officers team for their enduring support: Mrs Anna Bukey, Mrs Jessica Piotrowski, and Mr Philip Jacobson. • I particularly thank Debbie Booth (Senior Research Librarian, Academic Division, the University of Newcastle) for providing great assistance with the literature search for the Systematic review illustrated in chapter 5. • I wish to acknowledge the contribution of the research assistants Allison Brandt, Loren Stroud, and Kelly Rice, who kindly assisted with the systematic review process and data extraction illustrated in chapter 5. 3 • Chapters 3 and 4 analysed the Australian Longitudinal Study on Women’s Health surveys data. We are grateful to the Australian Longitudinal Study on Women’s Health for allowing us to access their survey data and to the women who took part at this study. I am also grateful to Prof Graham Giles (Cancer Epidemiology Centre of Cancer Council Victoria) for permission to use the ‘Dietary Questionnaire for Epidemiological Studies (Version 2),’ Melbourne: Cancer Council Victoria, 1996, for the purpose of these analyses. • I would also like to thanks my fellow RHD Students in HA06, for their kind understanding, help and support during the PhD journey. • Finally, I would like to deeply thank my family, especially my beloved husband (Andrea), for their constant support and for believing in me during this challenging and rewarding journey. Grazie ;-) Angelica 4 Conflict of interest Angelica Quatela reports no conflict of interest. 5 Publications and Presentations Arising from this Thesis Manuscripts in Peer-Reviewed Journals: Published 1. Chapter 3: Quatela, A., R. Callister, A.J Patterson, M. McEvoy and L.K. MacDonald-Wicks (2017). "Breakfast Cereal Consumption and Obesity Risk amongst the Mid-Age Cohort of the Australian Longitudinal Study on Women’s Health." Healthcare 5(3): 49. 2. Chapter 5: Quatela, A., R. Callister, A.J. Patterson and L.K. MacDonald-Wicks (2016). "The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions." Nutrients 8(11): 670. 1. Chapter 4: Quatela, A., R. Callister, A.J. Patterson, M. McEvoy and L.K. MacDonald-Wicks (2017). “The protective effect of muesli consumption on diabetes risk: Results from 12 years of follow-up in the Australian Longitudinal Study on Women’s Health.” Nutrition Research 51: 12. Manuscripts in Peer-Reviewed Journals: In the Process to be Resubmitted 1. Chapter 6: Quatela, A; A.J. Patterson; R. Callister; L.K. MacDonald-Wicks (2017) “Breakfast consumption habits of young Australian men from the ‘Typical Aussie Bloke’ study”. To be submitted to European Journal of Nutrition. Conference abstracts in Conference Proceedings or Peer-Reviewed Journals: Published 1. Quatela A., A.J. Patterson, R. Callister, L.K. MacDonald-Wicks, “The ‘Typical Aussie Bloke study’: breakfast consumption habits of young Australian men.” Asia Pacific Conference on Clinical Nutrition (2017) in Adelaide, Australia (poster presentation by Quatela, A). 2. Quatela A., A.J. Patterson, R. Callister, M. McEvoy, L.K. MacDonald-Wicks, “The effects of breakfast cereal consumption on obesity risk over 12 years among mid-aged women in the Australian Longitudinal Study on Women’s Health”, in International Society of Behavioural Nutrition and Physical Activity (ISBNPA) in Victoria, Canada, (2017) (oral presentation by Patterson, A). 6 3. Quatela A., A.J. Patterson, R. Callister, M. McEvoy, L.K. MacDonald-Wicks, “Breakfast cereal consumption and incident obesity: 12 years analyses of the Australian Longitudinal Study on Women's Health”, Nutrition Society of Australia (NSA) Annual Scientific Meeting in Melbourne, Australia, (2016) (poster presentation by Quatela, A). 4. Quatela A., A.J. Patterson, R. Callister, M. McEvoy, L.K. MacDonald-Wicks, “Is breakfast cereal consumption an effective strategy to prevent diabetes for mid-age Australian women?” NSA Annual Scientific Meeting in Melbourne, Australia, (2016) (poster presentation by Quatela, A). 1. Quatela A., R. Callister, A.J. Patterson, M. McEvoy, L.K. MacDonald-Wicks, “Breakfast cereal consumption and incident Diabetes Mellitus: Results from 12 years of the Australian Longitudinal Study on Women’s Health”. Australian Longitudinal Study on Women’s Health (ALSWH) in Newcastle, Australia, (2016) (oral presentation by Quatela, A). 5. Quatela A., R. Callister, A.J. Patterson, L.K. MacDonald-Wicks, “What it is not known of the effect of fat intake at breakfast on DIT.” ISBNPA in Edinburgh, Scotland (2015) (poster presentation by Quatela, A). 6. Quatela A., R. Callister, A.J. Patterson, L.K. MacDonald-Wicks, “The effect of breakfast size and frequency on diet induced thermogenesis.” ISBNPA in Edinburgh, Scotland (2015) (poster presentation by Quatela, A). Conference Abstracts in Conference Proceedings or Peer-Reviewed Journals: Accepted for Oral Presentation 1. Quatela A., A.J. Patterson, R. Callister, L.K. MacDonald-Wicks, “The ‘typical Aussie Bloke study’: The relationships of Habitual Breakfast consumption with mediators of obesity and chronic disease development amongst young Australian men.” Dietetic Association of Australia in Sydney, Australia, (2018) (accepted oral presentation by Quatela, A). 7 Glossary of Common Abbreviations AB = Above Baseline ABS = Australian Bureau of Statistics AIHW= Australian Institute of Health and Welfare ALSWH = Australian Longitudinal Study on Women’s Health BE = Breakfast Eating BS = Breakfast Skipping BM = Body Mass BMI = Body Mass Index CHO = Carbohydrate CI = Confidence Interval CHD = Coronary Heart Disease CVD = Cardiovascular Diseases CSANZ = Cardiac Society of Australia and New Zealand DA = Diabetes Australia AusDiab = Australia Diabetes DAA = Dietitians Association of Australia DIT = Diet Induced Thermogenesis DQES = Dietary Questionnaire for Epidemiological Studies DQES-FFQv2 = Dietary Questionnaire for Epidemiology Studies Version 2. EBE = Early Breakfast Eaters ECM = Energy Content of the Meal EE = Energy Expenditure 8 F = Female FE = Frequent Eaters FFM = Fat Free Mass FM = Fat Mass HBE = Habitual Breakfast Eaters HBS = Habitual Breakfast Skippers HMRI = Hunter Medical Research Centre HR = Hazard Ratio ISBNPA = International Society for Behavioural Nutrition and Physical Activity conference LBE = Late Breakfast Eaters LCT = Long Chain Triglycerides LFE = Less Frequent Eaters M = Male MBS: Medicare Benefits Schedule MCT = Medium Chain Triglycerides MET = Metabolic Equivalent Task MIT = Meal Induced Thermogenesis MUFA = Mono Unsaturated Fatty Acids NCD-RisC = NCD