Implementing Nutrient Recommendations for Breakfast in Europe through Dietetic Practice—The European Federation of Associations of Dietitians (EFAD) Breakfast Toolkit Survey ^†

Abstract

Background and objectives: The International Breakfast Research Initiative developed nutrient recommendations for a balanced breakfast, based on daily guidelines and actual contribution of breakfast in Europe. The aim of the Breakfast Toolkit Project is to translate nutrient recommendations into practical advice for both individuals and health professionals, and to develop a toolkit for dietitians. Methods: We conducted a 19-item online survey to assess the experience and resources of dietitians when recommending breakfast as part of a balanced diet. Results: A total of 336 dietitians from 27 countries participated in the survey. Forty-nine percent were working in clinical practice or private consulting. Around 50% thought that the general population is somewhat aware of the impact of breakfast on health, with the highest number of people not being aware in northern Europe. A lack of time and not feeling hungry in the morning are the main obstacles to achieve a healthy breakfast all over Europe, while a lack of money is more concerning in central and eastern Europe than other areas. Although slight differences are observed between European regions, increasing fresh fruit and vegetables (17%), decreasing sugary food (14.5%), and switching to whole grain cereals (18%) are the most peremptory needed interventions, according to the experience of the dietitians. Educational materials focused on breakfast are scarce and would be appreciated by dietetics practitioners. Breakfast printed infographics and recommendations are the most valued tools (39%), followed by examples of healthy recipes and menus (21%). Discussion: Nutritional quality of breakfast is an overall problem in Europe that dietitians need to address in any setting in which they work. Dietary malpractices at breakfast are the same in all countries, as are the obstacles people face when trying to improve the quality of breakfast. Thus, common evidence-based dietary guidelines and educational materials will help dietitians work in implementing healthy breakfast habits in the European population. Printable online materials, to be used in consultancy, and culinary tips are the most appreciated tools by practitioners.