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Behavior Genetics, Vol. 34, No.

5, September 2004 ( 2004)

Genetic and Environmental Factors in Breakfast


Eating Patterns

Anna Keski-Rahkonen,1,2,3,6 Richard J. Viken,4 Jaakko Kaprio,1,5


Aila Rissanen,2 and Richard J. Rose4

Received 27 Nov. 2001—Final 20 May 2004

Despite many studies on the prevalence of breakfast eating, we know little about factors
that determine breakfast eating patterns. Our aim was to find out to which extent breakfast
eating frequency is influenced by genetic and environmental factors using twin and twin-
family models in a population sample of 16-year-old twins (n ¼ 5250) and their parents
(n ¼ 4663). In common effects sex-limitation models, additive genetic effects explained 41%
(95% CI: 21–63%) of the variance in breakfast eating in girls and 66% (95% CI: 47–79%) in
boys, and common environmental effects 45% (95% CI: 23–62%) in girls and 14% (95% CI:
5–29%) in boys. Of twin-family models, phenotypic assortment models fitted the data best.
Heritability estimates increased somewhat (72%, 95% CI: 46–98% in girls and 63%, 95% CI:
38–89%) in boys. Common family environment remained substantial in both sexes. Cultural
transmission was nonsignificant. The relative influence of genetic and family factors on ado-
lescent breakfast eating frequency differs by sex and is generation-specific.
KEY WORDS: Adolescence; breakfast; family; Finland; sex; twin study.

INTRODUCTION (Brugman et al., 1998; Nicklas et al., 1998). The


prevalence of breakfast skipping among adolescents
Regular breakfast eating has traditionally been con-
has ranged from 3% to 67% in studies conducted in
sidered an important factor in a healthy lifestyle.
different countries (al Sudairy and Howard, 1992;
Nevertheless, breakfast skipping has become
Brugman et al., 1998; Höglund et al., 1998: Isralo-
increasingly widespread among children, adolescents
witz and Trostler, 1996; Michaud et al., 1990; Sam-
and adults in western countries during past 30 years
uelson et al., 1996: Shaw, 1998; Siega-Riz et al.,
(Haines et al., 1996; Nicklas et al., 1998; Siega-Riz
1998; Terre et al., 1990); the great variability of
et al., 1998). Breakfast skipping increases with age;
these estimates is caused by methodological and cul-
children in primary school do so less than teenagers
tural differences. The studies with largest number of
1
adolescent participants have been conducted in Swe-
Department of Public Health, University of Helsinki, Finland. den, Finland and the US (Höglund et al., 1998; Sie-
2
Department of Psychiatry, Helsinki University Central Hospi-
tal, Finland.
ga-Riz et al., 1998; Urho and Hasunen, 1999); in
3
Department of Epidemiology, Columbia University, New York, these studies, 13–25% of adolescents boys and 18–
NY, USA. 35% of girls aged 12–18 skipped breakfast. Each
4
Department of Psychology, Indiana University, Bloomington, study used a different method and a slightly differ-
Indiana, USA. ent age group.
5
Department of Mental Health, National Public Health Insti-
tute, Helsinki, Finland.
Adolescent girls generally skip breakfast more
6
To whom correspondence should be addressed at Department often than boys (Brugman et al., 1998; Höglund
of Epidemiology, Columbia University, Mailman School of et al., 1998; Isralowitz and Trostler, 1996; Shaw,
Public Health, Department of Epidemiology, 722 W 168th St, 1998). One explanation may be that girls are more
7th Fl., Room # 720-F, New York, NY 10032, USA. Tel.: +1- vulnerable to dieting pressure. Girls tend to diet by
212-2806575. Mobile: +358-40-5712095. Fax: +1-212-3059413.
e-mail: anna.keski-rahkonen@helsinki.fi
skipping meals (breakfast or lunch) and by decreas-
503
0001-8244/04/0900-0503/0  2004 Springer Science+Business Media, Inc.
504 Keski-Rahkonen, Viken, Kaprio, Rissanen, and Rose

ing their meal size; boys, on the other hand, tend to environmental factors in breakfast eating frequency
limit snacking and high-energy foods in order to using a large number of Finnish adolescent twin girls
lose weight (Brugman et al., 1997; Nowak, 1998). and boys. We also wished to examine how parental
Male and female dieters in a large European study breakfast eating affects the offspring.
conducted among university students were much
more likely to skip breakfast or lunch than non-
dieters (Bellisle et al., 1995). Dieting and dissatisfac- SUBJECTS AND METHODS
tion with body shape was more common among
Subject Sample
breakfast skippers than breakfast eaters in an Aus-
tralian study (Shaw, 1998). Norwegian 15–19-year- The data reported are from Finn Twin 16, a pop-
old girls with subclinical eating disorders skipped ulation-based study of five consecutive nationwide
breakfast more often than healthy control subjects birth cohorts of Finnish twins born between 1975 and
(Melve and Baerheim, 1994); breakfast skipping is 1979 (Rose et al., 1999). Data collection was subjected
also a typical feature of clinical eating disorders. to and approved by local ethics committees. After a
Dieting-related breakfast skipping may be at the pilot study, a questionnaire was mailed to twins born
milder end of the continuum that spans from in 1975–1979 within 2 months of their 16th birthday,
slightly disordered eating patterns to severe clinical The questionnaire contained questions on twin simi-
eating disorders. larity, personality and social relationships, symptoms,
Abnormal eating attitudes and disordered eat- and health habits, including breakfast eating. Identi-
ing tend to cluster with health-compromising behav- cal breakfast questions were sent to the twins’ moth-
iors, such as tobacco, alcohol, and substance use, ers and fathers in separate questionnaires addressing
and risk-taking in general (Fisher et al., 1991; Neu- parental life-style and health. A total of 3065 families
mark-Sztainer et al., 1997). Indeed, breakfast skip- were contacted: 5561 of the 6130 twins in these fami-
ping has been associated with smoking (Höglund lies (91%) returned the baseline questionnaire. Indi-
et al., 1998), alcohol and drug use (Isralowitz and vidual response rates were 93% for girls, 88% for
Trostler, 1996), sedentary lifestyle (Baumert, Jr. boys, 84% for fathers and 87% for mothers.
et al., 1998; Terre et al., 1990), obesity (Wolfe et al., Twin zygosity was determined by a question-
1994), frequent snacking and lunch skipping (Urho naire and was in some cases supplemented with
and Hasunen, 1999), and decreased ability to con- additional information from photographs, finger-
centrate on cognitive tasks (Benton and Parker, prints and DNA-marker studies as described previ-
1998; Nordlund and Jacobson, 1999). Breakfast ously (Sarna et al., 1978; Sarna and Kaprio, 1980).
skipping has also been linked to inadequate daily The twin pairs were classified as monozygotic (MZ),
dietary intake, low family socio-economic status, or dizygotic (DZ), or undetermined zygosity. Single
outright poverty (Brugman et al., 1998; Höglund respondents twins (n ¼ 91) and twins from pairs of
et al., 1998; Nordlund and Jacobson, 1999). undetermined zygosity (n ¼ 101 pairs) were excluded
There is a long tradition of studying the influ- from this study. Nine twin pairs in which either one
ence of environmental factors and social learning on of the twins had not completed the breakfast-eating
various behaviours. A more recent development is question were also excluded from this study. The
examining how genes influence behavior. These two sample used in this study thus contained all com-
viewpoints are not always combined, although it is plete twin pairs (n ¼ 2625) of known zygosity (497
unreasonable to assume that most behaviors are female MZ, 350 male MZ, 424 female same-sex DZ,
affected solely by genes or solely by environment. 446 male same-sex DZ, and 908 opposite-sex DZ
Several twin studies have shown that there may be pairs) who had answered the breakfast-eating ques-
genetic influences on eating behavior, although envi- tion, and their 2443 mothers and 2220 fathers.
ronmental influences are often more important (de
Castro, 1993; Faith et al., 1999; Falciglia and Nor-
Measures
ton, 1994; Heitmann et al., 1999; Hur et al., 1998;
van den Bree et al., 1999). We are, however, unaware The frequency of breakfast eating was assessed
of any studies examining how breakfast eating pat- by the following question: ‘‘How often do you eat
terns aggregate in families and whether breakfast eat- breakfast (for example, sandwiches, milk, hot cereal,
ing is genetically influenced. Thus the aim of this other similar food) before going to school or going
study was to determine the proportion of genetic and to work?’’ The three alternative responses were
Genetic and Environmental Factors 505

‘‘every morning’’, ‘‘3–4 times a week’’, ‘‘about once the Pearson chi-square statistic, we assessed whether
a week or less often’’. the proportion of MZ versus DZ twins attending a
Other measures used in the analyses were gen- different class in elementary school, attending a dif-
der, twin zygosity, parental age, and highest level of ferent junior high school, or living apart at the age
parental education, and family socio-economic sta- of 16 was different. We also assessed whether the
tus (SES). 95% confidence intervals of polychoric correlations
of breakfast eating frequencies of MZ twins living
together versus MZ twins living apart differed from
Equal Environments Assumption each other, and repeated this analysis for DZ twins.
The basic principle of twin studies is to com-
pare genetically identical MZ twins with DZ twins Model Fitting
who share only half of their genes on average. If
MZ twins are more similar to each other than DZ We used standard univariate twin analyses to
twins, the difference is caused by genetic effects. describe patterns of familial aggregation of break-
This, though, is only true if the greater similarity of fast eating frequency. Twin similarity was assessed
MZ twins is not a result of the environment treating using the pairwise concordance rate, and polychoric
MZ twins differently from DZ twins: to ensure that correlations were computed from pairwise contin-
higher MZ correlations of the trait studied are gency tables. We also analyzed the parents’ pairwise
caused by genes, not environment, we need to similarity for breakfast eating. The effect of parental
assume that environmental influences stay equal breakfast eating status on that of their offspring
across different zygosities. This crucial assumption was examined for each parent. Basic statistical anal-
made by twin studies is called the equal environ- yses were performed with SAS, release 6.12 (1996).
ments assumption. We tried to make sure that in We carried out model-fitting using the computer
matters possibly affecting breakfast eating, MZ and program Mx (Mx home page, 2001) to estimate the
DZ twin environments were not different. genetic and environmental components of variance in
breakfast eating. From data on twins reared together
one can model four separate parameters: additive
Data Analysis genetic effects (A), dominance genetic effects (D),
common environmental effects (C), and unique envi-
Descriptive Statistics
ronmental effects (E). If alleles at a locus or across
As an indicator of family SES we used father’s several loci act in an additive manner, the result is
or mother’s occupation, whichever ranked higher. If called additive genetic effects; if alleles or loci interact
only one parent had responded, that parent’s occu- (meaning that the net effect is greater than the simple
pation determined the family’s SES. If both parents’ additive effect), the effect is called dominance. Com-
occupations were unknown, the family was excluded mon environmental effects are those shared by both
from the analyses of the effect of SES on breakfast twins or all family members; unique environmen-
eating. The parental occupations were divided in tal effects are individual-specific and uncorrelated
seven categories using the Statistics Finland 1989 between family members. Unique environmental
classification of SES (Sosioekonomisen aseman effects include also measurement error.
luokitus, 1989, 1990); we contrasted the two highest Based on the different combinations of these
income categories with the five lowest, To assess parameters, AE, ACE, ADE, and CE models can
whether breakfast eating differed in high versus low be fitted. Effects caused by dominance and common
SES families or employed versus unemployed fami- environmental effects cannot be simultaneously
lies, we used the Pearson chi-squared test of inde- modeled (Falconer and Mackay, 1996). Model fit-
pendence with correction for clustered sampling ting started with ACE models, and advanced to
(expressed as an F ratio, as described by Rao and submodels AE and CE. We first analyzed both
Scott, 1984) in Stata, version 7.0 (2000). sexes separately.
To ensure that the equal environment assump-
tion was not violated, the similarity of the living
Indicators of Fit
conditions of the MZ and DZ twins and the
amount of time the twins spent together with their To assess how well a model fits the data, we
co-twins were assessed by several questions. Using used chi-square (v2 ) goodness-of-fit statistics and
506 Keski-Rahkonen, Viken, Kaprio, Rissanen, and Rose

their associated P values, with a large P value indi- Sex-limitation Models


cating a good fit. The likelihood-ratio of alternative
To assess whether sex-specific influences are
models was calculated by the difference in their v2
important in breakfast eating, we used data from
values. The difference of two such v2 goodness-of-fit
same-sex and opposite-sex twin pairs to fit general
statistics is itself distributed as a v2 statistic with
sex-limitation models and a common-effects sex-
degrees of freedom equal to the difference in degrees
limitation model. These models were fitted to data
of freedom of the two models being compared (Ne-
from 3 · 3 contingency tables using sex-specific
ale and Cardon, 1992), If the difference in the v2
threshold values. The general sex-limitation model
values of two models was not statistically significant
(Fig. 1) estimates sex-specific contributions of A, C,
Akaike’s information criterion (AIC, calculated as
and E, and either a sex-specific additive genetic
v2-2 df) was used as an additional indicator of fit: a
effect (AM) or a sex-specific common environment
model with a lower AIC value was chosen (Neale
effect (CM) that both load only on one sex, here
and Cardon, 1992). We compared alternative mod-
specified to be male. The common-effects model, a
els by means of the principle of parsimony. Models
submodel to the general sex-limitation model, esti-
with fewer parameters are preferable if they do not
mates only sex-specific A, C, and E (lacking AM or
provide substantially worse fit. Lower AIC values
CM). The common-effects model assumes that the
suggest a more parsimonious explanation of the
same genes and environmental factors influence
data.

Fig. 1. General sex-limitation model of twin phenotypes (shown here for opposite-sex pairs). Each phenotype is caused by additive (A),
common environmental (C), and unique environmental (E) factors. In addition the model allows for either genetic (AM) or common envir-
onmental (CM) effects that are sex-specific, here shown to affect the male phenotype. A submodel, the common-effects sex-limitation
model, does not include the sex-specific components (AM) or (CM).
Genetic and Environmental Factors 507

the breakfast eating of both boys and girls, but that ronment or unique environmental experiences,
the magnitude of the influences differs for sexes. because all the variables that determine the parental
The general sex-limitation model allows that sex dif- phenotype (A, C, and E) are correlated. In contrast
ferences may also be caused by different genes (or to the simplistic social homogamy model, spouse
environmental factors) in males and females. In our selection is not based on any component of the
models, we constrained the variance for one to phenotype (A, C, or E) alone. Cultural transmission
equal unity. The sex-specific threshold values were to the offspring originates from the parental pheno-
0.6, 1.2 for males and 0.5, 1.1 for females. type (being thus affected by A, C, and E), and influ-
ences the common environment of the offspring.
The model allows differing cultural transmission
Twin-family Models
for fathers-sons, fathers-daughters, mothers-sons,
To confirm and expand results obtained from and mothers-daughters. The phenotypic assortment
classical twin models, we then fitted twin-family model also implies that because parents pass both
models to data from polychoric correlation matrices genetic and environmental factors to their offspring,
and asymptotic covariance matrices based on all these factors (A and C) are somewhat correlated in
four family members using weighted least squares the offspring. In the classical twin model, this corre-
estimation. Twin-family models try to explain par- lation is assumed to be zero; in the phenotypic
ent-child behavioral resemblance by making formal assortment model, the magnitude of this correlation
assumptions about the parental generation’s geneti- can be estimated.
cally and environmentally mediated influence on the
offspring. First, we tested a model of social homog-
amy (Eaves et al., 1989). Social homogamy refers to RESULTS
spouse selection that is based on environmental sim-
Descriptive Statistics
ilarities: the community and culture of an individual
choose his spouse for him, and the spousal resem- Table I shows the breakfast eating frequencies
blance is solely due to this common environment of the twins and their parents. Breakfast skipping
(C) (Reynolds et al., 1996). This might for example was relatively common: 15.5% of girls and 12.9% of
be true for people marrying mainly because they boys ate breakfast only once a week or less often.
belong to the same religious community. According The fathers of twin families were the least frequent
to this model, parents influence their offspring in two breakfast eaters: only 59.8% of fathers ate breakfast
ways: through genes and through parental common daily, whereas 71.0% of mothers did so. Breakfast
environment (which brought the parents together in skipping of mothers and twins was significantly more
the first place), Parental unique environment (E) is common in families where at least one family mem-
assumed not to transmit to the offspring. ber had not responded the breakfast eating question
Second, we tested phenotypic assortment models than in families where everyone had responded (p <
(Maes et al., 1997). Phenotypic assortment refers to 0.000l for twins, p ¼ 0.014 for mothers, p ¼ 0.168
the selection of spouses based on observable charac- for fathers).
teristics (phenotypes) (Neale et al., 1994; Neale and The mean age of the fathers of the twins
Cardon, 1992; Reynolds et al., 1996), that is, traits was 46.4 (SD 5.7) years and that of mothers 44.3
that can be influenced by either genes, family envi- (SD 4.9). Concerning higher education, 19.2% of

Table I. Frequency of Breakfast Eating of 16-year-old Twins and their Parents

Twins Parents

Girls Boys Mothers Fathers

n % n % n % n %

Breakfast every morning 1883 68.5 1841 73.6 1735 71.0 1328 59.8
Breakfast 3–4 times a week 442 16.1 336 13.4 243 9.9 312 14.1
Breakfast once a week or less often 425 15.5 323 12.9 465 19.0 580 26.1
Total 2750 100.0 2500 100.0 2443 100.0 2220 100.0
508 Keski-Rahkonen, Viken, Kaprio, Rissanen, and Rose

fathers and 23.6% of mothers reported having com- year. Concerning time spent together at school,
pleted voluntary, academically oriented senior high 4.9% of the twins (5.1% of MZ, 5.4% of DZ twins,
school, which in Finland follows the compulsory difference not statistically significant) had not
nine years of basic education. The occupations of shared the same teacher and classroom in elemen-
the fathers were as follows: 20.1% of the fathers tary school (grades 1–6), and 6.7% of the twins
were independent entrepreneurs or independent farm- (2.3% of MZ, 9.4% of DZ twins, v2 ¼ 41.34, df ¼ l,
ers, or were otherwise self-employed; 24.4% were p < 0.00l) went to different junior high schools.
white-collar workers in executive, research, or teach- Thus the early environment of MZ and DZ twins
ing positions, or other positions requiring good the- was fairly similar in these respects, but on the verge
oretical skills; 17.0% were lower-level white-collar of adulthood DZ twins were more likely to go their
workers; 37.4% were blue-collar workers; 0.2% were separate ways.
retired, and 0.7% were of unclassified or unknown
occupation.
Model Fitting
Of the twin families, 39.6% belonged into the
higher SES group, 56.1% to the lower SES group, The pairwise concordance rates of breakfast
and 4.3% could not be classified as the occupation eating for twins are presented in Table II for each
of both parents was unknown or missing. Breakfast category of breakfast eating. Because the MZ twin
was skipped by 15.0% of twins belonging to lower correlations in both sexes were much higher than
SES group and 12.3% twins belonging to higher those of DZ twins, we thought it likely that genetic
SES group; the difference was not statistically sig- effects have an important contribution to breakfast
nificant (F ¼ 2.89, p ¼ 0.057). eating. Based on the twin correlations, it could be
During the year the questionnaire data were estimated that common environmental effects, not
collected, either or both of the parents had been dominance effects, are important for breakfast eat-
unemployed in 4.4% of the families in 1991, 10.3% ing. Thus we decided to concentrate on modeling
in 1992, 19.0% in 1993, 16.7% in 1994, and 19.4% common environmental effects (ACE models) rather
in 1995, respectively. These rates agreed well with than dominance effects (ADE models). Because cor-
the Statistics Finland unemployment rates in the relation coefficients for opposite-sex DZ twins were
respective years (Statistics Finland home page, lower than those for female same-sex DZ twins, we
2000). Twins living in families where at least one of expected that there may be sex differences in genetic
the parents had been unemployed during the year influences, environmental influences, or both.
of the query were significantly more likely to skip We used model fitting to estimate more accu-
breakfast than twins living in fully employed fami- rately the components of genetic and environmental
lies: 17.7% of twins living in unemployed families variance in breakfast eating. First, we fitted simple
and 13.7% of twins living in employed families ate twin models, i.e., different combinations of additive
breakfast once a week or less often (F ¼ 3.24, genetic (A) and common (C) and unique (E) envi-
p ¼ 0.041). ronmental effects, to data from like-sexed twin pairs
An attempt was made to examine some factors only. For females, the ACE model was the only one
that might affect the equal environment assumption that gave the data an acceptable fit. For males, both
and make some twins more similar than others. At the ACE and AE model fit the data well: by v2 dif-
the age of 16, 3.6% of the twins in this sample were ference test, the male ACE model had a significantly
living apart DZ twins lived apart slightly more better fit that the male AE model (Dv2 ¼ 4.02,
often than MZ twins (4.0% versus 2.5%, v2 ¼ 3.94, Ddf ¼ l, p ¼ 0.04).
df ¼ l, p ¼ 0.047), but breakfast eating correlations Second, we used more complex models that
of MZ twins living together and apart did not differ could manage data from all twin pairs, including
significantly; neither did those of DZ twins living opposite-sex twin pairs, to test whether different
together and apart. Moreover, 68.4% of twins living factors are important for different sexes. These sex-
apart had done so only since the age fifteen or later, limitation models are detailed in Table III. The gen-
that is, for a year or less. In Finland, compulsory eral sex-limitation model (the model with additive
schooling is completed at the age of 15 or 16; thus genetic effects specific to males, AM, or common
it is logical that twins making a different career environmental effects specific to males, CM) did not
choice may move apart at that stage. Only 22 twin differ significantly from the more parsimonious
pairs reported having lived apart for more than a common-effects sex-limitation model by v2 differ-
Genetic and Environmental Factors 509

Table II. Pairwise Breakfast Eating Concordance Rates of the Twins

Concordant for Discordant for


breakfast eating breakfast eating

1 2 3 1–2 1–3 2–3 Total of discordants Polychoric


correlation
n (individuals) n (pairs) n(%) n(%) n(%) n(%) n(%) n(%) n(%) coefficient 95% CI

Female MZ 994 497 322 36 43 43 19 34 96 0.86 0.81–0.91


64.8 7.2 8.7 8.7 3.8 6.8 19.3
Male MZ 700 350 247 14 23 28 19 19 66 0.81 0.73–0.89
70.6 4.0 6.6 8.0 5.4 5.4 18.9
All MZ 1694 847 569 50 66 71 38 53 162 0.84 0.80–0.88
67.2 5.9 7.8 8.4 4.5 6.3 19.1
Female like-sexed DZ 848 424 234 21 34 69 36 30 135 0.65 0.56–0.75
55.2 5.0 8.0 16.3 8.5 7.1 31.8
Male like-sexed DZ 892 446 275 10 22 66 47 26 139 0.54 0.42–0.66
61.7 2.2 4.9 14.8 10.5 5.8 31.2
All like-sexed DZ 1740 870 509 31 56 135 83 56 274 0.60 0.52–0.67
58.5 3.6 6.4 15.5 9.5 6.4 31.5
All opposite-sex DZ 1816 908 486 37 50 161 108 66 335 0.48 0.40–0.56
53.5 4.1 5.5 17.7 11.9 7.3 36.9
All DZ 3556 1778 995 68 106 296 191 122 609 0.54 0.48–0.59
56.0 3.8 6.0 16.6 10.7 6.9 34.3
Total of twins 5250 2625 1564 118 172 367 229 175 771
59.6 4.5 6.6 14.0 8.7 6.7 29.4

Note: 1, Breakfast every day. 2, Breakfast 3–4 times a week. 3, Breakfast once a week or less often. Rounding error in sums of some
percentages.

ence test (Dv2 ¼ 1.01, Ddf ¼ l, p ¼ 0.30). The com- Although mothers appear slightly more like their
mon-effects sex-limitation model was the best-fitting offspring than fathers do, the difference was not sta-
model according to AIC. The good fit of the com- tistically significant.
mon-effects sex-limitation model implies that com- Of twin-family models, we first fit a social
mon environmental effects in breakfast eating are homogamy model to the parent and offspring data
more important for females than males; additive from the five zygosity groups. Taking the results of
genetic effects account for a larger proportion of the sex-limitation models as a starting point, our
variability in breakfast eating in males than in baseline model assumed common effects sex limita-
females, but both sources of variation are needed to tion in the ACE estimates, but allowed for differing
account for the data. The sex differences appear cultural transmission for fathers–sons, fathers–
real: setting male and female ACE estimates to be daughters, mothers–sons and mothers–daughters.
equal caused a significant deterioration in model fit This model fit the data very well, v2 ¼ 22.33,
(Dv2 ¼ 7.25, Ddf ¼ 2, p ¼ 0.03). df ¼ 21, p ¼ 0.38. Relative to the sex-limitation
Third, family models were used to check the model based on the twins only (Table III), estimates
validity of modeling results explained above, and to of additive genetic effects were lower for both
explore assortative mating effects. The overall females (0.31) and males (0.47), and estimates of
breakfast eating correlation between parents of the common environmental effects were higher for both
twins was fairly strong, 0.39 (95% CI: 0.34–0.45). females (0.54) and males (0.27). Spousal assortment
The overall mother-daughter breakfast eating corre- based on the shared environment was estimated at
lation was 0.30 (95% CI: 0.25–0.36), mother–son the upper boundary of 1.0 (95% CI: ¼ 0.81–1.0).
correlation 0.35 (95% CI: 0.29–0 41), father–daugh- The individual cultural transmission parameters were
ter correlation 0.27 (95% CI: 0.21–0.33), and small and nonsignificant, and the four parameters
father–son correlation 0.29 (95% CI: 0.23–0.35). could be constrained to an equal estimate (0.16; 95%
510 Keski-Rahkonen, Viken, Kaprio, Rissanen, and Rose

32 0.059 )18.613 CI: ¼ 0.08–0.24) without disrupting fit (Dv2 ¼ 0.24,

Note: 1Either male-specific additive genetic component (Am) or male-specific common environmental component(Cm). 2Akaike Information Criterion. 3Best-fitting model by the
)17.70

)17.70
AIC2

Ddf ¼ 3). As in the twin-based sex limitation mod-


Goodness-of-fit tests

31 0.057 els, addition of sex-specific genetic (Dv2 ¼ 2.65,

31 0.057
Ddf ¼ l) or shared environmental (Dv2 ¼ 2.66,
P

Ddf ¼ l) parameters did not significantly improve


fit, but constraining genetic and environmental esti-
df

mates to be equal for males and females did result


Chi-squared

in a significant disruption of fit (Dv2 ¼ 6.24, Ddf ¼


45.39

44.31

44.31

2). The higher shared environmental and lower


genetic estimates relative to the sex-limitation models
based on twins alone reflect the fact that in the
M: male-specific

0.31 (0.00–0.52)

0.11 (0.00–0.29)

social homogamy model the substantial spousal


component1

correlations for breakfast eating can be explained


only by assortment based on shared environments.


The social homogamy model provides sensible
parameter estimates when C effects are large or
Common-effects 0.41 (0.21–0.63) 0.66 (0.47–0.79) 0.45 (0.23–0.62) 0.14 (0.05–0.29) 0.14 (0.11–0.19) 0.20 (0.14–0.28)

0.41 (0.22–0.63) 0.23 (0.00–0.77) 0.45 (0.24–0.62) 0.26 (0.06–0.48) 0.14 (0.10–0.19) 0.20 (0.14–0.29)

0.41 (0.22–0.63) 0.54 (0.27–0.77) 0.44 (0.24–0.62) 0.15 (0.05–0.30) 0.14 (0.10–0.19) 0.20 (0.14–0.29)

assortment effects are small. In the current data the


high spousal correlations imply a stronger common
Males

environmental effect than the twin correlations do,


environment

even with the assortment parameter at the upper


E: Unique

bound of 1.0, so C effects increase and A effects


decrease to compensate.
Table III. Sex-limitation Models

Components of variance estimates (95% CI)

Next, we fit a phenotypic assortment model to


Females

the data. Our baseline model again assumed com-


mon effects sex limitation in the ACE estimates, but
allowed for differing cultural transmission for
fathers–sons, fathers–daughters, mothers–sons and
mothers–daughters. This model fit the data very
Males

well (v2 ¼ 15.64, df ¼ 21, p ¼ 0.79). Addition of


sex-specific genetic (Dv2 ¼ 3.35, df ¼ l) or shared
environment
C: Common

environmental (Dv2 ¼ 3.35, df ¼ l) parameters did not


significantly improve fit. As in the social homogamy
model, the four cultural transmission parameters
Females

could be set equal without significantly disrupting fit


(Dv2 ¼ 5.16, df ¼ 3, p ¼ 0.16). This single cultural
transmission variable ()0.16; 95% CI: ¼ )0.37–0.01)
did not quite reach significance. The assortative mat-
ing parameter was estimated at 0.40 (95% CI: ¼
Males

0.34–0.47). Additive genetic variance components


were 0.72 (95% CI: ¼ 0.46–0.98) for women and
genetic effects
A: Additive

0.63 (95% CI: ¼ 0.38–0.89) for men. Common envi-


ronment estimates were 0.29 (95% CI: ¼ 0.20–0.41)
for women and 0.25 (95%CI: ¼ 0.16–0.36) for men.
Females

Akaike Information Criterion.

The gene-environment correlation induced by cul-


tural transmission was )0.19 (95% CI: ¼ )0.47–
0.01).
sex-limitation3

sex-limitation

sex-limitation

DISCUSSION
with AM

with CM

The determinants of breakfast eating fre-


General

General
Model

quency differ in adolescent boys and girls: the fam-


ily and pair-specific environment is more important
Genetic and Environmental Factors 511

for girls, whereas genes are more important for Even though we found no significant effect of
boys. In our data, twin-family models broadly sup- parental breakfast eating on child behavior, we found
ported the results obtained using classical twin significant effects of the family environment on ado-
models; compared to them, heritability estimates lescent breakfast eating for both boys and girls,
decreased in social homogamy models, and implying that other types of parental effects may be
increased in phenotypic assortment models. present. It is possible, for instance, that the parents
Although both the social homogamy models and who encourage regular breakfasts for their children
the phenotypic assortment models fit the data well, do not follow their own advice, so that children are
the parameter estimates were more reasonable in responding to something other than direct parental
the phenotypic assortment model. The somewhat modeling. It is also possible that the crucial environ-
unrealistic results of the social homogamy models mental influences on this behavior change from gen-
were not surprising. In the presence of strong eration to generation; the environmental factors
spousal correlations these models expect larger influencing the adolescents (even those created by the
common environmental effects than are typically parents) may differ from those that influence the
seen in behavior genetic research. same behavior in the parents. For generational differ-
The phenotypic assortment models indicated ences, it would be of interest to assess these adoles-
that A–C covariance was small and negative, mean- cents when they become parents themselves.
ing that in our data additive genetic factors and Why is breakfast eaten irregularly or not at all?
common environmental factors were passed on rela- The importance of breakfast as a meal has declined
tively independently, and that the classical twin during the past 50 years. The traditional Finnish pat-
model assumption that additive genetic effects and tern of three hot family meals has changed into one
common environmental effects are uncorrelated was of 1–2 daily meals, largely because most women work
a valid approximation. In contrast to the social outside home (Prättälä and Roos, 1999). Breakfast,
homogamy assumption of assortment by environ- previously a warm meal, has become lighter, consist-
ment, the assumption of phenotypic assortment pro- ing most often of bread, cheese, coffee, or tea, and
vided both a good fit and reasonable parameter contributing less than 20% of the daily energy intake
estimates. Eating habits may indeed be a factor in (Kleemola et al., 1997). Lunch is almost always eaten
spouse selection, as eating is an important form of outside the home: all students of Finnish schools
social interaction; however, it is hardly to be receive a free lunch that is designed to meet one third
expected that anyone chooses a spouse based on of the student’s daily nutritional requirements, and
breakfast patterns alone. Eating habits are more most adults purchase similar, often subsidized,
likely to reflect some other underlying factor that lunches at their workplace. Many families do not
affects spouse selection, e.g., SES, general health- bother to prepare another warm meal at home, pre-
oriented behavior, or other lifestyle factors. ferring individually eaten snacks. Disruption of fam-
Cultural transmission was of borderline impor- ily meal patterns may induce meal skipping.
tance, not quite statistically significant, and negative In studies conducted in developing countries,
in direction, implying that the breakfast eating hab- breakfast skipping is often linked with poverty and
its of parents (or correlated behaviors) have little malnutrition (Pollitt et al., 1998; Powell et al., 1998);
direct impact on the breakfast eating of children, or in Western countries, with low SES (Höglund et al.,
that children tend to behave in opposition to paren- 1998; Murphy et al., 1998). In our sample, breakfast
tal example. skipping was slightly more common among twins liv-
Another likely possibility is that the cultural ing in families of lower SES or with unemployed par-
transmission estimate is an artifact of the model’s ents. The years of data collection, 1991–1995,
assumption that the same genetic influences on coincided in Finland with economic depression and
breakfast eating are being expressed at the age of sharply rising unemployment. This fairly severe eco-
the children and the age of the parents. If, in fact, nomic hardship may even have affected nutritional
different genetic influences operate at the two ages, matters in some families. However, because breakfast
then the parent-offspring correlation will be lower skipping was also common in higher SES and fully
than expected. The only way for the model to employed families, it is more likely that other factors
decrease expected parent offspring correlations with- account for the majority of breakfast skipping. In the
out decreasing expected twin correlations is with a few previous studies assessing reasons of adolescents
negative estimate of cultural transmission. breakfast skipping in western countries, ‘‘lack of
512 Keski-Rahkonen, Viken, Kaprio, Rissanen, and Rose

time’’, ‘‘not hungry’’, or ‘‘not feeling like it’’ were the addresses only one age group of adolescents, its
reasons supplied by the majority of responders (Shaw, results may not be generalized to other age groups.
1998; Urho and Hasunen, 1999), Many Finnish ado- The genetic and environmental effects on breakfast
lescents may skip breakfast simply because they are eating quantified by our study may be age-specific;
tired in the morning and because the school lunch is breakfast eating of adults may be transmitted differ-
served early. We had no data on the average amount ently. Due to the cross-sectional study setting, cau-
of sleep of the twins in our sample; neither was the sal inferences cannot be made. Although it seems
trait morningness-eveningness measured in this sam- that there has been a change in breakfast habits in
ple. However, it is known that sleep length in adults Western countries over the past decades, this study
and morningness-eveningness in adolescents both cannot address transcultural or generational differ-
have an overall heritability estimate of 0.44 (Partinen ences. Models used in this study are based on
et al., 1983; Vink et al., 2001). In future studies it assumptions that heritable variance remains con-
would be of interest to assess whether sleep patterns stant across generations, and that environments are
or other chronobiological patterns and breakfast eat- similar for MZ and DZ twins. These assumptions
ing frequency have a partially shared genetic liability. may not be valid. Although the living conditions of
Some individuals, particularly girls, skip both our sample were fairly homogenous, it is possible
breakfast and lunch (Urho and Hasunen, 1999). Diet- that the equal environments assumption was vio-
ing, body dissatisfaction, and disordered eating are lated in more subtle ways.
more common among both girls and breakfast skip-
pers (Bellisle et al., 1995; Melve and Baerheim, 1994;
Shaw, 1998). For some individuals concerned with Conclusions
their body shape, especially girls, breakfast skipping
Breakfast eating is moderated differently in ado-
may thus be a chosen method of weight control. Fur-
lescent boys and girls. Unlike boys, girls are much
ther studies of breakfast eating that take into account
influenced by the family and pair-specific environ-
factors like total energy intake and expenditure, met-
ment. In girls, environmental influences may override
abolic differences, satiety mechanisms, and sleep pat-
genetically driven factors. Factors that constitute the
terns would be useful in determining how these issues
shared family environment relevant for the develop-
are related to each other.
ment of breakfast eating habits are unknown. As
both breakfast skipping and dieting are more com-
Strengths mon among girls than among boys, and even more
common among parents, family meal habits and
A particular strength of our study is its large,
body shape ideals may be more important determi-
representative, nationwide twin sample. There is lit-
nants of adolescent girl breakfast eating than physi-
tle bias in socioeconomic status of the study families
ological impulses.
compared to the general population. The high res-
Although specific factors that influence break-
ponse rate also ensures that the non-responder bias
fast eating are not known, these differences should
is small. Findings from previous population studies
be taken into account when breakfast eating is
on adolescent breakfast eating frequency in Sweden
promoted. Attempts of breakfast promotion that
(Höglund et al., 1998) and the US (Siega-Riz et al.,
are able to shape family-specific environmental fac-
1998) and adult breakfast eating in Finland (Puska
tors may be more successful than those that fail
and Smolander, 1980) are in line with our observa-
do so.
tions. A further strength of this study is the inclu-
sion of parental data, which increased the power of
the study, allowed us to confirm and expand results
ACKNOWLEDGMENTS
from classical twin models and to test alternative
models of parental transmission. This has previously This study was supported by grants from the
been fairly rarely accomplished in twin studies. National Institute of Alcohol Abuse and Alcohol-
ism (AA08315), the Academy of Finland (44069),
the European Union Fifth Framework Program
Weaknesses
(QLRT-1999-00916), and Yrjö Jahnsson, Jalmari and
This study is limited in several respects. Mea- Rauha Ahokas, Helsingin Sanomat, and Finnish
surements are based on self-report. As this study Cultural Foundations.
Genetic and Environmental Factors 513

REFERENCES schoolday breakfast in Lorraine (France). Nutr. Res.


10:1195–1203.
al Sudairy, A., and Howard, K. (1992). Dietary habits of techni- Murphy, J. M., Pagano, M. E., Nachmani, J., Sperling, P.,
cal and vocational students in Riyadh, Saudi Arabia—I. Kane, S., and Kleinman, R. E. (1998). The relationship of
Meal skipping. J. R. Soc. Health 112:217–218. school breakfast to psychosocial and academic functioning:
Baumert, P. W., Jr., Henderson, J. M., and Thompson, N. J. cross-sectional and longitudinal observations in an inner-
(1998). Health risk behaviors of adolescent participants in city school sample. Arch. Pediatr. Adolesc. Med, 152:899–
organized sports. J. Adolesc. Health 22:460–465. 907.
Bellisle, F., Monneuse, M. O., Steptoe, A., and Wardle, J. (1995). Mx: home page. (2001). http://views.vcu.edu/mx/ (accessed 27
Weight concerns and eating patterns: a survey of university November 2000).
students in Europe. Int. J. Obes. Relat. Metab. Disord. Neale, M. C., and Cardon, L. C. (1992), Methodology for genetic
19:723–730. studies of twins and families. Kluwer Academic Publishers,
Benton, D., and Parker, P. Y. (1998). Breakfast blood glucose, Dordrecht.
and cognition. Am. J. Clin. Nutr. 67:772S–778S. Neale, M. C., Walters, E. E., Eaves, L. J., Maes, H. H., and
Brugman, E., Meulmeester, J. F., Spec-van der Wekke, A., Beuker, Kendler, K. S. (1994). Multivariate genetic analysis of
R. J., Zaadstra, B. M., Radder, J. J., and Verloove-Vanhorick, twin-family data on fears: Mx models. Behav. Genet.
P. S. (1997). Dieting, weight and health in adolescents in The 24:119–139.
Netherlands. Int. J, Obes. Relat. Metab. Disord. 21:54–60. Neumark-Sztainer, D., Story, M., Toporoff, E., Himes, J. H.,
Brugman, E., Meulmeester, J. F., Spec-van der Wekke, A., and Resnick, M. D., and Blum, R. W. (1997). Covariations of
Verloove-Vanhorick, S. P. (1998). Breakfast-skipping in chil- eating behaviors with other health-related behaviors among
dren and young adolescents in The Netherlands. Eur. J. Pub- adolescents, J. Adolesc, Health 20:450–458.
lic Health 8:325–328. Nicklas, T. A., O’Neil, C. E., and Berenson, G. S. (1998). Nutri-
de Castro, J. M. (1993). Genetic influences on daily intake and ent contribution of breakfast, secular trends, and the role of
meal patterns of humans. Physiol. Behav. 53:777–782. ready-to-eat cereals: a review of data from the Bogalusa
Eaves, L. J., Fulker, D. W., and Heath, A. C. (1989). The effects Heart Study. Am. J. Clin. Nutr. 67:757S–763S.
of social homogamy and cultural inheritance on the covari- Nordlund, G., and Jacobson, T. (1999). Gymnasieelevernas matva-
ances of twins and their parents: a LISREL model. Behav. nor relaterat till hur de mår och känner sig, deras fysiska ak-
Genet, 19:113–122. tivitet, deras skolprestationer ock sociala bakgrund. [High
Faith, M. S., Rha, S. S., Neale, M. C., and Allison, D. B. (1999). school students, food habits in relation to their well-being,
Evidence for genetic influences on human energy intake: physical activity, school performance, and social background;
results from a twin study using measured observations. in Swedish]. Pedagogiska rapporter 58, Umeå universitetet.
Behav. Genet, 29:145–154. Nowak, M. (1998). The weight-conscious adolescent: body image,
Falciglia, G. A., and Norton, P. A. (1994). Evidence for a genetic food intake, and weight-related behavior. J. Adolesc. Health
influence on preference for some foods. J. Am. Diet. Assoc. 23:389–398.
94:154–158. Partinen, M., Kaprio, J., Koskenvuo, M., Putkonen, P., and
Falconer, D. S., and Mackay, T. F. C. (1996). Introduction to Langinvainio, H. (1983). Genetic and environmental determi-
quantitative genetics. 4th Ed. Prentice Hall, Harlow. nation of human sleep. Sleep 6:179–85.
Fisher, M., Schneider, M., Pegler, C., and Napolitano, B. (1991). Pollitt E., Cueto, S., and Jacoby, E. R. (1998). Fasting and cog-
Eating attitudes, health-risk behaviors, self-esteem, and anxi- nition in well- and undernourished schoolchildren: a review
ety among adolescent females in a suburban high school. J. of three experimental studies. Am. J. Clin. Nutr. 67:779S–
Adolesc. Health 12:377–384. 784S.
Haines, P. S., Guilkey, D. K., and Popkin, B. M. (1996). Trends Powell, C. A., Walker, S. P., Chang, S. M., and Grantham-
in breakfast consumption of US adults between 1965 and McGregor, S.M. (1998). Nutrition and education: a random-
1991. J, Am. Diet. Assoc. 96:464–470. ized trial of the effects of breakfast in rural primary school
Heitmann, B. L., Harris, J. R., Lissner, L., and Pedersen, N. L. children. Am. J. Clin. Nutr. 68:873–879.
(1999). Genetic effects on weight change and food intake in Prättälä, R., and Roos, E. (1999). From regional ethnographies
Swedish adult twins. Am. J. Clin. Nutr. 69:597–602. to interdisciplinary approaches-research on meals in Finland.
Hur, Y. M., Bouchard, T. J., Jr., and Eckert, E. (1998). Genetic Appetite 32:66–72.
and environmental influences on self-reported diet: a reared- Puska, P., and Smolander, A. (1980). Suomalaisen aikuisväestön
apart twin study. Physiol Behav. 64:629–636. terveyskäyttäytyminen, kevät 1980. [The health habits of
Höglund, D., Samuelson, G., and Mark, A. (1998). Food habits Finnish adults, spring 1980; in Finnish]. Kansanterveystieteen
in Swedish adolescents in relation to socioeconomic condi- laitoksen julkaisuja, Series B1.
tions. Eur. J. Clin. Nutr. 52:784–789. Rao J. N. K., and Scott A. J. (1984). On chi-squared tests for
Isralowitz, R. E., and Trostler, N. (1996). Substance use: toward multiway contingency tables with cell proportions estimated
an understanding of its relation to nutrition-related attitudes from survey data. Annals of Statistics 12:46–60.
and behavior among Israeli high school youth. J. Adolesc. Reynolds, C. A., Baker, L. A., and Pedersen, N. L. (1996). Mod-
Health 19:184–189. els of spouse similarity: applications to fluid ability measured
Kleemola, P., Roos, E., and Prättälä, R. (1997). Päivan tärkein in twins and their spouses. Behav. Genet. 26:73–88.
ateria – aterioiden koostumus vuonna 1992 [The most Rose, R. J., Kaprio, J. Winter, T., Koskenvuo, M., and Viken,
important meal of the day - composition of meals in 1992; in R. J. (1999). Familial and socioregional environmental effects
Finnish]. Suom. Lääkäril. 52:1027–1032. on abstinence from alcohol at age sixteen. J. Stud Alcohol
Maes, H. H. M., Neale, M. C., and Eaves. L. J. (1997). Genetic Suppl. 13:63–74.
and environmental factors in relative body weight and Samuelson, G., Bratteby. L. E., Enghardt, H., and Hedgren, M.
human adiposity. Behav. Genet. 27:325–351. (1996). Food habits and energy and nutrient intake in Swed-
Melve, K. K., and Baerheim, A. (1994). Signs of subclinical eat- ish adolescents approaching the year 2000. Acta Paediatr.
ing disorders in teenage girls. Scand, J. Prim. Health Care Suppl, 415:1–19.
12:197–203. Sarna, S., and Kaprio, J. (1980). Use of multiple logistic analysis
Michaud, C., Musse, N., Nicolas, J.P., and Méjean, L. (1990). in twin zygosity diagnosis. Hum. Hered. 30:71–80.
Nutrient intakes and food consumption in the adolescent’s
514 Keski-Rahkonen, Viken, Kaprio, Rissanen, and Rose

Sarna, S., Kaprio, J., Sistonen, P., and Koskenvuo, M. (1978). Urho, U.-M., and Hasunen, K. (1999) Yläasteen kouluruokailu
Diagnosis of twin zygosity by mailed questionnaire, Hum. 1998 [School meals in junior high school in 1998; in Finnish].
Hered. 28:241–254. Sosiaali-ja terveysministeriön selvityksiä 5.
SAS, Release 6.12. (1996). SAS Institute Inc., Cary, NC. van den Bree, M. B., Eaves, L. J., and Dwyer, J. T. (1999).
Shaw, M. E. (1998). Adolescent breakfast skipping: an Australian Genetic and environmental influences on eating patterns of
study. Adolescence 33:851–861. twins aged >/ ¼ 50 years. Am. J. Clin. Nutr. 70:456–465.
Siega-Riz, A. M., Popkin, B. M., and Carson, T. (1998). Trends Vink J. M, Groot A. S, Kerkhof G. A., and Boomsma D. I.
in breakfast consumption for children in the United States (2001). Genetic analysis of morningness and eveningness.
from 1965–1991. Am. J. Clin. Nutr. 67:748S–756S. Chronobiol. 18:809–822.
Sosioekonomisen aseman luokitus 1989. (1990). [The classifica- Wolfe, W. S., Campbell, C. C., Frongillo, E. A., Jr., Haas, J. D.,
tion of socioeconomic status, 1989; in Finnish.]. Käsikirjoja and Melnik, T. A. (1994). Overweight schoolchildren in New
17. Tilastokeskus, Helsinki. York State: prevalence and characteristics. Am. J, Public
Stata, Version 7.0. (2000). Stata Corporation, College Station, TX. Health 84:807–813.
Statistics Finland home page. (2000). Finland in figures, Labor
market, Unemployment. http://stat.fi/tk/tp/tasku/taskue_ty-
oelama.html (accessed 27 October 2000).
Terre, L., Drabman, R. S., and Meydrech, E. F. (1990). Relation-
ships among children’s health-related behaviors: a multivari-
ate, developmental perspective. Prev. Med. 19:134–146. Edited by Dorret Boomsma