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Randomized Controlled Trial
. 2014 Aug;100(2):507-13.
doi: 10.3945/ajcn.114.089573. Epub 2014 Jun 4.

The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial

Emily J Dhurandhar  1 , John Dawson  1 , Amy Alcorn  1 , Lesli H Larsen  1 , Elizabeth A Thomas  1 , Michelle Cardel  1 , Ashley C Bourland  1 , Arne Astrup  1 , Marie-Pierre St-Onge  1 , James O Hill  1 , Caroline M Apovian  1 , James M Shikany  1 , David B Allison  1
Affiliations
Randomized Controlled Trial

The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial

Emily J Dhurandhar et al. Am J Clin Nutr. 2014 Aug.

Abstract

Background: Breakfast is associated with lower body weight in observational studies. Public health authorities commonly recommend breakfast consumption to reduce obesity, but the effectiveness of adopting these recommendations for reducing body weight is unknown.

Objective: We tested the relative effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting.

Design: We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m²) between 25 and 40] aged 20-65 y. Our primary outcome was weight change. We compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast [no breakfast (NB)]. Randomization was stratified by prerandomization breakfast eating habits. A total of 309 participants were randomly assigned.

Results: A total of 283 of the 309 participants who were randomly assigned completed the intervention. Treatment assignment did not have a significant effect on weight loss, and there was no interaction between initial breakfast eating status and treatment. Among skippers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.71 ± 1.16, -0.76 ± 1.26, and -0.61 ± 1.18 kg for the control, breakfast, and NB groups, respectively. Among breakfast consumers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.53 ± 1.16, -0.59 ± 1.06, and -0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6% for the breakfast group and 92.4% for the NB group.

Conclusions: A recommendation to eat or skip breakfast for weight loss was effective at changing self-reported breakfast eating habits, but contrary to widely espoused views this had no discernable effect on weight loss in free-living adults who were attempting to lose weight.

Trial registration: ClinicalTrials.gov NCT01781780.

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Figures

FIGURE 1.
FIGURE 1.
Flow of participants through enrollment, allocation, and follow-up: CONSORT diagram. “Eat” indicates participants who were breakfast eaters before the study (≥4 times/wk); “Skip” indicates participants who were breakfast skippers before the study (≤3 times/wk). B, breakfast group; C, control group; CONSORT, Consolidated Standards of Reporting Trials; incl/excl, inclusion/exclusion; LTFU, lost to follow-up; NB, no-breakfast group.
FIGURE 2.
FIGURE 2.
Mean (±SD) covariate-adjusted weight changes by treatment and stratification. The gray dashed line represents “0” or no weight change from baseline. ANOVA found no significant effects of treatment or stratification on weight change. Among breakfast skippers, baseline mean (±SD) weight-, age-, sex-, site-, and race-adjusted weight changes were −0.71 ± 1.16, −0.76 ± 1.26, and −0.61 ± 1.18 kg for the C, B, and NB groups, respectively. Among breakfast eaters, baseline mean (±SD) weight-, age-, sex-, site-, and race-adjusted weight changes were −0.53 ± 1.16, −0.59 ± 1.06, and −0.71 ± 1.17 kg for the C, B, and NB groups, respectively. B, breakfast group; C, control group; NB, no-breakfast group.
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Comment in

  • Next will be apple pie.
    Levitsky DA. Levitsky DA. Am J Clin Nutr. 2014 Aug;100(2):503-4. doi: 10.3945/ajcn.114.092205. Epub 2014 Jun 25. Am J Clin Nutr. 2014. PMID: 24965309 No abstract available.

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