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Meta-Analysis
. 2019 Jan 30:364:l42.
doi: 10.1136/bmj.l42.

Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials

Katherine Sievert  1 , Sultana Monira Hussain  1 , Matthew J Page  2 , Yuanyuan Wang  1 , Harrison J Hughes  1 , Mary Malek  1 , Flavia M Cicuttini  3
Affiliations
Meta-Analysis

Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials

Katherine Sievert et al. BMJ. .

Abstract

Objective: To examine the effect of regular breakfast consumption on weight change and energy intake in people living in high income countries.

Design: Systematic review and meta-analysis.

Data sources: PubMed, Ovid Medline, and CINAHL were searched for randomised controlled trials published between January 1990 and January 2018 investigating the effect of breakfast on weight or energy intake. ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform search portal were also searched in October 2018 to identify any registered yet unpublished or ongoing trials.

Eligibility criteria for selecting studies: Randomised controlled trials from high income countries in adults comparing breakfast consumption with no breakfast consumption that included a measure of body weight or energy intake. Two independent reviewers extracted the data and assessed the risk of bias of included studies. Random effects meta-analyses of the effect of breakfast consumption on weight and daily energy intake were performed.

Results: Of 13 included trials, seven examined the effect of eating breakfast on weight change, and 10 examined the effect on energy intake. Meta-analysis of the results found a small difference in weight favouring participants who skipped breakfast (mean difference 0.44 kg, 95% confidence interval 0.07 to 0.82), but there was some inconsistency across trial results (I2=43%). Participants assigned to breakfast had a higher total daily energy intake than those assigned to skip breakfast (mean difference 259.79 kcal/day, 78.87 to 440.71; 1 kcal=4.18 kJ), despite substantial inconsistency across trial results (I2=80%). All of the included trials were at high or unclear risk of bias in at least one domain and had only short term follow-ups (mean period seven weeks for weight, two weeks for energy intake). As the quality of the included studies was mostly low, the findings should be interpreted with caution.

Conclusion: This study suggests that the addition of breakfast might not be a good strategy for weight loss, regardless of established breakfast habit. Caution is needed when recommending breakfast for weight loss in adults, as it could have the opposite effect. Further randomised controlled trials of high quality are needed to examine the role of breakfast eating in the approach to weight management.

Study registration: PROSPERO registration number CRD42017057687.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
PRISMA flow diagram of included articles
Fig 2
Fig 2
Review authors’ judgments about each risk of bias item, presented as percentages across all included studies. Grey area in the blinding of outcome assessment (objective outcomes) indicates that the domain was not applicable because some trials did not measure any eligible objective outcomes.
Fig 3
Fig 3
Random effects meta-analysis of the mean difference in weight (kg), based on breakfast consumption or no breakfast consumption. Data for Dhurandhar 2014a are based on the subset of participants who identified as breakfast eaters in general, whereas data for Dhurandhar 2014b are based on the subset of participants who identified as breakfast skippers in general. Data for Geliebter 2014a are based on the comparison of cornflakes with no breakfast, whereas data for Geliebter 2014b are based on the comparison of porridge with no breakfast (sample size for the no breakfast group was halved in each comparison to avoid double counting). Data for Schlundt 1992a are based on the subset of participants who identified as breakfast eaters in general, whereas data for Schlundt 1992b are based on the subset of participants who identified as breakfast skippers in general
Fig 4
Fig 4
Contour enhanced funnel plot for random effects meta-analysis of mean difference in weight (kg), based on breakfast consumption or no breakfast consumption
Fig 5
Fig 5
Random effects meta-analysis of the mean difference in total daily energy intake (kcal/day), based on breakfast consumption or no breakfast consumption. 1 kcal=4.18 kJ=0.00418 MJ
Fig 6
Fig 6
Contour enhanced funnel plot for the random effects meta-analysis of the mean difference in total daily energy intake (kcal/day), based on breakfast consumption or no breakfast consumption. 1 kcal=4.18 kJ=0.00418 MJ
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References

    1. NCD Risk Factor Collaboration (NCD-RisC) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017;390:2627-42. 10.1016/S0140-6736(17)32129-3 - DOI - PMC - PubMed
    1. Peeters A, Backholer K. Is the health burden associated with obesity changing? Am J Epidemiol 2012;176:840-5. 10.1093/aje/kws328 - DOI - PubMed
    1. Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 377:557-567. - PMC - PubMed
    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-14. 10.1001/jama.2014.732 - DOI - PMC - PubMed
    1. British Dietetic Association. Healthy breakfast. 2016. https://www.bda.uk.com/foodfacts/healthy_breakfast

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