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Meta-Analysis
. 2020 Jun;28(6):1098-1109.
doi: 10.1002/oby.22791. Epub 2020 Apr 18.

Breakfast Skipping, Body Composition, and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Randomized Trials

Jonathan P Bonnet  1 , Michelle I Cardel  2 , Jaqueline Cellini  1 , Frank B Hu  3   4   5 , Marta Guasch-Ferré  3   4
Affiliations
Meta-Analysis

Breakfast Skipping, Body Composition, and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Randomized Trials

Jonathan P Bonnet et al. Obesity (Silver Spring). 2020 Jun.

Abstract

Objective: The objective of this study was to evaluate the effect of skipping breakfast on body composition and cardiometabolic risk factors.

Methods: This study conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating breakfast skipping compared with breakfast consumption. Inclusion criteria included age ≥ 18, intervention duration ≥ 4 weeks, ≥ 7 participants per group, and ≥ 1 body composition measure. Random-effects meta-analyses of the effect of breakfast skipping on body composition and cardiometabolic risk factors were performed.

Results: Seven RCTs (n = 425 participants) with an average duration of 8.6 weeks were included. Compared with breakfast consumption, breakfast skipping significantly reduced body weight (weighted mean difference [WMD] = -0.54 kg [95% CI: -1.05 to -0.03], P = 0.04, I2 = 21.4%). Percent body fat was reported in 5 studies and was not significantly different between breakfast skippers and consumers. Three studies reported on low-density lipoprotein cholesterol (LDL), which was increased in breakfast skippers as compared with breakfast consumers (WMD = 9.24 mg/dL [95% CI: 2.18 to 16.30], P = 0.01). Breakfast skipping did not lead to significant differences in blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein, insulin, fasting glucose, leptin, homeostatic model assessment of insulin resistance, or ghrelin.

Conclusions: Breakfast skipping may have a modest impact on weight loss and may increase LDL in the short term. Further studies are needed to provide additional insight into the effects of breakfast skipping.

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Conflict of interest statement

Disclosure: The authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Random-effects meta-analysis of changes in body weight (kilograms) in breakfast skippers as compared with breakfast consumers in RCTs. Closed rectangles and horizontal bars represent overall estimates (difference of means) and 95% CIs for individual studies. Diamonds represent overall estimate combining all the studies. ID, identifier; RCT, randomized controlled trial; WMD, weighted mean difference.
Figure 2
Figure 2
Random-effects model meta-analysis for changes in (A) HDL and (B) LDL concentrations in milligrams per deciliter from RCTs comparing breakfast skipping versus breakfast consumption. Conversion factor: TC from millimoles per liter to milligrams per deciliter: 38.67. Closed rectangles and horizontal bars represent the overall estimates (difference of means) and 95% CIs for individual studies. Diamonds represent the overall estimate combining all the studies. HDL, high-density lipoprotein cholesterol; ID, identifier; LDL, low-density lipoprotein cholesterol; RCT, randomized controlled trial; TC, total cholesterol; WMD, weighted mean difference.
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