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A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management.

ABSTRACT: The recommendation to eat breakfast has received scrutiny due to insufficient causal evidence for improvements in weight management. Despite the limited number of randomized controlled trials examining the effects of breakfast consumption compared with skipping breakfast on weight loss, an increasing number of studies target the hormonal and behavioral mechanisms underlying weight management. This review provides a comprehensive examination of the intervention-based clinical trials that test whether breakfast consumption improves appetite control and satiety as well as energy expenditure compared with skipping breakfast. Several factors were considered when interpreting the body of evidence. These include, but were not limited to, the following: the composition of breakfast, with a specific focus on dietary protein; meal size and form; and habitual breakfast behaviors. The evidence within this review shows positive to neutral support for the inclusion of breakfast for improvements in appetite control, satiety, and postprandial energy expenditure. The protein content, energy content, and form of the meal (i.e., beverages compared with foods) are key modulating factors for ingestive behavior and energy expenditure mechanisms. Specifically, breakfast meals containing a larger amount of protein (?30 g protein/meal) and energy (?350 kcal/meal) and provided as solid foods increased the magnitude of the appetite and satiety response compared with breakfast skipping. Longer-term randomized controlled trials including the measurement of ingestive behavior and weight management are needed to identify the role of breakfast for health promotion.

SUBMITTER: Gwin JA

PROVIDER: S-EPMC6247188 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management.

Gwin Jess A JA Leidy Heather J HJ

Advances in nutrition (Bethesda, Md.) 20181101 6

The recommendation to eat breakfast has received scrutiny due to insufficient causal evidence for improvements in weight management. Despite the limited number of randomized controlled trials examining the effects of breakfast consumption compared with skipping breakfast on weight loss, an increasing number of studies target the hormonal and behavioral mechanisms underlying weight management. This review provides a comprehensive examination of the intervention-based clinical trials that test whe ...[more]

PMID: 30204837

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Project description:BackgroundEvidence suggests that regular eating patterns (i.e., consistent day-to-day frequency and timing of consumption) may be favorable with respect to weight status, and breakfast may be a particularly important meal for weight maintenance. We examined the relationship between regular breakfast consumption habits and weight status among women.Materials and methodsModified Poisson regression models examined day-to-day regularity in breakfast consumption among 46,037 women in the prospective Sister Study cohort in relation to weight status. Cross-sectional outcomes included overweight (body mass index (BMI) ≥ 25.0 kg/m2) and obesity (BMI ≥ 30.0 kg/m2); waist circumference (WC) ≥ 88 cm; and waist-to-hip ratio (WHR) ≥ 0.85. Self-reported weight 5 years post-baseline was used to calculate 5 kg weight gain and incident overweight and obesity using BMI.ResultsCompared to women who reported eating breakfast 3 to 4 days/week (irregular breakfast eaters), women who ate breakfast 7 days/week were between 11% to 17% less likely to be obese as measured by WHR (prevalence ratio (PR): 0.89; 95%CI: 0.85, 0.94), WC (PR: 0.85; 95%CI: 0.82, 0.88), and BMI (PR: 0.83; 95%CI: 0.79, 0.87) after multivariable adjustment. Women who never ate breakfast were between 11% to 22% less likely to be obese as measured by WHR (PR: 0.89; 95%CI: 0.83, 0.96), WC (PR: 0.82; 95%CI: 0.78, 0.87), and BMI (PR: 0.78; 95%CI: 0.72, 0.84) compared to irregular breakfast eaters. Prospective analyses showed a 21% and 28% lower risk of 5-year incident obesity among participants who always (relative risk (RR): 0.79; 95%CI: 0.70, 0.90) or never (RR: 0.72; 95%CI: 0.59, 0.87) ate breakfast, respectively, compared to those who ate breakfast 3 to 4 days/week. No association was observed for incident 5 kg weight gain.ConclusionsResults suggest that a regular breakfast consumption habit, comprising eating breakfast every day or never, may be important for maintaining a healthy weight.

Project description:BACKGROUND:Despite existing best practice care recommendations for addressing tobacco smoking, alcohol consumption and weight management in preconception and antenatal care, such recommendations are often not implemented into routine practice. Effective strategies that target known barriers to implementation are key to reducing this evidence to practice gap. The aim of this review is to synthesise the evidence on the effectiveness of implementation strategies in improving the provision of preconception and antenatal care for these modifiable risk factors. METHODS:Randomised and non-randomised study designs will be eligible for inclusion if they have a parallel control group. We will include studies that either compare an implementation strategy to usual practice or compare two or more strategies. Participants may include any health service providing preconception or antenatal care to women and/or the health professionals working within such a service. The primary outcome will be any measure of the effectiveness of implementation strategies to improve preconception and/or antenatal care for tobacco smoking, alcohol consumption and/or weight management (including care to improve nutrition and/or physical activity). Secondary outcomes will include the effect of the implementation strategy on women's modifiable risk factors, estimates of absolute costs or cost-effectiveness and any reported unintentional consequences. Eligible studies will be identified via searching Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, ProQuest Dissertations and Theses and other sources (e.g. contacting experts in the field). Study selection, data extraction and risk of bias will be assessed independently by two review authors and differences resolved by a third reviewer. If data permits, we will conduct fixed-effects or random-effects meta-analysis where appropriate. If studies do not report the same outcome or there is significant heterogeneity, results will be summarised narratively. DISCUSSION:This review will identify which implementation strategies are effective in improving the routine provision of preconception and antenatal care for tobacco smoking, alcohol consumption and weight management. Such a review will be of interest to service providers, policy makers and implementation researchers seeking to improve women's modifiable risk factors in preconception and antenatal care settings. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42019131691.

Project description: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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A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management.

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A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management.

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