A Systematic Review of the Association of Skipping Breakfast with Weight and Cardiometabolic Risk Factors in Children and Adolescents. What Should We Better Investigate in the Future?

Abstract

The incidence of skipping breakfast in pediatric subjects is rising, and a relationship with overweight (OW) and obesity (OB) has been shown. Associations with cardiovascular outcomes and skipping breakfast in adults have been reported. The purpose of this systematic review was to summarize the association of skipping breakfast with body weight and metabolic outcomes in the pediatric population. We searched relevant databases (2008–2018) and identified 56 articles, of which 39 were suitable to be included, basing on inclusion criteria (observational; defined breakfast skipping; weight and/or metabolic outcomes). Overall, 286,804 children and adolescents living in 33 countries were included. The definitions of OW/OB, skipping breakfast, and the nutrient assessment were highly heterogeneous. Confounding factors were reported infrequently. The prevalence of skipping breakfast ranged 10–30%, with an increasing trend in adolescents, mainly in girls. Skipping breakfast was associated with OW/OB in the 94.7% of the subjects. The lack of association was shown mainly in infants. Moreover, 16,130 subjects were investigated for cardiometabolic outcomes. Skipping breakfast was associated with a worse lipid profile, blood pressure levels, insulin-resistance, and metabolic syndrome. Five studies reported a lower quality dietary intake in breakfast skippers. This review supports skipping breakfast as an easy marker of the risk of OW/OB and metabolic diseases, whether or not it is directly involved in causality. We encourage intervention studies using standardized and generalizable indicators. Data on confounders, time of fasting, chronotypes, and nutrition quality are needed to establish the best practice for using it as a tool for assessing obesity risk.

Secular Trends in Pediatric Overweight and Obesity in Korea

“…25 These are well-known risk factors for developing overweight and obesity in children and adolescents. [26][27][28][29] Interestingly, these behavioral characteristics were more common among high school students, which is in line with the rapidly increased prevalence of obesity in the same population group.…”

Chronotype and its association with lifestyle, health-related quality of life and academic performance among Japanese nursing students: A cross-sectional study

“…Many previous studies have reported an association between skipping breakfast and evening type (27,44,45). Skipping breakfast is unhealthy eating behavior which contributes to metabolic disorders including obesity and diabetes (46,47). In the present study, skipping lunch and dinner was associated with chronotype as well as skipping breakfast.…”

Prevalence and Risk Factors Associated with Primary Dysmenorrhea among Chinese Female University Students: A Cross-sectional Study

“…48 According to a systematic review, the prevalence of skipping breakfast ranged from 10% to 30%, with an increasing trend in adolescents, mainly in girls, which was associated with a worse lipid profile, worse blood pressure, and metabolic syndrome. 49 Although the mechanisms underlying the adverse effect of skipping breakfast are unclear, they might be related to inadequate intake of certain foods and might induce some degree of nutritional defect in the morning. For instance, low dietary intake of some fibercontaining foods and dairy products was found to be inversely correlated with menstrual pain.…”