g., an adolescent who normally eats breakfast, but has completed some measurements after an overnight fast as part of an experimental study). Various inter-related factors have contributed to the large multi-national increase in numbers of overweight and obese young people.30 An imbalance between energy intake and expenditure is, however, often posited as the root of the problem. Breakfast consumption
and composition represent modifiable factors that are both directly and indirectly related to the balance between energy intake and expenditure. A large body of cross-sectional evidence has shown consistently an inverse association between breakfast consumption and measures of obesity (most often body mass ISRIB manufacturer index (BMI)) in large diverse samples of young people and with the adjustment BAY 73-4506 supplier of potential confounding factors.3, 31 and 32 Moreover, prospective studies indicate that habitual breakfast consumption is predictive of lower BMI.11 and 31 In a longitudinal study with 2216 adolescents and a 5-year follow-up, Timlin et al.11 reported a dose–response inverse relationship between breakfast frequency and weight gain. Subsequently, a recent systematic review of 16 studies concluded that breakfast consumption was associated with reduced overweight and obesity risk in young people,3 although it should be noted that these relationships have not always been
the observed; for example, a reduction in BMI over time was associated with breakfast consumption in non-overweight, but breakfast skipping in overweight adolescents.33 Further longitudinal research with a 20-year follow-up indicated that skipping breakfast over prolonged periods of time led
to more pronounced changes in weight gain and disease risk; participants who skipped breakfast in both childhood and adulthood had a higher BMI, waist circumference, HOMA-IR score, fasting insulin concentration and total and LDL-cholesterol concentration than those who consumed breakfast at both time points.34 Breakfast consumption has also been associated with lower plasma total cholesterol concentration in young people,35 but more research is required on relationships between breakfast consumption and cardiometabolic health markers. Nutrition, meal patterns, physical activity (PA), and other lifestyle factors are likely to contribute to the lower BMI and disease risk markers in breakfast consumers. However, it is important to highlight that breakfast consumption may simply be a marker for a healthy lifestyle in general; research that can infer causality between breakfast consumption and health-related variables would be required to refute such claims. Since common breakfast foods come from the core food groups (breads and cereals, dairy products, and fruit), breakfast is typically a nutritious meal, low in fat and high in CHO.