Breakfast consumption and adiposity among children and adolescents: an updated review of the literature.

ABSTRACT

BACKGROUND: Breakfast consumption has been associated with reduced risk of overweight and obesity among children, but previous evidence reviews fail to confirm a causal relationship. OBJECTIVES: To review recent literature on breakfast consumption and adiposity among children and discuss potential underlying mechanisms. METHODS: A comprehensive literature search of studies published since the 2010 US National Evidence Library review (January 2010-January 2015) was conducted. RESULTS: Twelve studies met inclusion criteria. All were conducted in industrialized countries six in Europe, four in the USA, one in China and one in Australia. Ten of the studies used observational longitudinal designs, with follow-up periods ranging from 1 to 27 years (median 3, mean 7.4); of these, eight reported inverse associations between breakfast consumption and excess adiposity, while two found no association. The other studies (1 case-control, 1 experimental) each reported a protective effect of breakfast consumption on overweight and obesity among children. CONCLUSIONS: Findings corroborate results from previous reviews, adding support for a possible, protective role for breakfast consumption in preventing excess adiposity during childhood and adolescence. However, drawing a causal conclusion from the collective evidence is curtailed by methodological limitations and inconsistencies, including study design, follow-up duration and frequency, exposure and outcome assessment, as well as limited consideration of confounding, mediating and effect-modifying variables. More rigorous study designs employing valid and standardized measurement of relevant variables are needed.