June 30, 2014
In observational studies, breakfast is associated with lower body weight; therefore, public health authorities commonly recommend breakfast consumption to reduce obesity. The effectiveness of adopting these recommendations for reducing body weight is unknown, so Emily J. Dhurandhar, PhD, past postdoctoral trainee in the Obesity Training Program at the Nutrition Obesity Research Center (NORC) and assistant professor in the Department of Health Behavior, tested the relative effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting. Co-investigators include David B. Allison, PhD, director of NORC; John Dawson, PhD, postdoctoral trainee in the Department of Biostatistics, Section on Statistical Genetics; Amy S. Alcorn, MPH, RD, Program Manager I in the Office of Energetics; and James M. Shikany, DrPH, professor in the Division of Preventive Medicine.
A multi-site, 16-week, 3-parallel-arm randomized controlled trial was conducted in 309 otherwise healthy overweight and obese adults (with a body mass index [in kg/m2] between 25 and 40) aged 20 to 65 years, and the primary outcome was weight change. The researchers compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast (no breakfast, or NB). Randomization was stratified by participant’s typical breakfast eating habits before enrollment in the study, and participants were either defined as typical breakfast “skippers” or “consumers.”
A total of 283 of the 309 participants who were randomly assigned completed the intervention. Regardless of group assignment or pre-study breakfast eating habits, weight loss was the same among groups, indicating that breakfast recommendations do not impact weight loss. Among breakfast skippers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were −0.71 ± 1.16, −0.76 ± 1.26, and −0.61 ± 1.18 kg for the control, breakfast, and NB groups, respectively. Among breakfast consumers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were −0.53 ± 1.16, −0.59 ± 1.06, and −0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6 percent for the breakfast group and 92.4 percent for the NB group.
The team concluded that a recommendation to eat or skip breakfast for weight loss was effective at changing self-reported breakfast eating habits, but—contrary to widely espoused views—this had no discernable effect on weight loss in free-living adults who were attempting to lose weight.