SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy.
Nutrients. 2019 Feb 13;11(2):387. doi: 10.3390/nu11020387.
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.
儿童不吃早餐的发生率正在上升，并且已经证明与超重（OW）和肥胖（OB）有关。在成年人中，也有与心血管结果和不吃早餐有关的报道。本系统综述的目的是总结不吃早餐与儿科人群体重和代谢结果的关系。我们搜索了相关数据库（2008 年至 2018 年），并确定了 56 篇文章，其中 39 篇符合纳入标准（观察性；定义不吃早餐；体重和/或代谢结果）。总体而言，共有来自 33 个国家的 286804 名儿童和青少年被纳入研究。OW/OB、不吃早餐和营养评估的定义高度异质，报告的混杂因素很少。不吃早餐的发生率在 10⁻30%之间，在青少年中呈上升趋势，主要是女孩。94.7%的研究对象中，不吃早餐与 OW/OB 有关。主要在婴儿中没有显示出关联。此外，有 16130 名受试者接受了心血管代谢结果的调查。不吃早餐与血脂异常、血压水平、胰岛素抵抗和代谢综合征有关。五项研究报告称，不吃早餐的人饮食质量较差。本综述支持将不吃早餐作为 OW/OB 和代谢性疾病风险的一个简单标志物，无论它是否直接涉及因果关系。我们鼓励使用标准化和可推广的指标进行干预研究。需要有关混杂因素、禁食时间、昼夜节律和营养质量的数据，以建立将其作为评估肥胖风险工具的最佳实践。
