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儿童和青少年不吃早餐与超重/肥胖之间的关联:观察性研究的荟萃分析

The link between breakfast skipping and overweigh/obesity in children and adolescents: a meta-analysis of observational studies.

作者信息

Ardeshirlarijani Edris, Namazi Nazli, Jabbari Masoumeh, Zeinali Mina, Gerami Hadis, Jalili Reza B, Larijani Bagher, Azadbakht Leila

机构信息

1Simon Fraser University, Vancouver, Canada.

2Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Diabetes Metab Disord. 2019 Nov 28;18(2):657-664. doi: 10.1007/s40200-019-00446-7. eCollection 2019 Dec.

Abstract

PURPOSE

Childhood overweight/ obesity is one of critical public health concern. It has been suggested that there is a link between breakfast skipping and obesity. However, results are conflicting. The aim of the present study was to summarize the association between breakfast skipping and overweight/obesity in children and adolescent.

METHODS

We performed a literature search using Pubmed/Medline, Scopus, Web of Science and EMBASE electronic databases from 2000 through 28 February 2018 without language limitation. Observational studies in which risk measures were reported regarding the link between breakfast skipping and obesity in children and adolescent were included. Studies with at least the score of 5 from Newcastle-Ottawa Scale were considered as low risk of bias. Random effect model was used for data synthesis.

RESULTS

Of 3276 publications, finally 16 studies (14 cross-sectional studies, 2 cohort studies) were included for meta-analysis. Based on cross-sectional studies, we found a positive association between breakfast skipping and obesity (Odd ratio (OR) : 1.43; 95%CI: 1.32, 1.54), while cohort studies showed no significant link (OR:1.01, 95%CI: 0.93, 1.11; I2: 48%,  = 0.14). Subgroup analysis in cross-sectional studies showed that the association between breakfast skipping and the risk of obesity in boys was OR: 1.64; 95% CI: 1.38, 1.95; I: 38.3%,  = 0.18, while it was 1.56 (95% CI: 1.38, 1.77, I: 0.0%,  = 0.49) in girls.

CONCLUSION

The risk of obesity in children and adolescents who skipped breakfast was 43% greater than those who ate breakfast regularly in cross-sectional studies, while no significant link was found in cohort studies. However, due to high heterogeneity and limited cohort studies, findings should be interpreted by caution.

摘要

目的

儿童超重/肥胖是一个关键的公共卫生问题。有人提出不吃早餐与肥胖之间存在联系。然而,结果相互矛盾。本研究的目的是总结不吃早餐与儿童和青少年超重/肥胖之间的关联。

方法

我们使用Pubmed/Medline、Scopus、Web of Science和EMBASE电子数据库,在2000年至2018年2月28日期间进行了文献检索,无语言限制。纳入了报告了关于儿童和青少年不吃早餐与肥胖之间联系的风险测量的观察性研究。纽卡斯尔-渥太华量表得分至少为5分的研究被认为偏倚风险低。采用随机效应模型进行数据合成。

结果

在3276篇出版物中,最终纳入16项研究(14项横断面研究,2项队列研究)进行荟萃分析。基于横断面研究,我们发现不吃早餐与肥胖之间存在正相关(优势比(OR):1.43;95%置信区间:1.32,1.54),而队列研究未显示出显著联系(OR:1.01,95%置信区间:0.93,1.11;I²:48%,P = 0.14)。横断面研究的亚组分析表明,不吃早餐与男孩肥胖风险之间的关联为OR:1.64;95%置信区间:1.38,1.95;I²:38.3%,P = 0.18,而女孩为1.56(95%置信区间:1.38,1.77,I²:0.0%,P = 0.49)。

结论

在横断面研究中,不吃早餐的儿童和青少年肥胖风险比经常吃早餐的儿童和青少年高43%,而队列研究未发现显著联系。然而,由于异质性高且队列研究有限,研究结果应谨慎解释。

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