Vous êtes sur la page 1sur 13

CONTINUING MEDICAL

LEARNING
Is Breakfast Overrated in the Weight Loss
Plan?
News Author: Nancy A. Melville CME Author: Charles P . Vega, MD
CLINICAL CONTEXT

• Many adults are trying to lose weight via alternate-day fasting diet
plans, but do these plans really work?
• One hundred adults entered the study . Study dropout rates were highest in
the alternate-day fasting group. Weight loss was moderate overall and
similar in the alternate-day fasting and continuous calorie restriction
groups. Blood pressure, serum glucose, and C-reactive protein values were
similar in the intervention groups.
• Eating breakfast is generally considered to be healthy , and is part of
national public health recommendations in some countries. Skipping
breakfast may be associated with delayed satiety and increased caloric
consumption later in the day .
• The current meta-analysis queries whether breakfast really helps maintain
a healthy body weight.
STUDY SYNOPSIS
AND PERSPECTIVE
Breakfast does not appear to have an important role in weight loss after
all, with a new meta-analysis showing no evidence that eating breakfast
reduces daily caloric intake, and weight gain is no worse among those who
skip the meal.

"While breakfast has been advocated as the most important meal of the day in
the media since 1917, there is a paucity of evidence to support breakfast
consumption as a strategy to achieve weight loss, including in adults with
overweight or obesity ," the authors conclude.

"This systematic review of randomized controlled trials examining weight


change in adults consuming or skipping breakfast found no evidence to
support the notion that breakfast consumption promotes weight loss or that
skipping breakfast leads to weight gain,"
STUDY SYNOPSIS
AND PERSPECTIVE

• Although there was some inconsistency between studies, overall there was a
very small difference in weight favoring participants who skipped
breakfast (mean difference, 0.44 kg)
• Meanwhile, studies in which participants were assigned to eat breakfast
showed they had a higher total daily energy intake than those allocated to
skip breakfast (mean difference, 259.79 kcal/day), contrary to theories
that not consuming breakfast leads to overcompensation later in the day .
“ ◂ There was "no
evidence that
skipping breakfast
was associated with
increased total daily
caloric intake," say
Sievert and
STUDY SYNOPSIS
AND PERSPECTIVE
◂ Tim Spector notes that the "disadvantages of
skipping breakfast have now been debunked by
several randomised trials,“ which are examined
in the current meta-analysis

◂ The conclusions were the same as in recent


that no evidence supports the claim that
skipping breakfast makes you gain weight or
adversely reduces your resting metabolic rate
STUDY SYNOPSIS
AND PERSPECTIVE

There are data to suggest that these findings


on regular breakfast consumption in
observational studies are reflective of a
wider healthy lifestyle, in that individuals
who are more health conscious and of higher
socioeconomic status are more likely
to eat breakfast as part of making healthy
food choices,
STUDY SYNOPSIS
AND PERSPECTIVE

There are data to suggest that these findings on regular breakfast


consumption in observational studies are reflective of a wider healthy
lifestyle, in that individuals who are more health conscious and of higher
socioeconomic status are more likely
to eat breakfast as part of making healthy food choices
STUDY SYNOPSIS
AND PERSPECTIVE

"Although eating breakfast regularly could


have other important effects, such as
improved concentration and attentiveness
levels in childhood, caution is needed when
recommending breakfast for weight loss in
adults, as it could have the opposite
effect"
“ Could the Gut
Microbiome Play a
Role?
In his editorial, Dr Spector goes on to
explain that evidence is increasingly
pointing to the potential benefits of
fasting intervals in weight loss.

"The community of 100 trillion gut microbes


have a circadian rhythm and vary in
composition and function in fasting and fed
states“

"Although this is a young discipline, some


data suggest that microbial communities
could benefit from
short periods of fasting"

STUDY SYNOPSIS
AND PERSPECTIVE
CLINICAL IMPLICATIONS
◂ A previous randomized trial found that alternate-day fasting was associated
with higher study discontinuation compared with a diet featuring daily calorie
restriction. Blood pressure, serum glucose, and C-reactive protein values
were similar in the alternate-day fasting and continuous calorie restriction
groups.
◂ The current meta-analysis finds that consumption of breakfast was
associated with modest weight gain and greater total daily energy intake
compared with skipping breakfast.
◂ Implications for the Healthcare T eam: The healthcare team should focus
weight management efforts in areas other than encouraging breakfast
consumption among adults.
Thank
Thank
You
You