Energy Intake at Breakfast and Weight Change: Prospective Study of 6,764 Middle-aged Men and Women

Lisa R. Purslow; Manjinder S. Sandhu; Nita Forouhi; Elizabeth H. Young; Robert N. Luben; Ailsa A. Welch; Kay-Tee Khaw; Sheila A. Bingham; Nicholas J. Wareham


Am J Epidemiol. 2008;167(2):188-192. 

In This Article

Abstract and Introduction

To investigate the association between percentage of total daily energy intake consumed at breakfast and weight change in middle-aged men and women, the authors analyzed data from a prospective population-based cohort study from Norfolk, United Kingdom. Participants were 6,764 men and women aged 40-75 years at baseline (1993-1997). Participants completed a 7-day food diary at baseline, and objective measurements of height and weight were carried out at baseline and follow-up (1998-2000). Mean baseline body mass index (weight (kg)/height (m)2) was lowest among persons in the highest quintile of percentage of daily energy consumed at breakfast (mean values were 26.0 in the highest quintile and 26.3 in the lowest quintile), despite higher daily total energy intake in this group. Although all participants gained weight, increased percentage of daily energy consumed at breakfast was associated with relatively lower weight gain (adjusted β coefficient = −0.021, 95% confidence interval: −0.035, −0.007; p = 0.004). The association between percentage of daily energy intake consumed at breakfast and weight gain was independent of age, sex, smoking, total energy intake, macronutrient intake, social class, and physical activity. Redistribution of daily energy intake, so that more energy is consumed at breakfast and less energy is consumed later in the day, may help to reduce weight gain in middle-aged adults.

The proportion of people regularly consuming breakfast is in decline,[1,2] and skipping breakfast is associated with other lifestyle choices such as low levels of physical activity and high levels of soft-drink consumption.[2] Obesity and weight gain are associated with low socioeconomic position,[3] and skipping breakfast is more common among children and adolescents of low socioeconomic position.[2] Compared with lean women, obese women consume fewer calories in the morning.[4] By contrast, regular breakfast consumption is associated with successful maintenance of weight loss,[5] suggesting that consuming fewer calories in the morning or skipping breakfast could contribute to the development of obesity.

A cross-sectional association between skipping breakfast and obesity has been shown in adults.[6,7] Regular consumption of breakfast cereal is associated with lower body mass index (BMI) in adults[8] and children,[9] and greater energy intake at breakfast is associated with lower BMI in adolescents.[10] A large prospective study conducted in men showed a decreased risk of weight gain among regular consumers of breakfast cereal.[11] However, this study did not assess the time of day when cereal was eaten and therefore did not provide direct evidence of an association between breakfast consumption and weight change. Currently, the prospective association between energy intake at breakfast and weight change in adults is not known. Therefore, we investigated the association between percentage of total daily energy intake consumed at breakfast and weight change in a prospective population-based cohort study of middle-aged men and women.


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