Evaluating the Intervention-Based Evidence Surrounding the Causal Role of Breakfast on Markers of Weight Management, with Specific Focus on Breakfast Composition and Size1234

Nutritional strategies are vitally needed to aid in the management of obesity. Cross-sectional and epidemiologic studies consistently demonstrate that breakfast consumption is strongly associated with a healthy body weight. However, the intervention-based long-term evidence supporting a causal role of breakfast consumption is quite limited and appears to be influenced by several key dietary factors, such as dietary protein, fiber, and energy content. This article provides a comprehensive review of the intervention-based literature that examines the effects of breakfast consumption on markers of weight management and daily food intake. In addition, specific focus on the composition and size (i.e., energy content) of the breakfast meal is included. Overall, there is limited evidence supporting (or refuting) the daily consumption of breakfast for body weight management and daily food intake. In terms of whether the type of breakfast influences these outcomes, there is accumulating evidence supporting the consumption of increased dietary protein and fiber content at breakfast, as well as the consumption of more energy during the morning hours. However, the majority of the studies that manipulated breakfast composition and content did not control for habitual breakfast behaviors, nor did these studies include a breakfast-skipping control arm. Thus, it is unclear whether the addition of these types of breakfast plays a causal role in weight management. Future research, including large randomized controlled trials of longer-term (i.e., ≥6 mo) duration with a focus on key dietary factors, is critical to begin to assess whether breakfast recommendations are appropriate for the prevention and/or treatment of obesity.