Skipping breakfast reduces energy intake and physical activity in healthy women who are habitual breakfast eaters: A randomized crossover trial
Introduction
Obesity is a serious problem worldwide [1]. Although several factors affect the development of overweight and obesity, it is possible that skipping breakfast (SB) is one such factor [2]. Data from the 2013 National Health and Nutrition Survey in Japan have shown that the percentage of individuals with a BMI ≥ 25 was 7.4% of those aged 15–19 years and 16.5% of those aged 20–29 years, with the percentage of those with a BMI ≥ 25 increasing with increased age group. In addition, SB among those aged 15–19 and 20–29 years was 15.4% and 30.0% in males and 16.0% and 25.4% in women, respectively [3]. In Japan, SB and overweight and obesity are less common among teenagers, but increase about two-fold with changing social environments among those over 20 years old. Young adulthood is a difficult period with a substantially changing lifestyle, such as college life, living alone, new jobs, and providing for young families. Skipping breakfast might be one life pattern caused by such changing lifestyles. Many epidemiological studies using cross-sectional and prospective cohort designs have indicated a positive relationship between SB and negative health outcomes, including overweight and obesity [4], [5], [6]. A meta-analysis suggests a positive association between SB and overweight and obesity based on cross-sectional studies in Asian and Pacific regions [7]. Kaplan et al., [8] indicated that SB was associated with an increased risk of mortality.
Laboratory controlled studies indicate that total energy intake, including lunch and breakfast, is either lower or similar on SB days compared with eating breakfast (EB) days [9], [10], [11], [12]. The results of intervention studies under free-living conditions [13], [14], [15], [16] also report that total daily energy intakes are either lower or similar when SB. Interestingly, there are differences between groups in energy intake response based on adiposity (lean or obese) [9], [13] and the habit of SB (habitual breakfast skippers or breakfast eaters) [17]. Gorczyca et al., [18] reported that the phase of the menstrual cycle in women influences macronutrient intake. Many previous studies have focused on energy intake after SB (i.e., lunch or energy intake during the day), although there is a severe lack of studies involving measurements of both energy intake and physical activity during the day under free-living conditions after SB [13], [19]. Findings from the 2007–2008 National Health and Nutrition Examination Survey in the United States have shown that SB was associated with a higher body mass index (BMI) compared with EB, especially among women [5], [20]. The response of energy intake and physical activity when healthy lean women who are habitual breakfast eaters did not eat breakfast might anticipate an increase in BMI in the future. However, it is unclear whether SB affects energy intake and physical activity during the day among lean healthy women who are habitual breakfast eaters. Skipping breakfast might result in lower physical activity or higher energy intake if SB is indeed a predictor of increased future BMI. The present study used a randomized, crossover trial design among healthy lean women who were habitual breakfast eaters. This study had two hypotheses. First, SB lowers physical activity energy expenditures compared with EB. Second, total daily energy intakes are either lower or similar with SB compared with EB.
Section snippets
Participants
The present study was conducted using a randomized crossover design of EB or SB. The protocol was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN000019415). Twenty healthy women, aged 21–25 years, with a BMI of 17.3–24.2 kg/m2, without metabolic disorders, and who were habitual breakfast eaters (≥ 5 days per week) took part in the study. Breakfast eaters were defined as those participants who self-reported that they ate breakfast ≥ 5 times a week [17].
Baseline data and body composition
The mean age of participants was 21.8 ± 0.9 years. Height (SB = 160.1 ± 5.6 cm, EB = 160.1 ± 5.5 cm), weight (SB = 51.0 ± 4.8 kg, EB = 51.7 ± 5.0 kg), and BMI (SB = 20.2 ± 1.6 kg/m2, EB = 20.2 ± 1.8 kg/m2) were not significantly different between conditions (p > 0.05). The average length of the intervention period (washout period) was 2.3 ± 0.7 days. There were no significant differences in the condition by order interaction for physical activity and energy intake (p > 0.05). Participants purchased and ate a total of 246 food items
Discussion
The present study used a randomized, controlled, crossover trial design to evaluate the acute effects of SB on energy intake and physical activity under free-living conditions. The main findings are as follows: (1) decreased morning physical activity energy expenditure occurred after SB; (2) total physical activity energy expenditure was lower after SB compared with EB; (3) increased energy intakes at lunch occurred after extending the morning fast after SB; and (4) dietary compensation
Conclusions
The reduction in energy intake by skipping breakfast was larger than reduction in activity induced energy expenditure after skipping breakfast.
Conflicts of interest
The authors have no conflicts of interest to declare.
Acknowledgments
The authors wish to thank the participants of the study. This study was supported by a grant from Yazuya Co., Ltd. The sponsor had no role in the design, analysis, or writing up the results of the study. E.Y. and S.Y. designed the study and collected, analyzed, and interpreted the data. E.Y., Y.H., S.Y., and H.T. contributed to the interpretation of the data and manuscript editing.
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