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Effect of breakfast omission and consumption on energy intake and physical activity in adolescent girls: a randomised controlled trial

  • Julia K. Zakrzewski-Fruer (a1), Tatiana Plekhanova (a1), Dafni Mandila (a2), Yannis Lekatis (a2) and Keith Tolfrey (a2)...

It is not known if breakfast consumption is an effective intervention for altering daily energy balance in adolescents when compared with breakfast omission. This study examined the acute effect of breakfast consumption and omission on free-living energy intake (EI) and physical activity (PA) in adolescent girls. Using an acute randomised cross-over design, forty girls (age 13·3 (sd 0·8) years, BMI 21·5 (sd 5·0) kg/m2) completed two, 3-d conditions in a randomised, counter-balanced order: no breakfast (NB) and standardised (approximately 1962 kJ) breakfast (SB). Dietary intakes were assessed using food diaries combined with digital photographic records and PA was measured via accelerometry throughout each condition. Statistical analyses were completed using repeated-measures ANOVA. Post-breakfast EI was 483 (sd 1309) kJ/d higher in NB v. SB (P=0·025), but total daily EI was 1479 (sd 11311) kJ/d higher in SB v. NB (P<0·0005). Daily carbohydrate, fibre and protein intakes were higher in SB v. NB (P<0·0005), whereas daily fat intake was not different (P=0·405). Effect sizes met the minimum important difference of ≥0·20 for all significant effects. Breakfast manipulation did not affect post-breakfast macronutrient intakes (P≥0·451) or time spent sedentary or in PA (P≥0·657). In this sample of adolescent girls, breakfast omission increased post-breakfast free-living EI, but total daily EI was greater when a SB was consumed. We found no evidence that breakfast consumption induces compensatory changes in PA. Further experimental research is required to determine the effects of extended periods of breakfast manipulation in young people.

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      Effect of breakfast omission and consumption on energy intake and physical activity in adolescent girls: a randomised controlled trial
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Corresponding author
* Corresponding author: Dr J. K. Zakrzewski-Fruer, email
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1. Rampersaud, GC, Pereira, MA, Girard, BL, et al. (2005) Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 105, 743760.
2. Tanner, JM, Whitehouse, RH, Marshall, WA, et al. (1975) Prediction of adult height, bone age, and occurrence of menarche, at age 4 to 16 with allowance for midparental height. Arch Dis Child 50, 1426.
3. Vereecken, C, Dupuy, M, Rasmussen, M, et al. (2009) Breakfast consumption and its socio-demographic and lifestyle correlates in schoolchildren in 41 countries participating in the HBSC study. Int J Public Health 54, Suppl. 2, S180S190.
4. Zakrzewski, JK, Gillison, FB, Cumming, S, et al. (2015) Associations between breakfast frequency and adiposity indicators in children from 12 countries. Int J Obes 5, Suppl. 2, S80S88.
5. Brown, AW, Bohan Brown, MM & Allison, DB (2013) Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr 98, 12981308.
6. Hill, JO (2006) Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev 27, 750761.
7. Deshmukh-Taskar, PR, Nicklas, TA, O’Neil, CE, et al. (2010) The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999–2006. J Am Diet Assoc 110, 869878.
8. Sjöberg, A, Hallberg, L, Höglund, D, et al. (2003) Meal pattern, food choice, nutrient intake and lifestyle factors in The Göteborg Adolescence Study. Eur J Clin Nutr 57, 15691578.
9. Dubois, L, Girard, M, Potvin Kent, M, et al. (2009) Breakfast skipping is associated with differences in meal patterns, macronutrient intakes and overweight among pre-school children. Public Health Nutr 12, 1928.
10. Kral, TV, Whiteford, LM, Heo, M, et al. (2011) Effects of eating breakfast compared with skipping breakfast on ratings of appetite and intake at subsequent meals in 8- to 10-y-old children. Am J Clin Nutr 93, 284291.
11. Leidy, HJ & Racki, EM (2010) The addition of a protein-rich breakfast and its effects on acute appetite control and food intake in ‘breakfast-skipping’ adolescents. Int J Obes (Lond) 34, 11251133.
12. Clayton, DJ, Barutcu, A, Machin, C, et al. (2015) Effect of breakfast omission on energy intake and evening exercise performance. Med Sci Sports Exerc 47, 26452652.
13. Reeves, S, Huber, JW, Halsey, LG, et al. (2014) Experimental manipulation of breakfast in normal and overweight/obese participants is associated with changes to nutrient and energy intake consumption patterns. Physiol Behav 133, 130135.
14. Betts, JA, Richardson, JD, Chowdhury, EA, et al. (2014) The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr 100, 539547.
15. Yoshimura, E, Hatamoto, Y, Yonekura, S, et al. (2017) Skipping breakfast reduces energy intake and physical activity in healthy women who are habitual breakfast eaters: a randomized crossover trial. Physiol Behav 174, 8994.
16. Chowdhury, EA, Richardson, JD, Holman, GD, et al. (2016) The causal role of breakfast in energy balance and health: a randomized controlled trial in obese adults. Am J Clin Nutr 103, 747756.
17. Leidy, HJ, Ortinau, LC, Douglas, SM, et al. (2013) Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, ‘breakfast-skipping,’ late-adolescent girls. Am J Clin Nutr 97, 677688.
18. Leidy, HJ, Hoertel, HA, Douglas, SM, et al. (2015) A high-protein breakfast prevents body fat gain, through reductions in daily intake and hunger, in ‘Breakfast skipping’ adolescents. Obesity (Silver Spring) 23, 17611764.
19. Boushey, CJ, Kerr, DA, Wright, J, et al. (2009) Use of technology in children’s dietary assessment. Eur J Clin Nutr 63, Suppl. 1, S50S57.
20. Martin, CK, Nicklas, T, Gunturk, B, et al. (2014) Measuring food intake with digital photography. J Hum Nutr Diet 27, Suppl. 1, S72S81.
21. Wang, DH, Kogashiwa, M & Kira, S (2006) Development of a new instrument for evaluating individuals’ dietary intakes. J Am Diet Assoc 106, 15881593.
22. Martin, CK, Newton, RL Jr, Anton, SD, et al. (2007) Measurement of children’s food intake with digital photography and the effects of second servings upon food intake. Eat Behav 8, 148156.
23. Atkinson, G & Batterham, AM (2015) True and false interindividual differences in the physiological response to an intervention. Exp Physiol 100, 577588.
24. Janssen, I, Katzmarzyk, PT, Boyce, WF, et al. (2005) Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obes Rev 6, 123132.
25. Corder, K, van Sluijs, EM, Steele, RM, et al. (2011) Breakfast consumption and physical activity in British adolescents. Br J Nutr 105, 316321.
26. Vissers, PA, Jones, AP, Corder, K, et al. (2013) Breakfast consumption and daily physical activity in 9-10-year-old British children. Public Health Nutr 16, 12811290.
27. Corder, K, van Sluijs, EM, Ridgway, CL, et al. (2014) Breakfast consumption and physical activity in adolescents: daily associations and hourly patterns. Am J Clin Nutr 99, 361368.
28. Halsey, LG, Huber, JW, Low, T, et al. (2012) Does consuming breakfast influence activity levels? An experiment into the effect of breakfast consumption on eating habits and energy expenditure. Public Health Nutr 15, 238245.
29. Todd, AS, Street, SJ, Ziviani, J, et al. (2015) Overweight and obese adolescent girls: the importance of promoting sensible eating and activity behaviors from the start of the adolescent period. Int J Environ Res Public Health 12, 23062329.
30. Timlin, MT, Pereira, MA, Story, M, et al. (2008) Breakfast eating and weight change in a 5-year prospective analysis of adolescents: project EAT (Eating Among Teens). Pediatrics 121, 638645.
31. Cole, TJ, Freeman, JV & Preece, MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73, 2529.
32. McCarthy, HD, Jarrett, KV, Emmett, PM, et al. (2005) Trends in waist circumferences in young British children: a comparative study. Int J Obes (Lond) 29, 157162.
33. Brooks-Gunn, J, Warren, MP, Rosso, J, et al. (1987) Validity of self-report measures of girls’ pubertal status. Child Dev 58, 829841.
34. Morris, NM & Udry, JR (1980) Validation of a self-administered instrument to assess stage of adolescent development. J Youth Adolesc 9, 271280.
35. Tanner, JM (1962) Growth At Adolescents. Oxford: Blackwell Scientific.
36. Atkinson, FS, Foster-Powell, K & Brand-Miller, JC (2008) International tables of glycemic index and glycemic load values. Diabetes Care 31, 22812283.
37. Wolever, TM & Jenkins, DJ (1986) The use of the glycemic index in predicting the blood glucose response to mixed meals. Am J Clin Nutr 43, 167172.
38. Food Standards Agency (2007) Nutrient and food based guidelines for UK institutions. (accessed March 2017).
39. Timlin, MT & Pereira, MA (2007) Breakfast frequency and quality in the etiology of adult obesity and chronic diseases. Nutr Rev 65, 268281.
40. Scientific Advisory Committee on Nutrition (2011) Dietary Reference Values for Energy. London: TSO, Public Health England.
41. Foster, E, Adamson, A, Hawkins, A, et al. (2010) Young Person’s Food Atlas – Secondary. London: Food Standards Agency.
42. Foster, E & Adamson, AJ (2012) Development and validation of the Young Person’s Food Atlas. Proc Nutr Soc 71, 195.
43. Foster, E, Hawkins, A, Barton, KL, et al. (2017) Development of food photographs for use with children aged 18 months to 16 years: comparison against weighed food diaries – The Young Person’s Food Atlas (UK). PLOS ONE 15, 12:e0169084.
44. NHS Choices (2015) 5 A DAY: portion guide. (accessed March 2017).
45. Bland, JM & Altman, DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1, 307310.
46. Wang, YC, Gortmaker, SL, Sobol, AM, et al. (2006) Estimating the energy gap among US children: a counterfactual approach. Pediatrics 118, 17211733.
47. Phillips, LR, Parfitt, G & Rowlands, AV (2013) Calibration of the GENEA accelerometer for assessment of physical activity intensity in children. J Sci Med Sport 16, 124128.
48. Rowlands, AV, Rennie, K, Kozarski, R, et al. (2014) Children’s physical activity assessed with wrist- and hip-worn accelerometers. Med Sci Sports Exerc 46, 23082316.
49. Cohen, J (1988) Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates.
50. Schmitz, K, Treuth, MS, McMurray, R, et al. (2005) Predicting energy expenditure from accelerometry counts in adolescent girls. Med Sci Sport Exerc 37, 155161.
51. Treuth, MS, Catellier, DJ, Schmitz, KH, et al. (2007) Weekend and weekday patterns of physical activity in overweight and normal-weight adolescent girls. Obesity (Silver Spring) 15, 17821788.
52. Chowdhury, EA, Richardson, JD, Tsintzas, K, et al. (2015) Carbohydrate-rich breakfast attenuates glycaemic, insulinaemic and ghrelin response to ad libitum lunch relative to morning fasting in lean adults. Br J Nutr 114, 98107.
53. Shaw, ME (1998) Adolescent breakfast skipping: an Australian study. Adolescence 33, 851861.
54. Warren, JM, Henry, CJ & Simonite, V (2003) Low glycemic index breakfasts and reduced food intake in preadolescent children. Pediatrics 112, 414419.
55. Ball, SD, Keller, KR, Moyer-Mileur, LJ, et al. (2003) Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. Pediatrics 111, 488494.
56. Bornet, FR, Jardy-Gennetier, AE, Jacquet, N, et al. (2007) Glycaemic response to foods: impact on satiety and long-term weight regulation. Appetite 49, 535553.
57. Sun, FH, Li, C, Zhang, YJ, et al. (2016) Effect of glycemic index of breakfast on energy intake at subsequent meal among healthy people: a meta-analysis. Nutrients 8, 3751.
58. Macdiarmid, J & Blundell, J (1998) Assessing dietary intake: who, what and why of under-reporting. Nutr Res Rev 11, 231253.
59. Burrows, TL, Martin, RJ & Collins, CE (2010) A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water. J Am Diet Assoc 110, 15011510.
60. Livingstone, MB, Robson, PJ & Wallace, JM (2004) Issues in dietary intake assessment of children and adolescents. Br J Nutr 92, Suppl. 2, S213S222.
61. Small, L, Sidora-Arcoleo, K, Vaughan, L, et al. (2009) Validity and reliability of photographic diet diaries for assessing dietary intake among young children. ICAN 1, 2736.
62. Tarasuk, V & Beaton, GH (1991) The nature and individuality of within-subject variation in energy intake. Am J Clin Nutr 54, 464470.
63. Carlsohn, A, Fusch, G & Scharhag-Rosenberger, F (2011) Validity and reliability of athletes’ self-recorded food intake determined by doubly-labelled water. Med Sci Sports Exerc 43, 503504.
64. Tremblay, A, Sévigny, J, Leblanc, C, et al. (1983) The reproducibility of a three-day dietary record. Nutr Res 3, 819830.
65. Toeller, M, Buyken, A, Heitkamp, G, et al. (1997) Repeatability of three-day dietary records in the EURODIAB IDDM Complications Study. Eur J Clin Nutr 51, 7480.
66. Chaput, JP, Jomphe-Tremblay, S, Lafrenière, J, et al. (2016) Reliability of a food menu to measure energy and macronutrient intake in adolescents. Eur J Clin Nutr 70, 104108.
67. Arora, M, Nazar, GP, Gupta, VK, et al. (2012) Association of breakfast intake with obesity, dietary and physical activity behavior among urban school-aged adolescents in Delhi, India: results of a cross-sectional study. BMC Public Health 12, 881893.
68. Utter, J, Scragg, R, Mhurchu, CN, et al. (2007) At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. J Am Diet Assoc 107, 570576.
69. Bingham, S (1987) The dietary assessment of individuals; methods, accuracy, new techniques and recommendations. Nut Abstracts Rev 57, 705742.
70. Hjorth, MF, Damsgaard, CT, Michaelsen, KF, et al. (2015) Markers of metabolic health in children differ between weekdays – the result of unhealthier weekend behavior. Obesity (Silver Spring) 23, 733736.
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