title: The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial.
abstract: BACKGROUND
  Breakfast is associated with lower body weight in observational studies. Public health authorities commonly recommend breakfast consumption to reduce obesity, but the effectiveness of adopting these recommendations for reducing body weight is unknown.
  
  
  OBJECTIVE
  We tested the relative effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting.
  
  
  METHODS
  We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m²) between 25 and 40] aged 20-65 y. Our primary outcome was weight change. We compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast [no breakfast (NB)]. Randomization was stratified by prerandomization breakfast eating habits. A total of 309 participants were randomly assigned.
  
  
  RESULTS
  A total of 283 of the 309 participants who were randomly assigned completed the intervention. Treatment assignment did not have a significant effect on weight loss, and there was no interaction between initial breakfast eating status and treatment. Among skippers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.71 ± 1.16, -0.76 ± 1.26, and -0.61 ± 1.18 kg for the control, breakfast, and NB groups, respectively. Among breakfast consumers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.53 ± 1.16, -0.59 ± 1.06, and -0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6% for the breakfast group and 92.4% for the NB group.
  
  
  CONCLUSIONS
  A recommendation to eat or skip breakfast for weight loss was effective at changing self-reported breakfast eating habits, but contrary to widely espoused views this had no discernable effect on weight loss in free-living adults who were attempting to lose weight.
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Dhurandhar
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: John
authors.initials: J
authors.lastname: Dawson
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Amy
authors.initials: A
authors.lastname: Alcorn
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Lesli H
authors.initials: LH
authors.lastname: Larsen
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Thomas
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Michelle
authors.initials: M
authors.lastname: Cardel
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Ashley C
authors.initials: AC
authors.lastname: Bourland
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Arne
authors.initials: A
authors.lastname: Astrup
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: St-Onge
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: James O
authors.initials: JO
authors.lastname: Hill
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
authors.affiliation: From the Department of Health Behavior, School of Public Health (EJD); the Office of Energetics, Nutrition Obesity Research Center, Department of Nutrition Sciences, School of Public Health and School of Health Professions (JD, A Alcorn, and DBA); and the Division of Preventative Medicine, School of Medicine (JMS), University of Alabama at Birmingham, Birmingham, AL; The OPUS Centre, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark (LHL and A Astrup); the Department of Endocrinology, Metabolism, and Diabetes (EAT) and the Department of Pediatrics, Anshutz Medical Campus (MC and JOH), University of Colorado Denver, Denver, CO; the Nutrition and Weight Management Center, Boston Medical Center, Boston, MA (ACB and CMA); and the New York Obesity Research Center, Columbia University, New York, NY (M-PS-O).
authors.forename: David B
authors.initials: DB
authors.lastname: Allison
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D062408:Breakfast; D004038:Diet, Reducing; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D052756:Nutritional Sciences / Q000193:education; D009765:Obesity / Q000178:diet therapy*; D050177:Overweight / Q000178:diet therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D057566:Self Report; D015431:Weight Loss; D055815:Young Adult