The prevalence of type 2 diabetes has been dramatically increasing worldwide and is a major health concern. Many well-known lifestyle factors are associated with increased risk of type 2 diabetes; now, a recent study published in the January 2019 issue of The Journal of Nutrition suggests that skipping breakfast should be added to the list. Although previous studies have demonstrated an association between breakfast skipping and type 2 diabetes, this lifestyle choice was treated as a dichotomous variable.
A research team led by Dr. Aurélie Ballon from the German Diabetes Center hypothesized that not only is there an association between breakfast skipping and type 2 diabetes, but this relation presents in a consistent dose-response manner.
Data for this study were obtained by a systematic review and meta-analysis of 6 prospective cohort studies on breakfast skipping and risk of type 2 diabetes in adults. Breakfast skipping was analyzed as a continuous variable in order to determine whether the risk increased with increased frequency of breakfast skipping (i.e. a dose-response). The influence of body mass index on the association between breakfast skipping and risk of type 2 diabetes was also considered in the final analysis.
Nonlinear dose-response meta-analysis indicated that risk of type 2 diabetes increased with every additional day of breakfast skipping, reaching a plateau at 4‒5 days a week. No further increase in risk of type 2 diabetes was observed after 5 days of breakfast skipping per week. This association was partly mediated by obesity, but a positive association persisted after adjustment for obesity, suggesting that other factors might also influence this association. The researchers concluded, “future studies should also focus on breakfast quality.” In other words, would consuming an unhealthy breakfast be better than skipping breakfast altogether?
Reference Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Ballon A, Neuenschwander M, Schlesinger S. Journal of Nutrition. 2019; In Press. Breakfast Skipping and Type 2 Diabetes: Where Do We Stand? Mekary RA. Journal of Nutrition. 2019; In Press. https://doi.org/10.1093/jn/nxy284