Table 1.
Detailed characteristics of the 14 cohort studies included in this meta-analysis.
| Author, year | Country | Follow-up, year | Study design | Sample size, female (%) | Age, year | Exposure assessment | CVD/MetD assessment | Intervention (breakfast frequency) | Control (breakfast frequency) | Outcome | Main findings |
| Jaaskelainen et al[24] 2012 | Finland | 1986–2002 | Cohort study | 6247, 51% | 16 | Q | International Diabetes Federation paediatric definition | 7 | 0∼4 | Obesity | Among 16-year-olds, the five-meal-a-day pattern was robustly associated with reduced risks of overweight /obesity in both genders and abdominal obesity in boys. |
| Hypertension | |||||||||||
| HC | |||||||||||
| A-obesity | |||||||||||
| Sugimori et al[29] 1998 | Japan | 1976–1991 | Cohort study | 2573, 28% | 46.6 | Q | FBS≥ 110 mg/dL or DT | 1∼7 | 0 | T2DM | For females, breakfast skipping is positively associated with incidence of T2DM. |
| Uemura et al[30] 2014 | Japan | 2002–2011 | Cohort study | 4631, 22.3% | 47.6 | Q | FBG≥126 mg/dL, medical record | 1∼2 | 0 | T2DM | Breakfast skipping is positively associated with incidence of T2DM. |
| 3∼5 | |||||||||||
| 6 | |||||||||||
| 7 | |||||||||||
| Byrne et al[31] 2016 | USA | 2003–2012 | Cohort study | 10,248, 68.1% | 41.2 | Q | Concise Health Risk Assessment | 2∼3 | 0–1 | T2DM, | Top priorities for workplace health promotion should include low-fat diet, aerobic exercise, nonsmoking, and adequate sleep. |
| 4∼6 | CVD | ||||||||||
| 7 | Obesity | ||||||||||
| Stroke | |||||||||||
| Hypertension | |||||||||||
| HC | |||||||||||
| Odegaard et al[7] 2013 | USA | 1992–2011 | Cohort study | 3598, 55.7% | 32.0 | Q | BMI ≥ 30 kg/m2 | 4∼6, | 0–3 | T2DM | Daily breakfast intake is strongly associated with reduced risk of a spectrum of metabolic conditions. |
| SBP ≥ 140 mm Hg | 7 | Obesity | |||||||||
| DBP ≥ 90 mm Hg | Hypertension | ||||||||||
| NCEP-ATP III | MetS | ||||||||||
| FBG ≥ 6.99 mmol/L | A-obesity | ||||||||||
| 2 h PG ≥ 11.1 mmol/L | |||||||||||
| Cahill et al[32] 2013 | USA | 1992–2008 | Cohort study | 51,529, 0 | 58.6 | Q | Medical records or autopsy reports | 7 | 0 | CHD | Eating breakfast was associated with significantly lower CHD risk in this cohort of male health professionals. |
| Mekary et al[33] 2013 | USA | 2002–2008 | Cohort study | 121,700, 100% | 67.2 | Q | American Diabetes Association Criteria | 7 | 0–6 | T2DM | Irregular breakfast consumption was associated with a higher T2D risk in women |
| Rong et al[9] 2019 | China | 1988–2011 | Cohort study | 6550, 52% | 53.2 | Household Interview | ICD-9 | 1∼3 | 0 | CVM | Skipping breakfast was associated with a significantly increased risk of mortality from CVD. |
| ICD-10 | 4∼6 | ||||||||||
| 7 | |||||||||||
| Wennberg et al[34] 2014 | Sweden | 1981–2008 | Cohort study | 889, 52.2% | 43 | Q | International Diabetes Federation | 7 | 0 | MetS | Poor breakfast habits in adolescence predicted the metabolic syndrome in adulthood. |
| Hypertension | |||||||||||
| LHDL-c | |||||||||||
| A-obesity | |||||||||||
| Yokoyama et al[35] 2016 | Japan | 1988–2009 | Cohort study | 83,410, 59% | 40–79 | Q | ICD-10 | 7 | 0 | CVM | Our findings showed that skipping breakfast is associated with increasing risk of CVM. |
| ICD-9 | |||||||||||
| Kubota et al[36] 2016 | Japan | 1995–2010 | Cohort study | 82,772, 53.2% | 56.5 | Q | The criteria of the National Survey of Stroke | 7 | 0 | CVD | The frequency of breakfast intake was inversely associated with the risk of stroke |
| Stroke | |||||||||||
| CHD | |||||||||||
| Mekary et al[37] 2012 | USA | 1992–2008 | Cohort study | 29,206, 0% | 58.1 | Q | American Diabetes Association Criteria | 7 | 0 | T2DM | breakfast consumption was inversely associated with T2D risk in men |
| Wijtzes et al[38] 2016 | The Netherlands | 2y | Cohort study | 5913, 50.3% | 6 | Q | International Obesity Task Force | 7 | 0–6 | obesity | Breakfast skipping at age 4 years is associated with a higher percent fat mass at age 6 years |
| Kim et al[39] 2015 | Korea | 2001–2006 | Cohort study | 1228, 100% | 46.9 | Household Interview | NCEP-ATP III | 7 | 0 | MetS | Implications include the need for stronger emphasis on weight control before midlife and experiencing menopause |
A-obesity = Abdominal-obesity, CVD = Cardiovascular Diseases, CVM = cardiovascular Mortality, DBP = diastolic blood pressure, DT = diabetic therapy, FBS = fasting blood sugar, HC = Hypercholesterolemia, ICD = International Statistical Classification of Diseases, LHDL-c = Low HDL cholesterolemia, MetD = Metabolic Diseases, MetS = Metabolic Syndrome, NCEP-ATP III = National Cholesterol Education Program Adult Treatment Panel III criteria, PG = postchallenge glucose, Q = Questionnaire, SBP = systolic blood pressure.