The causal role of breakfast in energy balance and health

a randomized controlled trial in lean adults. ISRCTN31521726

J Betts, J D Richardson, E Chowdhury, G D Holman, Kostas Tsintzas, Dylan Thompson

Research output: Non-textual formData set/Database

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Abstract

Background: Popular beliefs that ‘breakfast is the most important meal of the day’ are grounded in cross-sectional observations linking breakfast to health, the causal nature of which remains to be explored under real-life conditions.
Objective: To conduct a randomized controlled trial examining causal links between breakfast habits and all components of energy balance in free-living humans.
Design: The Bath Breakfast Project is a randomized controlled trial with repeated-measures at baseline and follow-up amongst a cohort in South-West England aged 21-60 y with Dual-Energy X-Ray Absorptiometry (DXA)-derived fat mass indices ≤11 kg·m-2 (women; n=21) and ≤7.5 kg·m-2 (men; n=12). Components of energy balance (resting metabolic rate, physical activity thermogenesis, energy intake) and 24-h glycemic responses were measured under free-living conditions with random allocation to daily breakfast (≥700 kcal before 1100 h) or extended fasting (0 kcal until 1200 h) for 6 weeks, with baseline and follow-up measures of health markers (e.g. hematology/biopsies).
Results: Contrary to popular belief, there was no metabolic adaptation to breakfast (e.g. resting metabolic rate stable within 11 kcal·d-1), with limited subsequent suppression of appetite (energy intake remained 539 kcal·d-1 greater than fasting; 95%CI=157, 920). Rather, physical activity thermogenesis was markedly higher with breakfast than fasting (442 kcal·d-1; 95%CI=34, 851). Body mass and adiposity did not differ between treatments at baseline or follow-up and neither did adipose tissue glucose uptake or systemic indices of cardiovascular health. Twenty-four hour glycemia was more variable during the afternoon/evening with fasting than with breakfast by the final week of intervention (2%; 95%CI=0.1, 8).
Conclusions: Daily breakfast is causally linked to higher physical activity thermogenesis in lean adults, with greater overall dietary energy intake but no change in resting metabolism. Cardiovascular health indices were unaffected by either treatment but breakfast maintained more stable afternoon/evening glycemia than fasting.
Original languageEnglish
Place of PublicationBath, U. K.
PublisherUniversity of Bath
Media of outputOnline
Publication statusAccepted/In press - 2014

Fingerprint

Breakfast
Randomized Controlled Trials
Health
Fasting
Thermogenesis
Energy Intake
Basal Metabolism
Exercise
Social Conditions
Photon Absorptiometry
Adiposity
Appetite
Hematology
Random Allocation
Baths
England
Habits
Meals
Adipose Tissue
Fats

Keywords

  • Breakfast
  • Fasting
  • Health
  • Energy Balance

Cite this

The causal role of breakfast in energy balance and health : a randomized controlled trial in lean adults. ISRCTN31521726. Betts, J (Author); Richardson, J D (Author); Chowdhury, E (Author); Holman, G D (Author); Tsintzas, Kostas (Author); Thompson, Dylan (Author). 2014. Bath, U. K. : University of Bath.

Research output: Non-textual formData set/Database

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abstract = "Background: Popular beliefs that ‘breakfast is the most important meal of the day’ are grounded in cross-sectional observations linking breakfast to health, the causal nature of which remains to be explored under real-life conditions.Objective: To conduct a randomized controlled trial examining causal links between breakfast habits and all components of energy balance in free-living humans.Design: The Bath Breakfast Project is a randomized controlled trial with repeated-measures at baseline and follow-up amongst a cohort in South-West England aged 21-60 y with Dual-Energy X-Ray Absorptiometry (DXA)-derived fat mass indices ≤11 kg·m-2 (women; n=21) and ≤7.5 kg·m-2 (men; n=12). Components of energy balance (resting metabolic rate, physical activity thermogenesis, energy intake) and 24-h glycemic responses were measured under free-living conditions with random allocation to daily breakfast (≥700 kcal before 1100 h) or extended fasting (0 kcal until 1200 h) for 6 weeks, with baseline and follow-up measures of health markers (e.g. hematology/biopsies).Results: Contrary to popular belief, there was no metabolic adaptation to breakfast (e.g. resting metabolic rate stable within 11 kcal·d-1), with limited subsequent suppression of appetite (energy intake remained 539 kcal·d-1 greater than fasting; 95{\%}CI=157, 920). Rather, physical activity thermogenesis was markedly higher with breakfast than fasting (442 kcal·d-1; 95{\%}CI=34, 851). Body mass and adiposity did not differ between treatments at baseline or follow-up and neither did adipose tissue glucose uptake or systemic indices of cardiovascular health. Twenty-four hour glycemia was more variable during the afternoon/evening with fasting than with breakfast by the final week of intervention (2{\%}; 95{\%}CI=0.1, 8). Conclusions: Daily breakfast is causally linked to higher physical activity thermogenesis in lean adults, with greater overall dietary energy intake but no change in resting metabolism. Cardiovascular health indices were unaffected by either treatment but breakfast maintained more stable afternoon/evening glycemia than fasting.",
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AU - Tsintzas, Kostas

AU - Thompson, Dylan

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N2 - Background: Popular beliefs that ‘breakfast is the most important meal of the day’ are grounded in cross-sectional observations linking breakfast to health, the causal nature of which remains to be explored under real-life conditions.Objective: To conduct a randomized controlled trial examining causal links between breakfast habits and all components of energy balance in free-living humans.Design: The Bath Breakfast Project is a randomized controlled trial with repeated-measures at baseline and follow-up amongst a cohort in South-West England aged 21-60 y with Dual-Energy X-Ray Absorptiometry (DXA)-derived fat mass indices ≤11 kg·m-2 (women; n=21) and ≤7.5 kg·m-2 (men; n=12). Components of energy balance (resting metabolic rate, physical activity thermogenesis, energy intake) and 24-h glycemic responses were measured under free-living conditions with random allocation to daily breakfast (≥700 kcal before 1100 h) or extended fasting (0 kcal until 1200 h) for 6 weeks, with baseline and follow-up measures of health markers (e.g. hematology/biopsies).Results: Contrary to popular belief, there was no metabolic adaptation to breakfast (e.g. resting metabolic rate stable within 11 kcal·d-1), with limited subsequent suppression of appetite (energy intake remained 539 kcal·d-1 greater than fasting; 95%CI=157, 920). Rather, physical activity thermogenesis was markedly higher with breakfast than fasting (442 kcal·d-1; 95%CI=34, 851). Body mass and adiposity did not differ between treatments at baseline or follow-up and neither did adipose tissue glucose uptake or systemic indices of cardiovascular health. Twenty-four hour glycemia was more variable during the afternoon/evening with fasting than with breakfast by the final week of intervention (2%; 95%CI=0.1, 8). Conclusions: Daily breakfast is causally linked to higher physical activity thermogenesis in lean adults, with greater overall dietary energy intake but no change in resting metabolism. Cardiovascular health indices were unaffected by either treatment but breakfast maintained more stable afternoon/evening glycemia than fasting.

AB - Background: Popular beliefs that ‘breakfast is the most important meal of the day’ are grounded in cross-sectional observations linking breakfast to health, the causal nature of which remains to be explored under real-life conditions.Objective: To conduct a randomized controlled trial examining causal links between breakfast habits and all components of energy balance in free-living humans.Design: The Bath Breakfast Project is a randomized controlled trial with repeated-measures at baseline and follow-up amongst a cohort in South-West England aged 21-60 y with Dual-Energy X-Ray Absorptiometry (DXA)-derived fat mass indices ≤11 kg·m-2 (women; n=21) and ≤7.5 kg·m-2 (men; n=12). Components of energy balance (resting metabolic rate, physical activity thermogenesis, energy intake) and 24-h glycemic responses were measured under free-living conditions with random allocation to daily breakfast (≥700 kcal before 1100 h) or extended fasting (0 kcal until 1200 h) for 6 weeks, with baseline and follow-up measures of health markers (e.g. hematology/biopsies).Results: Contrary to popular belief, there was no metabolic adaptation to breakfast (e.g. resting metabolic rate stable within 11 kcal·d-1), with limited subsequent suppression of appetite (energy intake remained 539 kcal·d-1 greater than fasting; 95%CI=157, 920). Rather, physical activity thermogenesis was markedly higher with breakfast than fasting (442 kcal·d-1; 95%CI=34, 851). Body mass and adiposity did not differ between treatments at baseline or follow-up and neither did adipose tissue glucose uptake or systemic indices of cardiovascular health. Twenty-four hour glycemia was more variable during the afternoon/evening with fasting than with breakfast by the final week of intervention (2%; 95%CI=0.1, 8). Conclusions: Daily breakfast is causally linked to higher physical activity thermogenesis in lean adults, with greater overall dietary energy intake but no change in resting metabolism. Cardiovascular health indices were unaffected by either treatment but breakfast maintained more stable afternoon/evening glycemia than fasting.

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KW - Health

KW - Energy Balance

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PB - University of Bath

CY - Bath, U. K.

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