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Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l42 (Published 30 January 2019) Cite this as: BMJ 2019;364:l42
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A GOfER diagram (Graphical Overview for Evidence Reviews) showing a visual summary of the included trials from this review.

Opinion

Breakfast—the most important meal of the day?

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Re: Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials

Sievert and Hussain deserve congratulation for their systematic review, if only for highlighting the paucity of good research and the tiny sample size of most of the studies they looked at. While they comment on the high or unclear risk of bias of the studies, they omit clear mention of the potential impact of conflict of interest on the part of the authors. The only large study > 100 participants by Dhurandar et al (2014) states under conflicts of interest "The authors disclose that, although not for the support of this study, the authors or their institutions have received gifts, grants, or consulting fees from multiple organizations that market products commonly consumed at breakfast." In other studies showing positive effects of eating breakfast industry I noticed funding was received variously from Kelloggs, Quaker Oats, and PepsiCo, and the Institute of Life Sciences (recently noted by BMJ to be heavily sponsored by Coca Cola).
As Tim Spector comments NHS guidelines currently recommend breakfast. Breakfast cereal is mentioned as a healthy choice. Yet what is it? Highly processed grain with added vitamins minerals and sugar, so very high in carbohydrate. It is also very effectively marketed. I myself (after personal experimentation) need breakfast to function optimally during the day, but haven't touched the processed stuff for years, as I was always hungry 2-3 hours later.

Competing interests: No competing interests

06 February 2019
Janet Watters
GP
BMA and RCGP member
Belfast