Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies

OBJECTIVE: Breakfast skipping has been reported to be associated with type 2 diabetes (T2D), but the results are inconsistent. No meta-analyses have applied quantitative techniques to compute summary risk estimates. The present study aimed to conduct a meta-analysis of observational studies summarizing the evidence on the association between breakfast skipping and the risk of T2D. DESIGN: Systematic review and meta-analysis. SETTING: Relevant studies were identified by a search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and SINOMED up to 9 August 2014. We also reviewed reference lists from retrieved articles. We included studies that reported risk estimates (including relative risks, odds ratios and hazard ratios) with 95% confidence intervals for the association between breakfast skipping and the risk of T2D. SUBJECTS: Eight studies involving 106,935 participants and 7419 patients with T2D were included in the meta-analysis. RESULTS: A pooled adjusted relative risk for the association between exposure to breakfast skipping and T2D risk was 1·21 (95% CI 1·12, 1·31; P=0·984; I² =0·0%) in cohort studies and the pooled OR was 1·15 (95% CI, 1·05, 1·24; P=0·770; I² =0·0%) in cross-sectional studies. Visual inspection of a funnel plot and Begg's test indicated no evidence of publication bias. CONCLUSIONS: Breakfast skipping is associated with a significantly increased risk of T2D. Regular breakfast consumption is potentially important for the prevention of T2D.