Abstract
Previous studies evaluating the association between skipping breakfast and hypertension in adult population showed inconsistent results. We performed a meta-analysis to systematically evaluate the association. Observational studies which evaluated the relationship between skipping breakfast and hypertension in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Web of Science databases. A random-effect model which incorporated the potential intrastudy heterogeneity was used for the meta-analysis. A total of six observational studies with 14189 adults were included, and 3577 of them were breakfast skippers. Pooled results showed that skipping breakfast was independently associated with hypertension in these populations (adjusted odds ratio (OR): 1.20, 95% confidence interval: 1.08 to 1.33, P < 0.001) with no significant heterogeneity (I2 = 0%). Sensitivity by excluding one study at a time showed consistent results (OR: 1.18 to 1.22, all P <0.01). Subgroup analyses showed that the association between skipping breakfast and hypertension in adults was consistent in the general population and in patients with type 2 diabetes, in studies from different countries, in cohort and cross-sectional studies, in breakfast skippers defined as taking breakfast ≤3 days/week and as self-reported habitual breakfast skipping, and in studies with and without adjustment of body mass index (Pfor subgroup difference, all P>0.10). In conclusion, skipping breakfast is associated with hypertension in the adult population.
Highlights
Hypertension is a prevalent risk factor of cardiovascular diseases, in elderly population and in the developing countries [1–3]
A recent meta-analysis of randomized controlled trials (RCTs) including 425 participants showed that skipping breakfast with an average duration of 8.6 weeks did not significantly change the blood pressure (BP) [22], which further suggested the uncertainty regarding the relationship between skipping breakfast and hypertension
Studies were identified via systematic search of electronic databases of PubMed and Embase via the following terms: (1) “breakfast” odds ratios (ORs) “morning meal” OR “eating patterns” OR “meal frequency” OR “skipping meals” and (2) “hypertension” OR “blood pressure” OR “hypertensive.” e search strategies were developed based on previous meta-analyses of “skipping breakfast” [8] and “hypertension” [25], respectively, which have been validated in these previous meta-analyses. e search was limited to human studies published in English. e reference lists of related original and review articles were analyzed using a manual approach. e final literature search was performed on September 10, 2021
Summary
Hypertension is a prevalent risk factor of cardiovascular diseases, in elderly population and in the developing countries [1–3]. Studies evaluating the association between skipping breakfast and hypertension in the adult population showed inconsistent results [16–21]. Some studies suggested that skipping breakfast may be an independent risk factor for hypertension in adults [18–20], while others did not [16, 17, 21]. A recent meta-analysis of randomized controlled trials (RCTs) including 425 participants showed that skipping breakfast with an average duration of 8.6 weeks did not significantly change the blood pressure (BP) [22], which further suggested the uncertainty regarding the relationship between skipping breakfast and hypertension. In this study, we performed a meta-analysis to systematically evaluate the association between skipping breakfast and hypertension in adult participants. Methods e meta-analysis was performed in accordance with the MOOSE (Meta-Analysis of Observational Studies in Epidemiology) [23] and Cochrane’s Handbook [24] guidelines
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