The Impact of Skipping Breakfast on the Body Weight of Children and Young People in Saudi Arabia; A Systematic Review

Aim: To review evidence on the impact of skipping breakfast on the body weight of children and young people of Saudi Arabia.  Method: A systematic search of the Cochrane Library, EBSCO (AMED, MEDLINE, and CINAHL), Web of Science, SCOPUS, PubMed, and EMBASE was conducted in March 2018 to identify primary published research. Additional studies were identified by hand searching in other sources such as subject-specific journals and grey literature. Any observational study, published in the English language in the last 20 years (1998-2018), involving healthy children and/or young people (5-24 years) in Saudi Arabia was included and the effect of skipping breakfast on their body weight was evaluated. Pre-defined information was extracted from each study onto a data extraction form for evaluation, following the Cochrane method for undertaking a systematic review. Study quality was evaluated using a Quality Assessment Tool for Quantitative Studies.  Results: Eight studies met the inclusion criteria, of which seven graded weak in quality assessment, while one paper scored moderate. Six studies show that regular breakfast consumption has a protective effect against overweight/obesity, of which three studies tested the correlation, while controlling for confounding variables. Two of the eight studies demonstrated no significant correlation. Breakfast intake was also found to have a positive association with student's academic performance, with two out of three trials demonstrating a significant relationship, but in linking regular breakfast habit with socioeconomic status, no effect was found.  Conclusion: The findings suggest that skipping breakfast is associated with a higher risk of overweight and obesity in children and adolescents in Saudi Arabia and thus breakfast consumption is associated with a reduced risk of overweight and obesity. However, in view of the array of methods used to define breakfast skipping and overweight/obesity, as well as the less robust nature of observational studies we cannot conclusively assume this relationship, suggesting further more controlled studies are required. Key words: Obesity, overweight, breakfast, breakfast skipping, children, young people, Saudi Arabia.