Association of skipping breakfast with depression: a systematic review and meta-analysis

Junwen Tan^1*Sijing Cheng²Cheng Luo¹Shipeng Zhang¹Xueying Li^1*Yanjie Jiang^3*

• ¹Chengdu University of Traditional Chinese Medicine, Chengdu, China
• ²Dazhou Central Hospital, DaZhou, Sichuan Province, China
• ³Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Liaoning Province, China

Objective: Depression is a significant global public health issue, and Breakfast habits may be related to its onset. This study conducted a meta-analysis of previous studies to analyze the correlation between breakfast and depression, comprehensively evaluated the association between skipping breakfast and the risk of depression, and explored the potential sources of heterogeneity.Methods: PubMed, Embase, and Web of Science databases were searched(the retrieval time limit for all was from the establishment of the databases to September 1, 2024), English documents were selected from the databases(the research type was observational study), and then the data was extracted and the Newcastle-Ottawa Scale(NOS) was evaluated for data analysis of the selected studies. This study followed the guidelines of the Preferred Reporting Project (PRISMA) and Prospero Registration Agreement. The mixed-effects model combines the maximum adjusted estimates and measures heterogeneity using the I 2 statistic. Sensitivity analysis verified the robustness of the analysis and assessed publication bias.A meta-analysis of 12 literatures showed that skipping breakfast was positively correlated with the incidence of depression (RR=1.83, [95%CI 1.52-2.20], τ 2 : 0.09, I 2 : 96.37%). Egger test was conducted on the relationship between skipping breakfast and depression, P=0.067 > 0.05, and the result suggested that there was no significant publication bias. Subgroup analysis indicates that current studies in different regions still have deficiencies, and the analysis shows that the occurrence of depression is associated with gender and the sample size of the study.Skipping breakfast can increase the risk of depression. It suggests that we should pay attention to having a regular and standardized breakfast to reduce the risk of depression. High heterogeneity may stem from differences in dietary culture and assessment methods. In the future, more research is needed to explore the mechanism and increase studies in different regions.