Breakfast Habits, Anthropometry, and Nutrition-Related Outcomes in Adolescents From Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Breakfast skipping is a commonly reported dietary habit among adolescents despite this life stage marked by critical growth and development. Limited comparable evidence exists from low- and middle-income countries (LMICs), where the detrimental effect of inadequate diets remains a major public health challenge. We conducted a systematic review to assess the scientific evidence available from LMICs regarding the association of breakfast skipping and consumption habits and anthropometry- and nutrition-related outcomes in adolescents 10-19 years old. Electronic searches for relevant studies were conducted on MEDLINE, EMBASE, CINAHL, CENTRAL and Web of Science from the date of database inception until June 28, 2023. Additionally, reference lists of included studies and gray literature were searched. We included studies of all designs that compared breakfast skipping and consumption habits among adolescents aged 10-19 years in LMICs. Exclusion criteria included the following: review articles, if the target population age was outside the WHO definition of adolescents, assessed only lunch or dinner consumption, skipped any other meal besides breakfast, only collected point prevalence data, did not include a breakfast consumer control group, or co-interventions were inconsistent across breakfast habit groups. The primary outcomes were body mass index (BMI in kg/m