The Problem With Research
Is breakfast truly the most important meal of the day? Unfortunately, many studies carried out to answer this question have different definitions of what constitutes breakfast and skipping breakfast. The methods used to correlate nutrient consumption and breakfast with overall diet quality are also inconsistent. However, the evidence remains strong that breakfast is vital for overall dietary nutrient density, weight loss, and appetite control, heart disease prevention, and reduction of impaired glucose tolerance and type 2 diabetes.
Breakfast and Children
A report of the European branch of the World Health Organization illustrated that among 200,000 male and female schoolchildren between the ages of 11 and 15, regular breakfast consumption is associated with higher intakes of micronutrients. This diet includes more fruits and vegetables and less frequent consumption of soft drinks. Other research has shown that children who skip breakfast:
- Have higher intakes of saturated fatty acids
- Lower intakes of dietary fiber
- Lower intakes of most vitamins and minerals
Children who eat breakfast cereals have higher intakes of total sugar (but not added sugar) and fiber coupled with lower intakes of fat and sodium. They also tend to have higher intakes of most vitamins and minerals. Breakfast adds more variety to the diet, an important factor in nutrient balance.
Habitual breakfast consumption is associated with better cognitive performance and academic achievement. Tasks requiring attention, executive function, and memory are improved in children who have eaten breakfast.
Breakfast and Weight Loss
According to the National Weight Loss Registry, seventy-eight percent of people who lost weight and kept it off for at least five years eat breakfast every day.
Although a study published in the American Journal of Clinical Nutrition had the media abuzz with the news that eating breakfast didn’t help with weight loss, researchers point out that the study wasn’t designed to determine if specific foods or the timing of breakfast make a difference. It only determined that eating breakfast didn’t seem to make a difference among these 300 overweight and obese individuals between the ages of 20 and 65.
Eating breakfast, especially if the meal is high in protein, might increase dopamine levels in the brain, thereby reducing food cravings and overeating later in the day. In one study, the breakfast meal had to contain at least 30 grams of protein and 350 calories to improve appetite control and satiety. In one review, only half of the studies showed improvements in appetite and satiety outcomes after consuming a lower-calorie breakfast (<200 calories). Regardless of nutrient content, meal replacement beverages do not improve appetite control or satiety like solid foods do.
Levels of ghrelin, which stimulates appetite and promotes fat storage, fall after eating breakfast (especially one that is higher in protein), while levels of PYY and GLP-1 concentrations, both of which decrease appetite, increase. Breakfast consumption changes satiety hormones to increase satisfaction and satiety.
Although it seems that in some cases, more fat is burnt when we exercise on an empty stomach, research from the University of Bath in the UK found that breakfast eaters expended more energy via physical activity throughout the day compared to individuals who fasted until noon. When extrapolated across 24 hours, the increase in postprandial energy expenditure after breakfast consumption ranged from 40 to 200 calories per day and varied based on the chosen foods.
Breakfast and Heart Health
Individuals who skip breakfast are at a higher risk for following an overall unhealthy lifestyle, including poor overall diet, frequent alcohol consumption, and smoking. However, there is a possible association between skipping breakfast and the prevalence of subclinical atherosclerosis independent of the overall unhealthy lifestyle. Individuals who consume mostly toast, pastries and coffee in the morning also have an increased risk of having carotid and iliofemoral atherosclerotic plaques.
A cohort study showed a 14% greater risk of cardiovascular disease, an 18% greater risk of total stroke, and a 36% greater risk of hemorrhage among those who skip breakfast. In another study, breakfast skippers had an average 27% higher risk of coronary heart disease, but BMI and health conditions mediated the risk.
A multivariable analysis controlling for waist circumference, hypertension, diabetes, dyslipidemia, and smoking, suggests that skipping breakfast could be one of the risk factors clustering around the early onset and development of atherosclerosis. In this analysis, 45% of those who skipped breakfast followed a “social-business eating plan,” including overall unhealthy food choices, frequent eating out, and busy schedules. They also have the highest intake of red and processed meat, appetizer, sugar-sweetened beverages, and alcohol during the rest of the day.
Breakfast and Metabolism
The American Heart Association issued a scientific opinion in 2017, concluding that “daily breakfast consumption among US adults may decrease the risk of adverse effects related to glucose and insulin metabolism.” Even in young, healthy people, glycemic response after lunch was significantly higher than glycemic response after an identical lunch when breakfast was consumed.
Breakfast does not seem to affect basal metabolism, which is the rate at which the bodies use energy (calories) while at rest to keep vital functions going, such as breathing and keeping warm.
If you don’t like breakfast, there are a few things that might make it easier for you:
- Don’t limit yourself to “breakfast foods.” If you want a turkey and cheese sandwich, go for it.
- Make your breakfast the night before.
- Split your breakfast into two “snacks” eaten an hour or two apart.
- Try eating your breakfast earlier in the evening, if possible. Don’t snack at nighttime.
Regardless of what you may hear in the media, research clearly proves that breakfast is important for your health. Just don’t set the tone for your day with a sugar-laden pop-tart! You’re worth so much more…
Adolphus K, Lawton CL, Champ CL, Dye L. The effects of breakfast and breakfast composition on cognition in children and adolescents: A systematic review. Adv Nutr. 2016 May 16;7(3):590S-612S. doi: 10.3945/an.115.010256. PMID: 27184287; PMCID: PMC4863264.
Betts JA, Chowdhury EA, Gonzalez JT, Richardson JD, Tsintzas K, Thompson D. Is breakfast the most important meal of the day? Proc Nutr Soc. 2016 Nov;75(4):464-474. doi: 10.1017/S0029665116000318. Epub 2016 Jun 13. PMID: 27292940.
Bi H, Gan Y, Yang C, Chen Y, Tong X, Lu Z. Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr. 2015 Nov;18(16):3013-9. doi: 10.1017/S1368980015000257. Epub 2015 Feb 17. PMID: 25686619.
Clayton DJ, James LJ. The effect of breakfast on appetite regulation, energy balance and exercise performance. Proc Nutr Soc. 2016 Aug;75(3):319-27. doi: 10.1017/S0029665115004243. Epub 2015 Dec 14. PMID: 26653842.
Galioto R, Spitznagel MB. The effects of breakfast and breakfast composition on cognition in adults. Adv Nutr. 2016 May 16;7(3):576S-89S. doi: 10.3945/an.115.010231. PMID: 27184286; PMCID: PMC4863263.
Gibney MJ, Barr SI, Bellisle F, Drewnowski A, Fagt S, Livingstone B, Masset G, Varela Moreiras G, Moreno LA, Smith J, Vieux F, Thielecke F, Hopkins S. Breakfast in human nutrition: The International Breakfast Research Initiative. Nutrients. 2018 May 1;10(5):559. doi: 10.3390/nu10050559. PMID: 29723985; PMCID: PMC5986439.
Gwin JA, Leidy HJ. A review of the evidence surrounding the effects of breakfast consumption on mechanisms of weight management. Adv Nutr. 2018 Nov 1;9(6):717-725. doi: 10.1093/advances/nmy047. PMID: 30204837; PMCID: PMC6247188.
Maki KC, Phillips-Eakley AK, Smith KN. The effects of breakfast consumption and composition on metabolic wellness with a focus on carbohydrate metabolism. Adv Nutr. 2016 May 16;7(3):613S-21S. doi: 10.3945/an.115.010314. PMID: 27184288; PMCID: PMC4863265.
Ogata H, Hatamoto Y, Goto Y, Tajiri E, Yoshimura E, Kiyono K, Uehara Y, Kawanaka K, Omi N, Tanaka H. Association between breakfast skipping and postprandial hyperglycaemia after lunch in healthy young individuals. Br J Nutr. 2019 Aug 28;122(4):431-440. doi: 10.1017/S0007114519001235. PMID: 31486356.
Uzhova I, Fuster V, Fernández-Ortiz A, Ordovás JM, Sanz J, Fernández-Friera L, López-Melgar B, Mendiguren JM, Ibáñez B, Bueno H, Peñalvo JL. The importance of breakfast in atherosclerosis disease: insights From the PESA study. J Am Coll Cardiol. 2017 Oct 10;70(15):1833-1842. doi: 10.1016/j.jacc.2017.08.027. PMID: 28982495.