As a dietitian, I will frequently ask my patients what they ate to start their day. Most of the time, breakfast is often not mentioned as their first meal of the day. Surprisingly though, this is not uncommon. You may have heard of an intermittent fast where people will choose to skip eating for long periods of time in hopes of health benefits. I am not about to dispute the science behind intermittent fasting since much of the research is robust and does deserve our attention. However, every decision we make when it comes to food should receive skepticism from both sides. The question is then, is skipping “the most important meal of the day” the best idea? Granted, everybody wakes up at a different time and what may be breakfast to one person could be somebody else’s lunch. For arguments sake, let’s just say that breakfast is a meal that occurs at either one of two occasions: within 2 hours of waking up, approximately no later than 10 a.m. or between 5 and 9 a.m. Due to societal changes over the last 40 years, our priorities have shifted and “the most important meal of the day” has arguably taken a back seat. With rising costs of food and housing, more families are forced to work long hours and do not have time to produce a hearty meal for themselves in the morning. Often, children and adolescents are being sent to school without a meal. This is a topic for an entirely different article, but you get the point.
Our societal construct has deemed the consumption of breakfast unnecessary under the scope of productivity. To some degree, we have romanticized the idea of sacrificing crucial calories to keep up the pace. If your workday is not prioritizing your meals, then maybe your hopes of slashing off calories will. Many people think that cutting out breakfast may reduce their total caloric intake for the day and inevitably push them into a caloric deficit. And yes, skipping breakfast may potentially reduce your caloric intake and lead to weight loss.
A recent systematic review by Sievert et al. confirmed this notion after reviewing 11 randomized controlled trials (RCT).1 They found that omitting breakfast from one’s food schedule might reduce total caloric intake and does not lead to overconsumption of foods later in the day. Of course, many of the RCTs reviewed included breakfast foods of relatively poor quality; many of which were sugary-based cereals that lacked fiber and protein. Beware though! As consumers, we often fall into a sort of reductionist approach when evaluating a food item or an entire meal. By this I mean that we only hyper focus on one aspect of the food without considering the other potential benefits or concerns with it. It is quite easy to fall into that pitfall and much harder to climb out of it once you do. Besides fear of weight gain, people should also turn their attention to what might be systemically occurring in their body when they choose to leave breakfast out. Glucose sensitivity, insulin response, appetite hormone regulation, and cortisol levels might all be affected. Any sustained disturbance to these levels may put patients at risk for chronic diseases such as Type Two Diabetes and Cardiovascular disease.
In the American Journal of Clinical Nutrition, Nas et al. conducted a randomized controlled crossover trial observing 17 participants over a 4-week period. Each of the participants belonged to one of three groups: breakfast skipping day (BSD), dinner skipping day (DSD), and regular 3-meal consumption.2 Researchers measured energy balance, macronutrient balance, postprandial glucose levels, inflammatory responses, 24-hour glucose, and insulin secretion. At the end of the study, researchers surprisingly found an increase in energy expenditure and fat oxidation for those who were in both the BSD and DSD groups. These findings suggest that skipping these meals may lead to an intermittent fast and recruitment of lipids for sustained metabolic activity. In other words, the body is turning to its fat reserves for energy. Despite such findings though, researchers also determined that majority of the BSD subjects experienced a higher postprandial insulin concentration compared to the control and DSD group. A significant rise in insulin 30 minutes to 2 hours after lunch may be characteristic of insulin resistance, which has been directly linked to metabolic syndrome. Insulin resistance is the reduced response by tissues to take in glucose with normal levels of insulin present. To compensate for this poor response, the pancreas will then produce an even greater concentration of insulin to allow for the regular uptake of glucose into the body and hopefully return the body to regular glycemic homeostasis. If the pancreas continues to be asked to perform beyond its normal capabilities though, it might eventually become fatigued and start producing less insulin as a result.
Another study by Joo et al. in 2020 examined the association between breakfast frequency and risk of increase insulin resistance.3 The supporting data came from the 2016-2018 Korea National Health and Nutrition Examination Survey looking at over 12,000 participants. Using a triglyceride-glucose (TyG) index, they were able to assess for insulin resistance. The TyG index is of high predictive value when it comes to insulin resistance and has proven to be a valuable assessment tool in previous studies. Scientists found that a decreased weekly breakfast frequency led to a higher risk of insulin resistance in people without diabetes. It is important to consider then that prolonged breakfast skipping may impart some metabolic confusion. Higher than normal insulin levels in the blood may have unforeseen consequences in the blood leading to chronic diseases such as type two diabetes and cardiovascular disease. Therefore, a balanced breakfast is what you as the consumer should aim for. Many times, we go for the sugar-laden cereal that goes way above the suggested serving size in a bowl with a generous amount of milk. Or we may just settle for a slice of toast with butter and coffee. If you are going to have a breakfast, try to impress yourself with a balanced meal; one that includes a vegetable, protein, and fiber-rich grain. Seize the day and start it with breakfast!
1. Sievert, K., Hussain, S. M., Page, M. J., Wang, Y., Hughes, H. J., Malek, M., & Cicuttini, F. M. (2019). Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ (Clinical research ed.), 364, l42. https://doi-org.proxy.library.stonybrook.edu/10.1136/bmj.l42
2. Nas, A., Mirza, N., Hagele, F., Kahlhofer, J., Keller, J., & Rising, R. (2017). Impact of breakfast skipping compared with dinner skipping on regulaton of energy balance and metabolic risk. American Journal of Clinical Nutrition, 105, 1351–1361.
3. Joo, H. J., Kim, G. R., Park, E.-C., & Jang, S.-I. (2020). Association between Frequncy of Breakfast Consumption and Insulin Resistance Using Triglyceride-Glucose Index: A Cross-Sectional Study of the Korea National Health and Nutriton Examination Survey (2016-2018). International Journal of Environmental Research and Public Health, 17(3322), 1–13.