Breakfast: Eat Or Skip?

​

​Veronique Gingras, MS, PhD

Breakfast is often advertised as “the most important meal of the day”. Many nutritional guidelines include regular breakfast as a strategy to maintain a healthy weight and eating breakfast is the focus of many weight loss strategies. However, the importance of eating breakfast for weight control or as part of a weight loss strategy remains controversial and it continues to be debated in the scientific literature and community.

In addition, skipping breakfast remains fairly common. In the US, 18% of children and 20% of adults reported having skipped breakfast on the previous day (NHANES data from 2011 – 2014) and another study including adolescents from 31 countries showed that only 38-73% of adolescents ate breakfast daily, depending on the country of origin.

Recently, a meta-analysis (a study combining and analyzing results from all intervention trials) reported no benefit to the addition of breakfast for weight loss, and a potential opposite effect. This study raises, once again, a tricky question: do we need to eat breakfast or is its reputation exaggerated?

There are numerous studies that examined the associations of regular breakfast consumption and obesity risk, and most studies come to the same conclusion: breakfast eaters are leaner and less likely to become overweight. Eating breakfast has been shown to be a common characteristic of weight loss retainers in the National Weight Control Registry. In addition, breakfast eating is typically associated with an improved overall nutritional profile, including higher intakes of micronutrients (vitamins and minerals), fruits, whole grains and dairy. 

However, all these benefits attributed to eating breakfast come from observational studies, and these studies looked at associations, not causal effects of eating breakfast. In observational studies several unaccounted factors can bias the findings. For example, it’s possible that eating breakfast is part of an overall healthier lifestyle, and that other health behaviors are driving the associations observed. Although results from observational studies have consistently shown benefits of breakfast, intervention studies have yielded poor evidence of the benefits from breakfast so far. As mentioned above, the combined evidence from all intervention studies showed no benefit from eating breakfast for weight loss, and the combined analysis seemed to favor skipping breakfast for weight loss interventions. However, the authors acknowledged that the quality of the studies included was mostly low, and that their conclusion should be interpreted with caution. Additionally other factors could influence whether a breakfast intervention is beneficial or not: prior breakfast habits, type of breakfast eaten, length of the intervention, etc.

In a recent publication using data from Project Viva, a cohort study from eastern Massachusetts, we showed that eating breakfast daily during childhood (between 4 and 10 years old) was associated with lower body weight and adiposity in early adolescence (around 13 years of age). Our findings suggest that breakfast consumption starting at an early age and sustained throughout the following years could be a key element to maintain a healthy weight. 
​

To conclude, I don’t think we can clearly answer the question whether breakfast is necessary to maintain a healthy weight or to lose weight. In nutrition, a one-size fits all approach is rarely effective, and studies remain needed to understand the effects of meal frequencies and meal skipping on weight control. Also, when thinking of breakfast, it is important to consider other potential benefits beyond weight management, such as improved concentration and attentiveness, particularly in children, and to keep in mind that breakfast can be a good occasion to spend some quality time with family or friends.