Farewell, pancakes? Farewell, breakfast sausage?
A new review that suggests breakfast skippers eat fewer calories over the day and weigh slightly less than breakfast eaters is reigniting debate over the quaint notion that breakfast is “the most important meal of the day.”
While some experts say the research is further evidence skipping breakfast might be a fruitful way to lose weight, critics say the study is only adding to confusion and wildly contradictory dietary advice. And even the authors acknowledge their work was based largely on low quality studies that had only short-term follow-up, and should therefore be interpreted with caution.
Published last week in the British Medical Journal, the study found that, despite the almost dogmatic belief skipping breakfast makes people hungrier later and thus more likely to overeat — a claim promoted by cereal makers for decades and ingrained in international dietary guidelines — breakfast skippers consumed, on average, 260 fewer calories per day than regular breakfast eaters and were, on average, 0.44 kilograms lighter.
“While breakfast has been advocated as the most important meal of the day in the media since 1917, there is a paucity of evidence to support breakfast consumption as a strategy to achieve weight loss, including in adults with overweight or obesity,” the authors wrote.
Eating breakfast could have other important effects, they said, like improved concentration and attentiveness in children. However, “caution is needed when recommending breakfast for weight loss in adults, as it could have the opposite effect.”
It’s all a bit much for some nutritionists and obesity specialists, who say the meta-analysis — a study of studies — was based on research lasting as little as 24 hours and only as long as 16 weeks. Some compared breakfast eaters who were allowed to eat “ad libitum” to a “no-breakfast arm” that had to fast (no food or drink) until 11:30 a.m. each day.
“This isn’t helpful in any shape or form in the discourse around weight management or breakfast,” said University of Ottawa assistant professor of family medicine Dr. Yoni Freedhoff.
But how solid is the science behind breakfast?
“The idea that early eating is essential makes perfect sense for farm labourers and small children,” New York University nutrition professor Marion Nestle wrote in 2015 on her site, Food Politics. “Whether it matters for normal sedentary adults is a different question.”
Many international dietary guidelines insist that skipping breakfast is a surefire path to weight gain, the presumption being that if we don’t break our overnight fast in the morning, we’ll overcompensate for it later in the day.
“Furthermore, it is also postulated that the satiating properties of food over the course of the day decline,” the authors of the BMJ review wrote. “And, therefore, eating earlier in the day could promote greater satiety than eating later in the day.”
We are all unique! People should now accept that skipping breakfast is not harmful
However, Nestle (who isn’t much of a breakfast eater herself) has long argued many breakfast studies were sponsored by cereal companies, which have an obvious vested interested in the outcomes.
“These almost invariably concluded that eating breakfast helped control body weight,” Nestle said in an email. “This (new) meta-analysis says that eating breakfast correlated with consumption of more calories and a slightly higher body weight,” she said, adding that isn’t all that surprising, given weight loss is about reducing energy.
Breakfast provides calories. If people consume more calories in a day than they need, they will gain weight.
“It’s perfectly possible to maintain a healthy weight whether you do or do not eat breakfast,” Nestle said. “It’s the overall diet that counts.”
For the BMJ study, a team from Monash University in Melbourne looked at 13 randomized controlled trials comparing breakfast consumption with no breakfast. The studies were conducted mainly in the U.S. and the U.K. and published between 1990 and 2018.
The studies — all in adults — looked at the effect of eating breakfast on weight change and calorie intake.
Overall, they found that, at the end of the trials — the mean follow-up was two weeks — people assigned to the breakfast groups had a higher total daily calorie intake. Breakfast skippers “did not compensate their energy intake later in the day.”
As well, while the “eat breakfast for weight loss” mantra was partly premised on the belief eating early makes our bodies more efficient at burning calories throughout the day, there were no differences in the metabolic rates between the two groups.
Simply put, the researchers found “no evidence to support the notion that breakfast consumption promotes weight loss or that skipping breakfast lead to weight gain.”
“The key message is that if a person likes to eat breakfast that is fine,” senior author Flavia Cicuttini, head of the musculoskeletal unit at Monash University, said in an email. “However, there is no evidence that we should be encouraging people to change their eating pattern to include breakfast in order to prevent weight gain or obesity.”
Personally, Cicuttini counts herself among those who skip breakfast, “simply because I am not hungry.”
Tim Spector, professor of genetic epidemiology at King’s College London, argues that the health benefits of breakfast have now been “completely debunked,” despite it being rooted in motherhood.
“The British fry-up is thought by many to be the country’s main contribution to world cuisine,” Spector wrote in a related commentary in the BMJ.
So, how did the guidelines get it wrong, according to Spector? Part of it is around the belief we should “eat little and often” in order to avoid stressing the body to digest larger meals later in the day when metabolic rates are lower. But that thinking was based mostly on studies in rodents, and only a handful in humans, wrote Spector, author of the 2016 book, The Diet Myth: The Real Science Behind What We Eat.
Other observational studies — where researchers simply “observe” what people are doing, without intervening — also found that obese people skipped meals more often than thin people. But Spector said the studies were flawed by bias.
“People who skipped breakfast were more likely on average to be poorer, less educated, less healthy and to have a generally poorer diet,” he wrote. There’s also some evidence to suggest that people with obesity have altered hunger hormone profiles, so they’re not hungry in the morning, but are late at night.
“We are all unique! People should now accept that skipping breakfast is not harmful,” Spector wrote in an email from Japan, where he was enjoying “about 20 diverse items for breakfast,” though he normally eats yogurt with nuts, seeds and berries, plus an espresso. “People should listen to their own bodies and internal clocks and for some people this may help them lose weight. The key message is no one size fits all.”
Still, the quality of studies in the Monash analysis were “mostly low,” the authors write, with only short-term follow up. And the difference in weight between the groups marginal.
The types of breakfasts also varied, and although they tended to focus on healthier options (like crisped rice cereal and semi-skinned milk), in one study, the breakfast eaters ate bran cereal between 7 and 8 a.m. followed, by a chocolate-covered cookie between 10:30 and 11 a.m.
“Fruit Loops is not the same as scrambled eggs, not in terms of health, not in terms of fullness and almost certainly not in terms of long-term impact on weight, ” Freedhoff said.
“Like everything else around diet — coming to these firm conclusions on meals, on particular dietary strategies is harmful. If there was one right diet that would help everybody in their quest to manage their weight, everybody would already be on it.”
For the majority of his patients who struggle with weight, a protein-rich breakfast of whole foods helps control appetite.
Despite headlines like, “Skip brekkie, lose 1 lb,” others, too, were unconvinced. “I don’t feel the findings are robust enough to recommend (forgoing breakfast) as a weight-loss strategy for most people,” Dana Hunnes, a senior dietician at the Ronald Reagan UCLA Medical Center in Los Angeles told Live Science.
In the end, it may come down more to the timing of eating. Scientific interest is mounting in “time-restricted” feeding, a form of intermittent fasting. One small, pilot study published last August in the Journal of Nutritional Science by University of Surrey researchers split people into two groups: those who were told to delay their breakfast by 90 minutes and have their dinner 90 minutes earlier, and those who ate meals as they would normally.
After 10 weeks, those who changed their mealtimes lost, on average, more than twice as much body fat as those who ate their meals as normal.
National Post
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