If someone asked you what the most important meal of the day is, you would not be alone if you answered, “breakfast.”
From doctors to government guidelines, we’re surrounded by a strong emphasis on the importance of breakfast. It is supposed to get your metabolism going and get your day off to a healthy start, while simultaneously lowering your risk of obesity and other chronic conditions.
There always seems to be new research on how eating breakfast contributes to overall health, including a 2013 study that linked eating breakfast and lower instances of coronary heart disease in men; a 2012 study that found a relationship between skipping breakfast and an increased risk of type 2 diabetes; and a 2016 study that found that skipping breakfast was related to an increased risk of cancer and circulatory disease in Japanese men and women.
And yet, according to market research groups, more than 31 million Americans don’t eat breakfast, either because they aren’t hungry in the morning or because they are too busy trying to get to work or school on time.
If you’re one of those 31 million, are you permanently destroying your chance at a healthy life?
There’s a lot more nuance and complexity in breakfast research than might first appear.
In all three of those studies, the relationship found between eating breakfast and health problems was correlational, not causal. The researchers had no way of knowing whether skipping breakfast caused health problems, or whether people who skipped breakfast were simply also more likely to have health problems. In the 2013 study, for example, the participants who skipped breakfast also exercised less, smoked more, and drank more than participants who ate breakfast regularly.
Many nutritional studies are observational, meaning the participants are watched or observed, but there are no randomized trials or changes being made to their behavior. These studies are cheaper to conduct, but they can only provide information about whether two traits appear to have a relationship, not whether one trait causes the other.
When randomized trials into the effect of breakfast are conducted, the results become much murkier.
A 2014 study randomly assigned participants a breakfast of high-fiber oatmeal, a breakfast of low-fiber cereal, or no breakfast at all. The results showed that the only group to lose weight was actually the no breakfast group, though the two groups that ate breakfast had lower cholesterol at the end of the study.
In 2016, a randomized, controlled trial of obese adults found similarly mixed results. Participants were randomly assigned to either eat breakfast or skip it for six weeks, while researchers followed up with tests for various health markers. They found that participants who ate breakfast were more active in the morning but showed greater levels of insulin sensitivity, while neither group showed significant changes in weight or most other health outcomes.
Of course, there are reasons other than weight that you might want to eat something in the morning.
Multiple studies have found that eating breakfast leads to better memory and learning in school-aged children, as well as improving their behavior and attention span. These studies are often designed to look at the effect of school breakfast programs for children who don’t get enough to eat, and, as anyone who has taken care of children knows, hungry children often have trouble paying attention or behaving well.
For adults, research suggests that eating in the morning could lead to some improvement in memory, attention, and executive cognitive function.
However, when it comes to physical health, research into the effect of eating breakfast is often less clear-cut than you have been led to believe.
A 2013 literature review of breakfast studies found that this is common especially when talking about the proposed effect of breakfast on obesity, or PEBO. The review found that researchers who claim that skipping breakfast causes obesity are often guilty of a biased interpretation of their own results, improperly describing their results as causal, citing others’ research in a misleading way, or improperly describing others’ research as causal.
“The belief in the PEBO,” the review concluded, “exceeds the strength of scientific evidence.”
In other words, eat a healthy breakfast when you are hungry for it. But if you wait until lunch, you’ll still probably be okay.
September 19, 2016
Janet O’Dell, RN