First time here? Get a 15% off on your first group session with Dr. Juman with code JA15
Should You Eat Breakfast?

Should You Eat Breakfast?

by Jumana Antoun in News

For decades, breakfast has been labeled the “most important meal of the day,” but is it truly essential for health and weight management? Let’s explore what the research says.

What Defines Breakfast?

Breakfast is simply the first meal consumed after an overnight fasting. However, the definition varies across studies. According to Baltar et al. (2018), breakfast is not just about the time of consumption but also the caloric intake, with a minimum of 50 kcal required to be considered breakfast.

Nutritional Quality of Breakfast

An ideal breakfast should:

  • Deliver adequate protein, fiber, vitamins, and minerals
  • Limit added sugar and unhealthy fats, especially from processed foods
  • Include whole grains or fortified cereals to enhance nutritional value

A healthy Lebanese breakfast combines protein, fiber, and healthy fats while embracing traditional flavors. Foul medames and balila offer plant-based protein and fiber, while labneh with olive oil provides protein and healthy fats. Prioritizing whole grains, legumes, dairy, and fresh vegetables while minimizing added sugar makes for a nutritious and satisfying breakfast.

Does Breakfast Improve Health?

Cardiometabolic Health

Breakfast consumption has been associated with improved cardiometabolic markers (Santos and Tinsley, 2023; Lukomskyj, 2021), but what does that mean? Cardiometabolic health combines heart and metabolic functions, including blood sugar control, blood pressure, cholesterol levels, and weight management.

A meta-analysis of 7 cohort studies involving 221,732 participants has shown that skipping breakfast was associated with elevated risk of cardiovascular disease (relative risk 1.22 95% confidence interval 1.10–1.35) and all-cause mortality (relative risk 1.25 95% confidence interval 1.11–1.40) compared with eating breakfast regularly (Chen et al., 2020). Another review of 18 studies involving 242,095 participants found that skipping breakfast was linked to a 27% higher risk of all-cause mortality (HR: 1.27, 95% CI: 1.07–1.51) and a 28% increased risk of cardiovascular disease (CVD) mortality (HR: 1.28, 95% CI: 1.10–1.50). Additionally, skipping breakfast was associated with a 34% higher risk of cancer mortality (HR: 1.34, 95% CI: 1.11–1.61) (Wang et al.2020).

Obesity

A systematic review of 40 retrospective studies with 323,244 children aged 2–20 years found that breakfast skippers had a 59% higher prevalence of obesity (OR: 1.59, 95% CI: 1.33–1.90) compared to breakfast eaters (Wang et al., 2023).

A meta-analysis of 45 observational studies has shown that skipping breakfast increases the risk of overweight/obesity. People who skip breakfast are 48% more likely to be overweight or obese and 31% more likely to have excess belly fat compared to those who eat breakfast regularly (Ma et al., 2020). Another review has shown that people who skipped breakfast at least three times a week had an 11% higher risk of being overweight or obese than those who skipped breakfast less often. However, when looking at changes in body mass index (BMI), there was no difference between those who ate breakfast and those who skipped it (Wicherski et al., 2021).

Mental Health

A systematic review and meta-analysis found that skipping breakfast is associated with an increased risk of depression and stress-related disorders (Zahedi et al., 2020). The findings suggest that breakfast consumption plays a role in mental well-being, particularly in reducing depression symptoms.

Cognitive functions

Breakfast is critical in children and adolescents’ cognitive function, academic performance, and overall well-being (Rani et al., 2020). A review of 45 studies from 43 articles examined the effects of breakfast on cognitive function, with most focusing on the immediate impact of a single breakfast (34 studies). The findings suggest that eating breakfast improves attention, memory, and executive function, especially in undernourished children, but only in the short term (the same morning) (Adolphus et al., 2016).

Does Skipping Breakfast Help with Weight Loss?

A meta-analysis of 13 RCTs involving 1,416 participants found that people assigned to eat breakfast consumed 260 kcal more per day, and skipping breakfast led to a mean weight loss of 0.54 kg (95% CI: −1.05 kg to −0.03 kg) for 4–16 weeks (Sievert et al., 2019).

The National Weight Control Registry (NWCR) has shown that 78% of successful weight maintainers reported eating breakfast daily. While this doesn’t prove that breakfast prevents weight regain, it suggests that structured eating habits may support long-term weight maintenance by helping regulate hunger and calorie intake throughout the day.

Conclusion

Eating breakfast offers several health benefits, but its role in weight management remains unclear. Some studies suggest that skipping breakfast may be linked to weight gain, while others indicate it could reduce daily calorie intake. The key takeaway? Listen to your body. If you wake up hungry, have a balanced, nutritious breakfast. But if eating early makes you hungry throughout the day, skipping breakfast might be a better choice. Whatever you decide, focus on quality, choose healthy, whole food, and eat in moderation.

References

Adolphus, K., Lawton, C.L., Champ, C.L. and Dye, L., 2016. The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Advances in Nutrition, 7(3), pp.590S-612S.

Baltar, V.T., Cunha, D.B., Santos, R.O., Brito, F.S. & Marchioni, D.M. (2018). ‘Breakfast eating patterns and their association with BMI in adults: A systematic review and meta-analysis.’ Public Health Nutrition, 21(13), pp.2425-2435.

Chen, H., Zhang, B., Ge, Y., Shi, H., Song, S., Xue, W., Li, J., Fu, K., Teng, W. and Tian, L., 2020. Association between skipping breakfast and risk of cardiovascular disease and all cause mortality: A meta-analysis. Clinical Nutrition, 39(10), pp.2982-2988.

Lukomskyj, N., Shi, Y., Allman‐Farinelli, M. and Rangan, A., 2021. Associations between breakfast consumption from childhood to adulthood and cardiometabolic health: A systematic review. Nutrition & Dietetics, 78(1), pp.6-23.

Ma, X., Chen, Q., Pu, Y., Guo, M., Jiang, Z., Huang, W., Long, Y. and Xu, Y., 2020. Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis. Obesity research & clinical practice, 14(1), pp.1-8.

Rani, R., Dharaiya, C.N. & Singh, B. (2023). ‘Breakfast consumption and mental health: a systematic review and meta-analysis of observational studies.’ Nutritional Neuroscience, 26(4), pp.653-669.

Santos, H.O. & Tinsley, G.M. (2023). ‘Is breakfast consumption detrimental, unnecessary, or an opportunity for health promotion? A review of cardiometabolic outcomes and functional food choices.’ Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 16, pp.123-140.

Sievert, K., Hussain, S.M., Page, M.J., Wang, Y., Hughes, H.J., Malek, M. and Cicuttini, F.M., 2019. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. bmj, 364.

Wang, Y., Li, F., Li, X., Wu, J., Chen, X., Su, Y., Qin, T., Liu, X., Liang, L., Ma, J. & Qin, P. (2020). ‘Breakfast skipping and risk of all-cause, cardiovascular and cancer mortality among adults: a systematic review and meta-analysis of prospective cohort studies.’ International Journal of Food Sciences and Nutrition, 71(5), pp.546-55

Wang, K., Niu, Y., Lu, Z., Duo, B., Effah, C.Y. and Guan, L., 2023. The effect of breakfast on childhood obesity: A systematic review and meta-analysis. Frontiers in Nutrition, 10, p.1222536.

Wicherski, J., Schlesinger, S. and Fischer, F., 2021. Association between breakfast skipping and body weight—A systematic review and meta-analysis of observational longitudinal studies. Nutrients, 13(1), p.272.

Zahedi, H. et al. (2020) ‘Breakfast consumption and mental health: a systematic review and meta-analysis of observational studies’, Nutritional Neuroscience, 25(6), pp. 1250–1264. doi: 10.1080/1028415X.2020.1853411.

Related Posts

Why Having ‘Healthy Obesity’ Is Still Dangerous for Your Health?

Why Having ‘Healthy Obesity’ Is Still Dangerous for Your Health?

Introduction Obesity has long been linked to shorter lifespans, lower quality of life, and increased risk of disabilities due to cardiovascular diseases like diabetes and atherosclerosis. This raised the question: how can some individuals with obesity appear healthy over the long term, whereas others show immediate signs of health problems? The concept of metabolically healthy obesity has caused quite a stir in the medical community and beyond in recent years, as it challenges deeply held beliefs and long-standing understandings. But the recognition of this phenomenon is far from a new discovery! It dates to Jean Vague’s observations in the 1950s that certain individuals with obesity had different predispositions towards diabetes and atherosclerosis, which seemed to be related to where their fat was concentrated on their bodies. What is the definition of metabolically healthy obesity? While individuals who have metabolically healthy obesity (MHO) have been extensively researched, a consensus on a definition in adults has only recently been reached. Metabolically healthy obesity (MHO) is defined as a BMI of 30 kg/m2 or higher and no concurrent metabolic disorder or cardiovascular diseases, such as type 2 diabetes or atherosclerotic disease. A more recent definition has been proposed, requiring additional criteria such as serum triglycerides ≤150 mg/dl and HDL-cholesterol serum concentrations higher than 40 mg/dl in men or 50 mg/dl in women. Do people with “healthy obesity” people exist? Recent studies show that MHO is found in 35% of the world’s population. However, there were notable differences between regions and various parts of the world. Irrespective of the definitions used and the remarkable regional and gender variation, MHO is not a rare condition. Long-term studies have suggested that MHO might be a transient state. About 30% of people with MHO develop or convert to a metabolically unhealthy obesity (MUHO) state with cardio-metabolic complications over a 5-10-year period. Aging and additional weight gain are risk factors for this conversion. Fortunately, increasing physical activity and losing weight can increase the likelihood of preserving MHO status. What are the health risks of “healthy obesity”? Metabolically healthy obesity is an interesting and complex phenomenon – on the one hand, these individuals are typically free of metabolic signs associated with “unhealthy weight”, yet they still have higher cardiovascular risks than those who maintain a normal weight.  However, their cardiovascular risks are lower than those of people with metabolically unhealthy obesity (MUHO). A 2019 study, for example, found that those with metabolically unhealthy obesity (MUHO) are 5-20 times more likely to develop diabetes than those with a ‘metabolically healthy normal weight’. Even for those with metabolically healthy obesity (MHO), there is still a 4-fold increased risk of developing diabetes compared to metabolically healthy normal weight. Similarly, the risk of cardiovascular diseases is 50% greater in people with MHO at baseline than in people who are metabolically healthy at a normal weight.  This means that while there are still risks involved with being classified as metabolically healthy obese, they are nowhere near as severe as those associated with those who are metabolically unhealthy. How to prevent the transition to metabolically unhealthy obesity? As MHO is not a static condition, attention has now shifted to what factors may predict metabolic deterioration from MHO to MUHO. A study in Spain identified three main factors: an increase in BMI, waist circumference, and waist-to-hip ratio. On the flip side, lifestyle choices like following a healthy diet, regular exercise, and avoiding or quitting smoking prevented the transition to MUO. It’s clear from this that good habits can help maintain our health and protect us from potentially serious conditions like MUO. Conclusion There is such a thing as metabolically healthy obesity, but it may be transient and comes with its own risks. The best way to avoid these risks is to maintain a healthy weight through diet and exercise. So, let’s take care of our health and be more mindful of what we eat and how much we exercise. References Blüher, M. (2020). Metabolically Healthy Obesity. Endocrine Reviews, 41(3), 405.‏ Smith GI, Mittendorfer B, and Klein S. 2019. Metabolically healthy obesity: facts and fantasies. The Journal of clinical investigation 129:3978-3989. Post navigation

Learn more
Homeostatic and Hedonic Hunger

Homeostatic and Hedonic Hunger

Have you ever wondered why you can’t stop eating, even when you’re full? Or why do you eat more than your body needs? Have you ever felt like starving even after eating a big meal? Or found yourself craving food, even if it wasn’t remotely close to mealtime? If so, what you experienced is called hedonic hunger. It turns out that what we think of as “hunger” is two different things. In modern times, among well-nourished populations, an increasing proportion of human food consumption appears to be driven by pleasure, not the need for calories —which isn’t necessarily bad! In this article, we’ll look at homeostatic and hedonic hunger to better understand the motivations behind food consumption. History of Human Food Consumption For most of human history and prehistory, the primary objective of seeking food was survival through maintaining energy homeostasis and avoiding starvation. Humans had to eat enough food that provided enough calories to meet their daily needs. It was essential for early humans to have enough energy to perform physical tasks such as gathering food and other resources or defending themselves from predators. In modern times, energy homeostasis is no longer an issue for most people living in developed countries who no longer need to worry about finding food for existence. The availability of an abundance of tasty foods has changed our relationship with eating from one primarily focused on survival to one also driven by pleasure. Hemeostatic vs. Hedonic Hunger Homeostatic hunger is what most people think of when they hear the word “hunger.” It refers to the body’s need for energy to maintain balance (homeostasis). When your body needs energy, it sends signals to your brain telling you to eat. Physiological needs drive this type of hunger. Hedonic hunger, however, is driven by pleasure and anticipation of reward rather than physiological needs. Hedonic hunger is an intense, psychological desire for food triggered by external cues such as the sight or smell of food, social events, time, or advertising campaigns. Unlike homeostatic hunger, which is generally limited to only what our bodies need in terms of calories, hedonic hunger is not constrained by physical limitations and can often result in over-consumption. The interplay between these two types of hunger has become increasingly complex in recent years due to the availability of calorie-dense foods with high levels of added sugar and fat. These foods are designed for maximum pleasure, making them difficult for many people to resist even if their body does not need them.   How do We Know We are Hungry? Hunger is challenging to specify. We need help not only quantifying our hunger, but many need help identifying whether we are hungry at all. There may be no solid characteristic pattern of hunger symptoms when it comes to typical hunger sensations. When participants were asked about hunger sensations, there were three key identifiers. First and foremost, most people experience a growling stomach as an indicator that it’s time for food. Secondly, many people also report feeling an empty sensation in their stomach when they are hungry. Lastly, some people describe feeling mild to moderate stomach pain when hungry. In addition to these typical hunger sensations, many people experience extreme hunger sensations: headaches, lightheadedness, or dizziness, being fixated on food and feeling irritable or cranky. Understanding the distinction between homeostatic and hedonic hunger is essential for physical and mental health since it can help us make better food choices. There are distinct neural pathways associated with homeostatic and hedonic motivation for eating with animal models;  however, further research should be conducted to understand how these systems interact within humans. It is sometimes hard to recognize the type of hunger in real life. However, hedonic hunger involves two constructs: liking and wanting. Liking vs. Wanting Food The primary difference between liking and wanting food lies in the motivation behind eating. Liking is a pleasure derived from oro-sensory stimulation of food – think flavors, textures, smells, etc. Conversely, wanting is defined as incentive salience or the motivation to engage in eating. When you want something, you are more likely to seek it out despite any associated costs or calories involved. By understanding these two different types of motivation when it comes to eating, we can begin to make better decisions about our diets and health goals. For example, if you “like” a specific type of food but do not necessarily need it (i.e., don’t have an urgent “want”), then it may be best to practice moderation rather than overindulge in something your body doesn’t need. On the other hand, if you want a particular type of snack despite having already eaten earlier in the day (or week!), then perhaps it’s time to take a step back and ask yourself why – are you bored? Stressed? Anxious? Identifying those underlying motivations for wanting specific foods can help us develop healthier habits and make more informed decisions about what we eat. Conclusion Enhanced hedonic response to foods can augment hunger even when satiated, meaning that even if we don’t feel hungry, we may still be tempted by tasty treats. Identifying between homeostatic and hedonic hunger can be challenging but ultimately rewarding. You will have more control over your eating habits if you understand where those cravings come from! By paying attention to cues from your body, keeping track of meals/snacks throughout the day, and taking breaks whenever necessary, you’ll be able to tell which type of hunger is driving your appetite–and make healthier choices accordingly! All this shows just how complex our relationship with food can be. References Lowe, M.R. and Butryn, M.L., 2007. Hedonic hunger: a new dimension of appetite?. Physiology & behavior, 91(4), pp.432-439. Blundell, J.E. and Finlayson, G., 2004. Is susceptibility to weight gain characterized by homeostatic or hedonic risk factors for overconsumption?. Physiology & behavior, 82(1), pp.21-25.

Learn more
Evidence on Intermittent Fasting: Reality Check

Evidence on Intermittent Fasting: Reality Check

Intermittent fasting (IF) is a dietary approach involving fasting and eating periods. Unlike traditional diets that focus on what you eat, IF focuses on when you eat. The idea behind intermittent fasting is to restrict calorie intake during specific periods of the day or week while allowing for unrestricted eating during other periods. There are several types of intermittent fasting, including periodic fasting, alternate-day fasting, and time-restricted eating. Types of Intermittent Fasting Periodic fasting, also known as periodic calorie restriction, is a type of intermittent fasting that involves fasting for one or more days a week. For example, you might fast for two days a week and eat normally for the other five days. Alternate-day fasting is a type of intermittent fasting that involves fasting every other day. On fasting days, you restrict your calorie intake to 500-600 calories; on non-fasting days, you eat normally. This type of fasting is more challenging than periodic fasting because it involves fasting every other day. Time-restricted eating is intermittent fasting that restricts your eating window to a certain number of hours daily. For example, you might fast for 16 hours and eat within an eight-hour window. This approach is easier to implement than periodic fasting or alternate-day fasting because you don’t have to go without food for extended periods. Effectiveness of Intermittent Fasting Despite the increasing popularity of IF, the evidence regarding its effectiveness in promoting weight loss is conflicting. I will review the evidence from various meta-analyses. Meta-analysis is an invaluable tool to draw high-level conclusions from multiple studies centered on the same topic or research question. It is a powerful tool for providing a more accurate view of a subject or treatment. It allows researchers to combine data from multiple studies, eliminating the risk of any one study skewing the results. A review of the various meta-analyses (umbrella of meta-analyses) has found at least 28 associations between IF on BMI, body weight, fat mass, LDL-C (bad cholesterol) total cholesterol, triglycerides, fasting plasma glucose, fasting insulin, HOMA-IR (a marker of insulin resistance), and systolic and diastolic blood pressure, mostly in adults with overweight or obesity. However, most of those associations were of very low to low evidence. Only one association was supported by high-quality evidence, the effect of modified alternate-day fasting for 1-2 months on weight loss and fatty liver compared to a regular diet.  IF was most successful for weight loss in the initial 1 to 6 months, followed by a plateau. A recent meta-analysis found that IF diets were not associated with a significantly different body weight at different durations ranging from 2-4 months, 6-8 months, 10-14 months, and 18-30 months compared to calorie-restricted diets. The effectiveness of IF in promoting weight loss and improving overall health is still under debate. Fasting or Calories Restriction As IF involves periods of fasting, this naturally leads to a reduction in calorie intake. Whether the effects of intermittent fasting (IF) on weight loss and health benefits are primarily due to the fasting process or the calorie restriction involved is a subject of ongoing debate and research. Although intermittent fasting may have unique metabolic and hormonal effects that go beyond simple calorie reduction based on timing (morning vs evening fasting) and pattern of fasting (alternate day vs. time restricted). However, those changes were not translated into better health outcomes or weight loss. Further research is needed to unravel the underlying mechanisms and determine the specific contributions of each factor. Some individuals may find it easier to adhere to an IF eating pattern and experience positive outcomes, while others may struggle with the restricted eating window given the social implications of eating time and symptoms of fatigue and headache during the fasting periods. Individuals should be mindful of their eating patterns during the normal eating periods. One can still consume excessive calories within the eating window, defeating IF’s purpose.  Finding a balanced and sustainable approach to weight loss that aligns with one’s lifestyle and preferences is crucial for successful weight management and overall health. References Patikorn C, Roubal K, Veettil SK, et al. Intermittent Fasting and Obesity-Related Health Outcomes: An Umbrella Review of Meta-analyses of Randomized Clinical Trials. JAMA Netw Open. 2021;4(12):e2139558. doi:10.1001/jamanetworkopen.2021.39558 Harris, Leanne1; Hamilton, Sharon2,3; Azevedo, Liane B.2,3; Olajide, Joan2,3; De Brún, Caroline2,3; Waller, Gillian2,3; Whittaker, Vicki2,3; Sharp, Tracey4; Lean, Mike1; Hankey, Catherine1,∗; Ells, Louisa1,3,∗. Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis. JBI Database of Systematic Reviews and Implementation Reports 16(2):p 507-547, February 2018. | DOI: 10.11124/JBISRIR-2016-003248 Gu L, Fu R, Hong J, Ni H, Yu K, Lou H. Effects of Intermittent Fasting in Human Compared to a Non-intervention Diet and Caloric Restriction: A Meta-Analysis of Randomized Controlled Trials. Front Nutr. 2022 May 2;9:871682. doi: 10.3389/fnut.2022.871682. PMID: 35586738; PMCID: PMC9108547. Elortegui Pascual, P., Rolands, M.R., Eldridge, A.L., Kassis, A., Mainardi, F., Lê, K.A., Karagounis, L.G., Gut, P. and Varady, K.A., 2023. A meta‐analysis comparing the effectiveness of alternate day fasting, the 5: 2 diet, and time‐restricted eating for weight loss. Obesity, 31, pp.9-21. https://doi.org/10.1002/oby.23568

Learn more
Home Search Cart Products About