A new study published in the Journal of the American College of Cardiology has reignited the old question of whether or not it’s okay to skip breakfast.(1)
Conducted by Wei Bao, an assistant professor of epidemiology at the University of Iowa College of Public Health, the study took data on 6,550 participants from the National Health and Nutrition Examination Survey III between the years 1988 to 1994 and followed up over a period of 17 to 23 years.
It found that 5.1 percent never consumed breakfast, 10.9 percent rarely did, 25 percent ate breakfast some days and 59 percent did every day. After the follow up it was determined that 2,318 deaths occurred and 619 of them were from cardiovascular disease. It found that after controlling for age, sex, race, socioeconomic status, dietary and lifestyle factors, body mass index and cardiovascular risk factors,
skipping breakfast was associated with a significantly increased risk of mortality from cardiovascular disease.
Bao also noted that skipping breakfast is a behavioral marker for unhealthy lifestyle habits, as those who don’t eat it were more likely to be overweight, former smokers, have higher cholesterol, and/or physically inactive.
Conflicting Evidence
This is a crucial point and it’s one that many detractors are sticking to. The fact is that most of us have been told our whole lives that eating breakfast is healthy, therefore it’s more likely that if you follow a lot of the other advice for a healthy lifestyle — eating well, exercising, not smoking, and so on —then you probably follow the advice to eat your breakfast as well.
Indeed, a significant amount of evidence has found that reducing your eating window (say, by skipping breakfast or dinner) is linked to less insulin in the blood, a lower risk of diabetes, and an increase in autophagy, which refers to a process whereby the body repairs or removes damaged cells.(2)(3)(4)
Many other studies that have focused on the pros and cons of fasting, including high quality randomized controlled trials, found that there’s no significant difference in body composition whether you skip breakfast or even fast every other day.(5)(6)(7) Others suggest that breakfast skipping does indeed lead to a lower BMI.(8)(9)(10)
Correlation Doesn’t Equal Causation
Health guidelines usually tell you to eat breakfast, so people following health guidelines usually eat breakfast. People who skip breakfast may be less likely to live healthy lives overall.
Some might consider this what’s called reverse causality bias. You see it a lot in studies on artificial sweeteners: does diet soda make people obese, or are obese people more likely to consume diet soda because they want to lose weight?(11) If we’re told that it’s healthy to eat breakfast — and we’re not saying there’s anything wrong with eating breakfast at all — are healthy people more likely to eat breakfast?
Bao’s study also failed to specify what people were eating for breakfast and whether or not their breakfast habits remained the same during the lengthy follow-up period.
[Learn more in our complete guide to intermittent fasting.]
Putting It All Together
When you eat has far less to do with your health than what and how much you eat. Your overall lifestyle is what matters most.
But it’s important to remember that while isocaloric studies haven’t found much of a reason to demonize breakfast skippers, the average person has no interest in tracking their calories and not everybody responds well to fasting. Maybe it makes you overeat later in the day, or maybe skipping breakfast keeps your appetite low all day and you don’t eat enough food or enough of the right foods.
If going without breakfast makes you miserable or leads to poor choices, then it’s a good idea to eat breakfast. But if you find that a morning fast helps you to eat better, then there doesn’t seem to be anything wrong with it. The trick is working out which category you fall into — there’s nothing wrong with either.
Editor’s note: The content on BarBend is meant to be informative in nature, but it shouldn’t take the place of advice and/or supervision from a medical professional. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. Speak with your physician if you have any concerns.
References
1. Bao W et al. Association of Skipping Breakfast With Cardiovascular and All-Cause Mortality. J Am Coll Cardiol. 2019Apr;73(16):2025-2032.
2. Heilbronn LK, et al. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. Am J Clin Nutr. 2005 Jan;81(1):69-73.
3. Barnosky AR, et al. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Transl Res. 2014 Oct;164(4):302-11.
4. Alirezaei M, et al. Short-term fasting induces profound neuronal autophagy. Autophagy. 2010 Aug;6(6):702-10.
5. Moro T, et al. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. J Transl Med. 2016 Oct 13;14(1):290.
6. Betts JA, et al. The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr. 2014 Aug;100(2):539-47.
7. Catenacci VA, et al. A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity. Obesity (Silver Spring). 2016 Sep;24(9):1874-83.
8. Reeves S, et al. Experimental manipulation of breakfast in normal and overweight/obese participants is associated with changes to nutrient and energy intake consumption patterns. Physiol Behav. 2014 Jun 22;133:130-5.
9. Geliebter A, et al. Skipping breakfast leads to weight loss but also elevated cholesterol compared with consuming daily breakfasts of oat porridge or frosted cornflakes in overweight individuals: a randomised controlled trial. J Nutr Sci. 2014 Nov 13;3:e56.
10. LeCheminant GM, et al. A randomized controlled trial to study the effects of breakfast on energy intake, physical activity, and body fat in women who are nonhabitual breakfast eaters. Appetite. 2017 May 1;112:44-51.
11. Pereira MA, et l. Sugar-sweetened and artificially-sweetened beverages in relation to obesity risk. Adv Nutr. 2014 Nov 14;5(6):797-808.
