Weight Loss Science: Breakfast May Not Be as Helpful as We Thought

There was a time when skipping breakfast was nothing short of dietary blasphemy. But recently, breakfast’s status as the “most important meal of the day” has come under some scrutiny, especially its key role in common weight loss strategies. Proponents of the idea that eating breakfast is important for weight loss have just been dealt another blow. An analysis of 13 studies published Wednesday suggests there’s no reason to force breakfast upon yourself if weight loss is your goal.

Lead study author and clinical epidemiologist Flavia Cicuttini, Ph.D., tells Inverse that breakfast’s reputation for weight loss is built on two main pillars: the idea that eating breakfast can keep you satiated for longer (which leads to less overall caloric intake) and the idea that eating in the morning actually increases the rate of calorie burning throughout the day. While there are numerous studies that have demonstrated this individually, her analysis of 13 of them, published in the BMJ, suggests that the combined findings actually don’t support these two concepts.

“The key message is that if a person likes to eat breakfast, that is fine,” she tells Inverse. “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.”

Don’t Force Down Breakfast if Weight Loss is the Goal

Cicuttini, a professor at Australia’s Monash University, adds that although previous studies have shown that eating breakfast leads to weight loss, many of those conclusions were based on observational studies. This makes it impossible to completely rule out the idea that the weight loss can’t be attributed to other aspects of the participants’ lives, like healthier eating patterns or healthier lifestyles. That’s not to say that their findings aren’t legitimate, but maybe it’s enough to warrant taking a second look at whether breakfast promotes weight loss.

"“If people like eating breakfast, they should. If they don’t there is no evidence to say they should."

When Cicuttini grouped all the data from the past observational studies together, she found that, on average, people who ate breakfast ate approximately 260 more calories per day than those who didn’t and that those who skipped breakfast were actually slightly lighter — but only by a very small amount (roughly one pound). Still, her paper indicates that these results are enough to cast doubt on the two pillars of the breakfast for weight loss dogma. It’s not a surefire way to curb calorie intake throughout the day or jumpstart metabolism.

“Over the years I was often struck by the number of patients who sought help for their weight and were advised to eat breakfast as part of their weight management plan, some who even felt obliged to force themselves to eat breakfast, even if they didn’t feel like doing this,” says Cicuttini.

Importantly, Cicuttini’s study is not evidence that abandoning breakfast is a good idea for everyone. For some people, breakfast may still have important implications for health, regardless of what a morning meal may or may not do for weight loss. As examples, she suggests that children who need to concentrate in school benefit from a morning meal, as do athletes who find that a meal helps improve a workout. Diabetics may also need to maintain a certain eating schedule to manage medications and blood sugar spikes.

The Case for Eating When You Want To

The point of Cicuttini’s paper is that the evidence suggesting that breakfast isn’t the silver bullet for weight loss that it may have once appeared to be. Rather, it might be better to embrace your preferences when it comes to food timing, which Tim Spector, Ph.D., professor of genetic epidemiology at King’s College London, adds in his accompanying commentary. Spector is also the scientific founder of a personalized nutrition company, Zoe Global Ltd.

In his commentary, Spector adds that the circadian clocks that help our bodies regulate when to burn energy and when to intake more are highly individualized. If your specific biological rhythm doesn’t leave you craving an early morning meal, he suggests it’s not worth forcing one down for the sake of weight loss.

“Some people are programmed to prefer eating food earlier in the day and others later, which might suit our unique personal metabolism,” Spector writes.

In short, the paper and accompanying commentary have a simple takeaway. When it comes to breakfast, do what you want. “If people like eating breakfast, they should,” adds Cicuttini. “If they don’t, there is no evidence to say they should.”

Abstract:

Objective — To examine the effect of regular breakfast consumption on weight change and energy intake in people living in high income countries.

Design — Systematic review and meta-analysis.

Data sources — PubMed, Ovid Medline, and CINAHL were searched for randomised controlled trials published between January 1990 and January 2018 investigating the effect of breakfast on weight or energy intake. ClinicalTrials.gov and the World Health Organization’s International Clinical Trials Registry Platform search portal were also searched in October 2018 to identify any registered yet unpublished or ongoing trials.

Eligibility criteria for selecting studies — Randomised controlled trials from high income countries in adults comparing breakfast consumption with no breakfast consumption that included a measure of body weight or energy intake. Two independent reviewers extracted the data and assessed the risk of bias of included studies. Random effects meta-analyses of the effect of breakfast consumption on weight and daily energy intake were performed.

Results — Of 13 included trials, seven examined the effect of eating breakfast on weight change, and 10 examined the effect on energy intake. Meta-analysis of the results found a small difference in weight favouring participants who skipped breakfast (mean difference 0.44 kg, 95% confidence interval 0.07 to 0.82), but there was some inconsistency across trial results (I2=43%). Participants assigned to breakfast had a higher total daily energy intake than those assigned to skip breakfast (mean difference 259.79 kcal/day, 78.87 to 440.71; 1 kcal=4.18 kJ), despite substantial inconsistency across trial results (I2=80%). All of the included trials were at high or unclear risk of bias in at least one domain and had only short term follow-ups (mean period seven weeks for weight, two weeks for energy intake). As the quality of the included studies was mostly low, the findings should be interpreted with caution.

Conclusion — This study suggests that the addition of breakfast might not be a good strategy for weight loss, regardless of established breakfast habit. Caution is needed when recommending breakfast for weight loss in adults, as it could have the opposite effect. Further randomised controlled trials of high quality are needed to examine the role of breakfast eating in the approach to weight management.