BREAKFAST AND BODY WEIGHT

It’s no secret that intermittent fasting – and the various ways to do this (time-restricted eating, 5:2 diet and alternate-day fasting, to name a few) – has become wildly popular in recent years among people seeking to lose weight. This can mean missing the breakfast meal due to eating just one large meal at night or only during an eight-hour window, or fasting every other day.

So where does this leave breakfast, a meal that has long been recommended for people looking to lose weight and keep it off?

What does the evidence tell us?

Systematic reviews of observational studies have found that adults who skip breakfast are more likely to have a higher body mass index (BMI) or to be overweight or obese than adults who eat breakfast.1-3 For children, skipping breakfast is thought to be one of the most important factors in predicting whether they will become overweight or obese.4

Eating breakfast is also a key recommendation for long-term weight management from the US National Weight Control Registry.5 This long-standing study of more than 6,000 people who have lost an average of 30 kilograms, and successfully kept it off, found eating breakfast every day was one of the three dietary strategies contributing to their success.

Evidence supports a positive effect of breakfast on factors such as appetite regulation, satiety and postprandial energy expenditure.Consuming sufficient protein might help manage hunger and retention of muscle mass while losing weightand increasing high-fibre foods can promote satiety and reduce kilojoule intake, body fat and body weight.8,9

When it comes to randomized controlled trials, the research has produced mixed results on whether skipping or adding breakfast impacts weight loss.10 Perhaps that’s not surprising because there is no agreed definition for ‘breakfast’ or a ‘quality breakfast’, although some guidelines have been proposed based on either nutrients11 or food groups12.

As a result, inresearch studies ‘breakfast’ is subject to how individual study participants or researchers define it (even ‘any beverage’ constitutes ‘breakfast’ in some studies) and that might account for conflicting results.12 Research studies also need to account for any concurrent changes in other meals, snacking or levels of physical activity.

A recent Australian review of intervention studies, lasting from eight hours to 16 weeks, concluded that ‘eating breakfast is not a good weight management strategy’.13However, the researchers did not consider the type or quality of the breakfasts consumed, or whether they were of sufficient kilojoules or nutrients to have an impact. And as the authors (and others) point out, the quality of the studies was mostly low.

Breakfast choice linked with BMI and waist circumference

Another approach is to investigate the impact of different meal patterns at breakfast. A recently-published study* did just that and found that different breakfast meal patterns impacted on overall dietary intake and were associated with differences in BMI and waist circumference.14

This secondary analysis of the Australian Bureau of Statistics National Nutrition Survey data found that Australian adults who ate breakfast cereal at breakfast were more likely to be a healthy weight, and had the lowest BMI and waist circumference, compared to those who ate other breakfasts or skipped breakfast.

Among the outcomes, which have been summarised here, the study found that breakfast cereal eaters were most likely to approach the recommendations of the Australian Dietary Guidelines (ADG), and had the lowest daily intakes of discretionary foods,added sugars and free sugars.  

In contrast, breakfast skippers weremore likely to be overweight, and had the highest mean BMI and waist circumference. They also had the least healthy diets– with the highest intake of discretionary foods, and added and free sugars, and were the least likely to meet the ADG Five Food Group recommendations. This result aligns with the consistent finding of an inverse relationship between breakfast skipping and diet quality.15

Evidence from a 2014 systematic literature review** showed that regularly eating breakfast cereal is associated with a lower BMI, compared to breakfast skippers and other breakfast consumers. Regularly eating breakfast cereal was also associated with a 12% lower risk of being overweight or obese among both adults and children.16

The bottom line

Alongside high rates of overweight and obesity in Australia17, breakfast skipping may be more common for Australians moving away from regular meals towards grazing, or those who adopt popular diets for weight loss that involve time restricted eating or intermittent fasting.

Systematic reviews of observational studies have found skipping breakfast to be linked with a higher BMI and increased risk of being overweight or obese. But the lack of an agreed definition of ‘breakfast’ and what constitutes a ‘quality breakfast’, is needed to advance our knowledge in this area.

Evidence shows that intermittent fasting diets may lead to weight loss, but are not superior to a standard reduced-kilojoule diet.18,19

What is clear is that eating breakfast, compared to skipping it, contributes to overall nutrient intakes and diet quality,11,20 and the type of breakfast consumed is associated with dietary intake, BMI and waist circumference14,16.  

As always, when it comes to diet, there is no one-size-fits-all approach, and this applies to the breakfast meal. Professional, personalised dietary guidance is invaluable when discussing body weight and advice on breakfast – especially given individuals have unique dietary preferences, energy and nutrient needs, physical activity levels and medical nutrition therapy requirements.

*This study was funded by the Australian Breakfast Cereal Manufacturers Forum (ABCMF). ABCMF had no part in study design, data coding, analysis, interpretation or the final manuscript. A summary of this research is available here.

**This study was funded by the Australian Breakfast Cereal Manufacturers Forum (ABCMF). The author had responsibility for all parts of the manuscript.A summary of this systematic literature review is available here.

Always get the best advice

This information is provided for health and nutrition professionals review. It is not a substitute for medical advice. A trusted medical advisor and an Accredited Practising Dietitian provide personalised health and nutrition advice.

June 2019

Leigh suit cereal variety IMG_0882 Leigh Reeve is an Advanced Accredited Practising Dietitian and Director of the Australian Breakfast Cereal Manufacturers Forum (ABCMF). Leigh has over 30 years experience as a dietitian and is passionate about sharing practical, evidence-based nutrition information and delicious food ideas.


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