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.6 Consuming sufficient protein might help manage hunger and retention of muscle mass while losing weight7 and 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.
- Mesas AE, Muñoz-Pareja M, López-García E, Rodríguez-Artalejo F. Selected eating behaviours and excess body weight: A systematic review. Obes Rev 2011; 13(2): 106-35. https://doi.org/10.1111/j.1467-789X.2011.00936.x
- Horikawa C, Kodama S, Yachi Y, Heianza Y, Hirasawa R, Ibe Y, et al. Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: a meta-analysis. Prev Med 2011; 53: 260-7. https://doi.org/10.1016/j.ypmed.2011.08.030
- Brown AW, Bohan Brown MM, Allison DB. Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr 2013; 98(5): 1298-308. https://doi.org/10.3945/ajcn.113.064410
- Kelly Y, Patalay P, Montgomery S, Sacker A. BMI Development and Early Adolescent Psychosocial Well-Being: UK Millennium Cohort Study. Pediatrics 2016; 138(6). https://doi.org/10.1542/peds.2016-0967
- Hill JO, Wyatt HR, Phelan S, Wing RR. Lessons Learned From the National Weight Control Registry. In: Kushner RF, Bessesen DH. (eds) Treatment of the Obese Patient. Contemporary Endocrinology. Humana Press: 2007. (Available from: https://link.springer.com/chapter/10.1007/978-1-59745-400-1_21#citeas, accessed 4 June 2019).
- Gwin JA, Leidy HJ. A review of the evidence surrounding the effects of breakfast consumption on mechanisms of weight management. Adv Nutr 2018; 9(6): 717–25. https://doi.org/10.1093/advances/nmy047
- Noakes M. Protein Balance: New Concepts for Protein in Weight Management; CSIRO; 2018. (Available from: https://www.csiro.au/en/News/News-releases/2018/Is-breakfast-protein-the-secret-to-weight-loss, accessed 4 June 2019).
- Slavin J, Green H. Dietary fibre and satiety. Nutr Bull 2007; 32(Suppl 1): 32-42. https://doi.org/10.1111/j.1467-3010.2007.00603.x
- Slavin JL. Dietary fibre and body weight. Nutrition 2005; 21(3): 411-18. https://doi.org/10.1016/j.nut.2004.08.018
- Schlundt DG, Hill, JO, Sbrocco T, Pope-Cordle J, Sharp T. The role of breakfast in the treatment of obesity: A randomized clinical trial. Am J Clin Nutr 1992; 55: 645-51. https://doi.org/10.1093/ajcn/55.3.645
- Gibney MJ, Barr SI, Bellisle F, et al. Towards an evidence-based recommendation for a balanced breakfast: A proposal from the International Breakfast Research Initiative. Nutrients 2018; 10(10): 1540. https://doi.org/10.3390/nu10101540
- O’Neil CE, Byrd-Bredbenner C, Hayes D, Jana L, Klinger SE, Stephenson-Martin S. The role of breakfast in health: Definition and criteria for a quality breakfast. J Acad Nutr Diet 2014; 114(12): S8-26. https://doi.org/10.1016/j.jand.2014.08.022
- Sievert K, Monira Hussain S, Page MJ, et al. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ 2019; 364:l42. https://doi.org/10.1136/bmj.l42
- Fayet-Moore F, McConnell A, Cassettari T, Petocz P. Breakfast choice is associated with nutrient, food group and discretionary intakes in Australian adults at both breakfast and the rest of the day. Nutrients 2019; 11(1): 175. https://doi.org/10.3390/nu11010175
- Leech RM, Worsley A, Timperio A, McNaughton S. Understanding meal patterns: Definitions, methodology and impact on nutrient intake and diet quality. Nutr Res Rev 2015; 28(1): 1-21. https://doi.org/10.1017/S0954422414000262
- Williams PG. The benefits of breakfast cereal consumption: A systematic review of the evidence base. Adv Nutr 2014; 5(5): 636S-673S. https://doi.org/10.3945/an.114.006247
- Australian Institute of Health and Welfare. The Health of Australia’s Males; The Health of Australia’s Females. AIHW 2019. (Available from: https://www.aihw.gov.au/reports-data/population-groups/men-women/overview, accessed 4 June 2019).
- Sundfor TM, Svendsen M, Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial. NMCD 2018; 28(7): 698-706. https://doi.org/10.1016/j.numecd.2018.03.009
- Schubel R, Nattenmuller J, Sookthai D, et al. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: A randomized controlled trial. AJCN 2018; 108(5): 933-45. https://doi.org/10.1093/ajcn/nqy196
- O’Neil CE, Nicklas TA. Breakfast consumption versus breakfast skipping: The effect on nutrient intake, weight and cognition. Nestle Nutr Inst Workshop Series 2019; 91. https://doi.org/10.1159/000493707