Breakfast Controversy
February 23, 2011 Written by JP [Font too small?]Every so often a news story is promoted that questions fundamental beliefs about good nutrition. I used the word “promoted” purposefully. If there’s a health related press release that is likely to be controversial or sensational, it generally moves to the front of the line for consideration. Take for example the recent publicity surrounding a study that supposedly found that eating a “big breakfast” increases daily caloric intake rather than lowering it. Previous inquiries have reported that starting the day off with a hearty breakfast is probably one of the best ways to ensure better subsequent food selection and a healthier weight. So the fact that one study refutes this widely held opinion can be big news.
The headline-making study in question was published in the January 2010 issue of the Nutrition Journal. The data itself was based on an analysis of the eating habits of 100 normal weight men and women and 280 obese counterparts. According to the authors of the study, “The increasing ratio of breakfast to total daily energy intake was associated with a significant reduction of overall intake on days where post-breakfast energy was significantly reduced”. In other words, those who consumed fewer calories during breakfast generally consumed fewer overall calories throughout the day. (1,2)
So, have I and other nutritional experts been wrong in emphasizing the importance of breakfast all along? To answer that question, I sifted through the recent medical literature to see what I could find. After all, my ultimate goal is to provide my clients and readers with the most accurate and practical information possible. If that means breakfast should be avoided, so be it.
British Journal of Nutrition, Feb. 2011 – The current issue of the BJN reports that eating a protein rich breakfast in a solid form, rather than as a “protein-rich beverage”, is significantly more effective in reducing appetite and food intake at lunchtime meals. (3)
Clinical Nutrition, Jan. 2011 – Eating a breakfast containing high amounts of calcium and Vitamin D supports post-meal calorie and fat burning (diet induced thermogenesis and fat oxidation rates). Calcium and D-rich breakfasts may also reduce hunger and overall energy intake in the two successive meals. (4)
Nutrition and Metabolism, Jan. 2011 – Adding whole almonds to a high carbohydrate breakfast lowered blood sugar and supported a “daylong feeling of fullness” in 14 test subjects with glucose intolerance. This particular trial examined the effects of various types of almond-based ingredients including almond butter, almond oil and defatted almond flour. The results indicate that whole almonds provided the most pronounced effects. (5)
Nutrition Journal, Jan. 2011 – Researchers from the Department of Food Technology at Lund University, Sweden determined that whole grain rye kernels are a better option than wheat kernels with respect to the breakfast/daily calorie connection. Ten healthy volunteers, consuming the respective grains on different occasions, revealed that the consumption of rye products lowered “acute insulin responses” and resulted in a “16% lowering of energy intake at a subsequent lunch meal”. What’s the secret to rye’s success? Bulking fiber or indigestible carbohydrates which help fill you up and produce beneficial fermentation metabolites. (6)
Diabetes Care, Dec. 2010 – Eating a soy yogurt “prebreakfast high-protein snack” lowers post-meal blood sugar elevation in type-2 diabetics by almost 40%. Of note, the participants in this study were already engaging in a diabetic-friendly diet and/or controlling blood sugar via the medication Metformin. (7)
High-Protein, Pre-Breakfast Soy Yogurt Snack May Benefit Diabetics and Non-Diabetics
Source: Diabetes Care November 29, 2010 vol. 33 no. 12 2552-2554 (link)
The above examples were all interventional trials. In the past few months, several observational studies have also been published in prestigious medical journals, including the Journal of the American Dietetic Association, Nutrition Metabolism and Cardiovascular Diseases and the American Journal of Clinical Nutrition. Each and every one of these scientific evaluations found positive outcomes to various populations who regularly eat a morning meal. For instance: a) postpartum teens that ate breakfast 6 to 7 days a week consumed 1,197 fewer calories/week from salty and sweet snacks, 1,337 fewer calories from sweetened drinks and had a lower body mass index than teens that ate breakfast two or less times weekly; b) an examination of the eating habits of 18,177 adults of Italian decent revealed that “subjects with a higher breakfast food consumption had a lower risk of high body mass index, abdominal obesity, systolic and diastolic blood pressure, blood glucose, triglycerides, total cholesterol and C Reactive Protein“; c) a unique study that investigated “breakfast skipping” in a group of children and followed up with them as adults determined that long term breakfast avoidance was strongly linked to higher fasting insulin, larger waist circumference, LDL (“bad”) and total cholesterol. Collectively, the risk factors identified in these large segments of society point to an easily modifiable way of reducing the risk of cardiovascular disease, diabetes and obesity – eating breakfast. (8,9,10)
In my book, the take home message about breakfast is as follows: Opt for breakfast foods that are rich in healthy fats, fiber and protein. Solid foods are probably the best way to go because they promote mindfulness. This latter point cannot be emphasized enough. The reality is that many people are in too much of a hurry to register exactly what they’re eating. This may seem odd, but it’s quite common. Being aware of what you eat is essential to assisting your body and mind to understand what good nutrition ought to look and feel like. A food diary is an excellent tool in this pursuit. Another important step to consider is to set aside 5 to 10 minutes just to enjoy your food. No Internet surfing, phone calls, radio or television. Just sit down long enough to acknowledge what you’re about to put in your mouth. You’ll digest your food better and savour the experience in a more meaningful way. A by-product of doing so is that you may find that your appetite and waistline respond in a decidedly pleasing way.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Breakfast, Heart Health, Inflammation
Posted in Diet and Weight Loss, Food and Drink, Nutrition
February 25th, 2011 at 2:34 am
This article reminds me to make your blueberry flax muffins again!
February 25th, 2011 at 4:37 pm
Hope you enjoy them, Nancy!
More recipes coming soon!
Be well!
JP
February 27th, 2011 at 5:32 am
Good morning ☼ JP!
great article! You are a real breakfast-rescuer :-)! I could’t live without breakfast, its my most important meal of the day, if breakfast is bad…everything is bad 😉 I like to eat things for breakfast, other people would eat for lunch or dinner i.e. fish, veggetables, cheese…but i do rarley eat a dinner, don’t like eatin in the evening, so my latest “dinner” is in the afternoon..thats my way, and i like it ☻♥
Have a great weekend – you both of course – and thanks for your work on this site!
Greetings,
Nina K.
February 27th, 2011 at 2:02 pm
Thank you, Nina!
That reminds me of the old saying, “Eat breakfast like a king, lunch like a prince and dinner like a pauper”. 🙂
I hope you and yours have a wonderful weekend as well!
Be well!
JP
March 1st, 2011 at 5:46 am
Whether to eat breakfast is certainly an interesting controversy. Like you, I grew up hearing all the ‘Yays’ in favor of eating breakfast: a hearty breakfast is a healthy way to start the day. And through the years, that has been my habit as well: while my breakfast was not always the healthiest, it was at least something, even if just a piece of fruit.
Last year, I signed up for a 10 session weight loss course with my acupuncturists and of all the advice and rules she gave me, one of the most unusual was, ‘don’t eat breakfast. Save the calories and avoid the blood sugar spike so early in the day. Just drink water all morning. If you really need to eat breakfast, just have a couple of eggs.’ This totally threw me after years and years of being told to eat breakfast. So I tried following her advice; at first it was hard but then I got used to it. Now I find that if I don’t eat breakfast, it sets the precedent for an overall lower calorie day. I tend to have a heartier lunch that keeps me full through the end of the day, no snacking and just a light dinner. Thus I’ve really only consumed 1 large and 1 very small meal, essentially resulting in a calorie deficiency.
All that being said, I still think there is some validity to the studies you referenced. I think whether to eat breakfast depends on 2 main points:
1) The Individual – what your food habits are, what you’re accustomed to, what works best for your body. The only way to find out is to try different approaches.
2) The Contents of the Breakfast – if you’re going for sugary cereals or high carb bagels, you’re going to spike your blood sugar and feed yourself empty calories, such that by lunchtime, you’re just as hungry and tired, or maybe more so, than if you hadn’t eaten breakfast at all. If you’re ok with eating protein in the morning and that keeps you full and alert through to lunchtime, then that’s probably a good option. If you’re in the first category though, I’d say skip breakfast and save the calories to enjoy a heftier lunch.
February 11th, 2015 at 4:41 pm
Thank you for sharing your experience and thoughts, Toffler! Sorry for the delayed response!
Be well!
JP
February 11th, 2015 at 4:43 pm
Update:
http://www.nutritionj.com/content/pdf/s12937-015-0002-7.pdf
A randomized, controlled, crossover trial to assess the acute appetitive and metabolic effects of sausage and egg-based convenience breakfast meals in overweight premenopausal women
Background: Dietary protein at breakfast has been shown to enhance satiety and reduce subsequent energy intake more so than carbohydrate or fat. However, relatively few studies have assessed substitution of protein for carbohydrate on indicators of appetite and glucose homeostasis simultaneously.
Methods: The acute appetitive and metabolic effects of commercially-prepared sausage and egg-based breakfast meals at two different protein levels (30?g and 39?g/serving), vs. a low-protein pancake breakfast (3?g protein) and no breakfast (water), were examined in premenopausal women (N?=?35; age 32.5???1.6?yr; BMI 24.8???0.5?kg/m2). Test products provided ~280?kcal/serving and similar fat (12?14?g) and fiber contents (0?1?g). Visual Analog Scale ratings for appetite (hunger, fullness, prospective consumption, desire to eat) and repeated blood sampling for plasma glucose and insulin concentrations were assessed throughout each test day. Energy intake was recorded at an ad libitum lunch meal at 240?min.
Results: Results showed increased satiety ratings for both the 30 and 39?g protein meals vs. the low-protein and no breakfast conditions (p?
May 18th, 2015 at 7:44 am
http://www.mdpi.com/2072-6643/7/5/3449/htm
Nutrients. 2015 May 11;7(5):3449-63.
One Egg per Day Improves Inflammation when Compared to an Oatmeal-Based Breakfast without Increasing Other Cardiometabolic Risk Factors in Diabetic Patients.
There is concern that egg intake may increase blood glucose in patients with type 2 diabetes mellitus (T2DM). However, we have previously shown that eggs reduce inflammation in patients at risk for T2DM, including obese subjects and those with metabolic syndrome. Thus, we hypothesized that egg intake would not alter plasma glucose in T2DM patients when compared to oatmeal intake. Our primary endpoints for this clinical intervention were plasma glucose and the inflammatory markers tumor necrosis factor (TNF)-α and interleukin 6 (IL-6). As secondary endpoints, we evaluated additional parameters of glucose metabolism, dyslipidemias, oxidative stress and inflammation. Twenty-nine subjects, 35-65 years with glycosylated hemoglobin (HbA1c) values <9% were recruited and randomly allocated to consume isocaloric breakfasts containing either one egg/day or 40 g of oatmeal with 472 mL of lactose-free milk/day for five weeks. Following a three-week washout period, subjects were assigned to the alternate breakfast. At the end of each period, we measured all primary and secondary endpoints. Subjects completed four-day dietary recalls and one exercise questionnaire for each breakfast period. There were no significant differences in plasma glucose, our primary endpoint, plasma lipids, lipoprotein size or subfraction concentrations, insulin, HbA1c, apolipoprotein B, oxidized LDL or C-reactive protein. However, after adjusting for gender, age and body mass index, aspartate amino-transferase (AST) (p < 0.05) and tumor necrosis factor (TNF)-α (p < 0.01), one of our primary endpoints were significantly reduced during the egg period. These results suggest that compared to an oatmeal-based breakfast, eggs do not have any detrimental effects on lipoprotein or glucose metabolism in T2DM. In contrast, eggs reduce AST and TNF-α in this population characterized by chronic low-grade inflammation. Be well! JP
August 22nd, 2016 at 11:08 am
Updated 08/22/16:
http://www.mdpi.com/2072-6643/8/8/490/htm
Nutrients. 2016 Aug 10;8(8).
Breakfast Macronutrient Composition Influences Thermic Effect of Feeding and Fat Oxidation in Young Women Who Habitually Skip Breakfast.
The purpose of this study was to determine if breakfast macronutrient composition improved thermic effect of feeding (TEF) and appetite after a one-week adaptation in young women who habitually skip breakfast. A randomized, controlled study was conducted in females (24.1 ± 2 years), who skip breakfast (≥5 times/week). Participants were placed into one of three groups for eight days (n = 8 per group): breakfast skipping (SKP; no breakfast), carbohydrate (CHO; 351 kcal; 59 g CHO, 10 g PRO, 8 g fat) or protein (PRO; 350 kcal; 39 g CHO, 30 g PRO, 8 g fat). On days 1 (D1) and 8 (D8), TEF, substrate oxidation, appetite and blood glucose were measured. PRO had higher (p < 0.05) TEF compared to SKP and CHO on D1 and D8, with PRO having 29% higher TEF than CHO on D8. On D1, PRO had 30.6% higher fat oxidation than CHO and on D8, PRO had 40.6% higher fat oxidation than CHO. SKP had higher (p < 0.05) fat oxidation on D1 and D8 compared to PRO and CHO. There was an interaction (p < 0.0001) of time and breakfast on appetite response. In addition, CHO had a significant increase (p < 0.05) in PP hunger response on D8 vs. D1. CHO and PRO had similar PP (postprandial) glucose responses on D1 and D8. Consumption of PRO breakfast for 8 days increased TEF compared to CHO and SKP, while consumption of CHO for one week increased PP hunger response. Be well! JP
January 13th, 2017 at 7:11 pm
Updated 01/13/17:
http://www.sciencedirect.com/science/article/pii/S0195666316310315
Appetite. 2017 Jan 4.
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.
PURPOSE: The purpose of this study was to determine the effects of eating breakfast on energy intake, physical activity, body weight, and body fat in women who are nonhabitual breakfast eaters over a four-week period.
METHODS: Forty-nine women who were nonhabitual breakfast-eaters were randomized to one of two conditions: breakfast or no breakfast. Breakfast eaters were required to eat at least 15% of their daily energy requirement before 8:30 a.m. Non-breakfast eaters did not consume any energy until after 11:30 a.m. Weight and body fat were assessed at baseline and after four weeks of intervention. Body fat was measured by dual energy x-ray absorptiometry (DXA). Participants completed seven 24-hour recalls to assess dietary intake during the intervention. Physical activity was measured by accelerometry for 32 consecutive days.
RESULTS: On average, the participants randomized to eat breakfast consumed 266 ± 496 (F = 12.81; P < 0.01) more calories per day over the course of the study and weighed 0.7 ± 0.8 kg (F = 7.81; p < 0.01) more at the end of the intervention. There was no observed caloric compensation at subsequent meals and no change in self-reported hunger or satiety. There was also no physical activity compensation with the addition of breakfast. CONCLUSION: The findings of our study showed that requiring non-breakfast eaters to eat breakfast resulted in higher caloric intake and weight gain. Future research should evaluate this relationship for a longer period of time to see if adding breakfast to the diet of women who generally do not eat breakfast results in adaptive behavior change over time. Be well! JP
March 2nd, 2017 at 7:32 pm
Updated 03/02/17:
http://link.springer.com/article/10.1007%2Fs00394-017-1392-4
Eur J Nutr. 2017 Feb 27.
Comparable effects of breakfast meals varying in protein source on appetite and subsequent energy intake in healthy males.
PURPOSE: The satiating effect of animal vs plant proteins remains unknown. The present study examined the effects of breakfasts containing animal proteins [milk (AP)], a blend of plant proteins [oat, pea and potato (VP)] or 50:50 mixture of the two (MP) compared with a carbohydrate-rich meal (CHO) on appetite, energy intake (EI) and metabolic measures.
METHODS: A total of 28 males [mean age 27.4 (±SD 4.2) years, BMI 23.4 (±2.1) kg/m2] consumed three isoenergetic (1674 kJ) rice puddings matched for energy density and macronutrient content as breakfast (25% E from protein) in a single-blind, randomised, cross over design. Appetite ratings and blood samples were collected and assessed at baseline and every 30 and 60 min, respectively, until an ad libitum test meal was served 3.5 h later. Free-living appetite was recorded hourly and EI in weighed food records for the remainder of the day.
RESULTS: No differences in subjective appetite ratings were observed after consumption of the AP, VP and MP. Furthermore, there were no differences between the AP, VP, MP and CHO breakfasts in ad libitum EI and self-reported EI during the remainder of the day. Although insulin metabolism was not affected, CHO induced a higher glucose response (P = 0.001) and total amino acids concentration was in the order of AP = MP > VP > CHO breakfast (P = 0.001).
CONCLUSION: Manipulating the protein source of foods consumed as breakfast, elicited comparable effects on appetite and EI at both laboratory and free-living environment in healthy men.
Be well!
JP
December 9th, 2017 at 1:35 am
Updated 12/08/17:
https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effect-of-breakfast-omission-and-consumption-on-energy-intake-and-physical-activity-in-adolescent-girls-a-randomised-controlled-trial/1FCA87437794406CF119F09E783C8130/core-reader
Br J Nutr. 2017 Sep;118(5):392-400.
Effect of breakfast omission and consumption on energy intake and physical activity in adolescent girls: a randomised controlled trial.
It is not known if breakfast consumption is an effective intervention for altering daily energy balance in adolescents when compared with breakfast omission. This study examined the acute effect of breakfast consumption and omission on free-living energy intake (EI) and physical activity (PA) in adolescent girls. Using an acute randomised cross-over design, forty girls (age 13·3 (sd 0·8) years, BMI 21·5 (sd 5·0) kg/m2) completed two, 3-d conditions in a randomised, counter-balanced order: no breakfast (NB) and standardised (approximately 1962 kJ) breakfast (SB). Dietary intakes were assessed using food diaries combined with digital photographic records and PA was measured via accelerometry throughout each condition. Statistical analyses were completed using repeated-measures ANOVA. Post-breakfast EI was 483 (sd 1309) kJ/d higher in NB v. SB (P=0·025), but total daily EI was 1479 (sd 11311) kJ/d higher in SB v. NB (P<0·0005). Daily carbohydrate, fibre and protein intakes were higher in SB v. NB (P<0·0005), whereas daily fat intake was not different (P=0·405). Effect sizes met the minimum important difference of ≥0·20 for all significant effects. Breakfast manipulation did not affect post-breakfast macronutrient intakes (P≥0·451) or time spent sedentary or in PA (P≥0·657). In this sample of adolescent girls, breakfast omission increased post-breakfast free-living EI, but total daily EI was greater when a SB was consumed. We found no evidence that breakfast consumption induces compensatory changes in PA. Further experimental research is required to determine the effects of extended periods of breakfast manipulation in young people.
Be well!
JP
March 2nd, 2018 at 5:12 pm
Updated 03/02/18:
https://academic.oup.com/jn/article-abstract/148/2/220/4913034?redirectedFrom=fulltext
J Nutr. 2018 Feb 1;148(2):220-226.
A High-Fat Compared with a High-Carbohydrate Breakfast Enhances 24-Hour Fat Oxidation in Older Adults.
Background: The ability to oxidize fat is associated with a lower risk of chronic metabolic disease. Preclinical data in mice showed that a high-fat “breakfast” increased 24-h fat oxidation relative to a high-carbohydrate breakfast.
Objectives: The objectives of this study were to determine whether the timing of macronutrient intake in humans affects daily fuel utilization and to examine associations between fuel utilization and metabolic indexes.
Methods: Participants were 29 healthy sedentary men and women (aged 55-75 y) with a body mass index (kg/m2) between 25 and 35. Participants were randomly assigned to receive either a high-fat breakfast (FB; 35% carbohydrate, 20% protein, 45% fat; n = 13) or a high-carbohydrate breakfast (CB; 60% carbohydrate, 20% protein, 20% fat; n = 16) for 4 wk while consuming a “neutral” lunch and dinner. Twenty-four-hour and postprandial respiratory quotients (RQs) were measured by whole-room indirect calorimetry. Insulin and glucose measures including insulin sensitivity were determined by an oral-glucose-tolerance test. Measures were taken at baseline and after the 4-wk intervention. Group-by-time interactions were determined by 2-factor repeated-measures mixed-model ANOVA. Pearson’s correlation analyses were used to determine associations of 24-h RQs with metabolic measures after the intervention.
Results: There was a significant group-by-time interaction for change in the 24-h RQ [FB (mean ± SD): 0.88 ± 0.02 to 0.86 ± 0.02; CB: 0.88 ± 0.02 for both; P < 0.05], breakfast RQ (FB: 0.88 ± 0.03 to 0.86 ± 0.03; CB: 0.89 ± 0.02 to 0.90 ± 0.02; P < 0.01), and lunch RQ (FB: 0.089 ± 0.03 to 0.85 ± 0.03; CB: 0.89 ± 0.03 for both; P < 0.01). In the CB group at follow-up, 24-h RQ was positively associated with fasting glucose (r = 0.66, P < 0.05), glucose area under the curve (AUC) (r = 0.51, P < 0.05), and insulin AUC (r = 0.52, P < 0.05) and inversely associated with insulin sensitivity (r = -0.51, P < 0.05). Conclusions: The macronutrient composition of breakfast affects substrate utilization throughout the day in older adults. The consumption of a high-fat, lower-carbohydrate breakfast may reduce the risk of metabolic disease. Be well! JP