A friend recently shared an article from the popular press that reported the results of a scientific study from the Journal of the American College of Cardiology titled: “Association of skipping breakfast with cardiovascular and all-cause mortality”1. The article2 attempted to make the leap to “intermittent-fasting”, a popular technique for weight-loss. The challenge for the lay person is that the information is not presented in its original form. The challenge for the scientist is that it is only one of many studies. Moreover, it is a correlation study, and correlations don’t demonstrate causation. As well as the authors attempted to control for a range of variables in the study, there are still limitations to the study. There is certainly strong evidence that skipping breakfast may contribute to certain health risks3, but there is much else to consider. For instance, there is also reasonable evidence to suggest that intermittent-fasting can have health benefits (e.g., fat loss). So, what is one to make of this information?
Well, first timing of meals is important. Moreover, the quality of what one eats is important. It would appear from the literature that occasionally skipping breakfast is not a great risk to one’s health. It is probably not a big issue to regularly skip breakfast (e.g., intermittent fasting), though it may be argued that breakfast is simply the first meal eaten in the day (“break fast”), so we really don’t “skip breakfast”. The literature is not clear on the health importance of when the first meal is eaten, and meal timing is not consistently defined in the literature due to many cultural differences. Irregular timing of meals seems to be more concerning than the occasional skipped breakfast. As well, the literature suggests that who is skipping breakfast and why they are skipping are of some importance. Often, irregular meal patterns are characteristic of individuals with other health risk factors (e.g., smoking, alcohol, stress, etc.).
Intermittent fasting is tied to decreased body weight—if it includes the appropriate caloric balance and healthy food content. Skipping breakfast is often linked to obesity and corresponding cardiovascular health risks because, in lieu of eating a healthy balanced first meal, many skip a nutrition sit-down breakfast meal and settle for a quick high-sugar/high-fat/high-calorie snack. This leads to premature hunger and over-eating—along with excessive insulin spiking. Skipping breakfast may, then, lead to more frequent snacking and excessive calories.
As a rule, I recommend avoiding high-sugar/high-fat breakfasts—particularly avoiding processes breakfast foods. Proteins and healthy fats are good choices. These empty more slowly from the gut and will keep one satisfied longer. Thus, one will be less likely to need to snack before the next meal. What snack one eats should be planned in advance. Indeed, regular meal planning seems to be important.
I have shared regularly Dr. Mike Israetel’s (Renaissance Periodization) breakdown of the importance of the various components of weight management: caloric balance—50%, macro balance—30%, nutrient timing—10%, food composition—5%, and supplements—5%. With this in mind, it is most important to understand what and when one needs to eat. Eat breakfast, or don’t, but be sure that, at the end of the day, you are in the proper caloric balance. Distribute calories according to your exercise habits and your hunger patterns.
Personally, I find intermittent fasting nearly impossible. Instead, I prefer to eat a modest amount of calories in the morning and eat the greater amount of my calories in the evening. If I delay breakfast for weight loss purposes, I find I will need to eat more, but will emphasize protein, vegetables, and fats. Typically, a “buttered coffee” and a few eggs scrambled with spinach keep me going until late afternoon after I have finished teaching. If I eat high-carbs, I am going to “crash” mid-morning or be craving a snack. Over all, this seems to work best (for me) for consistent energy levels. My greatest weakness is probably in not being as conscientious about calorie portions in the evening.
Whatever your goals, have a plan and stick to it. Have a regular schedule—sleep, eat, and exercise like clockwork. Track and control food portions. The most successful dieters prepare meals ahead of time (“meal prep”). Most importantly, keep it simple. Consider partitioning nutrients in more, rather than fewer meals. Focus on eating fewer calories, quality fats, carbohydrates, and proteins, and eat to exercise rather than exercise to eat. Don’t “skip” breakfast, but don’t feel that the window between dinner and breakfast needs to be smaller rather than larger (10-12 hours seems moderate and reasonable; intermittent-fasting is typically around 16 hours). From the scientific literature, it would appear that consistency is most important.
Be your best today; be better tomorrow.
Carpe momento!
1Rong S, Snetselaar LG, Xu G, et al. Association of skipping breakfast with cardiovascular and all-cause mortality. J Am Coll Cardiol 2019;73: 2025–32.
3St-Onge M-P, Ard J, Baskin ML, Chiuve SE, Johnson HM, Kris-Etherton P, Varady K. Meal timing and frequency: implications for cardiovascular disease prevention. Circulation 2017;135: e96-e121.