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The Most Important Meal of the Day…?
November 12, 2008
In the hustle and bustle of everyday life, the idea of eating a healthy and well-balanced breakfast has become a thing of the past. Though we have grown up hearing the worn-out phrase “breakfast is the most important meal of the day”, a substantial portion of the nation’s population does not heed this advice. Around 20% of the population skips breakfast regularly, and that percentage is expected to be even higher in adolescents. Many abstain from eating breakfast in order to save time, while others try to avoid the additional calories that breakfast contains. However, numerous studies have demonstrated that breakfast is not only beneficial in maintaining a healthy diet, but is important in the fight against obesity. We are constantly stressed of the importance of eating a “well-balanced breakfast” but are the health outcomes, especially its role in preventing obesity, justified?
Rise and Shine
Breakfast products flood our supermarkets and our homes, but which ones are actually good for us? Surely we know Quaker® oatmeal is a more suitable breakfast than a Pop-Tart™, but why is this so? The answer lies in the nutrition facts of what we put into our bodies in the morning. According to a nutrition study by the Mayo Clinic, the key elements of a healthy breakfast are carbohydrates, protein and a small amount of fat. Therefore, a nutritious breakfast can consist of fruits and vegetables, grains, low-fat dairy products and lean meats or eggs. Thus, Krispy Kreme® doughnuts or Hardee’s® Loaded Biscuit ‘N’ Gravy Bowl are not viable breakfast options due to their high fat and sugar content. Furthermore, a healthy breakfast should be limited to less than 500 calories. This is why fruits and grains are such good options because they are naturally low-calorie foods. (http://www.mayoclinic.com/health/food-and-nutrition/NU00197) Two servings of cantaloupe and 2 pieces of white toast is a 400 calorie meal with only 4 grams of fat. However, Hardee’s® Gravy Bowl weighs in at a stomach-churning 770 calories and 54 grams of fat. Thus, an important concept to grasp with breakfast is the fact that it is not only when you eat but what you eat.
Fuel for Your Body
How exactly does eating breakfast contribute to losing weight as well as its numerous other benefits? The idea itself seems contradictory to common sense. How can eating in the morning allow one to keep pounds off more effectively than skipping the meal all together? This occurs because the skipping of breakfast results in a long period of a lack of consumption. In fact, this is where breakfast gets its name: to break the fast. Therefore, this relatively long period of abstinence from eating has two results: slowing down the body’s metabolism as well as causing a drop in blood sugar. This drop in blood sugar will cause you to feel excessively hungry later in the day, forcing you to eat more to satiate your appetite. However, the resulting slowed metabolism will fail to burn the calories from lunch and dinner as regularly. As a result, the effects of skipping breakfast are two fold in their contribution to gaining weight.
Recent studies have also shown that eating breakfast plays a role in reducing the risk of insulin resistance. Insulin resistance is a precursor to Type II diabetes, another U.S. health epidemic linked to obesity and poor diet. In a study entitled Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women, Dr. Farshchi et al. (2005) of the Queen’s Medical Centre in Nottingham, United Kingdom organized a study of ten women with a BMI of less than 26. The motivation of the study was to research the health benefits of eating breakfast, as a majority of previous studies had proven inconclusive. In this study, five of the subjects were given a regimented breakfast before 8AM while the other five were given the same meal at 11AM. The food intake and eating times of the subjects were controlled during the day for three other meals for both groups. After two weeks of implementing this study and collecting data, Farshchi found that the “Omitting Breakfast” group had higher insulin resistance levels than those in the “Eating Breakfast” group, even though the total caloric intake of both groups was the same. This resistance to insulin puts a strain on the body’s natural ability to stabilize blood glucose levels. Therefore, habitually eating breakfast over long periods of time helps maintain insulin resistance in check and has been associated with a 35 to 50 percent reduction in Insulin Resistance Syndrome, a precursor to type II Diabetes. (http://www.mealsmatter.org/EatingForHealth/Topics/article.aspx?articleId=5)
Helps the Young…
Additional research has shown that habitually eating breakfast is most important in the health outcomes of youth and adolescents for various reasons. However, around 30% of adolescents skip breakfast, more than any other age group! (http://breakfastresearchinstitute.org) In a five year prospective cohort study of 2216 students, Dr. Timlin et al. (2008) studied the association between breakfast frequency and body mass index in adolescent males and females. The study, known as Project EAT (Eating Among Teens), was published in the Journal of the American Academy of Pediatrics in order to better understand the foundation of the obesity epidemic among adolescents. At the beginning of the study in 1999, the participants completed a survey indicating how many times per week they ate breakfast. Their height and weight were also measured by research staff in order to calculate the BMI of each participant. In 2004, the participants once again answered a survey indicating how many times per week they ate breakfast, and had their BMI measured once again. The participants were divided into categories of Always, Intermittent and Never, depending on their frequency of breakfast consumption. The results of the study displayed an increase in BMI of nearly 2.5 points in those who never ate breakfast, compared to a BMI increase of 1.5 points in those who always ate breakfast. Perhaps most significant, those who intermittently ate breakfast showed a BMI increase of 1.9 points. This study is revealing because it associates breakfast skipping with changes in BMI as opposed to weight gain. BMI is a far more useful method of measuring weight change because it takes into account potential changes in height of the growing adolescents. The reason all three groups displayed a BMI increase is attributed to natural changes in the body during teenage years. Those not eating breakfast show a greater increase in BMI due to the metabolic effects of skipping breakfast. However, the results of the study depend on the truthfulness of the adolescents and do not take into account the varying healthiness of the breakfasts.
In 2003, the Harvard School of Public Health finalized a three year longitudinal study of breakfast frequency, change in BMI and self-reported quality of schoolwork. This study was unique because it studied the cognitive effects of skipping breakfast as well as its effects on weight. The participants of the study were 16,882 children between the ages of 9 and 14. The participants were chosen because they were the children of registered nurses all over the country. Once a year for three years, the mother-nurses would record their children’s BMI as well as ask them survey questions concerning amount of physical activity, videogame playing and satisfaction with schoolwork. Likewise, the study demonstrated that skipping breakfast was associated with overweight children cross-sectionally. However, this study demonstrated that overweight children who did not eat breakfast showed a decrease in BMI as opposed to overweight children who ate breakfast everyday. This loss in BMI was attributed to a loss in fat, but the ultimate health outcomes of this were undeterminable. Most interestingly, the children who skipped breakfast were less likely to report that they were doing well in school. According to the study, “this is consistent with a large educational literature (including randomized controlled trials and assessments of the School Breakfast Program) on the benefits of breakfast, which include increases in standardized test scores and reductions in psychosocial problems, absenteeism, and tardiness.” (Gilman et al. 2003 p.1263). However, this data must be taken with skepticism because the mothers giving the survey probably caused the children to censure their answers concerning their performance in school. Nonetheless, it is believable that school success is influenced by the health benefits that come with a balanced breakfast routine.
...And the Old!
Research studies have also shown that breakfast consumption controls weight gain in adults as well. A Prospective Study of Breakfast Consumption and Weight Gain Among U.S. Men by Van der Heijden et al. (2007) is a ten year prospective study of over 20,064 adult U.S. males between the ages of 46 and 81. The study was published in the October 2007 edition of Obesity research journal. Similar to the studies involving adolescents, the principal motivation of the paper is to shed light on possible causes and preventions of the obesity epidemic in the United States. Through questionnaires, the subjects recorded their eating patterns and BMI in addition to several potential confounders such as marital status, smoking status and amount of daily physical activity which could possibly skew the data. After 10 years, the prospective study revealed that almost 17 percent of men were non-breakfast consumers as opposed to the 83 labeled breakfast consumers. Not only did the breakfast consumers have a lower BMI average, they were less likely to smoke and were more physically active. These results are ambiguous in interpretation because it is not clear if abstinence from smoking and physical activity result in a lower mean BMI or if breakfast consumption is in fact the explanation. However, “when we took into account factors that could lead to changes in dietary habits by excluding smokers and men who developed chronic disease during follow-up secondary analyses, associations were stronger or essentially unchanged.” (Van der Heijden et al. 2007 p. 2468). While true causality of lack of weight gain due to breakfast consumption is difficult to prove, there is strong evidence that the two are sufficiently related.
Breakfast companies have jumped all over the positive publicity that breakfast has recently received. Kellog’s Smart Start® Cereal claims to “make your heart stronger” if you eat it every morning. (www.smartstart.com) According to their website, Quaker® Oatmeal helps to lower your cholesterol, and proves this by way of touching testimonies of people losing more cholesterol points than their golf handicap. (http://www.quakeroatmeal.com/). Even Lucky Charms® is now advertising itself as “A magical, nutritious cereal” because of its vitamin D and calcium content, but the cereal has marshmallows in it. The point is that with the growing acceptance of eating breakfast as a healthy lifestyle choice, advertisers are manipulating this in their marketing techniques. The responsibility falls on the consumer in understanding that breakfast moderation is the key to nutrition.
The short answer to the “Should I eat Breakfast?” question is a definitive yes. As studies have shown, breakfast consumption is linked to decreased weight gain, decreased insulin resistance, and even possible certain cognitive benefits. However, the long answer to the question is that breakfast is beneficial only if consumed health consciously with balance and moderation. Several of the studies were not able to definitively prove that breakfast consumption caused improved overall health because the breakfast meals were not equivalent among subjects. Therefore, eating bacon and eggs every morning may have serious health risks even though it qualifies as breakfast.
Regardless, give it a try. Tomorrow morning wake up 15 minutes early and have a bowl of cereal and fruit instead of the usual Pop-Tart™ or nothing at all. Chances are you will not be as hungry later in the day, and you will feel more refreshed and energized in your daily activities.
Farshchi, H., Macdonald, I., Moira, T. (2005). Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women. American Journal of Clinical Nutrition. 81 (2), 388-396.
Timlin, M., Pereira, A., Story, M., Neumark-Sztainer, D. (2008). Breakfast Eating and Weight Change in a 5-Year Prospective Analysis of Adolescents: Project EAT (Eating Among Teens). Pediatrics. 121(3), e638-e645.
Berkey, C., Rockett, H., Gillman, M., Field, A., Colditz, G. (2003). Longitudinal study of skipping breakfast and weight change in adolescents. International Journal of Obesity. 27, 1258-1266.
Van der Heijden, A., Hu, F., Rimm, E., Van Dam, R. (2007). A Prospective Study of Breakfast Consumption and Weight Gain among U.S. Men. Obesity. 15, 2463-2469.
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