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Is breakfast toast? St. Paul’s dietitians weigh in

A review by the British Medical Journal (BMJ) recently made headlines by concluding that eating breakfast might not be a good strategy for weight loss. This challenged our long-held mantra that our first meal is the most important of the day.

As Nutrition Month in Canada launches today,  Yeiji Jang, Registered Dietitian and Tanya Choy, Registered Dietitian, Certified Diabetes Educator, Providence Health Care, assess the review’s merits through their professional lens.

What stands out for us first is, the studies included in this analysis were mostly low quality and short term, following participants for little as 24 hours to 16 weeks. The small number of participants and the inconsistent definition of breakfast make it impossible to conclude that there is causal effect of breakfast on weight. Even the reviewers admitted that more high-quality trials of longer duration are needed to examine the role of breakfast and weight management.

So we view any advice based on this analysis with skepticism and caution people not to be swayed by the sweeping headline.

Weight is not the only indicator of health, and proper, individualized nutrition can help with many factors such as digestion, physical activity, blood sugar control and mental health.

Skipping Breakfast Can Affect Us All Differently

For some people, skipping breakfast may contribute to increased hunger later in the day, which can lead to overeating at the next meal. Overeating at any meal can cause difficulty with digestion and bloating, and over time may create a disconnect with hunger and fullness cues. For those with a physically active job or who exercise early in the day, skipping breakfast could deprive them of the fuel they need to perform optimally. Even for someone who is not as active, skipping breakfast can remove an opportunity to get adequate fibre, vitamins and minerals.

Does It Matter What You Eat for Breakfast?

Not all breakfast is created equal. A typical North American breakfast of a bowl of cereal or baked goods and coffee is lower in nutrition than one with whole grains, protein, fruits and vegetables. Studies have shown that breakfasts high in fibre and protein, and low in processed foods is associated with lower risk factors for diabetes and metabolic syndrome versus no breakfast or simple carbohydrate-based breakfasts. Healthy breakfast consumption has been shown to improve insulin sensitivity and blood glucose control in both healthy and high-risk groups even in the absence of effect on weight or energy balance.

Breakfast for Brain Power?

Apart from potential nutritional and metabolic benefits, many studies have investigated the effect of breakfast-eating on cognition, especially in children and adolescents. Recent reviews suggest there may be benefits in improved cognitive and academic performances, although it may depend on specific breakfast composition (e.g., more nutrient-dense). In adults, breakfast may improve memory and alertness, which is partly due to improved blood-sugar control.

Bottom Line  

While both sides of the breakfast debate need better quality and longer- term studies to provide definite conclusions about its effects on weight, eating a balanced breakfast seems to provide important metabolic and other benefits to our health. We say the focus should be on an overall healthy lifestyle instead of on one meal.

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