To breakfast or not to breakfast? That is the question when you’re trying to lose weight or dealing with type 2 diabetes. Dr Marc Bubbs gives his verdict…
Jack Dorsey, the CEO of Twitter, eats only one meal a day. In the late afternoon, he consumes one large feast. Dorsey also goes multiple days without eating, believing it provides him with a productivity edge.
Is skipping breakfast really giving Dorsey a competitive edge? Or is it setting him up for major problems down the road? There are some key nuances to explore and meal timing is one of the most influential external cues that impacts your physiology and, indirectly, your ability to maintain a healthy weight.
Should I try intermittent fasting?
More and more people are skipping breakfast. Time restricted eating (TRE) is the term used to describe shrinking the “window” of time during which you eat. For example, you might delay your breakfast or first meal until 11am or noon and stop eating from 6-7pm.
You might have heard this being referred to as intermittent fasting (IF), but IF is actually when you fast for two days per week, eating less than 500-800 calories on those days, and eating normally the remaining days of the week. Nevertheless, fasting is a popular option today.
But, does it help with weight loss? How about fighting off chronic conditions? In the complex world of nutritional science, there are few clear-cut answers. But the research world has been abuzz with studies examining the benefits and pitfalls of eating, versus skipping, breakfast on weight loss and health.
The breakfast debate: research timeline
In 2014, a randomised controlled trial of more than 300 overweight and obese adults investigated whether eating breakfast versus skipping breakfast over a 16-week period had any impact on weight loss.
What did it reveal? Breakfast consumption did not improve weight loss relative to breakfast skipping. This added fuel to the ‘skipping breakfast’ fire – perhaps Jack Dorsey is on to something.
Over the next few years, the surge in popularity for TRE led The British Medical Journal to publish a review of 13 studies examining the effects of breakfast on weight loss.
Researchers wanted to put to the test the commonly held beliefs that skipping breakfast leads to more snacking later in the day and that eating breakfast helps improve satiety for the rest of your day. What did they uncover?
Scientists couldn’t find consistent evidence that eating or skipping breakfast was superior for weight loss. Some people did lose weight, others did not. Some people improved their glucose and insulin levels, while others did not.
However, researchers did find that people who eat breakfast tend to follow an array of healthy lifestyle choices: they exercise more regularly, they go to bed earlier, they consume more fibre and they’re less likely to smoke or binge drink.
New science is starting to unpack with more precision the potential pitfalls of skipping breakfast and how eating the “right” breakfast can lay the foundation for health and weight loss.
What happens when you’re skipping breakfast?
Let’s circle back and look at the common traits of people who regularly skip breakfast. People who don’t eat breakfast typically have higher HbA1c levels (a three-month average blood sugar control), higher diastolic blood pressure, higher triglycerides, higher uric acid levels (a marker of inflammation) and lower HDL cholesterol levels.
Breakfast skippers are more likely to have a higher body weight, a greater risk of developing Type 2 diabetes and an increased prevalence of atherosclerosis (where arteries become clogged with fatty substances).
This connection between breakfast skipping and increased risk of atherosclerosis has been found to be independent of conventional heart disease risk factors in middle-aged adults who do not suffer from any cardiovascular disease symptoms.
Breakfast skippers also have a higher risk of heart attack and stroke, regardless of whether they have a history of poor heart health. People who skip breakfast often struggle with lifestyle behaviours as well. They tend to stay up later and have poorer sleep quality.
If you’re struggling with high blood glucose levels, it’s important to note that skipping breakfast can amplify your glucose response to meals during the rest of the day and impair insulin secretion. But it’s important to remember, correlation isn’t causation. Skipping breakfast isn’t causing these outcomes.
Skipping breakfast as a lean and active person:
A few years ago, Dr Javier Gonzalez, PhD, and his team at Bath University compared how lean (defined as a BMI between 18.5 and 24.9kg/m2) versus obese individuals responded to cutting out breakfast for an extended period.
They recruited 49 individuals and instructed the breakfast group to consume at least 700 calories by 11am and a minimum of 50 per cent of those calories within two hours of getting up.
Gonzalez assessed markers of body composition and cardiovascular and metabolic health before and after the intervention, as well as the activity of more than 40 different genes and proteins.
How did breakfast impact the lean versus obese individuals? Eating breakfast resulted in a drop in fat-burning genes in lean individuals. This is not surprising because any time you consume food your body will put the brakes on body-fat breakdown and shift gears to burning the food you’ve eaten for fuel.
Despite consuming significant calories for breakfast, the lean individuals burned off those calories throughout their typically active day. Things got interesting when they skipped breakfast.
The lean individuals improved their capacity to burn body fat. In a fasted state, your body switches over to burning its fuel reserves (ie body fat) to fuel your day. If you are active and lean, some fasting in the morning can be beneficial to improve your ability to burn body fat.
Skipping breakfast as an overweight or obese person:
How did the obese participants fair? Eating breakfast also resulted in a drop in fat-burning genes but, surprisingly, it decreased the activity of genes involved in insulin resistance. This was a novel twist.
Eating breakfast in the obese group actually improved their ability to take up carbohydrates, a finding that was in step with previous research that showed breakfast consumption is associated with better glucose control in fat cells.
This is an important finding for obese and overweight individuals looking to improve glucose control and lose weight: eating breakfast helped – big time!
Another surprising finding in the obese group was that skipping breakfast increased the genes associated with inflammation, something not seen in the lean group.
This has the potential to be problematic in the long-term for obese and overweight individuals, as chronic inflammation worsens glucose control.
Skipping breakfast also worsens your blood glucose response to lunch. If you eat breakfast, your glucose tolerance at lunchtime improves. This is a phenomenon known as the “second meal effect”.
Eating vs. skipping breakfast: context matters
If you’re obese or overweight, breakfast appears to be an important strategy for protecting against Type 2 diabetes and the subsequent adverse health effects of chronically high blood sugar levels. Of course, you need to pick the right breakfast.
If you’re active and have a healthy body weight, you can choose from both options: skipping breakfast on specific days to support metabolic health and eating breakfast on the other days to support intense exercise and to avoid the pitfalls fasting can have on your daily energy expenditure and muscle mass.
This all highlights the importance of individualised approaches – context matters!
This is an adapted extract from Peak 40: The New Science of Mid-Life Health for a Leaner, Stronger Body and a Sharper Mind, by Marc Bubbs (£10.99).
