I’m a morning person, which means I get up in the morning. But don’t talk to me until I’ve had breakfast and I start to feel human again. And why’s that? I’m starving. I haven’t eaten for 12 hours making me hangry. Besides, breakfast is the most important meal of the day, isn’t it?

corn flakes

I’ve always ate breakfast. As a kid, each morning when I got up I would grab the box of Corn Flakes or Cheerios, pour it in a bowl, add milk along with sugar (unless it was something like Frosted Flakes, then I’d skip the sugar), and without much fuss, have my breakfast. While it satisfied my hunger there was probably as much nutrition in the cardboard box the cereal came in than the cereal itself (minus the milk of course).

When I was young, my parents encouraged my siblings and me to eat breakfast. Back then there were these Kellogg’s TV commercials that said kids who start their day off with breakfast did better in school. Sounds pretty good, although it never dawned on me to think who were the kids who didn’t have breakfast. I now know they tend to be the more economically deprived kids who miss breakfast, and these kids have greater challenges in life than just missing breakfast.

Throughout the day, my meals would increase in size so that lunch was bigger and dinner was the biggest of all. Nothing like pushing back from the dinner table with your pants tight around the waist.

king, queen, jack

As I got into the field of cardiac rehabilitation, I started to hear things like: Eat Breakfast Like a King, Lunch Like a Queen and Dinner Like a Pauper. Based on this, I had it all wrong, as did many millions of the cereal-eating legion. So if I eat breakfast like a King, should I just eat more cereal (and become the King of Cereal)? Somehow I don’t think that was the idea. I was told we also need to get protein in our breakfast as well; that little bit of milk splashed on my flakes didn’t cut it.

One of the earliest bits of evidence I came across about breakfast was from the National Weight Loss Registry in the US. The registry is a volunteer database of people who have lost weight (fat primarily) with the aim of trying to understand the successes of weight loss. In 2002 it reported that nearly 80% of the 3000 members ate breakfast regularly. The news spread like wildfire; breakfast was essential to weight loss. Not one to buck a trend, I got on that bandwagon saying how important it was. No one seemed to mention that study also found no difference in total daily calories between those who ate and the 20% who didn’t eat breakfast.

breakfast registry

Over the years, the notion breakfast was essential for weight loss grew. It wasn’t until much later that randomized (comparison) studies emerged. These studies generally found no difference in short-term weight loss between people eating breakfast compared to skipping breakfast. Another study reported that people who skipped breakfast made up for the missing morning calories later in the day, suggesting that skipping breakfast isn’t a great weight loss strategy either. However, with these studies being less than four months, the long-term implications aren’t clear, and we know sustaining weight loss is difficult.

Now weight loss isn’t the end all and be all (nor should it be). There are other potential health consequences to keep tabs on. A cross-sectional study found that breakfast skippers have a 2.5 fold greater risk for atherosclerosis compared to non-skippers. A comprehensive review of long-term studies noted a 21% increase risk for diabetes with breakfast skipping.

It’s possible that eating breakfast could just be a marker for other healthy habits (people who eat breakfast tend to be more health conscious) and breakfast itself could have nothing to do with long-term health. However, a number of well-conducted short-term studies indicate skipping breakfast can adversely affect blood sugar metabolism, which may be at the root of the higher risk for diabetes. This makes sense as our body is starving from fasting so long and extended fasting may not be beneficial over the long-term.

While it’s unclear if breakfast is more important than any other meal, having breakfast may be the better than not having it. So then why do people skip it? Some people do so thinking it will lower how many calories they eat and help lose weight, but the studies above show that isn’t the case.

smoothie

Another reason people give is not having enough time in the morning. I find this a bit hard to believe. Breakfast doesn’t have to take a lot of time. Things like yogurt and having hard boiled eggs in the fridge (you can boil a whole week’s worth in a few minutes the evening before) are simple, ready-made meals. There’s also a lot more choice in cereals (i.e. more nutritious ones) than there used to be. A number of my friends have yogurt and fruit smoothies in the morning they can take with them on their morning commute.

Armed with all this information, I continue to eat breakfast and I have carried on the family tradition of nagging my kids to have breakfast. I have made some changes in what I eat trying to diversify away from simple cereal. Some mornings I’ll have eggs and toast, or oatmeal, or peanut butter and toast. All very adventurous you might say. But it’s hard to break a nearly 50 year habit and I still eat cereal on most mornings but have switched to cereals higher in fibre and protein. These I find more satisfying and keep me full throughout the morning.