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July 02, 2021 9 min read

As young kids, our parents always told us to eat a good breakfast before going to school, but as we get older and enter teenage years and beyond; many of us start to skip breakfast. 

But what role does breakfast play in the overall picture of health & fitness? In this article, we’ll examine some recent evidence on this topic.

Breakfast is a powerful trigger that can either shift your metabolism into fat burning mode or fat storing mode.

Demand for dietary recommendations to improve health and mitigate lifestyle-related chronic diseases is increasing at both the individual and population levels [1].

Breakfast continues to be touted as an important part of a healthy dietary pattern, potentially as a result of the countless observational studies documenting strong associations between breakfast consumption and the promotion of weight management [2].

Despite the fact that breakfast recommendations have recently come under scrutiny due to a postulated lack of causal evidence supporting breakfast for weight and fat loss [3, 4], increasing consumer demand and sales of breakfast foods are climbing in the United States [5].

Therefore, it is imperative to examine the strength of evidence concerning the consumption of breakfast on health-related outcomes.

Given the lack of data from long-term randomized controlled breakfast trials, prior reviews were unable to support (or refute) the efficacy of daily breakfast consumption to promote weight loss, changes in body composition, or reductions in daily food intake [6]. 

A recent review critically evaluated the intervention-based literature examining the effects of breakfast consumption compared with breakfast skipping on appetite, satiety, energy expenditure, and circadian health. 

Each of these factors contribute to the regulation of energy balance and thus modulate weight management.

The following factors were considered when interpreting the body of evidence:

The evidence within this review shows positive to neutral support for the inclusion of breakfast for improvements in appetite control, satiety, and postprandial (after eating) energy expenditure.

The protein content, energy content, and form of the meal (i.e., beverages compared with foods) are key modulating factors for consumption behavior and energy expenditure mechanisms.

Specifically, breakfast meals containing a larger amount of protein (≥30 g protein/meal) and energy (≥350 kcal/meal) and also provided as solid foods increased the magnitude of the appetite and satiety response compared with skipping breakfast.

Appetite control and satiety 

The majority (66%) of the study comparisons showed postprandial (after eating) reductions in hunger after meals throughout the day when breakfast was consumed compared to when it was skipped.

Similarly, postprandial (after eating) fullness increased in 68% of the study comparisons when breakfast was consumed instead of skipped.

These findings suggest that breakfast consumption modulates ingestive behavior through enhanced satiety as evidenced by increased fullness and associated satiety hormones [7]. 

A recent randomized crossover study examined the effects of breakfast consumption in 20 overweight, breakfast-skipping, adolescent girls.

They found that hormonal responses (ghrelin and PYY) were affected by having a breakfast compared to skipping breakfast, but these responses were dependent on breakfast composition. 

Although both breakfast meals increased fullness compared with skipping breakfast, the higher-protein breakfast treatment elicited greater increases in fullness than the normal-protein version.

In addition, as shown in the figure below, only the higher-protein breakfast elicited improvements in PYY and ghrelin responses compared with skipping breakfast [3]. 

 

Fig: Perceived hunger (A) and fullness (B) responses throughout the testing days in 20 adolescent girls. The line graph displays the time course of change throughout the 10-h days in the BS, NP, and HP patterns; the bar graphs depict total and specific time segment AUCs across the day. Post hoc pairwise comparison analyses were performed when main effects and interactions were detected. Different lowercase letters denote significance (P < 0.05) between testing days. The empty triangle on the x-axis denotes the breakfast meal; the shaded triangle on the x-axis denotes the lunch meal. BS, breakfast skipping; HP, high protein; NP, normal protein. Figure above adapted from Leidy et al. [3]

 

Collectively, the majority of study comparisons (67%) showed ≥1 improvement in select indexes of appetite and satiety after the consumption of breakfast compared with skipping.

Moreover, none of the comparisons reported deleterious effects of breakfast consumption, such that all findings indicated either positive or neutral effects [7].

Breakfast meal protein composition

There is a keen interest in increasing dietary protein at breakfast given the documented satiety effects of consuming ≥ 30g protein [8]. 

Many studies that compared higher protein breakfast and breakfast skipping reported improvements in ≥ 1 of the outcomes of interest (appetite, hormonal responses, etc.) after the higher protein breakfast compared with skipping breakfast. 

There were greater improvements in appetite and/or hormonal responses in studies that compared higher protein breakfast with normal protein versions [3, 9, 10].

There is further work that needs to be done in this area given the limited number of studies, but evidence clearly points to have a breakfast that includes higher amounts of quality protein.

Breakfast meal size

Meal size may also be another factor to take into consideration. Evidence demonstrates that consuming larger meals earlier in the day led to greater weight loss after a 3-month intervention than consuming larger meals later in the day [11]. 

Further examination of the energy, macronutrient content and the form of breakfast indicates that breakfast meals containing a larger amount of energy (≥350 kcal/meal), protein (≥30 g protein/meal) and provided as solid foods increased the magnitude of the appetite and satiety response compared with breakfast skipping [3]. 

Breakfast habits

In addition, habitual breakfast patterns can also be an important moderating factor if left unaddressed. Breakfast consumers reported greater hunger and lower fullness during breakfast skipping compared with when the breakfast skippers continued to skip [12].

Although these data are from a single study and have not been replicated in the literature, this work suggests a need to consider breakfast habits when determining the appetitive effects of breakfast.

It’s also been demonstrated that individuals with the most substantial change in their breakfast habits lost the greatest weight over 3 months, lending further support for the potential moderation of breakfast effects by habitual dietary behaviors [13].

In summary, the majority of studies reported improvements in appetite control and satiety indexes after the consumption of breakfast compared with skipping breakfast.

Energy Expenditure

How does eating vs. skipping breakfast influence energy expenditure? 

Of course, a key component of energy balance and weight management includes energy expenditure, and when compared with skipping breakfast, the addition of breakfast increased postprandial (after eating) energy expenditure in most of the research. 

When extrapolated across 24 hours; the increase in postprandial energy expenditure after breakfast intake ranged from 40 to 200 kcal/day and varied according to breakfast composition [7].  

Whether breakfast meals containing higher quantities of protein result in increased energy expenditure compared with skipping breakfast has not really been investigated.

Most research to date showed greater postprandial (after eating) energy expenditure after the consumption of a higher-protein breakfast compared with breakfast skipping or compared with a normal-protein breakfast [14-17].

Limitations of these studies include the composition and type of breakfasts. Most of the studies used only protein and were beverage breakfasts. Therefore, the current evidence is only supportive of beverage breakfasts composed of protein. There is definitely more work that needs to occur in this area.

Breakfast: association with overweight, obesity and fat loss

It’s clear that the consumption of breakfast has a positive role on satiety, but what is its effect on people that are overweight?

A very recent study examined the association between breakfast consumption and overweight/obesity in university students. A limitation is this study is that only used questionnaires were uses and they also assessed body mass index (BMI). They found that eating breakfast reduced the odds of obesity in these university students [18].  

A study published in 2014 evaluated the effects of 2 low-calorie diets but with different distributions of calories throughout the day on weight loss and other major obesity-related metabolic parameters.

They randomly assigned participants into two groups that underwent a 3 month individualized Mediterranean-style diet.

The difference in the groups was the amount of energy consumed earlier in the day compared to the rest of the day.

  • Group 1 was: 70% breakfast, morning snack, lunch and 30% afternoon snack and dinner
  • Group 2 was: 55% breakfast, morning snack, lunch and 45% afternoon snack and dinner).

Dual-energy X-ray absorptiometry was used for pre- and post-intervention to assess body composition, and what they found was exciting. 

Both groups had significant improvements in body composition and metabolic parameters, but group 1 had enhanced results for weight loss, waist circumference reduction, and fat mass loss.

Improvements were detected in both groups for blood pressure and blood and lipid parameters. Group 1 participants demonstrated enhanced insulin sensitivity [11].

In conclusion, this investigation showed that it’s better to consume the majority of your calories earlier in the day.

Summary

It’s clear from the current body of evidence that having breakfast with ≥30g protein is ideal for appetite control, satiety and is effective strategy to prevent overeating throughout the day.

In addition; consuming breakfast helps with losing weight and fat mass.

The important point here is the composition of the breakfast. The data points to the benefits of having protein in your breakfast. Another words, just having pancakes or waffles hasn’t been shown to have the same effect as breakfast with protein.

Further investigation of breakfast consumption utilizing longer-term interventions accounting for study duration, meal composition and size, and habitual breakfast behaviors is required to determine the beneficial effects of breakfast to promote health.

Although most of the research has looked at the potential of breakfast influencing fat/weight loss and satiety; there is no doubt that having a solid breakfast with quality protein will aid in your quest to gain lean tissue.

Most of us come off a 6-8 hour fast from sleeping so kick starting you day and metabolism with a proper breakfast including protein will also refill the amino acid pool and begin to drive protein synthesis.

If you are an early morning exerciser, I recommend fast acting pre/post carb/protein and then a solid food breakfast within 30-60 minutes following your workout.  

 

References: 

1. Pham, J. and D. Pelletier, Action-Oriented Population Nutrition Research: High Demand but Limited Supply. Glob Health Sci Pract, 2015. 3(2): p. 287-99.

2. Odegaard, A.O., et al., Breakfast frequency and development of metabolic risk. Diabetes Care, 2013. 36(10): p. 3100-6.

3. Leidy, H.J., et al., Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, "breakfast-skipping," late-adolescent girls. Am J Clin Nutr, 2013. 97(4): p. 677-88.

4. Brown, A.W., M.M. Bohan Brown, and D.B. Allison, Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr, 2013. 98(5): p. 1298-308.

5. NPD Group, I., U.S. consumers love their breakfasts and morning snacks whether in- or away-from-home. 2016.

6. Leidy, H.J., et al., Evaluating the Intervention-Based Evidence Surrounding the Causal Role of Breakfast on Markers of Weight Management, with Specific Focus on Breakfast Composition and Size. Adv Nutr, 2016. 7(3): p. 563S-75S.

7. Gwin, J.A. and H.J. Leidy, A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management. Adv Nutr, 2018. 9(6): p. 717-725.

8. Leidy, H.J., et al., The role of protein in weight loss and maintenance. Am J Clin Nutr, 2015. 101(6): p. 1320S-1329S.

9. de Graaf, C., et al., Short-term effects of different amounts of protein, fats, and carbohydrates on satiety. Am J Clin Nutr, 1992. 55(1): p. 33-8.

10. Leidy, H.J. and E.M. Racki, The addition of a protein-rich breakfast and its effects on acute appetite control and food intake in 'breakfast-skipping' adolescents. Int J Obes (Lond), 2010. 34(7): p. 1125-33.

11. Lombardo, M., et al., Morning meal more efficient for fat loss in a 3-month lifestyle intervention. J Am Coll Nutr, 2014. 33(3): p. 198-205.

12. Thomas, E.A., et al., Usual breakfast eating habits affect response to breakfast skipping in overweight women. Obesity (Silver Spring), 2015. 23(4): p. 750-9.

13. Schlundt, D.G., et al., The role of breakfast in the treatment of obesity: a randomized clinical trial. Am J Clin Nutr, 1992. 55(3): p. 645-51.

14. Neumann, B.L., et al., Breakfast Macronutrient Composition Influences Thermic Effect of Feeding and Fat Oxidation in Young Women Who Habitually Skip Breakfast. Nutrients, 2016. 8(8).

15. Karst, H., et al., Diet-induced thermogenesis in man: thermic effects of single proteins, carbohydrates and fats depending on their energy amount. Ann Nutr Metab, 1984. 28(4): p. 245-52.

16. Kobayashi, F., et al., Effect of breakfast skipping on diurnal variation of energy metabolism and blood glucose. Obes Res Clin Pract, 2014. 8(3): p. e201-98.

17. Nair, K.S., D. Halliday, and J.S. Garrow, Thermic response to isoenergetic protein, carbohydrate or fat meals in lean and obese subjects. Clin Sci (Lond), 1983. 65(3): p. 307-12.

18. Mansouri, M., et al., Breakfast consumption pattern and its association with overweight and obesity among university students: a population-based study. Eat Weight Disord, 2020. 25(2): p. 379-387.

 

Dr. Paul Henning

About Dr. Paul

I'm currently an Army officer on active duty with over 15 years of experience and also run my own health and wellness business. The majority of my career in the military has focused on enhancing Warfighter health and performance. I am passionate about helping people enhance all aspects of their lives through health and wellness. Learn more about me