A study published last month demonstrated that patients who skip out on the morning meal are more likely to be deficient in specific nutrients. In this article, I’ll share what those nutrients are, why patients who skip breakfast may be more likely to have suboptimal levels of those nutrients, and other reasons why it’s critical that we, as practitioners, encourage our patients to start the day with a substantial breakfast.
What does the research actually say about the effects of skipping breakfast on adults’ nutrient status?
A study out of Ohio State University that analyzed the diets of 30,889 Americans found that adults who skipped breakfast were likely to be low on the following nutrients for the entire day: folate, calcium, iron, and vitamins A, B1, B2, B3, C, and D. [1]
The study authors suggested that these potential nutrient deficiencies and insufficiencies are likely because these nutrients are abundant in the foods that Americans culturally consider to be “breakfast foods.” Researchers further explained that those who missed out on these nutrients at breakfast seldom made up for their lack at later meals.
This study also demonstrated that adults who skipped breakfast were significantly more likely to consume more calories, more carbohydrates, more total and saturated fat, and more added sugars during lunch, dinner, and snacks, specifically when compared to those who did actually eat breakfast on a given day.
The diets of “breakfast skippers” tended to be of significantly poorer quality when compared to the diets of those who did consume breakfast on a regular basis.
Does skipping breakfast have any health effects in children?
The results of the study I just shared are reminiscent of an earlier study conducted on two groups of children—two- to five-year-olds and six- to twelve-year-olds. This study concluded that children who skipped breakfast were less likely to consume adequate amounts of various nutrients, including calcium, iron, folate, and fiber. [2]
In contrast to adult breakfast skippers, this study found that children who skipped breakfast were likely to consume fewer calories throughout the day, although they consumed more calories at non-breakfast meals and snacks when compared to their breakfast-eating peers.
Furthermore, children who skipped breakfast tended to have worse overall diet quality scores and worse fruit-, whole fruit-, whole grains-, dairy-, and empty calorie subscale scores.
What other benefits are associated with eating breakfast everyday?
We know from a previous study that habitually consuming breakfast is associated with decreased risk for multiple chronic diseases, including coronary artery disease, metabolic syndrome, diabetes, and chronic kidney disease. [3-15]
Breakfast skipping is particularly disruptive to optimal blood sugar control, as it leads to more significant post-prandial blood sugar spikes after other meals. On the other hand, eating a substantial breakfast each day is associated with increased insulin sensitivity and better balanced blood sugar levels overall.
Summary
In conclusion, recent research demonstrates that adults who skip breakfast are at increased risk for inadequate intakes of folate, calcium, iron, and vitamins A, B1, B2, B3, C, and D. They’re also more likely to consume too many calories, carbohydrates, added sugars, and saturated and total fat. Breakfast skipping in children was associated with increased risk of inadequate nutrient intake as well as an increased likelihood of having a poorer diet overall, when compared to consistent breakfast eating.
In addition to increased potential for nutrient deficiencies, skipping breakfast has also been associated with increased risk for insulin resistance and poor blood sugar control, as well as other chronic health concerns.
As providers it’s in our patients’ best interests for us to talk with them about their diets (even if we’re not nutritionists or dieticians). Prioritizing consistent breakfast intake is a simple action that we can recommend to our patients and by which we can help reduce the overall burden of chronic disease in our country.
[1] Fanelli, S., Walls, C., & Taylor, C. (2021). Skipping breakfast is associated with nutrient gaps and poorer diet quality among adults in the United States. Proceedings of the Nutrition Society, 80(OCE1), E48. doi:10.1017/S0029665121000495
[2] Ramsay, S. A., Bloch, T. D., Marriage, B., Shriver, L. H., Spees, C. K., & Taylor, C. A. (2018). Skipping breakfast is associated with lower diet quality in young US children. European journal of clinical nutrition, 72(4), 548–556. https://doi.org/10.1038/s41430-018-0084-3
[3] St-Onge, M. P., Ard, J., Baskin, M. L., Chiuve, S. E., Johnson, H. M., Kris-Etherton, P., Varady, K., & American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council (2017). Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association. Circulation, 135(9), e96–e121. https://doi.org/10.1161/CIR.0000000000000476
[4] Cahill, L. E., Chiuve, S. E., Mekary, R. A., Jensen, M. K., Flint, A. J., Hu, F. B., & Rimm, E. B. (2013). Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals. Circulation, 128(4), 337–343. https://doi.org/10.1161/CIRCULATIONAHA.113.001474
[5] Odegaard, A. O., Jacobs, D. R., Jr, Steffen, L. M., Van Horn, L., Ludwig, D. S., & Pereira, M. A. (2013). Breakfast frequency and development of metabolic risk. Diabetes care, 36(10), 3100–3106. https://doi.org/10.2337/dc13-0316
[6] Smith, K. J., Blizzard, L., McNaughton, S. A., Gall, S. L., Dwyer, T., & Venn, A. J. (2012). Daily eating frequency and cardiometabolic risk factors in young Australian adults: cross-sectional analyses. The British journal of nutrition, 108(6), 1086–1094. https://doi.org/10.1017/S0007114511006398
[7] Ballon, A., Neuenschwander, M., & Schlesinger, S. (2019). Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. The Journal of nutrition, 149(1), 106–113. https://doi.org/10.1093/jn/nxy194
[8] Uemura, M., Yatsuya, H., Hilawe, E. H., Li, Y., Wang, C., Chiang, C., Otsuka, R., Toyoshima, H., Tamakoshi, K., & Aoyama, A. (2015). Breakfast Skipping is Positively Associated With Incidence of Type 2 Diabetes Mellitus: Evidence From the Aichi Workers' Cohort Study. Journal of epidemiology, 25(5), 351–358. https://doi.org/10.2188/jea.JE20140109
[9] Ha, K., & Song, Y. (2019). Associations of Meal Timing and Frequency with Obesity and Metabolic Syndrome among Korean Adults. Nutrients, 11(10), 2437. https://doi.org/10.3390/nu11102437
[10] Jung, C. H., Lee, J. S., Ahn, H. J., Choi, J. S., Noh, M. Y., Lee, J. J., Lee, E. Y., Lim, J. H., Lee, Y. R., Yoon, S. Y., Kim, C. H., Cho, D. H., Choi, Y. S., & Choi, K. M. (2017). Association of meal frequency with metabolic syndrome in Korean adults: from the Korea National Health and Nutrition Examination Survey (KNHANES). Diabetology & metabolic syndrome, 9, 77. https://doi.org/10.1186/s13098-017-0277-2
[11] Drummond, S. E., Crombie, N. E., Cursiter, M. C., & Kirk, T. R. (1998). Evidence that eating frequency is inversely related to body weight status in male, but not female, non-obese adults reporting valid dietary intakes. International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 22(2), 105–112. https://doi.org/10.1038/sj.ijo.0800552
[12] Headland, M., Clifton, P. M., Carter, S., & Keogh, J. B. (2016). Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Intermittent Energy Restriction Trials Lasting a Minimum of 6 Months. Nutrients, 8(6), 354. https://doi.org/10.3390/nu8060354
[13] Holmbäck, I., Ericson, U., Gullberg, B., & Wirfält, E. (2010). A high eating frequency is associated with an overall healthy lifestyle in middle-aged men and women and reduced likelihood of general and central obesity in men. The British journal of nutrition, 104(7), 1065–1073. https://doi.org/10.1017/S0007114510001753
[14] Horne, B. D., Muhlestein, J. B., & Anderson, J. L. (2015). Health effects of intermittent fasting: hormesis or harm? A systematic review. The American journal of clinical nutrition, 102(2), 464–470. https://doi.org/10.3945/ajcn.115.109553
[15] Trepanowski, J. F., Kroeger, C. M., Barnosky, A., Klempel, M. C., Bhutani, S., Hoddy, K. K., Gabel, K., Freels, S., Rigdon, J., Rood, J., Ravussin, E., & Varady, K. A. (2017). Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial. JAMA internal medicine, 177(7), 930–938. https://doi.org/10.1001/jamainternmed.2017.0936