Monday, December 08, 2014

Asking if a Bad Breakfast is Better than No Breakfast is the Wrong Question

Strangely, breakfast is a source of great contention.

There's the camp that says breakfast is the most important meal of the day (be it for weight, health, attention, etc.), and then there's the gleefully contrarian camp that relishes any and every opportunity to "bust the myth" of breakfast as being beneficial or essential to anything.

Now I don't really have a horse in the breakfast race, though I do have some considerations. Personally, I'm a breakfast eater, and in my clinical experience with thousands of patients, it would seem that for many breakfast plays an important role in satiety and control (a phenomenon which at least associatively appears to be true with the thousands and thousands of the National Weight Control Registry's weight loss masters of who nearly 80% report having breakfast). But I wouldn't say I feel passionately about it. Meaning if there were good evidence for me to stop suggesting and consuming it, I'd have no issue doing so.

But there isn't.

Sure there have been studies on breakfast skipping being no big thing, including this recent teeny tiny one (36 subjects split among 3 groups, 4 weeks duration, and only a 2lb difference in weight) which had more than one highly respected colleague of mine conclusively exclaiming breakfast to be officially dead and done. But here's the thing, in this (and most) breakfast studies, the breakfasts themselves were crap.

The breakfasts that I recommend contain 300-500 calories (with liquid calories only as condiments) and a minimum of 20g of protein. For me and for my patients these sorts of breakfasts, when coupled with organized eating throughout the rest of the day, seem to help a great deal with whole day, and even evening, satiety and control. The study breakfasts? Well they're the usually North American drek - highly processed sugary carbs washed down with liquid calories (milk and/or juice) - breakfasts which wouldn't be expected to help with satiety in the short term, let alone long.

But even thoughtful breakfasts don't help everyone. And go figure, there are lots of different people out there. To suggest that breakfast (or snacking, or any other meal or meal frequency prescription) will suit everyone is ridiculous. For some people certain styles and approaches to eating will be incredibly helpful while for others those same approaches will prove a hinderance.

Why researchers and clinicians seem to be stuck on suggesting there one right way to go is beyond me, but if you are aiming to weigh in conclusively on breakfast, at the very least make sure the breakfast in question isn't a bowl of frickin' Frosted Flakes like in the first arm of that study linked up above.