Breakfast cereal and other ingredients in a wooden box. Picture: ISTOCK
Breakfast cereal and other ingredients in a wooden box. Picture: ISTOCK

Nutrition experts regularly say you should “eat breakfast like a king, lunch like a prince and dinner like a pauper”. Parents also regularly tell their offspring that breakfast is “the most important meal of the day”.

Now Australian researchers at Monash University School of Public Health are challenging that conventional “wisdom”, more so if you need to lose weight.

In a study published in The BMJ (British Medical Journal), the Monash scientists say that breakfast might not be a good strategy for weight loss, regardless of your established breakfast habits.

“Caution is needed when recommending breakfast for weight loss in adults as it could have the opposite effect,” they say.

The study is a systematic review and meta-analysis of randomised controlled trials investigating the effect of breakfast on weight and energy intake. (Randomised controlled trials remain the “gold standard” of scientific research.)

The authors acknowledge study limitations, saying the quality of included studies was mostly low, thus, the findings “should be interpreted with caution”.

Still, the researchers clearly believe the foundation on which experts have built the belief in breakfast as king is shaky — and not just for slimmers.

Their review also builds on other research undermining the critical importance of breakfast in health in general. In a randomised controlled trial reported in The American Journal of Clinical Nutrition in 2016, UK scientists said their data did not support a “common conception” that breakfast facilitates weight management by “kick-starting metabolism”.

The lead author of that study was Bath University’s James Betts, an expert in nutrition, metabolism and statistics. Betts said at the time that the belief in breakfast as the most important meal of the day “is so widespread that many people are surprised to learn that there is a lack of scientific evidence showing if or how breakfast may directly cause health changes”.

The study allowed the researchers to find out whether breakfast is “a cause, effect or simply a marker of good health”, Betts said. The authors concluded in favour of a marker. In other words, while some evidence suggests that regular breakfast-eaters tend to be slimmer and healthier, they also typically follow most other recommendations for a healthy lifestyle, including eating healthily and doing more exercise.

SA public health messages are still premised on the belief in breakfast as vital for health and weight loss, as the National Nutrition Week and National Obesity Week in October 2018 showed. During that time, a coalition including national and provincial departments of health, the Association for Dietetics in SA (Adsa), the Nutrition Society of SA and the Heart and Stroke Foundation SA vigorously promoted the message that “breakfast is the best way to start the day”.

Adsa said a “host of studies” show that people with a “healthy breakfast habit have better weight outcomes than those that skip”. And that all South Africans need information to make a “healthy breakfast a happy, lifetime habit”.

Other experts say the importance of breakfast is a myth that the cereal industry started decades ago and perpetuates to this day.

Tim Spector, head of genetic epidemiology at King’s College London, had this to say in an opinion piece in The BMJ on the Monash study: We have been “bombarded with messages extolling the health benefits of various processed cereals and porridge oats” over the past 50 years. We’ve been told that breakfast “helps our metabolism and that skipping it will make us much hungrier so we’ll overeat and put on weight”.

“These are not just old wives’ tales,” Spector said. They are clearly laid out in current Public Health England and National Health Service (NHS) guidelines that an expert scientific panel prepared with input from the food industry.

These tales are mirrored in other national guidelines (including SA’s), the media and websites globally, he said.

Spector raised the question: “What if this is just another diet myth?”, and proceeded to answer it.

He said one reason for enduring breakfast myths is a mindset “ingrained in nutritional dogma”. Nutrition experts have relied on observational studies flawed by bias. (Observational studies only show association, not causation.)

Several randomised controlled trials have debunked the disadvantages of skipping breakfast. The Monash study adds to “reasonable evidence” suggesting that skipping breakfast could be a useful weight-loss strategy, he said.

A common argument of the pro-breakfast lobby is that as well as reducing obesity, breakfast is essential for children’s mental well-being, even if they are generally well-nourished, Spector said.

“Again, the evidence is weak, largely observational and likely to be biased in the same way as for adults.”

He isn’t saying we should all skip breakfast or that the Monash research means all overweight people would benefit from skipping breakfast.

“Some people are programmed to prefer eating food earlier in the day and others later, which might suit [their] unique metabolism,” Spector said.

There is no “one-size-fits-all” message about breakfast. However, prescriptive, slow-moving diet guidelines filled with erroneous information look “increasingly counterproductive and detract from important public health messages”.

While waiting for guidelines to change, you’ll do yourself no harm by conducting your own personal experiments in skipping breakfast, Spector said.