How Important Is Breakfast for Overall Health?

By Dr. Liji Thomas, MDReviewed by Danielle Ellis, B.Sc.

Why is breakfast considered important?
Research insights on breakfast and health
Breakfast and resting metabolic rate
Breakfast’s role in cardiometabolic health
Skipping breakfast and disease risks
Breakfast and cognitive function
Conclusions 
References
Further reading

Popular media often refers to breakfast as the most important meal of the day. Apart from being an essential meal for optimizing one’s nutrition profile, it has been implicated in weight regulation, cardiometabolic risk, and cognitive performance in recent years.

However, the evidence for the health benefits of eating breakfast is inconclusive. Significant variations in study methodology, nutritional analysis, and diet quality assessment techniques weaken the strength of the conclusions of most studies that sought to compare health outcomes in breakfast consumers vs non-consumers.

Why is breakfast considered important?

The importance of breakfast depends on the need it fulfills as well as its long-term metabolic impact, if any. For those who wake up hungry, breakfast is obviously essential, as it is for those who aim for high physical performance in the morning. However, viewed against long-term health outcomes, consistent breakfast routines assume a different significance.¹

Research insights on breakfast and health

Some evidence suggests that eating or skipping a high-carbohydrate breakfast does not impact energy intake under laboratory conditions. However, another study by the same group showed a mean decrease in daily energy intake among non-consumers who eat breakfast versus consumption of an ad-lib breakfast.¹

When stratified by body weight, lean non-consumers lost weight, mostly fat, while lean consumers maintained their weight. Obese individuals maintained their total energy intake irrespective of whether they consumed breakfast or not.¹

Such people might eat more than usual in subsequent snacks and meals, or they might have different eating patterns when exposed to food compared to normal-weight individuals.¹

Breakfast and resting metabolic rate

Resting metabolic rate (RMR) is the major contributor to total energy expenditure, decreasing during starvation and with energy intake deficits. Multiple studies indicate that skipping breakfast does not directly impact the RMR. However, a long-term deficit in energy intake may result in significant weight loss, indirectly lowering the RMR.¹

Therefore, evidence universally shows that consistently extending the overnight fast by skipping breakfast does not directly affect resting metabolic rate, outside of the effect observed when weight loss results from energy intake decreasing over a long period.

Breakfast’s role in cardiometabolic health

Many studies suggest that breakfast consumption improves the cardiometabolic risk profile.¹ Having breakfast is likely to be a proxy factor for a healthy lifestyle rather than an independent protective factor against disease.^1,9,11

Intermittent fasting (IF) is widely promoted as a healthy meal pattern. When considered as part of IF, skipping breakfast is associated with weight loss, probably mediated by improved insulin sensitivity and glycemic control.^15,18 Such conclusions need to be buttressed by larger longitudinal studies.

Skipping breakfast and disease risks

Conflicting findings have been reported for health outcomes in those who skip breakfast. Some meta-analyses indicate significant weight loss^14,15 despite a rise in low-density lipoprotein cholesterol (LDL-C).¹⁴ Others suggest that among older adults, skipping breakfast increases mortality risk compared to a high-fiber breakfast, but based on poor-quality evidence.¹⁶ 

Again, some low-quality evidence indicates the negative impact of skipping breakfast on physiological alignment with Circadian rhythms, insulin resistance, stress hormone levels, and glycemic control.¹⁴ However, few trials have directly compared morning vs evening meals for effects on weight loss and energy expenditure, and more recent studies refute these conclusions, with RCT meta-analyses showing no significant effect on cardiometabolic risk other than a possible short-term rise in LDL-C.¹⁹

In contrast, several fasting studies indicated the beneficial impact of skipping breakfast on weight loss, total and abdominal fat, glycemic control, and increased insulin sensitivity.^4,17

Some studies suggested a higher risk of heart failure, obesity, hypertension, as well as metabolic syndrome among people who skip breakfast. This evidence is weak, and importantly, the association of breakfast with a healthy lifestyle likely confounds these associations, indicating the difficulty of producing guidelines based on such findings.⁸

Breakfast and cognitive function

A meta-analysis showed improved cognitive function to be associated with regular breakfast intake, particularly short-term benefits on attention, memory, and executive function. Among children, a healthy breakfast is suggested to result in better engagement with school.²⁰

Skipping breakfast may increase the risk of attention-deficit hyperactivity disorder and major depression while linked to reduced cognitive function and frailty.¹² However, too few studies exist for firm conclusions to be drawn.¹

Conclusions

Skipping breakfast as part of extended fasting helps induce an overall calorie deficit, weight loss, and improved glycemic regulation that lowers cardiometabolic risk, especially among obese or overweight individuals.

Given that available evidence suggests no notable health risks associated with consuming or skipping breakfast, breakfast consumption should be regarded as a lifestyle choice dictated by individual preferences and the expected long-term impact on health.

While there is no conclusive evidence that breakfast is indeed the most important meal of the day, when consumed, it should comprise health-promoting functional foods like eggs, whole grains, fruits, nuts and whole dairy, eggs, coffee, and tea.⁶

References

• Betts JA, Chowdhury EA, Gonzalez JT. (2016) Is breakfast the most important meal of the day? PNS. doi: 10.1017/S0029665116000318 .
• Ruddick-Collins LC, Johnston JD, Morgan PJ, et al. (2018) The Big Breakfast Study: Chrono-nutrition influence on energy expenditure and body weight. Nutr Bull. doi:10.1111/nbu.12323.
• Jakubowicz D, Wainstein J, Landau Z, et al. (2017) Influences of Breakfast on Clock Gene Expression and Postprandial Glycemia in Healthy Individuals and Individuals With Diabetes: A Randomized Clinical Trial. Diabetes Care. doi: 10.2337/dc16-2753.
• Sutton EF, Beyl R, Early KS, et al. (2018) Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab. doi: 10.1016/j.cmet.2018.04.010.
• Leidy HJ, Gwin JA, Roenfeldt CA, et al. (2016) 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. doi:10.3945/an.115.010223.
• Santos, H., O., and Tinsley, G. M. (2023). Is breakfast consumption detrimental, unnecessary, or an opportunity for health promotion? A review of cardiometabolic outcomes and functional food choices. Diabetes/Metabolism Research and Reviews. doi: 10.1002/dmrr.3684.
• Gibney, M. J., Barr, S. I., Bellisle, F., et al. (2018). Breakfast in Human Nutrition: The International Breakfast Research Initiative. Nutrients. Doi: https://doi.org/10.3390/nu10050559. https://pmc.ncbi.nlm.nih.gov/articles/PMC5986439/.
• Ofori-Asenso, R., Owen, A. J., and Liew, D. (2019). Skipping Breakfast and the Risk of Cardiovascular Disease and Death: A Systematic Review of Prospective Cohort Studies in Primary Prevention Settings. doi: https://doi.org/10.3390/jcdd6030030. https://pmc.ncbi.nlm.nih.gov/articles/PMC6787634 .
• Lv, L., Guo, Y., Zheng, Z., et al. (2024). Blood metabolites mediate effects of breakfast skipping on heart failure via Mendelian randomization analysis. Scientific Reports. doi: https://doi.org/10.1038/s41598-024-69874-7. https://www.nature.com/articles/s41598-024-69874-7.
• Chen, H., Zhang, B., Ge, Y., et al. (2020). Association between skipping breakfast and risk of cardiovascular disease and all cause mortality: A meta-analysis. Clinical Nutrition. doi: https://doi.org/10.1016/j.clnu.2020.02.004. https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30052-2/abstract.
• Reeves, S., Halsey, L. G., McMeel, Y., et al. (2013). Breakfast habits, beliefs and measures of health and wellbeing in a nationally representative UK sample. Appetite. doi: https://doi.org/10.1016/j.appet.2012.09.024. https://pubmed.ncbi.nlm.nih.gov/23032303/.
• Zhang, Z., Tan, J., and Luo, Q. (2024). Associations between breakfast skipping and outcomes in neuropsychiatric disorders, cognitive performance, and frailty: a Mendelian randomization study. doi: https://doi.org/10.1186/s12888-024-05723-1. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05723-1.
• Svendsen, M., and Forslund, H. B. (2023). Meal patterns, including intermittent fasting – a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research. doi: https://doi.org/10.29219/fnr.v68.10505. https://pmc.ncbi.nlm.nih.gov/articles/PMC10870972/.
• Yu, J., Xia, J., Xu, D., et al. (2023). Effect of skipping breakfast on cardiovascular risk factors: a grade-assessed systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. Frontiers in Endocrinology. doi: https://doi.org/10.3389/fendo.2023.1256899. https://pmc.ncbi.nlm.nih.gov/articles/PMC10715426/.
• Welton, S., Minty, R., O’Driscoll, T., et al. (2020). Intermittent fasting and weight loss: Systematic review. Canadian Family Physician. https://pubmed.ncbi.nlm.nih.gov/32060194/.
• King, D. E., and Xiang, J. (2021). A Relationship Between Mortality and Eating Breakfast and Fiber. JABFM. doi: https://doi.org/10.3122/jabfm.2021.04.210044. https://www.jabfm.org/content/34/4/678.long.
• Margina, D., Ungurianu, A., Purdel, C., et al. (2020). Chronic Inflammation in the Context of Everyday Life: Dietary Changes as Mitigating Factors. IJERPH. doi: https://doi.org/10.3390/ijerph17114135. https://www.mdpi.com/1660-4601/17/11/4135.
• Sievert, K., Hussain, S. M., Page, M. J., et al. (2019). Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ. doi: 10.1136/bmj.l42. https://pubmed.ncbi.nlm.nih.gov/30700403/.
• Bonnet, J. P., Cardel, M. I., Cellini, J., et al. (2020). Breakfast Skipping, Body Composition, and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Randomized Trials. Obesity. doi: 10.1002/oby.22791. https://pubmed.ncbi.nlm.nih.gov/32304359/.
• Moller, H., Sincovich, A., Gregory, T., et al. (2021). Breakfast skipping and cognitive and emotional engagement at school: a cross-sectional population-level study. Public Health Nutrition. doi: https://doi.org/10.1017/S1368980021004870. https://pmc.ncbi.nlm.nih.gov/articles/PMC9991782.

Further Reading

• All Nutrition Content
• The Role of Nutrition in Health
• What Are the Positive Health Effects of Eating Meat?
• What Are the Negative Health Effects of Eating Meat?
• Macrominerals and Trace Minerals in the Diet