Breakfast Consumption versus Breakfast Skipping: The Effect on Nutrient Intake, Weight, and Cognition

Carol E. O’Neil and Theresa A. Nicklas

Foods consumed at the breakfast meal are culturally different, but to most individuals, when they hear the local word for “breakfast,” it is understood what is meant. However, for researchers, nutrition educators, and nutrition policy makers there is no standard definition of breakfast, breakfast consumers, or breakfast skippers. This hinders interpretation of individual articles and makes it difficult to compare the literature. It has also led to conflicting results, compounding the difficulty for educators and policy makers to make recommendations for what to consume at breakfast. 

Breakfast has also been heralded as the “most important meal of the day,” not only because it is for most people the first major eating episode after the longest period without eating, but because it has been championed as a meal that contributes significantly to nutrient intake, can be used to lose weight or maintain a weight loss, and improve cognition and school performance in children. But is it the most important meal? There are two considerations here – what does “important” mean? Again, there is no definition. Further, how does the contribution of the breakfast meal to nutrient intake, weight management, or cognition compare with other meals and snacks? Breakfast has been intensively studied – lunch, dinner, and snacks, less so. 

How breakfast consumption or breakfast skipping is defined influences the results of studies. In general, nutrient intake and diet quality is better if breakfast is consumed. Weight and weight management also depends on the type of breakfast consumed. It has been demonstrated clearly that the type of breakfast consumed affects nutrient intake, diet quality, and weight; therefore, a simple definition of “breakfast” does not significantly add to the literature. Less well defined is the role breakfast plays in the cognition of students. Although accepted as fact, results evaluating acute and chronic consumption of breakfast and cognition are equivocal. Systematic reviews and one carefully conducted clinical trial have suggested that there is no association between consumption of breakfast and cognition in school-age children. 

More carefully controlled studies that use a standardized definition of breakfast consumption and breakfast skipping are needed to determine the effects of nutrient intake, health parameters, and academic performance. In addition, equivalent studies of the lunch and dinner meals are also needed, before it can be determined if “breakfast is the most important meal of the day.”

Suggested Reading
  • Adolphus K, Bellissimo N, Lawton CL, et al: Methodological challenges in studies examining the effects of breakfast on cognitive performance and appetite in children and adolescents. Adv Nutr 2017;8:184S–196S.
  • Adolphus K, Lawton CL, Champ CL, et al: The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Adv Nutr 2016;7:590S–612S.
  • Adolphus K, Lawton CL, Dye L: The effects of breakfast on behavior and academic performance in children and adolescents. Front Hum Neurosci 2013;7:425.
  • Betts JA, Chowdhury EA, Gonzalez JT, et al: Is breakfast the most important meal of the day? Proc Nutr Soc 2016;75:464–474.
  • Brown AW, Bohan Brown MM, Allison DB: 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;98:1298–1308.
  • Cho S, Dietrich M, Brown CJ, et al: The effect of breakfast type on total daily energy intake and body mass index: results from the Third National Health and Nutrition Examination Survey (NHANES III). J Am Coll Nutr 2003;22:296–302.
  • Crossman A, Anne Sullivan D, Benin M: The family environment and American adolescents’ risk of obesity as young adults. Soc Sci Med 2006;63:2255–2267.
  • Deshmukh-Taskar PR, Nicklas TA, O’Neil CE, et al: The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999–2006. J Am Diet Assoc 2010;110:869–878.
  • Dhurandhar EJ, Dawson J, Alcorn A, et al: The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. Am J Clin Nutr 2014;100:507–513.
  • Dietary Guidelines for Americans 2010. https://health.gov/dietaryguidelines/dga2010/ dietaryguidelines2010.pdf (accessed February 10, 2018).
  • Dietary Guidelines Advisory Committee Report 2015–2020. https://health.gov/ dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015Dietary-Guidelines-Advisory-Committee.pdf (accessed February 10, 2018).
  • Dietary Guidelines for Americans 2015–2020. https://health.gov/dietaryguidelines/2015/ guidelines (accessed February 10, 2018).
  • Edefonti V, Rosato V, Parpinel M, et al: The effect of breakfast composition and energy contribution on cognitive and academic performance: a systematic review. Am J Clin Nutr 2014;100:626–656.
  • Frank GC: Breakfast: what does it mean? Am J Lifestyle Med 2009;3:160–163.
  • Giovannini M, Verduci E, Scaglioni S, et al: Breakfast: a good habit, not a repetitive custom. J Int Med Res 2008;36:613–624.
  • Hoyland A, Dye L, Lawton CL: A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 2009;22:220–243.
  • Iovino I, Stuff J, Liu Y, et al: Breakfast consumption has no effect on neuropsychological functioning in children: a repeated-measures clinical trial. Am J Clin Nutr 2016;104:715–721.
  • Kerver JM, Yang EJ, Obayashi S, et al: Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 2006;106:46–53.
  • Nicklas TA, Reger C, Myers L, et al: Breakfast consumption with and without vitamin-mineral supplement use favorably impacts daily nutrient intake of ninth-grade students. J Adolesc Health 2000;27:314–321.
  • Nooyens AC, Visscher TL, Schuit AJ, et al: Effects of retirement on lifestyle in relation to changes in weight and waist circumference in Dutch men: a prospective study. Public Health Nutr 2005;8:1266–1274.
  • O’Neil CE, Byrd-Bredbenner C, Hayes D, et al: The role of breakfast in health: definition and criteria for a quality breakfast. J Acad Nutr Diet 2014;114(12 suppl):S8–S26.
  • O’Neil CE, Nicklas TA, Fulgoni VL 3rd: Nutrient intake, diet quality, and weight/adiposity parameters in breakfast patterns compared with no breakfast in adults: National Health and Nutrition Examination Survey 2001–2008. J Acad Nutr Diet 2014;114(12 suppl):S27–S43.
  • O’Neil CE, Nicklas TA, Fulgoni VL 3rd: Nutrient intake, diet quality, and weight measures in breakfast patterns consumed by children compared with breakfast skippers (NHANES) 2001–2008. AIMS Public Health 2015;2:441–468.
  • O’Neil CE, Zanovec M, Nicklas TA, et al: Pre-sweetened and non-pre-sweetened readyto-eat cereals at breakfast are associated with improved nutrient intake but not with increased body weight of children and adolescents: NHANES 1999–2002. Am J Life Med 2012;6:63–74.
  • Priebe MG, McMonagle JR: Effects of ready-to-eat-cereals on key nutritional and health outcomes: a systematic review. PLoS One 2016;11:e0164931.
  • Rampersaud GC, Pereira MA, Girard BL, et al: Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 2005;105:743–760.
  • School Breakfast Program. https://www.ers.usda.gov/topics/food-nutrition-assistance/ child-nutrition-programs/school-breakfast-program (accessed February 10, 2018).
  • United States Department of Agriculture/Agricultural Research Service: What We Eat in America. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-humannutrition-research-center/food-surveys-research-group/docs/wweia-data-tables (accessed February 10, 2018).
  • Wyatt HR, Grunwald GK, Mosca CL, et al: Long-term weight loss and breakfast in subjects in the National Weight Control Registry. Obes Res 2002;10:78–82.