The People's Perspective on Medicine

Eat Breakfast – Live Longer! Skip Breakfast – Die Faster

Does it matter whether you eat breakfast or run out the door on an empty stomach? A new study suggests that breakfast eaters have less heart disease. Why?

No doubt you have heard the expression, “Eat breakfast like a king, lunch like a prince and dinner like a pauper.” This saying has been attributed to the famous nutritionist and food writer, Adelle Davis (International Journal of Gastronomy and Food Science, July, 2017). She was way ahead of her time, given that she wrote this back in the 1960s when people were being told to avoid eggs and fat and embrace carbs and sugary cereals. We completely agree with Adelle Davis, except we would add that the kind of breakfast people eat makes a big difference. After five decades, science confirms that if you eat breakfast chances are you will live longer.

The New Research Says: Eat Breakfast!

How do you start your day? Do you eat a wholesome breakfast, or do you grab a cup of coffee and dash out the door? New research based on 6,550 American adults found that people who eat breakfast are less likely to die prematurely from cardiovascular disease (Journal of the American College of Cardiology, April, 2019).

This epidemiological study followed participants in the National Health and Nutrition Examination Survey for 17 to 23 years. Here’s a breakdown of breakfast-eating behavior:

• 59% of the volunteers always ate breakfast

• 25% breakfasted occasionally

• 11% rarely consumed breakfast

• 5% never ate breakfast

People who skipped breakfast were 87% more likely to die during the study. These data tell us nothing about the quality of the food people ate for breakfast. While it does NOT establish cause and effect, the link is strong enough to suggest that breakfast should be part of a healthy lifestyle.

Eat Breakfast or Skip Breakfast?

In their own words, the authors concluded:

“In this large prospective study of a nationally representative cohort with 17 to 23 years of follow-up, we found that skipping breakfast was significantly associated with an increased risk of cardiovascular mortality, especially stroke-specific mortality. The association was independent of demographic, socioeconomic, dietary, and lifestyle factors; BMI; and cardiovascular risk factors.”

“To the best of our knowledge, this is the first prospective analysis of skipping breakfast and risk of cardiovascular mortality. Our findings are generally in line with previous studies on the relationship between breakfast eating and CVD [cardiovascular disease] incidence.”

The authors go on to describe other research that confirms their findings. The Health Professionals Follow-Up Study (Circulation, July 23, 2013) reported that men who did not eat breakfast had an elevated risk of heart disease (27% increase) compared to men who ate breakfast. 

A Japanese study involving 82,772 men and women (Stroke, Feb. 2016)  concluded:

“The frequency of breakfast intake was inversely associated with the risk of stroke, especially cerebral hemorrhage in Japanese, suggesting that eating breakfast everyday may be beneficial for the prevention of stroke.”

People who skipped breakfast were at 36% greater risk of a bleeding stroke than those who ate breakfast regularly.

If  You Eat Breakfast, What Should It Contain?

We spoke with Dr. David Ludwig, the principal investigator of a study published in the BMJ (November, 2018). Dr. Ludwig demonstrated that a low-carb diet was more effective for maintaining weight loss. In an interview we conducted with him, he explains why a high-carb breakfast is not very healthy. You can listen to the free podcast by going to this link. Click on the green arrow for streaming audio or download the free mp3 file.

Show 1149: Is Cutting Carbs More Important Than Cutting Calories?

An even more convincing argument for breakfast comes from Justin Sonnenburg, PhD, associate professor in the Department of Microbiology and Immunology at the Stanford School of Medicine and his wife, Erica Sonnenburg, PhD. She is a senior research scientist at the Stanford University School of Medicine in the Department of Microbiology and Immunology, where she studies the role of diet on the human intestinal microbiota. Together, they have written The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-Term Health.

One of the intriguing parts of our interview with the Sonnenburgs came when they described what happens in your digestive tract when you skip breakfast. It turns out that hungry bacteria get impatient for food. They may begin munching on the mucosal lining of your colon. This is not good for your health. Find out what kind of breakfast your intestinal bacteria prefer.

You will want to listen to this fascinating free interview at this link:

Show 1156: How the Microbiota in the Good Gut Takes Care of You

Click on the green arrow above their photo for streaming audio or download the free mp3 file at the bottom of the page.

Do you eat a hearty breakfast or are you a coffee and Danish kind of person? Or do you skip breakfast entirely? Share your breakfast behavior in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Show 1156: How the Microbiota in the Good Gut Takes Care of You
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The trillions of tiny organisms that make up our microbiota have a profound influence on our health. Learn about their care and feeding.

Show 1156: How the Microbiota in the Good Gut Takes Care of You
Citations
  • Rong, S., et al. "Association of Skipping Breakfast With Cardiovascular and All-Cause Mortality," Journal of the American College of Cardiology, April, 2019, DOI: 10.1016/j.jacc.2019.01.065
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I am an educator of adults retired from teaching at a community college for many years but still teaching adults as a volunteer. I worked with adults facing challenges such as those with learning disabilities, physical disabilities, health issues, and learning English as a Second Language (ESL). When working with students with disabilities, I could tell during morning appointments which ones had not eaten breakfast because they couldn’t think clearly or rapidly. The students that consumed sugary pastries were just as foggy-brained as those who didn’t eat anything.

I always told my students that they wouldn’t try to start their cars without fuel in the tank, and they shouldn’t try to do that with their own bodies, either. I could tell when they took my advice because their thinking improved. Among my ESL students who were born in other countries, I never noticed the foggy-brain symptoms of not eating breakfast. Skipping breakfast appeared to be more prevalent among my students born in the United States.

I also have been reading about the benefits of intermittent fasting (14 hour fast). I stopped eating breakfast and lost 8 pounds and have been able to maintain that weight loss. I am not hungry in the morning. The first thing I do is go to the gym and take two fitness classes first, come home and eat around 10-11AM. I may eat a salad, eggs, nuts or some other form of protein. I try to avoid carbs first thing in the morning. It has worked well for me. I am full of energy and never get weak or lightheaded. Before, I would have to force myself to eat something. Since doing this, I have been able to lower my HgAic. I am not diabetic but have a very strong family history.

What time is considered breakfast time? If I have dinner at 7pm and wait until 10am is that considered breakfast OR is it a certain amount of hours after rising in the morning?

In my family we always ate a good breakfast. Later in my life I was shocked that some people do not eat breakfast. I’m 62 years old. During my life I dated three women who always skipped breakfast to avoid gaining weight. I tried repeatedly with each one to convince them that this was very dangerous, and would likely leave them to weak to fight off pneumonia if they ever had a really bad cold or flu. At least two of them were chronically anemic as a result of this. Sadly it happened just as I feared. Sara died at age 46, Rita died at age 54, and Faye died at age 70, all of pneumonia. This is a true story. Ron

When is a meal a breakfast? Is the time important? If I wake at 6 or 7 AM and eat at 10 AM or 11 AM, is that a breakfast ?

If I don’t eat within a hour or two of waking up I get hungry then cranky. People at walk wonder why I get up so early. Part of the reason is the time to fix and eat breakfast even if it just peanut butter toast. It also gives me time to read the comic pages in the newspaper. Always nice to start the day with a laugh or two.

I, like many others, am convinced that fasting 16 hours improves health. I have my last meal before 7pm. In the morning I fast solid food. I no longer have GI distress, no heartburn not belching. I await any confirming studies but for now I feel I am on the right track.

My interpretation of this information is that if someone is used to eating and fueling their body with carbohydrates they will need more carbohydrates soon after arising. If one is fat-fueled the need for food fuel is less because the fat on our body can be burned for the fuel. Carbohydrate heavy diets result in hunger. I will stick with my intermittent fasting and skip breakfast. We shall see in 30 years if this is paying off for me or not. My dad is 98, and I figure I am slated for that kind of longevity as well. I intend to be still fat- fueled at 100, By the way, my dad is a heavy carbohydrate consumer and he needs to eat as soon as he gets out of bed in the morning. What a bondage!

I eat a very nutrition-dense breakfast every day and I am able to get by on two meals with some snacks in between. I am 76 years young and take no prescriptions – just some vitamin supplements. My blood pressure is 122/65 most of the time. I have lots of energy and still work 2- 9 hour days.

I have read many of these comments based on personal opinion and and projection. I would suggest that there are differences in the digestion process using normal statistics called variance. To base conclusions on variances is misleading, and that is what I have observed in several comments. Perfer to follow the research and then do a trial to find if the conclusions apply to me. I will be eating a healthy breakfast and lighter fare the rest of the day.

I’ve read two articles about this study, and there are some glaring issues with the parameters of the study as reported by the writers. First, define ‘breakfast’. Breakfast means ‘breaking your fast’’, so the first meal of the day is breakfast. So what is the timeframe for this study? Whenever you wake up? Within a certain time of waking up? Between specific hours of the day?

Second, what constitutes a breakfast? Eggs? Bagels? Pizza? A chocolate bar, bag of chips, and a soda?

Third, How are the participants reporting this information? Are we talking about self-reporting (because that is notoriously unreliable if you are talking about a scientific study) or is there some observation going on?

I call BS on this. This feels like the 80s all over again when fat was bad, and carbs were good, and obesity/diabetes skyrocketed.

I started skipping breakfast in December. I eat what I want until I’m full. Since then I have lost over 25 pounds. I didn’t take blood pressure pills for a few days and my BP was 127/70. I’m sure my blood sugar levels are better. I eat within a six hour or less period every day. You could call that intermittent fasting. I find I cannot eat as much eating two meals as I was when I was eating three. I’m less hungry than I used to be.

I am a 75-year old female, a diabetic with a great A1C (5.8), and I take no medicine. I have had to eat breakfast nearly all of my life because of what I was told and also because it was easy for me to get low blood sugar. We have tried intermittent fasting because we were doing it anyway from the last meal of the evening to the next day’s waking up–at least 12 hours. We have been increasing that to 16 hours and eating our first meal (of 3) between 11:00am and 12:00noon. I feel fine, no low blood sugar, and I have been losing weight steadily and healthily (8 pounds in three months). I am obese but my husband and friends seriously dispute that even though the numbers confirm it. I apparently don’t look as though I weigh as much as I do (177).

I had a very serious heart condition for which I had life-saving surgery (septal myectomy for hypertrophic cardiomyopathy) in 2013. I still have the disease but removal of the muscular obstruction prolonged my life, and I can now exercise after 20 years of mobility impairment. We have essentially cut out sugar, pasta, bread and gluten. We eat all organic, tons of vegetables, nuts, seeds, organic chicken, pasture-raised organic lamb and lots of wild Alaskan salmon and other seafood. We don’t drink soda or pop, drink filtered water, eat moderate amounts of fruit (most berries). Our diet is exemplary. Sorry for all the words.

The only thing I an say about “not eating breakfast” is that, “it depends.” I have always thought shipping breakfast was a bad idea but it depends on all the other factors and habits.

First in viewing the study results what does this mean:

had hazard ratios of 1.87 (95% confidence interval: 1.14 to 3.04) for cardiovascular mortality and 1.19 (95% confidence interval: 0.99 to 1.42) for all-cause mortality.

Can someone explain this in plain English?

Also I disagree with the findings. I would bet that those who do not eat a healthy breakfast or breakfast at all don’t eat or exercise properly for the rest of the day. In fact there are other studies that indicate that the less you eat the longer you will live. Unless one can directly tie intake or eating habits directly to specific bodily affects then here again we have a conclusion by association situation.

Many people are not hungry immediately after arising, but allowing a period of an hour or so makes a difference in the desire to eat breakfast. About 1.5 hour after I get up, I have a vegetable omelette, having switched to that from a breakfast of fruit, cheese, toast. I made the switch because an osteopath pointed out that the first thing we put in our mouths in the morning “sets the dials” for the day. He’s right, and I find that I have less desire for sweet things with this arrangement.

I almost always eat a large high fiber breakfast–organic shredded wheat, scottish oatmeal, etc., with powdered milk and usually dried fruit and nuts. I am never hungry during the day, nor suffer loss of energy or irregular heart beat. I never eat high fat, high protein foods for breakfast as they make me sluggish and tired with rapid heart beat and loss of energy when they hit your bloodstream and during digestion. I sometimes skip lunch if not hungry, but eat a good sized healthy dinner-no red meat, pork, preserved meats, no snack foods or desserts. This regimen keeps my metabolism on an even keel all day long and I am asleep in minutes after going to bed. I don’t formally exercise but have an active life style with many chores to do every day. I can’t afford the ups and downs of an irregular diet, too much to do!

I never eat breakfast because I am never hungry in the early morning. I do not believe breakfast is the issue. The real problem is eating a big meal before sleep.
Studies should control for the last meal of the day.

What happens if you are fasting and don’t eat breakfast until noon? I am trying a 5-6 day intermittent fasting program where I eat a (regular) breakfast at noon and my last meal is around 6 PM. So I try to go 17-18 hours without eating regular food. I am still eating similar calories but have condensed the period in which I eat them. And one must also eat healthier and that means cutting out sugars and excess carbs. I think fasting leads to lower insulin levels and less fat gain. I am not diabetic. And I believe that what these people are eating makes a big difference. I think the lack of vitamin C is a cause of heart problems, not high cholesterol and fats. And I do not believe eating 5-6 times a day is healthy. This is why 99% of diets or calories restriction diets fail over time. Just look at the program “The Biggest Loser”. They lost tons of weight put eventually most gained much of it back. The medical community, Big Pharma and Big Food are all anti-fasting. That is why I know it will work for permanent weight loss and better health.

I don’t buy this at all. I eat two meals a day. Only coffee til 11. So what about the intermittent fasting research? I’m am starving at 10am if I eat at 6am and will put on 5 pounds. This is not a real double blind study. Totally BS. My paralegal weighs 300 lbs and eats a nice breakfast every morning. I’m 70, weigh 110 and in perfect health. I only eat breakfast on weekends. Hi

I’ve just started eating a Kurdish breakfast: fruit, nuts, cheese, olives, hard boiled egg, black tea.
Fruit is either dried figs or dates or fresh in season. I’m enjoying it, but not sure if I’ll get bored eventually.

Please consider the factor of eating a breakfast after rising from a period of sleep allows the body a extra bit of time to adjust to the more active awakened state . A slower more gradual start to meet the physical and mental demands of the awake period. This may well apply to persons on a night shift duty. A problem is likely to continue to exist with swing shift patterns . The human body has a long history of expected daylight activity and sleep being during periods of darkness so that in itself can create conflict with biology . Hope this adds to your discussion

I couldn’t function without breakfast. I always understood that breakfast was the most important meal of the day.
I’m 65 years old and a vegan, I eat every day a kale smoothie with frozen blueberries and pineapple and almond yogurt and almond butter. The best.

This seems to go counter to many articles about the benefits of fasting. It also seems illogical that our gut bacteria would start harming us if we don’t eat breakfast as I am sure that our ancestors for most of the history of mankind did not eat regular meals and often went for long periods without food. I am hypoglycemic and thought I must eat breakfast only to find out that skipping breakfast greatly improved my blood sugar stability and gave me more energy. It may well have contributed to my losing over 30 pounds without restricting food intake when I do eat.

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