The Breakfast Debate: Is it the Most Important Meal of the Day?

Originally published 2 September 2018. Last updated 13 October 2020.

QUESTION (via email): “Hi, I am a listener of the podcast. I listen from Germany. I would like to know the pros and the cons of skipping breakfast. In the morning I only drink tea, creating in this way something like a 14-hour intermittent fasting pattern. I started experimenting one month ago, and I have been told that it can negatively impact my metabolism and strength training, while it could have a positive effect on aging. Thank you very much in advance, I enjoy your work.”

DR. NEAL: Ah, breakfast.

First of all, thank you to the listener for your kind words and from listening all the way from Germany. I am always humbled by the fact that I have listeners all over the world. The timing of this question was perfect because we actually touched on this topic earlier this week.

In Episode 1154, I commented on pre-workout nutrition. But I didn’t discuss skipping breakfast specifically. So this is a perfect complement to what we were discussing just a couple of days ago.

Some of you may dread the thought of breakfast — it’s just never been a meal you could ever get used to eating. I was like that for a long time. For others, you would like to eat breakfast… if only you had the time in the morning to make it! Whatever your situation may be, I think you will still find this topic useful because I am going to provide some easy lower-carb breakfast ideas that are tasty, too.

Breakfast is “the most important meal of the day,” right? Well, that’s still debated.

Listen to Dr. Neal address this topic on Episode 125 and Episode 1150 of the podcast Optimal Health Daily.

Is Breakfast the Most Important Meal of the Day or is it Better to Fast?

Before talking about skipping breakfast and fasting vs. breakfast being the most important meal of the day, I must address something else that is just as important: the “placebo effect.” This effect is very real and far too often sways our ability to make objective decisions. A perfect example of this happened just the other day with family in fact…

I don’t remember how they got on this subject, but one of my in-laws blurted out that since they started taking this supplement called Airborne®, they don’t get sick anymore. Airborne® is essentially a vitamin C supplement that used to be marketed to teachers with the claim that if you use this product, you won’t get sick. Teachers were the targeted market because the product was created by a teacher and, let’s face it, their constantly around those little germ factories we call children. Back to the story… I kept my mouth shut and let them state their case as to why Airborne® is so great.

Another family member chimed in and said, “Oh, yeah, I swear by it. Since I started taking it, I noticed the same thing. I hardly ever get sick now.” It was at that moment my wife couldn’t take it anymore and exclaimed, “*Cough* Placebo! *Cough*”

I could see my in-laws' faces becoming contorted as they struggled to find an argument to counter this outburst. What my wife was trying to say is that we don’t really know whether Airborne® is causing your improved health or whether it’s sheer coincidence. Maybe it’s something else:

• You’re getting more sleep
• You’re less stressed
• You changed other aspects of your diet
• You just haven’t been around sick people lately
• You’ve been washing your hands more often
• You’ve been exposed to more sunlight
• You’ve been exercising more consistently
• Maybe by simply believing this product will work for you, it does. This is the placebo effect.

As my in-laws struggled to find an argument, my wife turned to me and said, “Babe, will you please set them straight.” I replied, “Oh, no… I’m not getting involved in this.” Surprisingly, my in-laws wanted my opinion, so all I said was, “Well, Airborne® was sued because the company claimed it would help people fend off the common cold and the flu but there weren’t any studies to prove it. They had to refund customers’ purchases which ended up being millions of dollars.”

My wife then sat back in her chair, folded her arms and gave her family that look—the one that says, “What else ya’ got?” There was no response. I could tell from their faces that they seemed a bit heartbroken, so I broke the silence by saying, “Look, if it’s not doing you any harm, which it probably isn’t, then it’s fine if you keep using it.” This seemed to bring them some relief. And that brings me back to the heart of this.

While some claim that skipping breakfast makes them feel better, this is very subjective and could, in fact, be a placebo effect. But I need to figure out whether skipping breakfast would do more harm than good.

The Science & Data on Skipping Breakfast

Based on a number of studies, here’s what we know: eating breakfast couldn’t hurt, but skipping it likely does more harm than good.

Skipping breakfast may increase risk for coronary artery disease. According to a meta-analysis (where they look at a bunch of studies on this same topic and find the common ground) skipping meals may lead to weight gain, which may increase a person’s risk for becoming overweight, increase blood cholesterol and triglyceride levels, increase blood pressure, and increase an individual’s risk for developing type 2 diabetes. Another meta-analysis examined 16 studies and found that all these studies showed an increase in BMI for those that skipped breakfast.

Breakfast is often recommended as part of a healthy eating pattern because we’re finding that many commonly consumed breakfast foods provide some important nutrients. Eating breakfast may also improve one’s ability to think more clearly and may improve academic performance.

But I must mention that the quality of one’s breakfast is important.

Fasting Before a Workout

But, what about fasting before a workout? Some health professionals believe that intermittent fasting may harm athletic performance.

Research in this area is sparse, so we can’t really say for sure what may or may not happen over the long-term. What we can say is that not eating means you’re not consuming energy, protein, vitamins, minerals, and phytonutrients which we know are important for athletic performance and recovery.

To try and make up for all those missed nutrients after the fact…that could lead to overeating. One study did find that male athletes following an intermittent fasting diet experienced reduced speed. But, without specific studies looking at muscle gains/losses, we can’t really say what’s happening.

There are some folks that I would advise avoiding this style of eating completely:

• Those that currently have diabetes
• Those with low blood sugar
• The elderly
• Children
• Pregnant and breastfeeding women

I wouldn’t recommend fasting before exercise – you may end up fainting (or worse) due to low blood sugar levels, which can make you feel weak and jittery.

As always, definitely check with your personal physician before beginning something like this just to be safe.

What Should You Eat for Breakfast?

A breakfast that incorporates some lean protein (think eggs, yogurt, and cottage cheese) and a whole grain (like oatmeal, whole grain breads and cereals) is best for optimal performance and lower disease risk. Throw in a serving of whole fruit and you’ve got a perfect start to your day.

Think about the most common breakfast foods. Go ahead, I’ll give you second to picture them… I wonder how many of you thought about some form of cereal first. Maybe it was oatmeal, or cold cereals, or grits or Malt O’ Meal. I hope there aren’t too many of you that began drooling at the thought of Frosted Flakes, Trix cereal, or my childhood favorite, Cocoa Puffs. On a side note, occasionally even I will indulge in these sugary, kids’ cereals but I eat them as a dessert–never as breakfast. Back to my original point: what are some other common breakfast foods?

• Bagels
• Toast
• English muffins
• Pancakes
• Crepes
• Waffles
• Croissants
• Danishes
• Muffins

And how can we forget about one of my most beloved foods: the doughnut! Then we wash all of this down with a glass of milk or orange juice, both of which are high in carbohydrate. I obviously didn’t list every single breakfast food out there (yes, I know I didn’t mention eggs), but I hope you noticed a theme. Many breakfast foods are high in carbohydrates. And unless you are really good and opt for whole grain varieties, these are going to be highly refined, highly processed carbohydrates—translation: lots of simple sugars!

A person can’t expect to eat those sugary breakfast cereals and expect to have a lower risk for obesity, heart disease, and type 2 diabetes.

If you’re not a big breakfast eater, that’s ok. For a long time, I wasn’t either. But even if you start with something small — two bites of an apple or an orange, 1 piece of toast, or even 1 spoonful of yogurt — it will help. Then over time you can slowly incorporate a little more, and before you know it, you’ll be eating a balanced breakfast. This is how I did it.

But because you are listener of this podcast, you likely take great care in choosing only those foods that will promote health and make you feel better. So how do we turn breakfast into a meal that supports these goals? Well, based on the foods I just listed, this can be tricky. I’ll share with you a quick example.

Listen to Dr. Neal address this topic on Episode 125 and Episode 1150 of the podcast Optimal Health Daily.

Creating a Low-Carb Breakfast Diet

As part of my research, I had to create menus for those that were following a low-carb diet. Sure enough, the most difficult meal to plan was breakfast. So many of the breakfast foods available are heavy in carbohydrates, I had a difficult time keeping their total carb intake within the boundaries we had set for them. At one point, the low-carbohydrate followers began complaining, “Eggs, again?! Can’t we have something else? I would love a piece of toast.” But I couldn’t give in to them. One piece of toast would have put them too close to their carbohydrate limit for the day.

For those of you that want to keep your carbohydrate intake on the lower side during breakfast, it doesn’t mean you need to completely avoid all carbohydrates. Instead, we just don’t want your carb intake to get out of hand right off the bat.

Here’s what I would recommend:

Choose foods like eggs, egg whites, plain Greek yogurt, and cottage cheese.

If you do want to eat some carbohydrates with breakfast, there’s nothing wrong with that! Just don’t go overboard. For example, eating one regular-sized bagel would be going overboard. Why? While bagels are higher in protein than most other breads, they are also very high in carbohydrate. Eating one regular-sized bagel has the same amount of carbohydrate as four slices of toast. Would you eat four slices of toast for breakfast? I hope not. So why would you eat a bagel then? For the protein? C’mon.

Instead, I have:

• Two scrambled eggs and one whole grain waffle topped with fruit on the side.
• Or 1 cup of plain Greek yogurt topped with ½ a cup of berries.
• Or one whole English muffin topped with 2 tablespoons of peanut butter (or some other nut butter) and sliced banana.
• Or a two-egg omelet with ¼ cup diced red and green bell peppers, onions and sliced mushrooms topped with three slices of avocado. That’s a nice way to get in some extra vegetables.

And oatmeal is great — just try and select the “steel-cut” variety as opposed to the “instant” or “quick” oats that come prepackaged with the flavoring and sugar already added. I like the idea of topping oatmeal with fruit and nuts, like walnuts or almonds. This is really nutritious and balanced because it contains whole grains, fiber, protein, heart-healthy fats, and lots of antioxidants.

While it may be tempting to want to go skip the carbs and load up on the bacon and sausage, just keep in mind a number of studies have “linked” (get it? Pun intended!) these types of processed meats with certain forms of cancer.

To end this post, here are some more lower-carbohydrate breakfast ideas you can try!

Healthy and Easy Low Carb Breakfast Ideas

Western Egg White Omelet

Serves 1

• 1 tablespoon chopped green bell pepper
• 1 tablespoon chopped scallion
• 1 tablespoon chopped red bell pepper
• ½ cup liquid egg substitute
• 3 tablespoons shredded cheese

Lightly coat a medium skillet with oil. Sauté the peppers and the scallions until they are tender-crisp. Pour the egg substitute over the vegetables. When partially set, spread the cheese over half of the egg substitute and fold the omelet in half over the filling. Continue cooking until cooked through. Serve immediately.

Source: Recipe and select menu options adapted from: Agatston A. The South Beach Diet: the Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss. Emmaus, PA: Rodale; 2003.

Neal Malik

Dr. Neal Malik ("Dr. Neal") has a Doctorate in Public Health with emphases in disease prevention and nutrition. He is also a Registered Dietitian and Certified Health Education Specialist. He is currently an assistant professor at California State University, San Bernardino. Dr. Neal has published peer-reviewed scientific research and been featured as a nutrition and wellness expert in over 70 media outlets including Parade and The L.A. Times. Send in your health related question and Dr. Neal will answer it on the Optimal Health Daily show!