Peri-menopause is a process that lasts over a 12-year period, and even before then, women start losing muscle mass at 30 years of age. How much lean muscle mass we have helps determines our metabolic rate and energy levels as well as overall metabolic health.
Eating breakfast is important for women's health. Meal timing and breakfast eating impact our lean muscle mass, our body’s fat storage enzymatic function, our hormone levels, and our mental health.
In my private practice, I see all too often that women are concerned about being smaller, not healthier. We do way too much in the name of “losing weight” instead of aiming for greater vitality or strength.
Just the other day, a client told me they know they feel better when they eat breakfast, but there’s a voice that tells them, “Don’t. You’ll gain weight”. The idea that skipping breakfast will lead to weight loss or eating it will certainly lead to weight gain are disordered beliefs that usually don’t serve my clients (or anyone) well.
Breakfast and Weight in Women
As a non-diet and Intuitive Eating dietitian, I don’t like the BMI chart or promote weight loss as a means to find greater health. But due to the disordered beliefs around breakfast skipping in women seeking weight loss, it is important to discuss what the research says (and research uses the BMI charts, unfortunately).
Research supports the connection between skipping breakfast and a higher likelihood of high BMI and unwanted weight gain. Eating a balanced and substantial breakfast is associated with reduced body weight, reduced BMI, and less weight cycling.
Daily breakfast consumption has also been inversely associated with weight regain. One study in post-menopausal women showed an inverse association between eating breakfast and weight regain- the more they skipped, the more weight they gained.
Breakfast eating elicits positive changes in metabolic function that promote weight stability and decrease levels of visceral fat (as seen in central adiposity measures), both for young women and women as we age. Weight cycling and high levels of visceral fat both have a negative impact on our long-term metabolic health.
Weight itself is not connected to health, but research has also elucidated a whole list of actual health benefits.
Let’s talk about the benefits and negative effects of eating and skipping breakfast, because I believe that by eating it daily, you might change the shape and cadence of your day, feeling more energized and vibrant.
The Benefits of Eating Breakfast
When we eat breakfast, we communicate with your body that we have enough food that day. This means we are telling our body to go ahead and burn energy as fuel, because we have more, don’t worry. This translates into us moving more during the day, having more pep in our step.
Morning eating also seems to be more satiating, and it reduces the total amount we eat throughout the day. Our satiety hormones, PYY and leptin, stay higher throughout the day in those who consume an adequate breakfast. Eating a moderate to high carbohydrate and high protein breakfast promotes increased satiety as well as decreased appetite throughout the day.
Ghrelin, our hunger hormone, stays suppressed in those who consume breakfast- particularly, a high protein, high fiber breakfast- so we are more satiated and have less cravings and strong hunger pangs.
This can help us be more intuitive eaters as we will feel more in step with the natural fluctuation of our hunger and fullness.
Eating breakfast daily is also strongly associated with a decreased risk of a myriad of metabolic issues, such as heart disease, diabetes, high blood pressure, stroke, elevated triglycerides, metabolic syndrome, high waist circumference (associated with high levels of pro-inflammatory visceral fat), and a low level of healthy HDL cholesterol. In one study, eating breakfast daily was associated with lower bad LDL cholesterol, high HDL good cholesterol, and lower blood pressure.
Ample research suggests that eating breakfast improves insulin function and decreases insulin resistance. In one randomized controlled trial, women with metabolic syndrome were randomized into two groups and told to eat 1400 kcal diets (which is too low for most people, btw)- the Breakfast group ate a 700 kcal breakfast, a 500 kcal lunch, and a 200 kcal dinner while the Dinner group at a 200 kcal breakfast, a 500 kcal lunch, and a 700 kcal dinner for 3 months. The Breakfast group had greater weight loss and waist circumference, as well as more significant drops in fasting glucose, insulin, ghrelin, and HOMA-IR (tells us level of insulin resistance). In the Breakfast group, average triglycerides dropped by ~ 34% while they increased by ~15% in the Dinner group. Hunger was significantly lower and satiety significantly higher in the breakfast group as well.
In women with PCOS, a bigger breakfast relative to dinner has been associated with reduced androgen and insulin levels. Other research shows breakfast skipping increases daily average blood glucose levels and is associated with higher hemoglobin A1c values (measure of average glucose over 3 months).
Not eating breakfast can send our blood sugars on a roller coaster ride- as they drop, our liver is responsible for churning out the blood glucose our brain and body need to function. This is a slower process and can cause anxiety or mood swings throughout the day as our blood glucose levels struggle to normalize.
Consuming breakfast daily has also been associated with better diet quality (more fruit, vegetables, whole grains, fiber). Breakfast, especially when containing food high in fiber, helps students pay attention, perform better on problem-solving tasks, and improves memory.
A study of older adults suggests that regularly eating breakfast may lead to a longer than-average life span.
Dietary protein consumed at breakfast leads to greater initial and sustained feelings of fullness (increased PYY levels) compared with when it is consumed at lunch or dinner. Adding protein to breakfast shows additional reductions in perceived appetite and subsequent- meal intake. In one study, eating protein evenly throughout the day (aiming for 30 gm per meal) instead of skewing protein intake towards the end of the day and eating a lower, 10 gm protein breakfast, caused a 40% higher rate of muscle protein synthesis (MPS). MPS is decreased in women as we age, particularly through peri-menopause and menopause, so eating a higher protein breakfast is one way we can hold on to and even build more precious lean body mass.
Overall, the benefits of eating breakfast may include:
· Higher feelings of fullness and satiety throughout the day
· Less cravings and decreased strength of appetite through the day
· Increased muscle protein synthesis with higher protein breakfast
· Improved blood pressure
· Improved insulin function
· Decreased risk of metabolic syndrome
· Decreased risk of heart disease (improved blood lipid and cholesterol profile)
· Less weight cycling or unwanted weight gain due to improved metabolism and satiety
· Greater ability to focus and memory improvement
· Less anxiety as a result of erratic blood sugar levels
· Higher quality of diet
· Possibly higher quality life-span
The Negative Impact of Skipping Breakfast
Skipping breakfast negatively impacts our blood glucose levels and decreases the quality of our diet which affects our mood and energy throughout the day. Research shows that young people who skipped breakfast were more likely to have higher perceived stress and depressive mood. In one meta-analysis, not eating breakfast was associated with a higher risk of stress, depression and psychological distress across the lifespan. Adolescents seem to be at greater risk of heightened anxiety.
Quality of diet is also negatively impacted. Studies show that breakfast skippers have higher daily intakes of fat, energy and cholesterol and lower intakes of vitamins, minerals and fiber than breakfast eaters.
As discussed in the benefits above, irregular breakfast eating (less than 5 times a week) has been linked to a higher risk of metabolic health conditions (heart disease, insulin resistance, metabolic syndrome, diabetes).
Our body aims to store more fat when we forgo the morning meal. Research shows that skipping breakfast and a pattern of later eating increases hunger, raises hunger hormones throughout the day, decreases satiety hormones, decreases daily energy expenditure, and alters our genes responsible for fat storage and use so that our body is more likely to favor fat storage and less likely to break it down for fuel.
This can also impact our energy levels throughout the day, making us feel more tired and sluggish.
One randomized crossover study found skipping breakfast and eating later in the day has been correlated with a decrease in body temperature as well as a slowing in metabolic rate by about ~60 calories a day or 420 calories a week. The thermogenic impact of food makes up about 10% of our energy expenditure, and if we skip breakfast, this post-meal increase in energy expenditure is blunted.
Other consequences of skipping breakfast include increased insulin resistance and blood glucose levels along with decreased fasting carbohydrate oxidation. Elevated fasting insulin levels are seen in those who routinely skip breakfast. High insulin levels increase something called hydroxy-methyl-glutaryl Co-A reductase. This higher enzyme activity increases the synthesis of cholesterol and triglycerides, and it is because of this that breakfast skipping seems to lead to increased fasting glucose levels, higher blood pressure and triglycerides, and low levels of the good cholesterol (HDL).
Skipping breakfast also makes us more likely to have a bigger lunch or binge eat later in the day. Studies show we compensate by eating larger meals, and our hunger hormones seem to remain elevated all day, despite this increased intake.
We also crave more energy dense and less nutrient-dense foods. Studies show the reward centers of the brain responded more strongly to high-calorie, higher fat foods at lunch in study participants who skipped breakfast. This can disrupt the Intuitive Eating process as our reward centers are highjacked by experiencing morning deprivation.
Some research notes that our chronotype can influence breakfast skipping. Those who stay up late and sleep in may have a causal genetic propensity and preference for this pattern, and this chronotype is also at higher risk of higher BMI, more depressive symptoms, and a higher likelihood of smoking.
Skipping breakfast seems to be an important proxy indicator of other concerning health behaviors, such as substance abuse, smoking, not moving enough, mental health issues, and mood changes. In one study, breakfast skippers had significantly worse health-related quality of life than breakfast eaters. Breakfast skippers had significantly lower scores in general health perceptions, vitality, social functioning, emotional role, and mental health.
Why women skip breakfast
Reasons clients have given me for skipping breakfast are highly variable. Some report feeling too sluggish in the morning while others say they simply have no appetite. Some women feel so weighed down by morning responsibilities with kids or work and eating breakfast seems impossible, selfish even (mom guilt, you’re not welcome).
Over the years, I’ve heard all manner of reasons for skipping. Here are a few more:
· Fear of weight gain
· Confusion about what to eat
· Eating too early causes nausea
· Lack of energy
· Lack of time
· Intermittent fasting goals
· “Saving” calories or diet mentality
· Morning medicine (needing to wait 30-60 minutes before eating)
· Eating breakfast interrupts morning workout
· Just not in the habit
· No desire for food in the morning
· Later chronotype (does better staying up late and sleeping in- midnight to 8 or 9 am-ish)
Some of these reasons (fear of weight gain, intermittent fasting, or diet mentality) are disordered core beliefs. I work with my clients to figure out where these came from and help them challenge them so that they can eat in line with hunger and fullness and nourishing their bodies.
I want to validate the other reasons (such as morning medicine timing, actual low appetite, time restraints, ect) as I know they may seem very insurmountable to some. These reasons are certainly barriers, but they are barriers that can and should be bypassed. Even a low appetite in the morning can be due to the habit of skipping breakfast, and once we start eating breakfast, our desire for it increases.
Barriers are usually a result of habits- and habits can be changed. We just need to believe that the benefits are worth our time in brainstorming and experimenting around the barriers.
Most people say skipping breakfast is a bad idea, but reports indicate only about half of us actually eat it. In one survey, 54% of adults said they’d like to eat breakfast, but put this desire to the test and only 34% of them maintain this habit.
I want to encourage you to try to eat breakfast. See how you feel throughout the day. Note what comes up for you and what food feels good in your body, keeps you satiated. I’m here if you need support.
Bodacious Nutrition offers 1 on 1 nutrition coaching and therapy to help you heal the food and body relationships and find a path to sustainable wellness and positive embodiment. Schedule a free discovery call today.
Resources:
Heo, J., Choi, WJ., Ham, S. et al. Association between breakfast skipping and metabolic outcomes by sex, age, and work status stratification. Nutr Metab (Lond) 18, 8 (2021). https://doi.org/10.1186/s12986-020-00526-z
Lee G, Han K, Kim H. Risk of mental health problems in adolescents skipping meals: The Korean National Health and Nutrition Examination Survey 2010 to 2012. Nurs Outlook. 2017 Jul-Aug;65(4):411-419. doi: 10.1016/j.outlook.2017.01.007. Epub 2017 Jan 20. PMID: 28196640.
Li ZH, Xu L, Dai R, Li LJ, Wang HJ. Effects of regular breakfast habits on metabolic and cardiovascular diseases: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2021 Nov 5;100(44):e27629. doi: 10.1097/MD.0000000000027629. PMID: 34871228; PMCID: PMC8568444.
Jakubowicz D, Barnea M, Wainstein J, Froy O. High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity (Silver Spring). 2013 Dec;21(12):2504-12. doi: 10.1002/oby.20460. Epub 2013 Jul 2. PMID: 23512957.
Vujovic N, Piron MJ, Qian J, et al. (2022). Late isocaloric eating increases hunger, decreases energy expenditure, and modulates metabolic pathways in adults with overweight and obesity. Cell Metabolism. 34, 1486–1498
The association of skipping breakfast with cancer-related and all-cause mortality in a national cohort of United States adults: https://doi.org/10.1007/s10552-021-01401-9
Ferrer-Cascales R, Sánchez-SanSegundo M, Ruiz-Robledillo N, Albaladejo-Blázquez N, Laguna-Pérez A, Zaragoza-Martí A. Eat or Skip Breakfast? The Important Role of Breakfast Quality for Health-Related Quality of Life, Stress and Depression in Spanish Adolescents. Int J Environ Res Public Health. 2018 Aug 19;15(8):1781. doi: 10.3390/ijerph15081781. PMID: 30126240; PMCID: PMC6121474.
Bajerska, J., Chmurzynska, A., Muzsik-Kazimierska, A. et al. Determinants favoring weight regain after weight-loss therapy among postmenopausal women. Sci Rep 10, 17713 (2020). https://doi.org/10.1038/s41598-020-74302-7