Skipping breakfast may not be such a barrier to weight loss, a randomized controlled trial found.

by Kristina Fiore, Staff Writer, MedPage Today
June 05, 2014

Skipping breakfast may not be such a barrier to weight loss, a randomized controlled trial found.

There were no differences in weight loss whether or not patients skipped the first meal of the day, Emily Dhurandhar, PhD, of the University of Alabama at Birmingham (UAB), and colleagues reported in the American Journal of Clinical Nutrition.

It’s the first randomized controlled trial to look at the question, and runs contrary to common wisdom, the researchers said.

“Previous studies have mostly demonstrated correlation, but not necessarily causation,” Dhurandhar said in a statement. “In contrast, we used a large, randomized controlled trial to examine whether or not breakfast recommendations have a causative effect on weight loss, with weight change as our primary outcome.”

David Katz, MD, MPH, director of Yale’s Prevention Research Center, told MedPage Todaythat most of the research on breakfast comes from studies of hungry children who went without breakfast involuntarily, and that choosing to skip breakfast is another matter altogether.

“All too often, dietary guidance substitutes dogma for data,” Katz said. “This study reminds us of the value in doing just the converse, and by doing so, provides us both more reliable information — and options.”

Dhurandhar noted, however, that the study wasn’t designed to look at a specific type of breakfast or the exact timing of food intake, so conclusions about those parameters and their effects on weight loss can’t be drawn yet.

Observational studies have shown an association between eating breakfast and having a lower body weight, and clinicians have long recommended eating breakfast as a major piece of the weight-loss puzzle.

But no randomized controlled studies have been done. So Dhurandhar and colleagues studied 309 overweight and obese patients over a 16-week period. Patients were assigned to one of three arms: an intervention group told to eat breakfast, an intervention group told to skip breakfast, or a control group that wasn’t given any specific information about breakfast. The control group could eat or skip breakfast as they pleased.

Overall, the researchers saw no differences between groups in terms of weight loss, despite good compliance in all arms.

Dhurandhar said the findings are contrary to widely held views that skipping breakfast is an impediment to weight loss.

She cautioned, however, that since they only measured body weight as an outcome, they can’t draw conclusions about the impact of eating breakfast on appetite, metabolism, or overall body fat.

Further studies could also help determine whether certain types of breakfast foods, the quantity of food, or the timing of first meal intake could have an impact on body weight.

David Allison, PhD, director of the UAB Nutrition Obesity Research Center and the senior investigator of the study, noted that the findings hold implications for the entire field of nutrition and weight-loss research.

“The field of obesity and weight loss is full of commonly held beliefs that have not been subjected to rigorous testing; we have now found that one such belief does not seem to hold up when tested,” Allison said in a statement. “This should be a wake-up call for all of us to always ask for evidence about the recommendations we hear so widely offered.”

Katz said the study “reaffirms that for weight loss to occur, we merely need to reduce calories in below calories out over a typical day. It is not dependent on exactly when we eat, nor on exactly what.”

That said, he continued, “we might argue that truly ‘skipping’ breakfast isn’t possible since, eventually, we all do break our overnight fast. Attempts to control weight by waiting too long to eat despite hunger often backfire, resulting in overcompensation. But for some of us, delaying breakfast so that it might better qualify as brunch, or even an early lunch, might be perfectly fine.”