Mom was right.
Breakfast really is the most important meal of the day.
That’s the conclusion of a recently published study designed to determine what effects the timing and frequency of meals has on changes in body mass index (BMI).
Here are some of the researchers’ findings.
What Seventh Day Adventists eat
For the recently published study, researchers spent seven years observing the eating habits of more than 50,000 Seventh Day Adventists, all 30 years of age or older.
They gathered data about the number of meals eaten per day, length of overnight fast, whether the subjects ate breakfast, and what time they ate their largest meal of the day.
Then they looked for, and grouped together, similar patterns of behavior.
After adjusting for demographic and lifestyle factors, the researchers calculated the mean changes in BMI for each group.
The study’s authors placed emphasis on the importance of eating breakfast.
“It has been shown that people who usually skip breakfast have an increased risk of obesity and obesity-related chronic diseases. Our study adds to this evidence,” the authors wrote.
They concluded that if you eat less often, do not snack, and make breakfast your largest meal of the day, you will likely lose more weight over the long term than if you do not adhere to those behaviors.
Although this might sound like common sense, the study does validate some of the advice medical professionals offer their patients.
There are some concerns
Dr. David Cutler, family medicine physician at Providence Saint John’s Health Center in California shared his thoughts with Healthline.
“This will not change what I do, but it will reinforce what I already do with my patients,” said Cutler.
Cutler cautioned, however, that he has some concerns about this study.
“The problem with the study is the very select population,” said Cutler. “You’re dealing with very healthy people already, and it’s kind of hard to draw conclusions for the general population.”
Cutler pointed out that, “For example, 93 percent of the people in the study already eat breakfast. That’s certainly not true of my patients.”
While only 5 percent of study participants had diabetes, Cutler believes that number is closer to 20 percent in his patients.
Similarly, Cutler said the same disparity shows up when comparing use of tobacco (1 percent vs. 15 to 20 percent) and alcohol consumption (10 percent vs. 75 percent or higher) against the general population.
As for the largest meal of the day, only 37 percent of study participants said that dinner was their largest meal. Among his own patients, Cutler said it is almost 100 percent.
“So you’re dealing with sort of a skewed population already and that makes it hard to draw conclusions for the general population,” he said.
Cutler acknowledged that, “it [the study] does reinforce the fact that eating calories earlier in the day, and specifically eating breakfast, and avoiding eating a large dinner, probably are healthy in terms of losing weight.”
“However, keep in mind,” he warned, the “amount of weight they’re talking about in this study is truly miniscule.”
Diabetics and others take note
Sarah Diehl, RD, and Silje Bjorndal, MS, RD, CNSC, are both registered dieticians with Orange Coast Memorial Medical Center in California.
They also expressed concern about the somewhat skewed population used in the study.
Diehl agreed that the study's recommendations might work for its healthier population.
“But with diabetic patients,” she told Healthline, “and with some of the other patients we see in the hospital, we would not be able to recommend having three meals and not having small, frequent meals.”
They also acknowledged the danger of people in general misinterpreting the study authors’ conclusions.
“I think for somebody who doesn’t take the time to look at this study and think about how it applies specifically to them, [following] it could put a lot of pressure on your body to break down a lot of food in the morning,” Bjorndal told Healthline.
This includes, she continued, “getting all the insulin moving, and moving all the sugars into the cells.”
Cutler expressed similar concerns.
“The conclusions really have to be tailored to the individual population that you’re dealing with,” he said. “If you’re dealing with an overweight population, they need to reduce the calories in their diet and follow a healthier diet.”
Moreover, “if you’re dealing with diabetics or high cholesterol patients, or high blood pressure patients, those conclusions have to be directed toward those specific populations and their health problems,” continued Cutler.
Bjorndal noted that “sometimes when we talk with patients in the hospital sense, they may not know what a calorie is, and they may not know how many calories they need in a day.”
To underscore the need for individualized solutions, Bjorndal gave an example.
“If somebody wants to lose a pound a week, you have to cut out 3,500 calories in that week in order to lose a pound,” she said.
Bjorndal also posed a question, “So if you take more of an individual approach, what does that mean?”
“If you’re a 6-foot-2-inch guy who requires 2,500 calories in order to maintain your weight,” she said, “it means you may eat 2,000 calories every day for a week to lose that pound.”
The study pointed out the positive effects of intermittent fasting.
Data show the greatest reduction in BMI occurs when subjects eat a large breakfast, a smaller lunch, and then nothing else until the following day.
“In general, when you start fasting,” Cutler said, “your body thinks you’re starving and it does change your body’s metabolism. And most studies do show help with weight loss, whether it’s being lumped into overnight fasts, or even if you’re going to fast a couple of days per week.”
“The thing you have to avoid, though, is that after you’re starving, your body really craves eating lots and lots of food,” said Cutler. “So what you do have to do is you have to control your dietary input, and controlling that dietary input means becoming more mindful of what you’re eating.”
Healthline asked Cutler about dietary supplements and whether people should take them when fasting.
Cutler responded, “The thing about dietary supplements is that people who are eating a good diet do not need any dietary supplements.”
“If you’re eating at least five servings of fruits and vegetables per day,” he explained, “you’re getting all the vitamins and minerals you generally need.”
There are some exceptions.
For example, “some women should be on calcium supplements,” said Cutler. “And some people, if they’re not getting sun exposure should probably be getting vitamin D supplements.”
Cutler noted, however, that these are two minor exceptions to the general rule that is good for most people.
“This bottom line issue of the importance of breakfast — I’ve been hearing about it for the last 50 years, since I was a kid,” he said.
Guess mom was right after all.