What is a healthy breakfast?

Getting the day started with something healthy is backed up by research pretty well. While there are some conflicting studies much of the research on intermittent fasting has been disappointing.

When you get up at 6:00 am it's likely that you have not eaten for 8 to 10 hours and not only is your body in need of some calories.   Going without food for that many hours appears to alter the body's metabolic rate to hold onto stored calories.. Skipping breakfast can mean that by the time mid-morning rolls around you are likely to be even hungrier and there is a chance that you will not make the best choices for your first meal of the day.

Many studies have shown that when those who are overweight consume more of their daily calories before noon they have an easier time losing weight. It has also been shown that breakfast-skippers have a higher BMI and, interestingly, breakfast eaters with a lower Body Mass Index are more likely to eat meals more regularly throughout the day. (AJCN l992;55:645-5l) Eating early in the day means you are less likely to snack later on, and research shows that people who eat breakfast snack more sensibly later in the day.

For example, in one study researchers found that participants who ate high-fiber cereals for breakfast ate less pizza at a meal served later in the day than those who ate a low-fiber cereal or white bread. The also found that the subjects' appetite levels fifteen minutes after eating were also much lower for those who ate the high-fiber cereal. Those who ate the low fiber cereal had the next highest appetite, followed by those who had white bread and then by those who had water. The higher fiber meals also helped keep the subjects' blood glucose levels more stable after their meals.

Eating a high fiber cereal at breakfast will help you feel less hungry at lunch. Compare the fiber levels of your favorite cereals or breads and pick the one that will keep you feeling fuller longer.

The prototype for your breakfast should be a great quality, higher fiber carbohydrate along with some protein and a piece of fruit. For example, an egg sandwich on whole wheat toast and a banana: good quality protein in the egg (with some equally good fats) and whole grain bread.

Researchers reviewing data from a large study of physicians found those who consumed two servings of high-fiber cereal per week had 20% lower rates of congestive heart failure. (Arch Int Med 2007;167:2080-2085) In another research study participants who ate cereals, quickbreads (like banana bread or zucchini bread) or muffins had a lower BMI when compared to those having meat and eggs.  This may be because the meat and egg eaters tended to consume more calories. Those having whole grain and cooked cereals fared better for folks than the ready to eat cereals or muffins. (JACN 2003, 22: 296-302)  This may be due to the ready to eat foods being more highly processed.

The eggs mentioned in this research are not necessarily the problem and eggs are an OK choice for breakfast.  Not every day but a few times a week.  However, it is often what we pair with the eggs that's the problem: a couple of slices of bacon and toast and potatoes and juice are the issue, not the eggs. As with so many of our meals, it is the add-ons that can be the challenge - not the basic ingredients. In fact, in one weight loss study of participants who had reduced their caloric intake, those who had eggs for breakfast tended to lose 65% more weight than those who had bagels for breakfast. The egg eaters also reduced their BMI by an additional 61% over the bagel breakfasters, all without increasing the participants' cholesterol levels. Note that this study was carried out by reputable scientists but funded by the American Egg Board.  (Int J of Obesity, 2008: 21, 1545-1551)

Eggs are a great source of protein, quality fats, and B vitamins, but there was a time when everyone thought eggs were bad for us. Fortunately, that has now been debunked.  In a great study a team in Australia recruited 121 overweight or obese men and women who had been diagnosed with diabetes or pre-diabetes to participate in a three-month dietary study known as DIABEGG (Diabetes and Egg) (AJCN 2015;101:705-13). Half were assigned to a "High Egg group" and half were assigned to a "Low Egg group." Those in the High Egg group were instructed to eat 2 eggs per day at breakfast, while those in the Low Egg group were told to eat no more than 2 eggs per week, while having 10 grams of lean animal protein (beef, chicken, or fish) at breakfast.

Both groups were counseled by a dietitian on replacing foods high in saturated fats with foods high in poly- and mono-unsaturated fats (for example, replacing butter with olive oil). Both groups' diets were designed to maintain the individual's body weight and both groups were told to maintain their usual level of physical activity. After three months the researchers compared the participants' cholesterol scores, glucose levels, and hemoglobin-A1c scores (a measure of diabetic control), from the start and end of the study and found that there were no significant changes in HDL cholesterol (the good cholesterol), LDL cholesterol (the bad cholesterol), or triglycerides, regardless of whether the participant ate 12 eggs per week or less than 2. Nor were there any changes in glucose levels or HbA1C scores.

Even better, those in the High Egg group reported being happier with the variety of food choices in their diet as well as feeling more satisfied after meals. Again, this study was funded by the Egg Board.

Eating breakfast regularly actually helps improve cholesterol profiles. One study found that women who didn't eat breakfast have higher total cholesterol and LDL (bad) cholesterol. Those women also had developed problems in how their insulin responds to eating. Such changes in insulin response are now clearly linked to a higher risk of heart disease and diabetes. (AJCN 2005;81:388-96)

But should you have a big breakfast, or a small one? Because we Americans are used to eating our largest meal in the evening, a good target for a 1500 calorie per day diet is to have between 250 and 500 calories at their breakfast meal, about the same at lunchtime, and the remainder at the evening meal. Research, however, suggests that those who are working on losing weight might do better to reverse that pattern of small meal in the morning/large meal in the evening (Obesity, 2013;21:2504-2512).

For their study the researchers recruited 74 overweight and clinically obese women to participate in a 12-week diet study. All of the women met with a dietitian to plan for a 1400 calorie per day daily intake. Half of the women were directed to eat half of their calories at breakfast, while the other half were directed to eat half their daily calories at the evening meal. All of the women had their cholesterol, glucose, and insulin sensitivity tested along with their blood pressure at the start of the study as well as at regular intervals throughout the study.

You would think that eating the same number of calories would mean losing about the same amount of weight regardless of when those calories were eaten. Not so! The women who ate the majority of their calories at the breakfast meal lost about 11% of their body weight, while those who ate a big dinner lost only 4% of their body weight.

Not only did they lose more weight, their blood pressures, insulin resistance, and cholesterol scores improved more than those eating the big evening meal. (Indeed, those eating the large evening meal actually saw their triglycerides increase by almost 15% while the big breakfast eaters reduced their triglycerides by about 30%.)

Breakfast may or may not be the most important meal of the day. In the end, it is a matter of personal preference. If you are going to start the day with breakfast, have a high fiber cereal or whole grain toast, muffins, or quickbreads and maybe occasionally some eggs if you like. Pairing this with fruit is a good idea. It is very possible you will be satisfied and less likely to eat more during the day.

What's a healthy breakfast? Here are some suggestions.