Skipping Breakfast Everyday Keeps Well-being Away

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J Food Sci Nutr Res 2018; 1 (1): 018-030 DOI: 10.26502/jfsnr.2642-1100003
Journal of Food Science and Nutrition Research 18
Review Article
Skipping Breakfast Everyday Keeps Well-being Away
Mohiuddin AK*
Department of Pharmacy, World University of Bangladesh, Bangladesh
*Corresponding Author: Mohiuddin AK, Department of Pharmacy, World University of Bangladesh,
Bangladesh, Tel: +8801716477485; E-mail: trymohi@gmail.com
Received: 28 November 2018; Accepted: 10 December 2018; Published: 20 December 2018
Abstract
Breakfast, the first meal of the day, is considered the most important meal throughout the day. As nutritionist Adelle
Davis famously put it back in the 1960s: “Eat breakfast like a king, lunch like a prince and dinner like a pauper”.
Breakfast is most commonly skipped meal more than lunch and dinner specifically in the young adult in the
university study period and those who wake up late. Lack of time is the main reason behind skipping meals, in
general, lack of appetite, inability to cook, fasting/religion, and not being hungry. Many people are used to be in a
hurry for job, business, children’s school in the morning where a filled stomach may prevent them to walk a long
way. It is obvious that the irregular omission of breakfast may be effective in energy intake reduction over the next
24 hours and in this day, exercise performance may be compromised. There is no evidence that breakfast skipping
reduces overeating or prevent weight gain. Some people argue that breakfast and good health is a marketing strategy
by breakfast companies.
Keywords: Breakfast; Meal; Appetite; Omission; Energy; Metabolism; Time; Fasting; Skipping meal
Abbreviation: BMI-Body Mass Index; CVD-Cardiovascular Disease; CAD-Coronary Artery Disease; CHD-
Coronary heart disease; EPIC-European Prospective Investigation into Cancer and Nutrition; FBG-Fasting Blood
Glucose; GLP-Glucagon-Like Peptide; HP-Helicobacter pylori; IBS-Irritable Bowel Syndrome; IRB-Institutional
Review Board; T2DM-Type 2 Diabetes Mellitus; WC-Waist Circumference
1. Introduction
The simple definition of breakfast is “the first meal of the day,” which is consistent with the etymology to “break”
the “fast”. It is simply identified as “the first meal of the day,” consumed within 2 hours of waking, before starting
daily activities. Experts say that people who eat breakfast are less likely to overeat the rest of the day. Breakfast-

J Food Sci Nutr Res 2018; 1 (1): 018-030 DOI: 10.26502/jfsnr.2642-1100003
Journal of Food Science and Nutrition Research 19
eaters tend to have lower rates of heart disease, high blood pressure and high cholesterol, the American Heart
Association reported in 2017. It might be better for weight loss to skip dinner, even eating an early dinner can boost
calorie burn, according to Times Magazine. Moreover, it is found that Japanese people has decreased energy intake
but the percentage of obese people has increased. This suggests that the timing of meals is related to obesity.
However, skipping meals has become an increasingly popular part of modern life, especially in young adults. It was
found that irregular omission of breakfast might be effective in energy intake reduction over the next 24 hours if the
breakfast is habitually consumed and, in this day, exercise performance may be compromised. Cardiac function and
sugar control mechanism disrupted along with wait gain, declined wits, mood swing, lethargy, bad breath, low
cortisol, chronic inflammation, worsen periods in women commonly reported.
2. Skipping Breakfast: An Unhealthy Approach
Unhealthy dietary behaviors play crucial role in increasing the upcoming risk of chronic diseases [1]. Breakfast is
recommended to contain 20%-35% of daily energy needs [2]. It is considered the most important meal of the day as
a part of a healthy balanced diet [3]. Breakfast habits are significantly associated with physiological, psychological,
and social health dimensions [4]. Several studies reported associations between breakfast skipping and fatigue at
noon, worsens memory and higher body mass index as well as increased prevalence of obesity-related chronic
illness [5-7]; deficient in total energy, vitamins and minerals [8], increased risk of central adiposity [9], and risk of
insulin resistance and cardio-metabolic disorders [10]. If the stomach is kept empty for a long time, the body will
suffer a deficiency of proteins and glucose. Then blood sugar will drop down followed by mood swing [11]. In an
Italian population-based study, there is a positive association between headache and meal skipping, especially due to
the irregular intake of breakfast [12]. Breakfast is often described as the most important meal of the day, providing
as it does sustenance and energy (i.e., calories) for whatever activities lay ahead [13]. Some studies have used solid
foods only as breakfast and neglected other highly calorific beverages available, even with the fact that there are
“differences in gastric emptying rate and metabolic response to different nutrients in solid versus liquid form” [14].
3. “Breakfast” Interpretation in Life Science
A calorie is a balance of net energy does not differentiate between ingested nutrients or calories regarding chewing
or not. By definition, it is the amount of heat required to raise the temperature of one gram of water from 14.5°C to
15.5°C. 1 calorie=4.184 joules. An amount of 209.2 kJ (50 kcal) is an appropriate starting spot to dismiss common
behaviors that would not be recognized as a meal by most of the people. On the other hand, “time of day, time of
waking, and/or the intervals that differentiate separate eating occasions” are also important considerations [15]. A
duration of 2 hours after waking up was used in the definition of the breakfast meal and has been differentiated from
snacks by a cut-off point of 1087.8 kJ (260 kcal) and independent consumption cases secluded on the basis of a 45
minutes period [16, 17]. Generally, it is sensible for an operational definition of breakfast to exemplify as “the first
meal consumed within 2 hours after prolonged sleep in any 24 hours duration,” which represents the extended daily
time consumed in the fasted-situation and the only time when most of the people are really post-absorptive [17, 18].

J Food Sci Nutr Res 2018; 1 (1): 018-030 DOI: 10.26502/jfsnr.2642-1100003
Journal of Food Science and Nutrition Research 20
4. A Common Issue of Breakfast Skipping with Young Adulthood
Meal skipping rates may be highest during young adulthood, a period of transition and development [19]. Silliman et
al. and Sakamaki et al. [20-21], reported a high prevalence of meal skipping among young adult population ranged
from 24% to 87%. Several studies reported that recurrent missed breakfast among different age groups was more
than lunch and dinner. Among the sample of Americans from different ages, the rate of breakfast skipping was
nearly 11% comparing with lunch skipping around 10% and dinner skipping more than 5% [22, 23]. Another study
among college students at the University of North Carolina, Charlotte reported that almost half (44.2%) of the
students never take their breakfast comparing with lunch (3.5%) and dinner (2.3%) [24]. Australian young adults
reported eating breakfast less than 5 days per week, compared with 10% of children and 33% of all adults (>18
years) [25].
4.1 Reasons behind breakfast skipping
Afolabi et al. [30] reported that 48%, 19%, and 13% of Nigeria university students skipping meals due to lack of
time, appetite, and inability to cook, respectively [30]. Fasting/religion and money were mentioned by about 20%
and 15% of Nigerian University students as a reason for skipping meals, respectively [31]. About half of Saudi
Arabia University students skipping meals because they did not feel hunger while one-third of them don’t have time
and one-fifth skip meals because they want to control weight [32]. The study conducted by Shaw revealed that 52%
of adolescent reported lack of time in the morning as the main reason for skipping breakfast [33]. Danquah et al.
[34] reported that lack of time, not being hungry, and eating late at night were the reasons behind skipping breakfast
in 57%, 22%, and 5% of Ghanaian university students [34]. In the study conducted by Lee et al. [35] on Korean
University students, the second cause of skipping breakfast after the lack of time (noted by 61%) was the habit
(17.6%). A similar study was found with four private university students of Bangladesh, more than 50% of the
respondents skipped their breakfast due to a variety of reasons including class pressure and had fast food after
finishing their classes [36].
4.2 Impact of skipping breakfast on subjective appetite
High protein breakfast consists of 50% protein, 30% carbohydrate, and 20% fat reported to have more benefits on
mood, alertness, and attention. This might be attributed to that high-protein breakfast resulted in more stable glucose
and insulin than adequate protein breakfast [37]. It was also stated that protein keeps blood sugar levels while
carbohydrate is important to offer energy to the body [38, 39]. Worldwide, there is a common thought that missing
breakfast causing an increase in the desire for food, which stimulating overeating at following meals and inducing
weight gain [10]. Subjective appetite variables such as “sensations of hunger, desire to eat, and prospective
consumption” are estimated as higher in breakfast skipping comparing with breakfast eating conditions. Studies
show that lunch intake was higher after breakfast skipping [40-43]. During 2015, two studies conducted by Clayton
et al. [44-45] where the breakfast representing 25% energy supplies was taken at 08:00 clock, and lunch and dinner
meals at 12:30 and 18:00-19:00 clock, respectively. A similar response was noted when standardized lunch (with
35% of energy requirements) and dinner (with 40% of energy supplies) meals were delivered so maintaining the

J Food Sci Nutr Res 2018; 1 (1): 018-030 DOI: 10.26502/jfsnr.2642-1100003
Journal of Food Science and Nutrition Research 21
energy shortage produced by breakfast skipping. These findings revealed that the inaccurate regulation of subjective
appetite is a result of an energy deficit. However, it should be noted that subjective appetite sensibilities do not
constantly portend following energy assimilation [46-47].
4.3 Effect of breakfast skipping on appetite-modulation peripheral hormones
Part of the organization of appetite included numerous intestines peptides and among them the appetite motivator
hormone ghrelin as well as hormones linked with satiation and satiety, like “peptide YY (PYY), (GLP-1), glucose-
dependent insulinotropic polypeptide, cholecystokinin, and leptin.” Recognition of the reaction of such hormones to
energy stability inconstancy could deliver worthy data about nutritional interferences (e.g. breakfast skipping) will
be acceptable out of the laboratory atmosphere [48]. Astbury et al. [39] reported that the orexigenic hormones, GLP-
1 and PYY were superior up to 30 minutes after consuming a 1,050 kJ liquefied meal two and half hours later to
breakfast intake, comparing with later to breakfast skipping. Yet, no variations in the orexigenic hormone ghrelin
were reported. Also, missing breakfast led to an increase in glucose and insulin as a result of the liquefied meal,
compared with breakfast eating. This inhibition of glycemic reaction to the second meal of the day, recognized as
the “second meal effect” which linked to glycogen storing [49]. In consistent, Gonzalez et al. [50] reported a trend in
increasing glucose and insulin response to a 1500 kJ liquescent meal ate 3 hours later to skipping, comparing with
eating breakfast, even that active GLP-1 levels didn’t not diverse between experiments.
Figure 1: Peripheral Mechanism of Appetite Regulation.
4.4 Breakfast skipping and obesity
Skipping breakfast had a greater influence on both waist circumference and BMI than eating dinner more than 3
hour before sleep [51]. An ethnic study shows correlation of overweight and obesity in school-going Fijian
adolescent girls [52]. A strong and conguous relationship between breakfast skipping and obesity, but not
overweight, reported among children in southeastern European population [53]. Breakfast Skipping is associated
with the Risk of Obesity in School-aged Children [54]. Surprisingly, in lean people, skipping breakfast for 6 weeks
increased the activity of genes that helped them to burn fat but this effect was not seen in obese adults [55]. A
positive association between skipping breakfast, overweight and obesity is globally observed regardless of cultural
diversity [56]. Eating of breakfast in all populations may be beneficial. Huang et.al [57] also supported with the

J Food Sci Nutr Res 2018; 1 (1): 018-030 DOI: 10.26502/jfsnr.2642-1100003
Journal of Food Science and Nutrition Research 22
potential role of breakfast eating in obesity prevention. Obesity and heart disease claimed in a recent study showing
that those who skipped breakfast increased their chance for hardening or narrowing their heart's arteries [58].
Gender may play a key part in breakfast skipping behaviors. In males, breakfast skipping was associated with
increased odds of being overweight/obese [59].
4.5 Breakfast skipping and cardiac complexities
Habitual avoidance found to be associated with increased risk for development of CAD and hypertension in Western
India [60]. Among adults, skipping meals may be linked to excess bodyweight, hypertension, insulin resistance, and
elevated fasting lipid concentrations. Men who skipped breakfast had nearly 30% higher risk of CHD as compared
with men who did not [61]. A relationship study between skipping breakfast and CVD risk factors such as blood
pressure, serum lipids, smoking, and lock of exercise shows equivalent nature to lack of exercise, smoking, high
blood pressure, and high serum total cholesterol [62]. More interestingly, a study in Brazil reflects Skipping
breakfast is related to cardiovascular risk factors in adolescents, and this relationship was mainly mediated by trunk
fatness [63]. However cardiovascular risk was found to associated with both skipping breakfast and late dinner [1].
Also, commendatory changes in cardiovascular risk factors have been reported by regular Korean traditional diet for
12 wk in hypertensive and diabetic patients [64].
4.6 Diabetes and breakfast
Skipping breakfast may increase the risk of T2DM independent of lifestyles and baseline levels of BMI and FBG in
middle aged male and female, as reported by Uemura et.al [65]. An IRB approved study by Harvard School of
Public Health (Boston, MA) reveals an increased risk of T2D in men even after adjustment for BMI [66]. A lower
risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome, prompting interest in the influence of breakfast on
carbohydrate metabolism and indicators of T2DM risk [67]. The Health Professionals Follow-Up Study, The
Nurses’ Health Study, a Japanese study and the German EPIC cohort provide evidence that regular healthy breakfast
consumption is associated with improved glycemic control [65], [68-70]. Skipping breakfast was closely associated
with annual changes in BMI and WC among men, and eating breakfast more than four times per week may prevent
the excessive body weight gain associated with skipping breakfast [71]. Also, development of metabolic inflexibility
reported in response to prolonged fasting that may in the long-term lead to low-grade inflammation and impaired
glucose homeostasis [72].
4.7 Altered cognitive functions
Skipping breakfast or eating a low-quality breakfast have a negative effect on cognitive function [73]. Glucose is the
main fuel for brain function, and optimal cognitive function requires the maintenance of a stable blood glucose level
[74]. Breakfast has a direct effect on blood glucose levels and, in turn, blood glucose levels have a direct effect on
cognitive function [75-76]. In general, the brain performs best when the blood glucose level is in the range of 80-120
mg/dL [77]. With the gradual depletion of blood glucose and, consequently, energy consumption, people begin to
feel hunger and fatigue and experience a decline in cognitive function [78]. A number of studies have reported that
skipping breakfast lowers cognitive function and work efficiency [79-81].

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4.8 Mood swing and performance
Psychological state and mood, all these variables can also be positively influenced by following healthy dietary
practices and it is widely believed that one such practice is the regular consumption of breakfast [82]. Breakfast
skipping has been considered an important determinant of an unhealthy lifestyle including alcohol use, smoking, and
sedentary lifestyle, as well as low educational attainment, mood changes, and depressive symptoms [83]. Rate of
depression has increased recently and association between the frequency of eating breakfast and depression in adults
found in a recent study. Lack of breakfast consumption is also associated with depression among adults with
different socioeconomic factors [84]. Children who habitually consume breakfast are more likely to have favorable
nutrient intakes including higher intake of dietary fiber, total carbohydrate and lower total fat and cholesterol.
Beneficial effects reported by Katie et.al, of breakfast for on-task behavior in the classroom, mainly in younger
children <13 years [85]. On the other hand, skipping breakfast and taking meals irregularly were associated with the
prevalence of fatigue in medical students [86].
4.9 Low cortisol and women’s health
Women would rather do their hair than start the day with some breakfast, says a new survey. Female breakfast
skippers display a disrupted cortisol rhythm and elevated blood pressure [87]. Habitual breakfast skippers would
display a similar pattern of circulating cortisol and alterations in meal and stress-induced cortisol reactions. Based on
a national survey, approximately 25% of American adults skip breakfast. Skipping breakfast adversely affects
menstrual disorders as reported in 2 different studies in young college students of Japan and Palestine [88-90].
Women from developed countries are 2-4 times more likely to have IBS than men [91, 92]. A study in Japan shows
fasting (1-2 L of fluid each day, along with some nutrition through their vein) improves pain, discomfort, abdominal
distension, diarrhea, anorexia, nausea and anxiety in IBS [93]. But breakfast is strictly recommended along with
regular meal pattern in patients with IBS-C because it stimulates colon and increase bowel movement [94-95].
However, Two out of five women admit missing breakfast leaves them hungry mid-morning, nearly 30% report
feeling tired and low in energy and 15 per cent find it hard to concentrate. One in three skip meal in order to get
ready for the day [96]. A thinning hair is reported in Reader’s Digest [97]. Teens that skip breakfast are almost twice
as likely to have bad breath; more than 35% suffered with bad breath reported in International Journal of Dental
Hygiene [98].
4.10 Abdominal discomfort, ulceration and cancer
A Mexican study found association of skipping breakfast with gastric cancer [99] which is third most common
cancer in men and the fifth in women. Frequent deviation in meal timing over a prolonged period appears associated
with increased risk of developing HP infection and gastritis [100]. Skipping meals, leaving the stomach empty
except for stomach acid, can create feelings of nausea [101]. Gallstones are more common in Europe, North
America, and Australia, and are less prevalent in Egypt, Kashmir, Japan, China, India, and Africa. Breakfast
skipping women are more prone to gallstone [102-103].

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5. Conclusion
Not only breakfast, skipping a meal often creates harm to health, although fasting has its own advantage which is
ritual in many religions. A healthy breakfast but not a heavy breakfast is highly recommended. Those who are in a
rush can take a protein rich low volume diet. Protein shake as an alternative for breakfast is a common practice in
many western countries but this discussion is not within the scope of this article. Skipping meal in IBS and
gastroenteritis may found little benefit but no study ever pointed to skip a breakfast for those issues. A healthy
breakfast is different for different people based on age, sex, living style and physical activities. School/University
going students should never miss a breakfast causes they badly need a jumpstart of energy for the day. Diabetic
people should keep in mind that the same is important for them to sensitize insulin release. Rich or poor, young or
elderly, all must have a healthy refreshment in the morning for an energized and enthusiastic day start.
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Citation: Mohiuddin AK. Skipping Breakfast Everyday Keeps Well-being Away. Journal of Food Science
and Nutrition Research 1 (2018): 018-030.