Skipping the morning meal even once a week may increase the likelihood of developing the disease, a new review suggests.
Although nutritionists, doctors, and parents have advised for years that a nutritious breakfast is an essential part of a healthy lifestyle, many people pass on the morning meal. In fact, a survey from the NPD Group reported that 1 in 10 Americans don’t eat breakfast.
A review published in November 2018 in The Journal of Nutrition from the American Society for Nutrition contributes to data finding that breakfast does a body good. The study suggests that skipping breakfast just one day a week may raise the risk of developing type 2 diabetes by 6 percent.
Missing the morning meal four to five days a week elevates that risk to 55 percent.
Sabrina Schlesinger, MSc, PhD, head of the junior research group Systematic Reviews at the German Diabetes-Center in Düsseldorf, and her colleagues analyzed health information from six different observational studies representing more than 90,000 individuals. Of those, 4,935 people developed diabetes.
The scientists discovered that diabetes risk rose for each day of the week that a person missed breakfast up until the fifth day, when the risk plateaued. The chance of getting type 2 diabetes was 32 percent greater overall for those who ever skipped breakfast compared with those who never skipped breakfast.
Researchers Saw a Higher Diabetes Risk Regardless of the Person’s Weight
Study authors observed that body mass index (BMI) was only partially linked to higher diabetes risk in people who skipped breakfast. BMI is a measure of body fat based on weight and height, and a BMI measure over 30 is considered obese, according to the Centers for Disease Control and Prevention (CDC).
“Even after taking into account the BMI, skipping breakfast was associated with an increased risk of diabetes,” said Dr. Schlesinger in a press release. Schlesinger was not available for direct comment.
Although she and her colleagues noted that obesity is a well-established risk factor for type 2 diabetes, and obese people are more likely to skip breakfast than those of normal weight, the results indicated that people of any weight who did not eat the morning meal still had higher likelihood of developing diabetes.
“This is important because most people think that breakfast skippers are always overweight or obese, and this could be the cause of increased risk for type 2 diabetes,” says Osama Hamdy, MD, PhD, medical director of the Obesity Clinical Program at Harvard Medical School’s Joslin Diabetes Center in Boston, who wasn’t involved in the study. “This research shows that the relationship still exists even after adjusting for body weight.”
Not Eating Breakfast May Be Tied to Other Unhealthy Behaviors
Study authors point out that the elevated diabetes risk in breakfast skippers may be linked to other unhealthy lifestyle behaviors. Those who miss breakfast are more likely to smoke, be less inclined to exercise, and drink more alcohol, according to the report.
“People who skip breakfast also may end up eating more total calories throughout the day, which has been demonstrated in many studies,” says Jan Rystrom, RD, a diabetes educator at Swedish Medical Center in Seattle, who was not involved in the investigation. A diet high in calories from any source contributes to weight gain, and weight gain heightens your risk for type 2 diabetes, according to the according to the American Diabetes Association.
Rystrom recommends that people with diabetes eat three to five times daily, at three- to five-hour intervals throughout the day. Eating regular meals helps maintain blood sugar control.
Other scientific investigations have shown additional benefits of eating a healthy breakfast. An article published in November 2012 in the American Journal of Lifestyle Medicine suggested young people who eat breakfast regularly tend to make healthier food choices throughout the day and have better weight control than those who don’t, thereby reducing their risk for diabetes. Plus, the American Heart Association says that eating breakfast lowers the risk of heart disease, blood vessel diseases, and stroke.
On the other hand, some research, such as evidence in an article published in May 2015 in the International Journal of Obesity, has suggested that skipping breakfast may have health benefits as a part of an intermittent fasting (IF) program.
“Many of our patients are choosing some intermittent fasting and find they do have better glucose control and better weight loss, but it is coupled with an appropriate diet, appropriate calorie intake, and lower carb intake,” says Rystrom. Regardless, more studies are needed to know what benefits, for people at risk for diabetes or otherwise, IF may offer.
What’s a Healthy Breakfast for People Living With Diabetes?
Schlesinger and her coauthors wrote that a diet high in processed meat and low in whole-grain cereals are linked to a higher diabetes risk.
When it comes to recommending a healthy breakfast for people with diabetes, Rystrom suggests very moderate carb amounts combined with lean protein and vegetables, such as vegetable scramble with an egg and whole-grain toast, or plain Greek yogurt with blueberries, chopped nuts, and chia seeds. She says that a bad breakfast for those with diabetes would be cereal made with refined (not whole) grains, milk, juice, and white bread. “That is a breakfast of highly processed, concentrated carbohydrate guaranteed to cause a post-meal blood sugar spike,” she says.
Although the review represented a large population, it was limited by including only six investigations from the United States and Asia, says Dr. Hamdy. The research was also limited as an analysis of other studies rather than a direct investigation of a population over time.
“Further studies are needed to elucidate not only the mechanisms of eating breakfast regularly but also the influence of the composition of the breakfast on diabetes risk,” Schlesinger says in the release. “In principle, a regular and balanced breakfast is recommended for all people — with and without diabetes.”