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What is Breakfast?

Breakfast is unique because it breaks a time of fasting (after a night of sleep). You are considered a breakfast eater if you eat your first meal of the day following your longest period of sleep, within 2 to 3 hours of waking and if your meal contains food or beverage from at least one food group. Your breakfast should provide at least 15% of your total daily caloric needs.

Should You Eat Breakfast?

Approximately one in five Americans are “breakfast skippers”. Skipping breakfast, as part of time-restricted eating patterns, such as intermittent fasting, has become increasingly popular as a weight management strategy. However, scientific evidence to support this is lacking. Many scientific studies have shown that breakfast skippers are at an increased risk for weight gain (e.g., increased hunger driving hormones, increased hunger throughout the day) and chronic disease.

A study comparing breakfast eaters to breakfast skippers found that those who ate breakfast had a decrease in appetite, improvement in healthy food choices and improved sleep quality. In addition, a study published in 2018 compared the effects of breakfast and dinner skipping in adult men and women. The study revealed that breakfast skipping, but not dinner skipping, negatively impacted the body’s ability to control blood sugar and insulin.

Research suggests that breakfast is important, but simply eating breakfast may only be half the battle. The true victory comes when you eat a high-quality breakfast packed full of protein and nutrients.

A Balanced Breakfast with Protein

Unfortunately, the majority of Americans who eat breakfast consume too little protein at their breakfast meal and instead, eat the majority of their daily protein at dinner. The higher amount of protein (greatly exceeding 30g of protein) typically consumed at dinner time cannot be stored for later use and is either used for energy or stored as fat.

Figure 1: Protein Distribution between Meals. Adapted from Paddon-Jones and Rasmussen, 2009

 

A high protein breakfast has been shown to benefit muscle health and to support weight loss by increasing muscle mass, energy expenditure (calories burned), satiety hormones, glucose regulation and by decreasing the desire to snack at night .

High protein breakfasts have also been shown to improve the body’s response to a high carbohydrate food up to 4-hours after the breakfast meal. A recent study looked at the effect of a high protein breakfast compared to a high fat or high carbohydrate breakfast on the body’s ability to control glucose and insulin following the consumption of white bread four hours after the breakfast meal. Participants consuming a high protein breakfast (30% protein) had improved blood sugar control and insulin levels after consuming the white bread.

Conclusion

Although breakfast may be the most frequently skipped meal in America, it continues to live up to its reputation as the most important meal of the day. So, when making your next breakfast choice, consider how much protein you have on your plate. Your first meal of the day can have long lasting effects throughout your day and on your long-term health!

References

  1. Nas A, Mirza N, Hagele F, Kahlhofer J, Keller J, Rising R, Kufer TA and Bosy-Westphal A. Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk. Am J Clin Nutr. 2017; 105(6):1351-1361.
  2. Astbury NM, Taylor MA and Macdonald IA. Breakfast Consumption Affects Appetite, Energy Intake, and the Metabolic and Endocrine Responses to Foods Consumed Later in the Day in Male Habitual Breakfast Eaters. The Journal of Nutrition. 2011; 141(7).
  3. Pereira MA, Erickson E, McKee P, Schrankler K, Raatz SK, Lytle LA and Pellegrini AD. Breakfast frequency and quality may affect glycemia and appetite in adults and children. J Nutr. 2011; 141(1):163-168.
  4. Baum JI, Gray M and Binns A. Breakfasts higher in protein increase postprandial energy expenditure, increase fat oxidation, and reduce hunger in overweight children from 8 to 12 years of age. The Journal of nutrition. 2015; 145(10):2229-2235.
  5. Mamerow MM, Mettler JA, English KL, Casperson SL, Arentson-Lantz E, Sheffield-Moore M, Layman DK and Paddon-Jones D. Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. J Nutr. 2014; 144(6):876-880.
  6. Gwin JA and Leidy HJ. Breakfast Consumption Augments Appetite, Eating Behavior, and Exploratory Markers of Sleep Quality Compared with Skipping Breakfast in Healthy Young Adults. Current Developments in Nutrition. 2018; 2(11).
  7. Leidy HJ, Ortinau LC, Douglas SM and Hoertel HA. Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, “breakfast-skipping,” late-adolescent girls. Am J Clin Nutr. 2013; 97(4):677-688.
  8. Paddon-Jones D, Campbell WW, Jacques PF, Kritchevsky SB, Moore LL, Rodriguez NR and van Loon LJ. Protein and healthy aging. Am J Clin Nutr. 2015; 101(6):1339S-1345S.
  9. Chanet A, Verlaan S, Salles J, Giraudet C, Patrac V, Pidou V, Pouyet C, Hafnaoui N, Blot A, Cano N, Farigon N, Bongers A, Jourdan M, et al. Supplementing Breakfast with a Vitamin D and Leucine-Enriched Whey Protein Medical Nutrition Drink Enhances Postprandial Muscle Protein Synthesis and Muscle Mass in Healthy Older Men. J Nutr. 2017; 147(12):2262-2271.
  10. Megn H, Mathan NR, Ausman LM and Lichtenstein AH. Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations. Am J Clin Nutr. 2017; 106:1246-1256.

 

By Teresa Johnson, MSPH, RD

A symposium chaired by Bahram Arjmandi, PhD, RD, and Carmen Castaneda-Sceppa, MD, PhD, provided insights into the etiology and pathophysiology of osteosarcopenic obesity, and presented suggestions for pharmacological and dietary treatment strategies.

Jasminka Ilich-Ernst, PhD, RD, a professor at Florida State University, outlined the problem and scope of osteosarcopenic obesity, a term first coined in 2012. Characterized by the coexistence of three distinct musculoskeletal disorders—osteopenia/osteoporosis, sarcopenia, and obesity—osteosarcopenic obesity is a complex condition, for which the proof-of-concept was established only recently.

A major concern with osteosarcopenic obesity, Ilich-Ernst said, lies in age-related fat redistribution and subsequent infiltration into bone and muscle. Typically bone, muscle, and fat progenitor cells differentiate in a balanced distribution to enable normal tissue development. But with aging, a sedentary lifestyle, poor nutrition, and low-grade inflammation, differentiation patterns become altered and fat production predominates.

Whereas current nutritional and lifestyle management recommendations address the individual components of osteosarcopenic obesity, they do not address the collective triad. Ilich-Ernst suggested adhering to current recommendations to achieve peak bone mass before age 30, gain and maintain adequate muscle mass, and maintain a health weight, but she added that increasing dietary protein to 25 percent of total energy and limiting carbohydrate consumption to approximately 40 percent of total energy might further reduce risk of developing osteosarcopenic obesity.

Further insights into the interconnected nature of bone, muscle, and fat were provided by Clifford J. Rosen, MD, a professor of medicine at Tufts University and research scientist at the Maine Medical Center Research Institute. Rosen explained that the three tissues derive from a single progenitor cell type, and their responses to various cytokines, hormones, and regulatory input, primarily the sympathetic nervous system, are similar.

He then described newly identified “beige,” or brown-like, adipocytes, which contain more mitochondria and are more thermogenic than classic white adipocytes. Beige adipocytes share a common progenitor cell with smooth muscle. As such, they can be viewed as a sort of “hybrid” between fat and muscle cells. Intermittent cold exposure induces beige adipogenesis, a process referred to as “browning,” and promotes weight loss by increasing sympathetic tone—a potential non-pharmacological approach to body fat loss.

However, Rosen noted, whereas sympathetic tone enhances fat loss, it uncouples the process of bone remodeling, promoting bone loss. He added that many of the new classes of drugs that target beige adipogenesis might have similar, deleterious off-target effects on bone.
Ronenn Roubenoff, MD, MHS, of Novartis Institutes for Bone Research, and a professor of medicine and nutrition at Tufts University, compared the effects of dietary versus pharmacological approaches to treating sarcopenia. Sarcopenia, Roubenoff said, is an age-related loss of muscle mass due to type II muscle fiber atrophy. He said that preventing sarcopenia might increase life span and improve quality of life in older adults.

Although some research suggests increasing dietary protein intake might reduce muscle wasting, few data support changing current recommendations, Roubenoff said. In addition, the muscle-sparing effects of dietary protein differ in women versus men. Whereas women benefit from increased intake, men (who experience a U-shaped curve in response to intake) benefit from more moderate intake.

Roubenoff added that muscle, unlike other organs, doesn’t senesce; rather, it remains plastic, providing the potential for older adults to regain muscle mass and function. However, muscle in older adults exhibits “anabolic resistance”—an inability to integrate and build muscle. Emerging pharmacological approaches target this resistance to reverse muscle wasting.

Finally, Wayne Campbell, PhD, a professor of nutrition science at Purdue University, described the differential effects of dietary protein intake during weight loss on bone, muscle, and fat. Specifically, Campbell addressed the question of how older adults can purposefully lose weight without compromising musculoskeletal function.

Campbell and his colleagues analyzed NHANES data from 1999-2004, a period that included dual energy X-ray absorptiometry data. They partitioned the data based on thresholds of the Recommended Dietary Allowance regarding bone health, and noted that whereas inadequate protein intake had an adverse effect on bone health in adults over age 50, high protein had variable effects. Campbell then described his research with whey supplementation and noted that groups that consumed higher amounts of a whey protein supplement lost more fat than groups consuming lesser amounts. However, they experienced no change in bone status, consistent with the epidemiological data.

At a minimum, Campbell said, adults should consume adequate protein. But he added that high dietary protein intake during weight loss has a positive effect on body composition, inducing greater fat loss while maintaining lean muscle mass. In addition, he noted that high protein intake has variable effects, depending on protein type. In particular, whereas protein from dairy and plant sources likely provides greater benefit to bone, protein from non-dairy animal sources likely benefits soft tissue.