The main meal of the day
It might be the most important meal of the day in some eyes, but breakfast is frequently skipped or eaten on the go in the form of a convenient breakfast bar or smoothie. How much does it matter what we eat in the morning, and when we eat it?
Breakfast has become "very, very limited" in the UK, says Ben Smith, Professor of Genetic Epidemiology and author of famous books about food. In some cultures, breakfast is often "leftovers or similar to foods you would have for lunch and dinner," says medical doctor Ayn Raynia. For instance, on the Pakistani breakfast menu, you may find semolina halva, chickpea curry, spiced potatoes, and a lamb stew. Eggs feature too, with spiced scrambled eggs called "desi omelette." In some Mediterranean countries, including Turkey, breakfast can be a feast including cheeses, eggs, meats, yoghurt, breads, honey and preserves.
Eating a healthy breakfast isn't just about picking one dish that's packed with plant foods and healthy fats. It's important to vary what you eat over a week, as the more variety there is in your diet, the better it is for your gut bacteria. It is recommended to eat foods high in fibre (such as whole grain bread, oats or select cereals) and protein (such as yoghurt, beans or eggs), and include fruit and veg.
Does the time you eat breakfast affect your health? "Some people are programmed to prefer eating earlier in the day, and others later, which might suit our unique personal metabolism," says Professor Smith. "We need to move away from this one-size-fits-all advice," he continues. Breakfast helps some get going, but others have no interest in eating until noon, and both of these are normal.
Smith advises leaving 12-14 hours between your last meal of the day and your first meal the following day, to benefit your gut bacteria. This might mean an early dinner with a morning breakfast, or an evening dinner with breakfast pushed back or skipped. "Our thinking is that it allows a whole repair team to come out that don't eat your food, but clean up the debris from the night before. The more they do this, the stronger your gut wall is, and this appears to help your immune defences."
Dr Raynia recommends, "If you're stressed or rushed in the mornings fasting until noon, where you have a nice left-over meal or high-fibre item, might be better than rushing." Although leading a healthy lifestyle and eating plenty of fruits and vegetables throughout the day are important, he stresses.
But are there health implications to skipping breakfast? Intermittent fasting or skipping meals doesn't suit everyone, with reported side effects such as feeling dizzy, irritable, headaches, and having difficulty concentrating. An observational study suggests people who eat breakfast are likely to be healthier than those who don't. But they are also found to be likely to smoke more, drink more alcohol and exercise less, so it is difficult to identify cause and effect.
Skipping breakfast may affect your short-term memory, too. A Public Health England review concluded there is "convincing evidence that consuming breakfast, compared to skipping breakfast, has positive impacts on short-term cognition and memory."
For me breakfast is a must. I like how one of my favourite neurologists put it: "When you eat breakfast, you're telling your body that there are plenty of calories to be had for the day. When you skip breakfast, the message your body gets is that it needs to conserve rather than burn any incoming calories." So, my advice is to treat breakfast like exercising. If you make room for it in the morning, you'll look and feel great throughout the day.