The latest boost of interest in intermittent fasting brings up some interesting questions about breakfast. Proponents of intermittent fasting often suggest skipping breakfast, but this goes completely against what you’ve always heard about the first meal of the day: "Don’t skip breakfast. It’s the most important meal of the day."Whether they're fasting or not, many people make excuses not to eat breakfast. Some are trying to lose weight, others aren't hungry, and still others simply don’t have the time to prepare something in the morning.In the 1960s, nutritionist Adelle Davis advised, “Eat breakfast like a king, lunch like a prince and dinner like a pauper” (2). The latest research suggests we consume about 15-25% of our daily calorie intake at breakfast (roughly 300-500 calories for women and 375-625 calories for men) (3,4,5). Despite this, large-scale surveys show that 18-25% of adults and 36% of teens in the US skip breakfast (6). While what we eat for breakfast varies from culture to culture, there are valid reasons not to skip it.So, what are the benefits of eating breakfast?A study done by Cahill, et. al in 2013 found that men that skipped breakfast had a 27% increase in coronary heart disease over men that ate breakfast (7). This is pretty significant for men at risk for heart disease.On the flip side, the risk for atherosclerosis is higher in those that consume a high-fat breakfast (read bacon & doughnuts) too frequently (8). Obviously what we actually consume at breakfast matters too. A recent study from Finland suggests that cognitive performance in middle-aged men is improved with the consumption of eggs at breakfast (9). Another study found that including foods high in protein at breakfast such as eggs, Greek yogurt, low-fat cheese or nut butters provide more satiety than eating carbohydrates alone, though animal based-protein foods allow for better blood sugar control (10).In addition, there are plenty of studies to support school-aged children eating breakfast, especially since skipping it often impairs academic performance (11,12). The type of food children eat at breakfast also impacts their appetite. A small study completed in Headstart children showed that high-protein and high-fiber foods eaten at breakfast provided more satiety than other foods (13). With the rate of obesity in children at 17%, this is a simple intervention to reduce obesity in this high-risk population.Speaking of weight control, Adelle Davis was way ahead of her time. Evidence shows that consuming more calories early in the day can aid weight loss. Recent research by Dr. Hana Kahleova, from the Loma Linda University School of Public Health (LLUSPH), in California evaluated the effect of meal timing and weight gain. The study is part of the Adventist Health Study-2, a health study observing over 96,000 Seventh Day Adventists in the US and Canada aged 30 and up. The research investigated the possible association between how frequently people eat and BMI. Body habitus varied among participants and eating habits and health status was monitored for approximately 7 years. Those that consumed frequent snacks along with meals experienced the most weight gain. The researchers discovered that subjects that ate breakfast most consistently lost the most weight and that those with a bigger breakfast instead of a bigger lunch or dinner experienced the greatest drop in BMI (14).If you’re at a loss for what to eat for breakfast, think outside the cereal box. Here are a few quick quick ideas:

• String cheese, whole grain crackers, and grapes
• Peanut or almond butter sandwich on whole grain bread
• Green eggs, no pan. Scramble 2 eggs and top them with 1 cup of fresh spinach. Pop the whole thing in the microwave for 1 minute, then add 1 tablespoon shredded cheese to create a mini omelet.
• Overnight oats using ½ cup regular oats, ½ cup Greek yogurt, ½ cup frozen berries. Mix well, pop in fridge and eat in the morning.
• Warm quinoa with ginger, cinnamon, and chopped walnuts.

By Lisa Andrews, MEd, RD, LDReferences:

1. http://time.com/4408772/best-times-breakfast-lunch-dinner/
2. Spencer, B., DON'T skip breakfast! Official advice warns that missing out on a morning meal raises the risk of obesity, heart disease and diabetes, DailyMail Online 2017, January 30th. http://www.dailymail.co.uk/health/article-4172850/DON-T-skip-breakfast.html
3. J.A. Betts, J.D. Richardson, E.A. Chowdhury, G.D. Holman, K. Tsintzas, D. ThompsonThe causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am. J. Clin. Nutr., 100 (2014), pp. 539-547
4. P.S. Haines, D.K. Guilkey, B.M. PopkinTrends in breakfast consumption of US adults between 1965 and 1991
5. A.K. Kant, B.I. GraubardSecular trends in patterns of self-reported food consumption of adult Americans: NHANES 1971–1975 to NHANES 1999–2002
6. Am. J. Clin. Nutr., 84 (2006), pp. 1215-1223
7. A.M. Seiga-Riz, B.M. Popkin, T. CarsonTrends in breakfast consumption for children in the United States from 1965 – 1991. Am. J. Clin. Nutr., 67 (1998), pp. 748S-756S
8. L.E. Cahill, S.E. Chiuve, R.A. Mekary, M.K.Jensen, A.J. Flint, F.B. Hu, E.B. RimmA prospective study of breakfast eating and incident coronary heart disease in a cohort of male U.S. health professionals. Circulation, 128 (2013), pp. 337-343
9. B.K. McFarlin, K.C. Carpenter, A.L. Henning, A.S. VenableConsumption of a high-fat breakfast on consecutive days alters preclinical biomarkers for atherosclerosis. Eur. J. Clin. Nutr. (2016), 10.1038/ejcn.2016.242
10. M.P.T. Ylilauri, S. Voutilainen, E. Lönnroos, J.Mursu, H.E.K. Virtanen, T.T. Koskinen, et al.Association of dietary cholesterol and egg intakes with the risk of incident dementia or Alzheimer disease: the Kuopio Ischaemic Heart disease risk factor study. Am. J. Clin. Nutr. (2017), 10.3945/ajcn.116.146753
11. Christina M. Crowder, Brianna L. Neumann, and Jamie I. Baum Breakfast Protein Source Does Not Influence Postprandial Appetite Response and Food Intake in Normal Weight and Overweight Young Women. J Nutr Metab. 2016; 2016: 6265789.
12. *K. Adolpus, C.L. Lawton, L. Dye The effects of breakfast on behaviour and academic performance in children and adolescents. Front. Hum. Neurosci., 7 (2013), p. 425, 10.3389/fnhum.2013.00425
13. K.A. Wesnes, C. Pincock, D. Richardson, G.Helm, S. Hails Breakfast reduces declines in attention and memory over the morning in schoolchildren. Appetite, 41 (2003), pp. 329-331
14. Ann G. Liu, PhD, Renee S. Puyau, RD, Hongmei Han, MS, William D. Johnson, PhD, Frank L. Greenway, MD, andNikhil V. Dhurandhar, The Effect of an Egg Breakfast on Satiety in Children and Adolescents: A Randomized Crossover Trial. J Am Coll Nutr. 2015; 34(3): 185–190.http://publichealth.llu.edu/adventist-health-studies/about