> The Breakfast Hype

SHELLEY RATTET of Framingham, Mass., has lost about 25 pounds these past few months. It was the first time the 55-year-old clinical psychologist had lost weight in 10 years.

One of the changes she made: Making sure that she ate a good breakfast.

Mark Mattson, a neuroscientist at the National Institute on Aging, disdains the morning repast. He hasn't eaten breakfast in 20 years, ever since he started running early in the mornings.

He says he's skinny and healthy and never felt better.

Whatever you do, don't skip breakfast.

Breakfast: It's the most important meal of the day.

Such pronouncements carry almost the aura of nutritional religion: carved in stone, not to be questioned. But a few nutritionists and scientists are questioning this conventional wisdom.

They're not challenging the practice of sending children off to school with some oat bran or eggs in their belly. They acknowledge the many studies reporting that children who eat breakfast get more of the nutrients they need and pay more attention in class.

They do say, however, that the case for breakfast's benefits is far from airtight — especially for adults, many of whom, if anything, could stand skipping a meal.

"For adults, I think the evidence is mixed," says Marion Nestle, professor of nutrition, food studies and public health at New York University who hasn't eaten breakfast in years because she is just not hungry in the morning.

"I am well aware that everyone says breakfast is the most important meal of the day, but I am not convinced," Nestle wrote in her book, "What to Eat." (She later received many e-mails from readers telling her that they were relieved to hear it.) "What you eat — and how much — matters more to your health than when you eat."

A few scientists go further than this. They say it may be more healthful for adults to skip breakfast, as long as they eat carefully the rest of the day.

"No clear evidence shows that the skipping of breakfast or lunch (or both) is unhealthy, and animal data suggest quite the opposite," wrote Mattson, possibly the ultimate anti-breakfast iconoclast, last year in the medical journal the Lancet. Advice to eat smaller and more frequent meals, he wrote, "is given despite the lack of clear scientific evidence to justify it."

Mattson admits that he hasn't proven his case yet. His studies are still preliminary.

But already, his findings have attracted a cadre of followers who started to skip breakfast once they heard of his results. Meanwhile, a diet plan that involves breakfast skipping — the Warrior Diet — is attracting followers in the U.S. and worldwide.

These aren't the only ones forgoing the morning repast, of course. Surveys show that about one-third of all people in the U.S. and Europe skip breakfast, primarily because they say they don't have enough time in the morning or because they want to lose weight — and what better way to do so than miss a meal?

Most nutritionists and health experts maintain that this is unwise. Breakfast skippers, they say, risk skimping on important nutrients. They also tend to binge later on, actually increasing their risk of gaining weight.

"There isn't any downside to eating a healthy breakfast," says registered dietitian Joan Salge Blake, a clinical assistant professor at Boston University who specializes in weight management. "Currently, Americans, on average, fall short on their daily servings of whole grains, fruits and dairy foods. Eating breakfast is an excellent way to add these foods to the diet."

Case for skipping

A few researchers would go further than saying breakfast is no great shakes. They'd say avoiding it may even be healthy.

Take dieting.

"If you look at the first change that dieters make in their habits, it's [dropping] breakfast," Levitsky says. He thinks they are on the right track. "They know more than the scientists," he says.

Unconvinced by the skip-breakfast-get-fat connection, Levitsky set out to test it in his lab. In a still unpublished study, he had undergraduate students eat well-defined meals under controlled conditions — including an all-you-can-eat breakfast some days and no breakfast on others. Both groups could eat as much as they wanted for the rest of the day.

The skippers, Levitsky found, ate about 150 more calories at lunch — but no extra calories for the rest of the day. As a result, they ate 450 fewer calories.

"If you skip breakfast twice a week, that's about 1000 calories less," Levitsky says — enough, over time, to make a significant difference in one's weight.

Mattson, of the National Institute on Aging, has done similar research, except he asked people to skip not only breakfast, but lunch as well. In a still unpublished study, he enrolled 20 normal-weight adult men and women, then instructed half of them to skip all meals except dinner. They were told to try to eat the same amount of calories.

None of the people on one meal a day ate more than those on three meals, he says. At the end of two months, those who were on one meal a day hadn't gained, or lost, any weight — although he suspects that they would have lost weight, if left to their own devices, because they found it difficult to eat all their allotted calories.

They also had more muscle compared with fat, showed signs of boosted immune responses, and didn't have higher blood insulin levels, as some scientists fear could result. But they did have higher cholesterol levels.

Mattson has also conducted "intermittent fasting" studies, as he terms them, on rodents. He's reported that animals deprived of food every other day have lower blood pressure and heart rate, lower insulin levels and an improved removal of glucose from the blood — all good things.

He would be the first to admit that neither his human or animal studies are quite analogous to just skipping one's morning meal. But, he adds, "My own gut feeling is that when the inter-meal interval is increased — whether through intermittent fasting or skipping breakfast — that will result in qualitatively similar beneficial effects."

It is not clear that major, federal money will ever be thrown at settling the breakfast dilemma. In the meantime, anyone who wants to skip it but is worried about those shortfalls in vitamins and minerals can take a handy tip from Mattson.

"Eat breakfast at lunch," he says.


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