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Is skipping breakfast unhealthy?

Observational studies show associations, but randomized trials do not confirm a causal harm. A look across both study designs.

KEY TAKEAWAY
  1. 01
    There is not enough consistent evidence to say that skipping breakfast alone is harmful to health.
  2. 02
    Observational studies link breakfast skipping to higher risk, but randomized trials do not confirm a causal effect.
  3. 03
    The day's overall diet quality and routine likely matter more than whether breakfast is eaten.

Conclusion

There is not enough consistent evidence to say that skipping breakfast is, on its own, harmful to health. Observational studies link breakfast skipping to higher rates of cardiovascular disease and death, but those links may reflect confounding lifestyle factors or reverse causation (feeling unwell and therefore skipping). Randomized trials show that eating breakfast does not reliably help with weight control.

The overall quality and quantity of the day's diet, along with daily routine, likely matter more than the presence of breakfast itself.

How much does it help?

Pooled observational data suggest that people who habitually skip breakfast have roughly 20 to 30 percent higher risk of cardiovascular disease and all-cause death. In randomized trials, however, the breakfast group tended to consume more total daily energy, and body weight was actually slightly lower in the breakfast-skipping group (on the order of a few hundred grams).

Association from cohort studies and causation from trials need to be read separately.

What the research shows

The evidence base includes meta-analyses of randomized controlled trials and meta-analyses of large prospective cohorts. Cohort studies show associations, but people who skip breakfast often differ in smoking, exercise, and sleep, so residual confounding cannot be fully removed. The trials mostly looked at weight and energy intake over the short term, and high-quality long-term data on cardiovascular and metabolic outcomes is limited.

Cautions

  • People managing blood sugar or medication for diabetes should not change meal timing on their own
  • Effects can be larger for growing children, during pregnancy, or where undernutrition is a concern
  • Skipping breakfast but then overeating later can lower the overall quality of the day's diet
  • People with existing conditions should consult a physician before changing meal patterns

A simple analogy

The link between eating breakfast and being healthy resembles the link between carrying an umbrella and wet streets. The umbrella does not cause the rain, and breakfast alone is not necessarily the cause either. The surrounding habits need to be considered together.

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This article is not medical advice. Consult a qualified professional for individual health concerns.
REFERENCES

Evidence behind this article (3)

  1. [01]
    Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials
    Sievert K, et al·BMJ 2019·PMID:30700403
  2. [02]
    Breakfast skipping, body composition, and cardiometabolic risk: a systematic review and meta-analysis of randomized trials
    Bonnet JP, et al·Obesity 2020·doi:10.1002/oby.22791
  3. [03]
    Association of skipping breakfast with cardiovascular and all-cause mortality
    Rong S, et al·Journal of the American College of Cardiology 2019
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