Healthy breakfast may mean healthier diet overall

NEW YORK (Reuters Health) - Breakfast may indeed be the most important meal of the day -- as long as that meal is not a doughnut -- a study suggests.

Using data from a national health survey of U.S. adults, researchers found that people who ate lower-calorie foods for breakfast tended to have a higher-quality diet overall.

Furthermore, men who ate a healthy breakfast generally weighed less. Among women, breakfast eaters -- regardless of the food involved -- tended to weigh less than those who skipped the morning meal.

The findings, reported in the American Journal of Clinical Nutrition, give some support to past studies finding that breakfast eaters are less likely to be overweight -- and that eating a high-quality breakfast, rather than grabbing a pastry, is the key.

Research has shown, for example, that people who eat a bowl of cereal for breakfast have a lower average weight than either those who skip breakfast or those who sit down to a plate of steak and eggs.

What's "unique" about the current study is that it suggests that breakfast foods low in "energy density" -- low in calories for a given amount of food -- "appear to predict better food choices for the rest of the day and may help with better management of body weight," Dr. James Rippe, one of the researchers on the work, said in a written statement.

Fruits, vegetables and high-fiber whole grains, for example, are low in energy density, while confections like Danish pastries and doughnuts have a high energy density.

The current findings underscore the importance of choosing low-energy- density options for breakfast, according to Rippe, a cardiologist with the Rippe Lifestyle Institute in Shrewsbury, Massachusetts.

The Rippe organization manages the Breakfast Research Institute, an industry-sponsored group that funds health and nutrition research. The BRI financed the current study.

The findings are based on responses from more than 12,000 U.S. adults who took part in three federal health surveys between 1999 and 2004.

Overall, people who reported eating a low-energy-density breakfast in the past day were more likely than their counterparts to choose lower-calorie foods for the rest of the day as well. As a group, they also had a higher-quality diet -- eating a wider variety of foods and more vitamins and minerals.

Among men, those who ate a breakfast low in energy density tended to weigh less, even with factors like exercise and income considered. For women, any type of breakfast was related to a lower likelihood of obesity -- though the calorie density of other meals did seem to be important.

More research is needed to confirm those particular findings, Rippe's team notes. For now, they suggest that men should be encouraged to eat a breakfast low in energy density, whereas women should eat breakfast but also focus on choosing low-energy-density foods throughout the day.

SOURCE: American Journal of Clinical Nutrition, November 2008.