By Mukaila Kareem
…it does not make sense to ascribe the (ill)health of a day to one meal…The campaign to promote breakfast included grocers handing pamphlets that read, “Eat a Good Breakfast-Do a Better Job” as far back as 1944 and may not be about your health after all, but many healthcare professionals are still reinforcing the marketing campaign to date.
There has never been a contradiction blaming the prevalence of obesity on “calories in, calories out” on one hand and the quick flip to advise that eating breakfast is a good strategy for weight control. The obvious question is: Which is it? First, a brief history: Medieval Europe historians noted that “breakfast was only a luxury for the rich, only necessity for laborers or mostly skipped”. During the Industrial Revolution, breakfast became a morning routine, as farming was replaced by a full day’s work. However, because breakfast was no different from other meals in mid-1800s America, workers preferred a “heavy” breakfast to start the day. As noted by an author: “Americans wanted meat, meat, meat. And potatoes. And cake and pie”. This inevitably caused the mass complaint of chronic indigestion or “dyspepsia” in a new work environment, where workers sat or stood all day in the industrial setting of division of labour. In what was likened to the present-day obesity debate, “magazines and newspapers just overflowed with rhetoric about this dyspeptic condition and what to do about it”, as noted by Abigail Carroll, the author of The Three Squares. Therefore, Americans yawned for a simpler and lighter breakfast. Entered cereals, the ultimate light meal.
According to literature, the mid to late 1800s was a period when the germ theory of disease was beginning to take root in medicine, but doctors were still often called quacks. Dr. John Harvey Kellogg, a vegetarian and deeply religious man, who believed hearty meals fueled the sin of masturbation and ill-health, developed corn flakes in 1890s to improve the health and morals of the nation. Even though the original cereal was bland, it was popular and regarded as the solution to the chronic indigestion of the era. In 1917, an article authored by Lenna Cooper, a dietitian who was mentored by Dr. Kellogg, wrote that “less attention is usually paid to breakfast…yet in many ways it is the most important meal of the day, because it is the meal that gets the day started”. The firm popularity of a light breakfast, its assumed health effects and clever marketing soon gave credence to “breakfast is the most important meal of the day”, even when it became the battle of taste, to Kellogg’s displeasure, as it was later coated in sugar and fortified with vitamins due to cereal companies’ fierce competition for market share. In 1944, to break the monopoly of the light cereal breakfast, Edward Bernays, a public relation expert, on behalf of Beech-Nut company, got a doctor to agree that a protein-rich heavy breakfast of bacon and eggs was healthier than the light breakfast and then sent that statement to about 5,000 doctors for their signatures. He proceeded to have this petition published in newspapers, making it appear like a scientific study. This effort not only tried to compete with cereal breakfast but falsely legitimised breakfast as the medically recommended meal.
Over the decades, the cereal companies, following Bernays’ example, have muddied the waters by sponsoring weak observational studies associating skipping breakfast with weight gain and diabetes, knowing fully well that the lay public would not discern the research phrase that “association is not causation” until proven by rigorous randomised studies. Even with caveats, credible medical sources are parroting the findings of these weak studies, as can be read on WebMD stating that “breakfast kick-starts your metabolism…(and) many studies have linked eating breakfast to good health, including better memory and concentration.” A dietitian and clinical instructor at the University of Delaware, who described herself as “totally pro-breakfast” advised eating breakfast within an hour of waking, adding that “it’s kind of like putting gas in your car”. Really?
…despite hunger, our ancestors were alert in the morning and able to plan and perform physical activity to obtain food, while fasting. The fact is that if our ancestors had to have breakfast first thing in the morning, which certainly was not available in the tents, they would not be physically able to go out hunting or foraging on overnight fasting and by extension, none us may not be here to talk about all the ills of skipping breakfast.
What has the lay public to do with nice sounding and meaningless phrases such as breakfast “kick-starts the metabolism or a fuel to start your day from healthcare professionals? To begin with, this is why you would hardly find a doctor, dietitian, or nutritional expert to prescribe or recommend fasting for obesity, diabetes or any noncommunicable disease, most of which bear root from chronic overconsumption. In addition, studies on breakfast willfully ignore the so-called “dawn phenomenon” or “cortisol awakening response”. This is an autonomous process that boosts the blood levels of a hormone called cortisol before waking up in the morning as survival strategy to support physical activity, since our ancestors did not go to “bed” with a huge storage of food supply for the next day. The brain and skeletal muscle therefore require energy to support foraging in order to obtain food for the new day. As such, cortisol preferentially boosts blood glucose levels for the brain and acts on the fatty tissue to release fatty acids, a fuel needed by skeletal muscle for locomotion. In other words, despite hunger, our ancestors were alert in the morning and able to plan and perform physical activity to obtain food, while fasting. The fact is that if our ancestors had to have breakfast first thing in the morning, which certainly was not available in the tents, they would not be physically able to go out hunting or foraging on overnight fasting and by extension, none us may not be here to talk about all the ills of skipping breakfast.
Therefore, it does not make sense to ascribe the (ill)health of a day to one meal. As Heather Arndt Anderson, the author of Breakfast: A History, puts it, “people make their lifestyle change at New Year and every morning is like New Year’s Day – a chance to start things off in the right direction. So, if you have cold pizza for breakfast, it says what sort of person you are.” The campaign to promote breakfast included grocers handing pamphlets that read, “Eat a Good Breakfast-Do a Better Job” as far back as 1944 and may not be about your health after all, but many healthcare professionals are still reinforcing the marketing campaign to date. Yeah, “breakfast is the most marketed meal of the day”.
Mukaila Kareem, a doctor of physiotherapy and physical activity advocate and can be reached through firstname.lastname@example.org