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Conference on 'Roles of sleep and circadian rhythms in the origin and nutritional management of obesity and metabolic disease'
Cuthbertson Medal Lecture
[dagger]. Joint first authors.
8-9 December 2015
The Joint Winter Meeting between the Nutrition Society and the Royal Society of Medicine
The Royal Society of Medicine, London
The broad field of nutrition and health is rife with myths, misconceptions and frequently posed yet seemingly fundamental questions that we intuitively feel should have simple answers. Is a calorie a calorie? Is obesity due to eating too much or doing too little? Is breakfast the most important meal of the day? Often there are simple answers, the first two being central to the themes considered in the present review and both absolutely 'yes' (just as a second is a second, one thermochemical calorie is simply a unit of measurement equivalent to 4·18 J). The third is not so easily answered and there can be no correct response until we refine that question; 'If you wish to converse with me' said Voltaire 'define your terms'. In this case, we must define both what is meant by breakfast and what is meant by important (i.e. important for what?).
Framing our question in terms of whether breakfast is the most important meal of the day also implies some inherent value in comparing breakfast with other daily eating occasions. Why should the potential benefits of breakfast and therefore our decision about breakfast consumption depend on the relative importance of lunch or dinner? For example, breakfast consumption is unlikely to be more important for our general health than physical exercise or not smoking but that does not discount that breakfast may be sufficiently important to form part of a wider healthy lifestyle(1-4). Indeed, markers of a healthy lifestyle are associated with frequent breakfast consumption, which confounds interpretation of causal links between breakfast and good health.
The true question to be explored in the present review therefore concerns our daily decision about when to interrupt an extended period of fasting (e.g. overnight). Whether what might then be defined as breakfast and has the potential to cause meaningful effects on various health markers across different populations and contexts can then be considered. While this approach is...