Breakfast: Most Important Meal of the Day More Important Than We Thought

Robert Murray, MD, FAAP

March 6, 2018

We finally have data to support the old adage that breakfast is the most important meal of the day. In fact, the effects of breakfast are even more striking than earlier generations might have imagined. Not only does it break an overnight fast and provide crucial nutrients to fuel the day, but it also improves attention and memory, heightens sense of well-being, and lowers the risk of obesity.

School nurses know what happens when children don’t get breakfast: headaches and stomach aches in the mid-morning. Teachers know, too: distracted and irritable kids. As pediatricians, part of our jobs is to help let families, communities and policymakers know.

Breakfast is particularly important for young children to ensure optimal growth and development. The brain uses more energy than any other organ in the body: more than half of infant’s daily kilocalories, and at least 20 percent of what older children and teens need. Brain scans during prolonged periods without food show activity mainly in the mid-brain, the area associated with anxiety, agitation, irritability, and mood swings. After feeding, the frontal cortex lights up and amygdala activity quiets. The child is ready to learn.

Earlier generations typically started the day with parents and kids eating together. Today, it’s a free-for-all. When my 3 kids were younger, we could make the breakfast selections. Not so when they were teens. Somehow in the 5 minutes between rising and heading out, we had to find a breakfast that worked for them. Milk-based breakfast drinks combined with carefully chosen cereal bars, or balanced energy bars worked well, along with fruit or yogurt. If they weren’t hungry right away, which was common, the items went into their backpack for later in the morning.

Ideally, the first meal of the day should include a mix of servings chosen from a few of the 5 food groups (fruits, veggies, grains, dairy, and quality proteins), each high in nutritional value. Carbohydrates provide fuel, while proteins and fats provide energy and satiety over time.Breakfast choices, and other snacks and meals a child eats throughout the day at school, matter. More than 55 million children and teens attend the nation's public schools, where they eat about 35 percent to 40 percent of their daily calories. It’s important those calories be healthy ones, especially since an about a third of the calories kids eat these days are not.

In its “Snacks, Sweetened Beverages, Added Sugars, and Schools" policy, the American Academy of Pediatrics (AAP) encourages pediatricians to counsel families and local school staff about improving the quality of foods served or brought into schools. This includes packed lunches and snacks, fundraisers, sporting events, in-class parties, and school celebrations. We can get involved as parents, members of the school’s wellness council, consultants, sports team physicians, members of the school board, and through AAP state chapter outreach efforts. We also can become nutritional cheerleaders by encouraging schools to achieve national or state recognition for their wellness efforts, as exemplified by the USDA’s Healthier US Schools Challenge.

"Brain scans during prolonged periods without food show activity mainly in the mid-brain, the area associated with anxiety, agitation, irritability, and mood swings. After feeding, the frontal cortex lights up and amygdala activity quiets. The child is ready to learn.”

It’s especially important to protect the school nutrition programs that, in turn, protect the millions of children at risk for food insecurity. School breakfasts are served to 15 million kids per day; school lunches to 32 million. These programs are healthier than ever after the USDA adopted new standards in 2010 that aligned them closely with the guidance of the Dietary Guidelines for Americans. More recently, the meals and snacks provided through the Child and Adult Care Feeding Program (CACFP), aimed at pre-school children, as well as Women Infant and Children (WIC) packages, have also been strengthened.

It’s not just the meals themselves that have had a make-over. Innovations in delivery of school breakfast also help kids get the nutrition they need. Breakfast in the classroom, grab-and-go options, access for children arriving late, and other adaptations have increased participation, and the USDA’s Community Eligibility Provision has been revolutionary. This rule allows schools with greater than 40 percent free-and-reduced meal participation to offer free breakfasts to all children at the school, no questions asked.

These critical policies support a child’s nutrition, classroom behavior, ability to learn and become healthy and productive citizens. Everybody wins.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author

Robert Murray, M.D., FAAP

Robert Murray, M.D., FAAP, served on the American Academy of Pediatrics (AAP) Council on School Health for 10 years, including 4 as the Chair. He was lead author of the policy statement, "Snacks, Sweetened Beverages, Added Sugars, and Schools" and writes the chapter on school-based nutrition for the AAP's Handbook of Nutrition. Currently, Dr. Murray is the President of the Ohio Chapter of the AAP. He has retired as professor of pediatrics at The Ohio State University.

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