Skipping Breakfast May Raise Dementia Risk, Study Says

For some folks, breakfast isn’t the most important meal of the day—it’s the most skipped. From 2015 to 2018, 15% of Americans older than 20 skipped breakfast regularly, according to data from the the Centers for Disease Control. Whether it’s because mornings can be annoyingly hectic or because intermittent fasting, which limits the amount of time you can eat each day, is a fairly popular weight loss tactic, it makes sense that some folks just aren’t taking the time to start each day with a meal.

And while there is evidence that intermittent fasting may help some people lose weight in the short term, skipping breakfast and intermittent fasting can both have some negative health consequences. This includes creating a stress response in the body, which encourages the release of cortisol, encouraging belly fat accumulation over time. Not eating in the morning can also increase feelings of anxiety due to low blood sugar, and it may increase brain fog, since your brain needs to be “fed”—and until it is, it can’t think clearly. After all, glucose is the brain’s primary fuel.

Skipping breakfast might also have some long-term negative consequences on brain health, according to a study released on November 30, 2024, in the Journal of Neurorestoratology. Let’s take a closer look at what they found.  

How Was This Study Conducted?

This study was an observational study, meaning that the researchers simply observed participants without creating specific conditions. For example, for other types of studies, participants would be randomly assigned to a group, with one group instructed to skip breakfast and another group instructed to eat breakfast. 

In this case, participants simply did what they normally do and recorded the timing of their meals so that researchers could compare certain characteristics of breakfast skippers to those who eat breakfast. Researchers considered “breakfast skippers” as those who regularly skip breakfast at least once a week. 

To qualify for this study, participants had to be at least 60 years old, live in Chengdu, Sichuan, China, and be willing to complete a three-year follow-up—the length of the study. People with certain co-morbidities, like severe cardiac disease and infections of the central nervous system, were not qualified to participate. 

While 973 individuals made the cut to participate in the study, only 859 made it the whole three-year study period. Of these, 117 were categorized as habitual breakfast skippers. Because of the mismatch in the number of breakfast skippers to breakfast eaters, researchers formed a sub-analysis, creating a 1:1 match-up with breakfast skippers to breakfast eaters based on age, sex, education level and ApoE genotype. This analysis is called 1:1 propensity score matching (PSM).

At baseline, demographic information, including age, sex and education level, was collected. Participants’ cognitive function was assessed using a test called the Mini Mental State Examination (MMSE), which was repeated every 18 months. The MMSE is a brief quiz that tests a person’s recall of simple facts, like what day it is or where they are. All participants were also tested for the ApoE gene, which, when present, increases one’s risk for Alzheimer’s disease.

Of the 859 participants, 179 also underwent brain magnetic resonance imaging (MRI) scans at each follow-up visit to assess brain volume—because where brains are concerned, size matters. Brain atrophy—a shrinking brain—has been linked to dementia. Of the 179, 34 of them were considered breakfast skippers. 

At the final 36-month follow-up visit, all participants also underwent additional bloodwork to assess biomarkers in the blood that signal neurodegeneration. Neurodegeneration is a loss of brain and nervous system function.

What Did This Study Find?

At baseline, there were no significant differences between breakfast eaters and breakfast skippers regarding cognitive performance, based on the MMSE scores. MMSE scores were still similar at the 18-month follow-up. It wasn’t until the final 36-month follow-up that differences between the breakfast eaters and breakfast skippers started surfacing. Those who habitually skipped breakfast had lower MMSE scores than breakfast eaters. This held true even after adjusting for age, sex, education level, BMI, ApoE carrier status, blood pressure, diabetes and hyperlipidemia (high cholesterol and blood fats). Results were similar for the PSM group, as well.

Researchers then used a type of regression model to help identify the factors related to cognitive decline over time. They found that lower education levels, obesity, hypertension and habitual breakfast skipping were associated with cognitive decline over the study period. 

In addition, they found that individuals who regularly skipped breakfast had higher levels of certain neurodegeneration biomarkers compared to those who did not skip breakfast. This held true in the PSM group as well. 

Falling in line with these results, the 34 breakfast skippers who underwent MRIs also showed more significant brain atrophy (shrinking) compared to those who ate breakfast. 

How Does This Apply to Real Life?

Because other influencing factors—like age and BMI—were adjusted for, this study suggests that regularly skipping breakfast may be an independent risk factor for cognitive decline in older adults. These researchers feel that habitually skipping breakfast may directly increase certain biomarkers of cognitive decline and reduce brain size. 

One key here is “habitual.” Habits are formed over time, which means that the participants who were skipping breakfast most likely had been doing so well before the study period. And we know that changes to the brain that result in Alzheimer’s disease and other forms of dementia can begin decades before symptoms show up. This means that now is the time to form the habit of eating breakfast if you tend to skip it.

If you are a regular breakfast skipper, examine why. Are you not hungry in the morning? Do you feel like you don’t have time for breakfast? Or did you somewhere along the line just fall into this habit? 

Breakfast doesn’t have to be a huge meal, nor does it have to take a lot of time in the morning. For example, smoothies come together quickly and can be taken with you to work or school. Overnight oats and chia pudding can be meal-prepped so that you have grab-and-go options that are available throughout the week. Ditto for baked oatmeal, egg bites and muffins. And rotating through a few of those options can keep you from getting stuck in a breakfast rut.

If you’re someone who feels that eating breakfast makes you hungrier mid-morning, it may be because you’re not including enough fiber or protein with your first meal of the day. For example, many boxed cereals don’t have enough of either nutrient to sustain you for long. If cereal is your thing, make sure it’s lower in sugar and higher in fiber. Eat it with cow’s milk, soy milk, yogurt or kefir for added protein. The fiber-protein combo will help prevent a sudden blood sugar crash, which may leave you with that hangry feeling. 

Whole-grain toast with eggs, avocado or a slather of nut butter are other great fiber-protein combo options. 

And who says breakfast has to be confined to what is considered traditional breakfast foods? Last night’s leftovers work, too. 

The Bottom Line

This study suggests that regularly skipping breakfast is linked with cognitive decline in older adults. Because negative changes in the brain can begin decades before symptoms show up, it’s important to start healthier habits now. This includes regularly eating breakfast if you’re not already—even if it’s just something small to feed your brain and break that overnight fast. If you’re in need of ideas, try shuffling through some of our simple, cozy winter breakfast recipes.