FOR at least the last 50 years we have been told breakfast is the most important meal of the day with advice on its benefits still robustly issued by the public health departments of several developed nations.

Yet this advice may not be entirely correct. Furthermore, many studies into the pros of breakfast have been funded by the food industry; a clear conflict of interests.

It has been claimed that breakfast sets you up for the day, improves concentration and productivity, and reduces cravings for mid-morning sugary treats. An even bolder assertion is that having breakfast prevents weight gain and benefits your metabolism.

However a review of several studies produced recently in the British Medical Journal has shown that skipping breakfast does not automatically lead to weight gain, nor does it adversely affect your metabolic rate. Indeed, the researchers found that those who consumed breakfast ate on average 260 more calories per day than those who didn’t, and that those who went without didn’t necessarily cave in to comfort food later in the day.

The argument for breakfast is that it is an easy meal to get right. A bowl of wholegrain cereal with semi-skimmed milk and a glass of fresh fruit juice is high in fibre, vitamins and minerals.

Certain groups should not miss breakfast. Children who do not get breakfast tend to struggle with concentration at school, as their fuel stores are used up during sleep and need to be refreshed in the morning. Pregnant or breastfeeding mothers and those with diabetes should not fast for prolonged periods.

On the other hand, persons thinking that breakfast should regularly extend to a full English are unlikely to find this an aid to weight loss.

Irrespective of what you eat or when you eat in the day, if you regularly put in more calories than you burn off, weight gain will occur. The concept of intermittent fasting suggests that our gut flora themselves may need time to recover and that if you skip breakfast, or even delay it by a few hours, this may give the bacteria in your intestines, or “microbiome”, more time to recover, and hence digest and metabolise better.

Whether you decide to have or skip breakfast remains a very personal choice. If you find that you need something to eat soon after you wake up in order to function, you should not deny yourself this. Aim to make sensible choices.

Many cereals, although promoted as healthy, may contain large amounts of sugar, fat or salt, so it is always worth reading the nutritional label, which will either give you the actual amounts per serving, or display them in a traffic light system; red being high levels.

On the other hand, if you can’t face food first thing in the morning, don’t force yourself.

Your breakfast will just be later in the day, and again try to pick something that will give you a sustained release of energy and won’t have you snacking on high calorie convenience food.

“Will my varicose veins stop me flying?”

Question: I’ve had varicose veins for as long as I can remember, at least since the birth of my son, who is now 30. They’re unsightly but apart from that I’m not bothered. Am I ok to go on a long haul flight? – Nupur, 50

Answer: Although there is now evidence that varicose veins are a risk factor for a deep venous thrombosis (DVT), they are only one pf several risk factors, and if you haven’t had a DVT in the past, this is probably the most important issue to be taken into account. Nevertheless long haul flight may result in sluggish blood flow in your legs. To reduce your risk of a DVT, ensure you drink plenty of water in flight, avoid or limit your caffeine and alcohol intake as these can dehydrate you, and regularly move your legs, even if this is just flexing your ankles a few times every so often to get your calf muscles pumping blood back up to your heart. A hot, swollen calf may indicate a DVT so never ignore these symptoms and seek immediate medical help.

Question: I’ve been diagnosed with high blood pressure. My doctor wasn’t keen to give me time to lose weight as he said the numbers were very high. If I lose the weight, will I be able to come off them? Horace, 60

Answer: Normally, once you are prescribed medication for high blood pressure, or hypertension, these tend to continue long term. Sometimes it is reasonable to see if the person can modify their lifestyle initially, however if readings are very high, or if you are slightly older, it is less likely that the readings will decrease without medication. That being said, this should not discourage you from weight loss and a healthy diet, as these will help your overall health. Equally healthy behaviours may mean you avoid higher doses of medication, or the need for more than one medication to control your blood pressure.

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Dr Uddin’s advice is provided in good faith and in accordance with currently accepted evidence. However, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of a GP, or other qualified health provider, regarding a medical condition.