邱正宏醫師

景升診所 醫美中心

吃不吃早餐 和肥胖的關係

網路上有一種說法，認為「要減肥一定要吃早餐」、「吃早餐的人比較不會胖」，很多人問我：「邱醫師，我想減肥，到底要不要吃早餐？」

我查詢已發表的醫學論文，以「早餐」和「肥胖」相關論文主題發表的醫學文獻，從1992年到2014年超過26篇，從這些論文的結論看來，可分成幾方面：

一、對兒童來說，有規律吃早餐的小朋友，的確比較不會有肥胖的問題

二、青少年及成人，結論並不一致。馬來西亞、印度和希臘發表的論文，認為吃早餐的人比較沒有肥胖問題，韓國的研究結論則相反，吃不吃早餐和肥胖無關。

這些結論可以從幾方面解釋：

一、規律吃早餐的小朋友，通常家人會比較關注小朋友的營養和健康問題，也會用心幫小朋友準備早餐，經濟水平較高，所以這些小朋友體重比較不會過重。

二、有吃早餐的小朋友，上學後比較不會肚子餓，所以下了課不會亂買零食、含糖飲料或其他高熱量的食物，因此比較不會吃進許過多高熱量的食物。

三、對成人來說，沒有每天一定要早起的問題，有些人可能睡到接近中午才起床，對這些人來說因為工作時間延後，沒吃早餐是很正常的。即便是早上要上班的人，沒吃早餐也會在中午吃正餐，對於總熱量的攝取並不會因為沒吃早餐而亂了套，因此影響不明顯。

四、成人比較會注重外表，一變胖就會控制自己，早餐吃不吃不是重點。

2008年委內瑞拉發表一篇報告

發現早餐吃得多的人，和三餐平均分配的人，在總熱量相同情況下能夠減掉更多的熱量，這篇報告是在國際內分泌學會的會議中發表的，並沒有寫成正式的論文，而且報告中也沒有提出合理的解釋。

如果以人體生理學來看，早上起床後交感神經的工作量開始超越副交感神經，以便應付一天的工作。這時腸胃道的血流和蠕動都會減緩，早餐吃進最大的份量，此時消化和吸收都會減少，800卡的熱量可能只吸收一半。

晚上下了班副交感神經的工作量開始超越交感神經，這時腸胃道的機能轉趨旺盛，如果此時吃進一天中最大的食量，剛好遇到消化和吸收最好的時段，可能將吃進去的熱量全部消化吸收。

所以想減肥的人，在每天吃進相同總熱量時，如果早上多吃一點晚上少吃一點，是可以幫助減肥的。但是請記住，這是指相同的總熱量喔，也就是說早餐增加的同時，午、晚餐的熱量必須減少。如果中餐和晚餐吃的量並沒有減少，為了減肥早餐多吃一些，這樣反而會發胖。

我的看法是，每個人的作息情況不同，早餐吃多了容易使血流往腸胃道集中，腦部的血流減少頭腦的反應會變慢，這對於早上需要集中腦力思考，專注開會的人，反而是不利的，因為吃太飽頭昏昏沈沈會想睡覺。

吃不吃早餐和肥胖的關係結論是：

1. 早餐吃得少晚餐吃得多的人不必緊張，如果你沒有肥胖的問題代表你的身體已經處在平衡的狀態，犯不著變更你的三餐比例。
2. 相反的，如果你有肥胖的問題，那麼，在不減少一天的食量和熱量的情況下，減少晚餐分量並增加早餐分量是可行的。

參考資料：

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