Breakfast: To Skip or Not to Skip? An Evidence-Based Perspective on Weight Management and Overall Health
September 4, 2026
We depend on traders in our markets for much of the food that reaches our homes. We meet and bargain with them for our foodstuffs – plantain, cassava tomatoes, garden eggs, fish, fruits, grains and countless other foods. But how often do we stop to think about the health and nutrition practices of the people behind the stalls?
I had an opportunity to do just that when I supervised an undergraduate research project involving 150 vendors in Dansoman, Accra. We were interested in their weight-management practices: how they perceived their own weight, whether they were trying to manage it, what they were actually doing and where they obtained information from.
What we found provides an interesting glimpse into what weight management can look like in everyday life and raises some important questions about the kind of support people need when they decide they want to lose weight.
First, What Did the Measurements Show?
We measured weight and height, waist and hip circumference, body fat percentage and muscle mass. We found that about four out of every ten vendors were classified as overweight, while approximately one in three were living with obesity. Only about one in five was within the normal BMI range. BMI, or body mass index, relates a person’s weight to their height and is widely used to screen for overweight and obesity. It is useful, particularly when looking at groups of people, but it does not tell us everything about an individual’s health. For example, BMI does not distinguish between fat, muscle and bone or tell us where body fat is stored. This is why other information, including waist circumference, body composition and relevant health indicators, can add to the picture.
In our study, many participants also had high or very high levels of body fat. This matters because excess body fat, particularly when carried around the abdomen, is associated with a higher risk of conditions such as type 2 diabetes and cardiovascular disease.
Next, we also wanted to know how the vendors saw themselves.
How the Traders Perceived Their Weight vs What We Measured
There was a noticeable difference between some participants’ measured weight and how they described their own weight. Although overweight and obesity were common when we took measurements, many participants perceived themselves as having a normal weight, and only a small proportion identified themselves as obese.
At the same time, dissatisfaction with body weight was common. Many participants were unhappy with their current weight and were trying to lose weight.
I find this combination particularly interesting.
It suggests that wanting to change one’s weight does not necessarily mean that a person has an accurate understanding of their current weight status. And that matters, because deciding what action to take should ideally begin with good information about where you are.
What Were They Doing to Lose Weight?
This was perhaps one of the most interesting parts of the study.
Walking was a commonly reported form of physical activity, while participation in more structured exercise such as going to the gym was uncommon.
When it came to food, one practice stood out: skipping meals.
A large number of the vendors reported skipping meals as a strategy for losing weight, while relatively few reported intentionally modifying their diet.
Does skipping meals help with weight loss? The answer is not as straightforward as we might think. Research examining how often people eat has produced mixed results, and there is currently little strong evidence that simply eating fewer meals is, by itself, an effective weight-management strategy. Research specifically examining breakfast has also found that routinely eating breakfast should not be prescribed to everyone as a weight-loss strategy.
Who Are Market Vendors Listening To?
Our study found that social media, friends and family were important sources of weight-management information. Comparatively few participants reported obtaining this information from dietitians or nutrition professionals.
This finding made me reflect on something beyond the individual choices of the vendors themselves.
People are likely to seek health information from sources that are available and accessible to them. Today, a phone can provide hundreds of suggestions about losing weight within minutes. Friends and relatives also readily share what worked for them.
But what works for one person may not necessarily be appropriate for another. And popularity does not necessarily tell us whether nutrition advice is reliable.
This is one reason nutrition professionals need to think seriously about where people are already looking for information and how credible nutrition guidance can become easier to access.
What Do We Know About Market Vendors in Ghana?
Our study is not the first to raise questions about weight and health among people who earn their living in Ghana’s markets, although this remains a population that deserves more attention.
A study involving 402 female traders at Abura and Kotokuraba markets in Cape Coast reported that about 32% had overweight and 39% had obesity. The researchers also found gaps in nutrition knowledge and dietary diversity.
Earlier work among traders at Kaneshie Market in Accra also examined obesity alongside hypertension, showing that concern about cardiometabolic health among market traders in Ghana is not new.
Our Dansoman study adds another piece to this picture because we were interested specifically in what vendors were doing about their weight, how they perceived it and where they were getting information about weight management.
These studies were conducted in particular markets and cannot be assumed to represent every market vendor in Ghana. But taken together, they suggest that the health and nutrition needs of this occupational group deserve greater attention.
Weight Management Has to Work in Real Life
For people spending long hours attending to customers and protecting the day’s income, recommendations about eating, exercise and weight management have to make sense within that working day.
It is easy to tell someone to eat differently or exercise more. It is another matter to understand when they eat, what foods are available around them, whether they can leave their stall, how their working hours are organised and what resources they have available.
Our study was not designed to establish that these working conditions caused the weight patterns or practices we observed. That would require different research. But they remind us of something important: nutrition advice has to be practical enough to fit into people’s real lives.
Final thoughts
Market vendors could benefit from greater access to credible nutrition information within the communities and environments where they already spend their time. Periodic health screening could also provide opportunities for people to learn about their weight, waist circumference, blood pressure and other relevant health indicators and, where necessary, be referred for appropriate care.
We also need better conversations about weight management. The starting point should not automatically be “Which meal should I stop eating?” Instead, people need help to look at the bigger picture: the foods and drinks they consume, portions, eating patterns, physical activity, sleep, health conditions, medicines and the other factors that may affect weight.
And if social media is already one of the places people go for information, nutrition professionals cannot ignore that space. There is an opportunity to make sound nutrition information easier to find, easier to understand and more relevant to everyday Ghanaian life.
I would like to acknowledge Yeboah Opoku Elvis, whose undergraduate research formed the basis of this article.
Written by Dr. Laurene Boateng (PhD, RD)
Dr. Laurene Boateng is a Registered Dietitian and Senior Lecturer in the Department of Dietetics, University of Ghana. She is the founder and editor-in-chief of Full Proof Nutrition, a Nutrition Consultancy committed to providing reliable, evidence-based, and practical healthy eating advice through its website www.fullproofnutrition.com. Click here to join Full Proof Nutrition WhatsApp channel to receive more educative content. Send us a mail on fullproofnutrition@gmail.com. Grab a copy of my book on healthy eating – available now on Selar (Buy HEALTHY EATING MADE SIMPLE by Laurene Boateng on Selar) and Amazon (https://amzn.eu/d/6i9OeVb).
References
Apprey, C., Mensah, M., Agyarko, D., Klu, Y. A. K., & Acquah, S. (2023). The influence of nutrition knowledge, attitude, practices, and dietary diversity on obesity among market women in the Cape Coast Metropolis, Ghana: A cross-sectional study. Health Science Reports, 6(12), e1742. https://doi.org/10.1002/hsr2.1742
Frimpong, Y. (2015). A cross sectional study on hypertension and obesity among traders at Kaneshie Market, Accra-Ghana, 2013. Pan African Medical Journal, 21, 208.
Schwingshackl, L., Nitschke, K., Zähringer, J., Bischoff, K., Lohner, S., Torbahn, G., Schlesinger, S., Schmucker, C., & Meerpohl, J. J. (2020). Impact of meal frequency on anthropometric outcomes: A systematic review and network meta-analysis of randomized controlled trials. Advances in Nutrition, 11(5), 1108–1122. https://doi.org/10.1093/advances/nmaa056
Sievert, K., Hussain, S. M., Page, M. J., Wang, Y., Hughes, H. J., Malek, M., & Cicuttini, F. M. (2019). Effect of breakfast on weight and energy intake: Systematic review and meta-analysis of randomised controlled trials. BMJ, 364, l42. https://doi.org/10.1136/bmj.l42
