Saturday, January 10, 2015

The Nutrition Debate #278: Skipping Breakfast

The Nutrition Debate #278: Skipping Breakfast
“Skipping breakfast doesn't cause weight gain. Bye bye, conventional wisdom,” tweeted Stephan Guyenet, PhD, obesity researcher, neuroscientist (“reward” theory expert) and blogger at Whole Health Source.  To support his tweet @whsource, Stephan attached this link to a randomized controlled trial published online in November 2014 in the Journal of Nutritional Science, a Cambridge University Press, UK, peer-reviewed journal. But his was not my takeaway.
In scientific fashion, this “study” has a hypothesis and a study design. The abstract begins, “Eating breakfast may reduce appetite, body weight and CVD risk factors, but the breakfast type that produces the greatest health benefits remains unclear. We compared the effects of consuming a high-fibre breakfast, a non-fibre breakfast, or no-breakfast control on body weight, CVD risk factors and appetite.” If I’m not being clear, we need an “unclear” condition in order to clear it up!
The study RESULT is seen in the title: “Skipping breakfast leads to weight loss but also elevated cholesterol compared with consuming daily breakfasts of oat porridge or frosted cornflakes in overweight individuals: a randomized controlled trial.” 
Unusually, this paper has no CONCLUSIONS section, but the last paragraph of DISCUSSION begins, “In summary, the present study shows that in overweight individuals, skipping breakfast daily for 4 weeks leads to a reduction in body weight, but this is accompanied by an increase in total cholesterol concentrations compared with consuming either a frosted cornflakes or oat porridge breakfast.” Note: Everybody knows that elevated total cholesterol concentrations are bad, right?           
Then – and this is where I start to get even more skeptical (cynical?) – the “summary” continues: “There were no differences in changes in body weight or total cholesterol concentrations between the groups consuming the frosted cornflakes no-fibre breakfast or the group that consumed the high-fibre oat porridge breakfast. These findings suggest that although skipping breakfast may be the more effective strategy to achieve weight loss than eating breakfast, there are associated detrimental effects on total cholesterol concentrations” (emphases added). To be clear, this publication is in the UK, and the “fibre” spelling, is for the Brits, who eat a lot of “oat porridge.” We call it “oatmeal” in the U.S.
Let’s cut to the chase. If you didn’t notice my emphases, “The present study was funded by the Quaker Oats Center of Excellence, PepsiCo R&D Nutrition.” The Quaker Oats division of PepsiCo makes the high-fibre oat porridge used. Their competitor, Kellogg’s, is the world’s second-largest snack company (after Pepsico) and makes the “no-fibre cornflakes.”
The lead author, Allan Geliebter (A.G.), is an MD, PhD, Professor of Psychology and Senior Researcher at the New York Obesity Nutrition Research Center, St. Luke’s-Roosevelt HC, Institute of Human Nutrition, Columbia U. College of Physicians and Surgeons, and in the Department of Psychiatry at the Columbia University MC. “A.G. was responsible for the study conception and design, and supervised acquisition of the data and edited the manuscript.” And,A.G. received funding from Quaker Oats Center for Excellence, Pepsico R&D Nutrition for the design, conduct and analysis of the study and for the preparation of the manuscript.” Also: “The funder contributed [they’re nottalking money here] to the study design and editing of the manuscript.” And this: “We thank Yi Fang of Pepsico for his helpful comments on the manuscript.”
To be CLEAR, there was no attempt on the part of the authors, their peer reviewers or their helpful funders to conceal the purpose of funding this study. “The aim,” the ABSTRACT concludes, “of the present study was to investigate the effects of consuming a high-fibre oat porridge, an isocaloric non-fibre cornflakes breakfast, and a no-breakfast water control daily for 4 weeks on body-weight changes, subjective appetite and CVD risk factors in overweight but otherwise healthy individuals.” 
Stepping back for a minute from the obvious “editorial bias,” several queer things struck me about this study when I first read it. For one, why wouldn’t any serious, unbiased scientist, who didn’t have an axe to grind or a funder to satisfy, and was genuinely interested in a breakfast type that “reduces appetite, body weight and CVD risk factors,” i.e., “produces the greatest health benefits,” include an isocaloric breakfast like bacon and eggs? Well, I guess that too is pretty CLEAR now.
For another, according to the Study Design section, the “data were collected in 1998 and 1999.” Why, then, is this old NYC study being dredged up and republicized in the UK in 2014? My answer is speculation: Perhaps it didn’t pass peer-review muster the first time, or perhaps Quaker Oats/Pepsico was just trying to get some more mileage out of their previously funded research with some new marketing in the U.K. To be CLEAR, Quaker Oats/Pepsico is a world-wide cereal marketer, and this study was just a hack job designed, in the way drug trials are designed, to show superiority of one breakfast cereal over another. Nobody intended the outcome to advocate not eating breakfast. That wouldn’t be good for business
Personally, I was unaware of the widespread “conventional wisdom” that skipping breakfast causes weight gain. I eat a good breakfast of bacon and eggs and H&H in my coffee almost every day. It can carry me all day if I want it to, but I usually eat a can of sardines in olive oil for lunch. If I were going to skip a meal – because I wasn’t hungry or I was trying to lose weight, I’d skip lunch. My wife makes breakfast, and she says she married me for better or worse, but not for lunch.


  1. Speaking evolutionarily, since when has mankind eaten to a schedule? Don't know when this 3 meals and several snacks a day started, but probably since we started eating a big pile of carbs which leaves us hungry all the time.

    1. Exactly! Well said, horfilmania. Would that I could adopt a lifestyle where I only ate when I was hungry.