Thursday, November 21, 2019

Retrospective #278: Skipping Breakfast

“Skipping breakfast doesn't cause weight gain,” Stephan Guyenet, PhD, obesity researcher and blogger at Whole Health Source, mockingly tweeted. Guyenet attached a link to a randomized controlled trial published online in November 2014 in the Journal of Nutritional Science, a Cambridge University Press, UK, peer-reviewed publication.
This study had a HYPOTHESIS, a STUDY DESIGN and an ABSTRACT. The ABSTRACT began, “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.” They seriously proposed to “clear up” this “unclear” condition.
The RESULT: “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.”
Interestingly, this paper had no CONCLUSION. But, the end of DISCUSSION began, “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 compared with consuming either a frosted cornflakes or oat porridge breakfast.” To be clear: Everybody knows that elevated total cholesterol concentrations are bad, right?           
Then – and this is where I started to get 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). This is a UK publication, and the “fibre” spelling is for Brits, who eat a lot of “oat porridge.” We call it oatmeal in the U.S.
Let’s cut to the chase. “The present study was funded by the Quaker Oats Center of Excellence.” The Quaker Oats division of PepsiCo made the high-fibre oat porridge used in the study. Their competitor, Kellogg’s, is the world’s second-largest snack company (after Pepsico) and makes the “no-fibre cornflakes.” And they call this “science.”
There was no attempt by the authors, their peer reviewers or the 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 a funder to satisfy, and was genuinely interested in a breakfast type that “reduces appetite, body weight and CVD risk factors,” and “produces the greatest health benefits,” include an isocaloric breakfast of bacon and eggs? Well, I guess that is clear now.
For another, according to the Study Design, the “data were collected in 1998 and 1999.” So, why is this old NYC study being dredged up and republicized in the UK in 2014? 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. Let’s 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 skipping a cereal breakfast is detrimental to your health. Nobody intended the outcome to advocate not eating breakfast. That wouldn’t be good for business.
Frankly, I was unaware of the widespread “conventional wisdom” in Guyenet’s mockery that skipping breakfast causes weight gain. I eat an “isocaloric” breakfast of bacon and eggs (protein and fat, not carbohydrates) with heavy whipping cream in my coffee. If I were going to skip a meal – because I wasn’t hungry or I was trying to lose weight, I’d skip lunch, not breakfast. My wife makes breakfast, and she says she married me for better or worse, but not for lunch.

No comments:

Post a Comment