The breakfast of also-rans

25 May 2016 - 09:20 By AARON E CARROLL

I don't eat breakfast. It's not that I dislike what's offered. Given the choice of breakfast food or lunch food, I'd almost always choose eggs or waffles. It's just that I'm not hungry at 7.30am when I leave for work. In fact, I'm rarely hungry until about lunchtime. So I don't eat much before noon. This habit has forced me to be subjected to more lectures on how I'm hurting myself, my diet, my work and my health than almost any other. Only a fool would skip the most important meal of the day, right?As with much other nutritional advice, our belief in the power of breakfast is based on misinterpreted research and biased studies.It does not take much of an effort to find research that shows an association between skipping breakfast and poor health. A 2013 study published in the journal Circulation found that men who skipped breakfast had a significantly higher risk of coronary heart disease than men who ate breakfast. But, like almost all studies of breakfast, this is an association, not causation.More than most other domains, this is one that suffers from publication bias. In a paper published in The American Journal of Clinical Nutrition, in 2013, researchers reviewed the literature on the effect of breakfast on obesity. They first noted that nutrition researchers love to publish results showing a correlation between skipping breakfast and obesity.However, they also found major flaws in the reporting of findings. People were consistently biased in interpreting their results in favour of a relationship between skipping breakfast and obesity. They improperly used causal language to describe their results. They misleadingly cited others' results. And they also improperly used causal language in citing others' results. People believe, and want you to believe, that skipping breakfast is bad.Good reviews of all the observational research note the methodological flaws in this domain, as well as the problems of combining the results of publication-bias-influenced studies into a meta-analysis. The associations should be viewed with scepticism and confirmed with prospective trials.Few randomised controlled trials exist. Those that do, although methodologically weak like most nutrition studies, don't support the necessity of breakfast.Further confusing the field is a 2014 study that found that getting breakfast skippers to eat breakfast, and getting breakfast eaters to skip breakfast, made no difference with respect to weight loss. But a 1992 trial that did the same thing found that both groups lost weight.Many of the studies are funded by the food industry, which has a clear bias. Kellogg funded an article that found that cereal for breakfast is associated with being thinner. The Quaker Oats Centre of Excellence financed a trial that showed that eating oatmeal or frosted cornflakes reduces weight and cholesterol (if you eat it in a highly controlled setting each weekday for four weeks).The bottom line is that the evidence for the importance of breakfast is something of a mess. If you're hungry, eat it. But don't feel bad if you'd rather skip it. Breakfast has no mystical powers.- © The New York Times..

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