Is Skipping Breakfast Deadly?

breakfast

Is it bad for your health to skip breakfast? In the midst of the intermittent fasting hype, many were no doubt unnecessarily scared away by media alerts some time ago.

As usual this was just based on inconclusive statistics from a survey. There’s no evidence of any causation, as several news reports made it sound like:

To eat or not to eat

No wonder people stop listening to health alerts in the media. This is an excellent example of the bizarre reasoning that such statistical reports may lead to.

How can it, according to the study, be harmful not to eat, but yet more harmful to eat?

  • According to the study people who don’t eat breakfast have a 27% increased risk of heart disease.
  • Meanwhile, people who eat after having gone to bed have a 55% increased risk.

In other words: it’s claimed that eating at night is dangerous. In the morning it’s dangerous not to eat. Or like Swedish paper Dagens Nyheter puts it:

According to the researcher, the effect on health is similar, although the opposite: Nightly meals strain the body because it doesn’t have time to digest food properly. This may lead to the same problems as fasting: high blood pressure, weight gain, changes in blood sugar levels.

Therefore, eating is as bad for your health as not eating. It will also produce the same health problems, depending on how early in the day you eat. And yes: you’ll gain weight both from eating and from not eating. At least this is what the researcher’s statistics show.

There are probably others than me who’d like to ask the researcher at what time of night that food suddenly starts producing the exact opposite effect on weight and health. This could be very useful information especially for shift workers and early-birds!

Statistics and Pseudoscience

The above is, of course, in all probability nonsense. This is what happens if, in retrospect, you try to force strained explanations to false statistical findings.

Similar statistical findings from such inconclusive questionnaire studies are most often incorrect. In general, there’s a 80-90% chance that such statistical findings are incorrect. In this case meaning that skipping breakfast isn’t dangerous at all.

Reading for those who have a special interest and want to understand more on the subject than most health journalists:

In this study, it’s clear that people who skipped breakfast also smoked more, moved less and drank more alcohol, etc. They picked a group of people living a generally unhealthy lifestyle – and then blamed their health problems on not eating breakfast. In reality, the cause could be something completely different.

Much like the study that found that people who were careless with shaving died prematurely. Is it deadly to have a beard? Hardly. But people who don’t shave properly are more likely to be careless with other things.

The Real Danger

The real danger is this continuous stream of media alerts, that unnecessarily worries a lot of people. This is what a true headline should have looked like:

Skipping breakfast may increase the risk of heart disease

After this, the article should have made it clear that this was speculation and highly uncertain statistics. Nothing else. Personally, I think it’s extremely unlikely that this is true.

My advice? Eat a good breakfast if you’re hungry and want to. Skip breakfast if you want to and if you’re not hungry. It’s hardly harmful. And no, you’ll never ever gain weight by not eating.

PS

As if the above wasn’t bad enough, I watched a 30-second-long interview on Swedish Television with the study’s main author. Here’s what she claims happens when you fast:

  • A short fasting period will lead to “high levels of cholesterol”, she says. This is wrong. When fasting, the cholesterol level is virtually unchanged (except for triglyceride levels which instead will drop).
  • Fasting increases insulin levels, she claims. This is completely wrong – insulin levels are at their lowest when fasting.
  • Fasting increases blood pressure, she says. In reality blood pressure is at its lowest in the morning as you wake up, fasting.

Find five errors.

More

Skipping Breakfast Means You’ll Eat LESS, Not More

New Study: A Low-Carb Diet and Intermittent Fasting Beneficial for Diabetics!

Is This the Healthy Mediterranean Diet?

Do Unhealthy Meat Eaters Live Shorter Lives?

Seven Myths About Obesity

21 Comments

  1. sten
    Not surprised. On a SAD "eating" is dangerous by definition: Skip one meal and the resulting hunger pang may make you go twice to the burger joint before you know it !

    They didn't test skipping breakfast on LCHF!
    A different ball park.

  2. Aaron V
    I've been intermittent fasting for years now and it makes staying shredded a lot easier and I feel great doing it. If anyone wants the REAL science on intermittent fasting and it's awesome benefits, check out Martin Berkhan's leangains.com or Brad Pilon's Eat Stop Eat.
    I am a huge supporter of the DietDoctor site and appreciate their shooting down pseduo science, thanks for staying awesome! =)
  3. Freja
    What happens if you binge on carbs while eating LCHF?

    I'm very curious about this question so I hope someone have an answer!:)

    Replies: #4, #7, #9
  4. Zepp
    Then yoy dont eats LCHF anymore!

    And you goes out of ketosis and lives on glucose for a time and stores fat!

  5. Eric Anderson
    Read Phinney and Voleck.

    Going in and out is not good for physical perfrmance and is counte productive. It seem the wacko ida is backed by no science and has counter factual evidence from researchers lkw phinney and Voleck

  6. Champ
    Your post says, "people who skipped breakfast also smoked more, moved less and drank more alcohol, etc. They picked a group of people living a generally unhealthy lifestyle – and then blamed their health problems on not eating breakfast."

    However, the study you cite says, "Multivariate models were adjusted for known and suspected risk factors of CHD such as ... alcohol intake ... diet quality ... physical activity ... smoking status..."

    Aren't they saying they controlled for those other factors but STILL found that differences in eating breakfast were significant? What am I missing?

    Reply: #8
  7. murray
    Freja, this is hypothesis, but I expect you would suffer a larger, more prolonged spike in blood glucose from a carbohydrate "binge" than a carb addict (who is not yet insulin resistant), with greater glycation damage. It seems that with a lower carb diet, there is down-regulation of insulin response and insulin sensitivity. Thus, LCHF patients often appear to do poorly on a glucose tolerance test. However, it is analogous to the alcohol tolerance of a heavy drinker versus a light drinker, such as me. I am good for a small glass of wine with dinner. More than that and I start noticeably feeling it. A couple of glasses will affect my sleep. A heavy drinker, by contrast, can drink a half bottle or more of wine and be fine. Were I to start having a couple of glasses or more with dinner every day, my alcohol tolerance would go up as my liver up-regulates the relevant metabolic pathways.

    So be kind to your liver and the rest of your body--don't binge either alcohol or carbs.

  8. sten
    The study described is by default an observational study. An observational study can really only be used to build a hypothesis, then testing if breakfast skipping predisposes to CVD in a RCT where for instance ultrasound is used to measure plaque build up or regression.
    Anything further is speculation because of lack of randomization. To say that a number of variables were "controlled for" is l meaningless when the study wasn't a random controlled trial.

    When it comes to LCHF we know that these eating habits do not induce hunger when a meal is skipped, whereas a standard american diet (SAD) usually has the opposite effect!
    Single point in case: When I ate a SAD and skipped lunch I could often eat a dinner twice the normal size to compensate for the skipped lunch. The size of any meal, in particular a high carb meals, determines the height and the duration of following postprandial blood sugar spike, for both diabetics and non-diabetics. Postprandial blood sugar spikes is a prominent risk factor for CVD, even for non-diabetics. Peak is reached about 1 hour after meal and could last 2-3 hours, even for non diabetics.

    "Studies by Levitan et al. have shown that PPPG appears to have a linear relation with CVD, even across the non - diabetic range."
    http://www.ijem.in/article.asp?issn=2230-8210;year=2012;volume=16;iss...

    That diabetics are recommended to eat smaller more frequent meals make sense.
    The day they are recommended to keep carbs below 20% to control meal related blood sugar completely is yet to come!

    Hence skipping any meal on a Standard American Diet would likely increase the risk of CVD. A hypothesis that deserves further investigation.

  9. Galina L.
    Any diet works till you follow it. The advantage of a LC diet is the luck of hunger, so most people are comfortable eating in a such way long-term. Probably, some people need a period of adaptation. Recently my friend decided to follow my diet example due to the age-related thickening of her middle (I have been successfully LCarbing since 2007), but after 3 days gave up and ate a whole loaf of Chiabata bread.
    May be that is the answer http://gettingstronger.org/2010/11/learning-to-fast/.
  10. ThatWriterChick
    First thing that popped into my mind: which cereal manufacturer sponsored this so-called "study"?
    Reply: #11
  11. sten
    You must of course be right!
    And there is no need to make a study comparing a breakfast based on eggs and bacon with a modern cereal breakfast in regards of the effect on blood sugar. Yet something the study of course not "controlled" for...
    We already know that the old fashioned breakfast has a very small effect on blood sugar while the modern breakfast, especially with lite milk and cereals based on modern dwarf wheat really spikes blood sugar. Something that is now well known to cause arterial damage moving on to heart disease. Check the link below to see how to reverse arterial damage simply by keeping 1 hour after-meal blood sugar as low as possible ! ( Secret #1: get rid of the cereal breakfast..) Add a glass of sweet lovely fruit juice to the cereal breakfast and diabetes or heart disease may be just around the corner a few years later, courtesy mainly the added fructose. Long before I got heart disease, angina, I ate those breakfasts with fruit juice morning after morning believing it was healthy... Much later in my life, after 6 weeks of strict low carb high fat eating, my fortunes were reversed to the better and they have now lasted that way for 2 years without any other medication than my new food! Thanks to Diet Doctor and others !

    http://www.trackyourplaque.com/library/fl_04-022postprandialcarbs.asp

  12. Brigitta
    Eat after having gone to bed? Is this sleep-eating or breakfast? lol
  13. James H.
    Funny.

    My rule-of-thumb is this: If the government or the media says "A," then one can safely bet the situation is actually "B." No one in their right mind believes anything the government or the media says about anything.

  14. Rozzy
    Did anybody check out T Colin Campbell's new book the low carb myth!?
    Replies: #15, #16, #17
  15. sten
    Checked what was written in Huff.Post by the author:
    "..whole food, plant based diet, which is naturally low in total fat, animal-based protein, and refined carbohydrates but rich in antioxidants and complex carbohydrates. "

    The truth of the matter is rather that diets that are not raising blood sugar substantially has a healing effect on our systems: Blood vessels are not inflamed more and glycation byproducts are produced in low quantity. So I agree that refined carbs is a main villain, and it includes whole grain wheat produce in particular, since it is made by modern dwarf wheat that raises blood sugar much faster than the lower yield old type wheats.

    But how to take the step from there to the unproven notion that animal based protein or animal fats could be harmful in any way at all beats me!
    It's like an infamous propaganda master that had a rule to tell one truth together with each lie, knowing that the (undisputed) truth always gave the lie a better probability to fly.

    From the cover of the book it seems that the man that fooled the whole world, Ancel Keys, is one of the author's heroes. I have read enough to save my time for interesting things.

    The cover also advertises that Campbell was the author of the first hailed and then discredited China study. I read some impressive in depth criticism by Denise Minger here: http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/

  16. Galina L.
    Tess did http://relievemypain.blogspot.com/2013/11/the-low-carb-fraud-review.html.
    It looks like Dr.Campbell doesn't know much about LC diets because he thinks they are very high in protein. Tess said "Has Dr. Campbell actually read anything that Drs. Eades, Cordain, Phinney, Volek, Westman or Bernstein have written? He keeps calling low-carb diets "high-protein diets." Pretty much any diet is higher in protein than his whole food plant based diet, but most modern low-carb diets call for high fat and moderate protein. He also says low-carb diets eliminate most vegetables, but even Atkins induction calls for two small salads a day. "
  17. paleozeta
    feeling great when IF. when i eat in the morning, then i graze.. still low carb, but get bouts of hunger. lately because of work i eat once a day and still i do not feel hungry most of the time. just wonderful.
    for the other thread: getting out of ketosis for me, at the beginning, with carb binges, meant a lot of water retention and my body confused which fuel to use. sport performance: terrible for a few days. now after over a year with strict lchf, the rare times i indulge, but no more sugar, just fruit or rarely worse : " bread !", i get back on track the day after with a 24 h IF. the longer i get into this type of nutrition the absolutely better, not only for my physical health, but more important my mental health.
  18. Todd Becker
    If you look at this study more closely, you'll notice that -- while it is a prospective (forward looking) study--it is not an interventional study, so it is still looking at associations. Let’s look at the 4 key findings:

    Men who skipped breakfast had a 27% higher risk of CHD compared with men who did not.

    Compared with men who did not eat late at night, those who ate late at night had a 55% higher CHD risk

    These associations were mediated by body mass index, hypertension, hypercholesterolemia, and diabetes mellitus.

    No association was observed between eating frequency (times per day) and risk of CHD.

    The last 3 findings are the give-away. Eating frequency was unrelated to CVD, but overweight and metabolic syndrome were. And above all else, late night eating was the elephant in the room. So this study is describing a pattern that is quite common…getting started eating later in the day, but making up for it by overeating late into the night, and overeating enough to boost BMI. Sleeping through the night on a full stomach leaves blood glucose and insulin levels elevated, obliterating the benefits of sleep as a period of fasting. Thus, the most reasonable explanation for the breakfast skipping is that these folks woke up “stuffed” from the night before. There was no deliberate effort to work through the mild hunger associated with real IF.

    The study doesn’t break out the minority of individuals who practice true intermittent fasting — refraining from food for 12-19 hours, without snack, confining eating to within a relatively short window of no more than 5 hours. Typically that window is somewhere between lunch and early evening. I make it a point not to eat after about 7 or 8 p.m., and at least 2-3 hours before going to bed.

    Intermittent fasting is also not an excuse for gorging. It’s important to pay attention to what goes in your mouth. Properly practiced, IF does not lead to being overweight, hypertensive, hypercholesterolemic, or diabetic. The opposite is usually the case! So if you are combining IF with a generally paleo or low carb diet, and your weight is normal, and you don’t have metabolic syndrome, I think you can discount the risk of elevated CHD. If you need any further proof, take a look at the people who eat this way.

    I think that practicing IF 2-5 days a week gives you most of the benefits. You don’t need to fast every day of the week. As Art Devany has argued, it’s probably good to mix things up and keep your body “guessing” to avoid adaptation to a low metabolic rate. I've blogged and talked about the benefits of intermittent fasting at http://gettingstronger.org/2011/05/intermittent-fasting-for-health-an...

    We need to be careful in interpreting these studies.

    Todd

  19. Galina L.
    Great! Todd Becker is here! Todd , it was your post "Learning to fast" which allowed me to start practicing IF a while ago. I enjoy my life now without "I have to eat NOW!!!" emergencies after I adopted a LC diet and then trained to fast. Several people thanked me for the link to the post.
  20. Carorees
    If you look closely at the study you will see that the association between skipping breakfast and increased risk of CHD disappeared (i.e., lost significance) after they corrected for BMI etc. Conversely the association between late night eating and CHD held after correcting for BMI. Thus, as pointed out above, it is eating late at night that is dangerous, not skipping breakfast.

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