The New Health Care: Sorry, There’s Nothing Magical About Breakfast

However, they also found major flaws in the reporting of findings. People were consistently biased in interpreting their results in favor 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 skepticism and confirmed with prospective trials.

Few randomized 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 (with more financial conflicts of interest than I thought possible) 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. A balanced perspective would acknowledge that we have no idea what’s going on.

Many of the studies are funded by the food industry, which has a clear bias. Kellogg funded a highly cited article that found that cereal for breakfast is associated with being thinner. The Quaker Oats Center of Excellence (part of PepsiCo) financed a trial regarding consumption of oatmeal or frosted cornflakes (if you eat it in a highly controlled setting each weekday for four weeks), and found that only the no-breakfast group, which lost weight, experienced an increase in cholesterol.

Many studies focus on children and argue that kids who eat breakfast are also thinner, but this research suffers from the same flaws that the research in adults does.

What about the argument that children who eat breakfast behave and perform better in school? Systematic reviews find that this is often the case. But you have to consider that much of the research is looking at the impact of school breakfast programs.

One of the reasons that breakfast seems to improve children’s learning and progress is that, unfortunately, too many don’t get enough to eat. Hunger affects almost one in seven households in America, or about 15 million children. Many more children get school lunches than school breakfasts.

It’s not hard to imagine that children who are hungry will do better if they are nourished. This isn’t the same, though, as testing whether children who are already well nourished and don’t want breakfast should be forced to eat it.

It has been found that children who skip breakfast are more likely to be overweight than children who eat two breakfasts. But that seems to be because children who want more breakfasts are going hungry at home. No child who is hungry should be deprived of breakfast. That’s different than saying that eating breakfast helps you to lose weight.

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, and don’t listen to those who lecture you. Breakfast has no mystical powers.

Correction: May 26, 2016
An earlier version of this article misstated the result of a study by the Quaker Oats Center of Excellence. It showed that a no-breakfast group had higher cholesterol levels, not that those eating oatmeal or frosted cornflakes had lower cholesterol levels or lower weight.

Continue reading the main story

Хостинг сайтов Joinder.Pro

Well: 4 Days, 11 Pounds

Photo

Credit Illustration by Ben Wiseman


This article appeared in the May 25, 2014 issue of The New York Times Magazine.

Losing weight is simple: Ingest fewer calories than your body burns. But how best to do that is unclear. Most experts advise small reductions in calories or increases in exercise to remove weight slowly and sensibly, but many people quit that type of program in the face of glacial progress. A new study, published in March in The Scandinavian Journal of Medicine & Science in Sports, suggests that minimal calories and maximal exercise can significantly reduce body fat in just four days — and the loss lasts for months. The catch, of course, is that those four days are pretty grueling.

Researchers in Spain and Sweden had 15 healthy but overweight Swedish men restrict their calories to about 360 a day, a reduction of approximately 1,800 calories. What calories they did ingest came in liquid form: Some men drank mostly sugary carbohydrates, others a high-protein drink. The men also exercised — a lot. Their days began with 45 minutes of cranking an arm-pedaling machine for an upper-body workout. Then, as a group, the men strolled for eight hours across the Swedish countryside, with only a 10-minute break every hour. They were allowed as much of a low-calorie, sports-type beverage as they wanted during their walks.

Most of the men “were surprised that it was easier than they thought it would be,” says José Calbet, a professor at the University of Las Palmas de Gran Canaria in Spain; he and his colleague Hans-Christer Holmberg, a professor at Mid Sweden University in Ostersund, led the study. Some of the subjects experienced “minor problems with pain in the joints” and blisters on their feet, according to Calbet, but none dropped out or complained of hunger.

After four days, the men had each lost almost 11 pounds, with nearly half of that coming from body fat; the rest of the loss came primarily from muscle mass. The researchers had anticipated that the high-protein drink would protect people against muscle-mass loss. In fact, the losses were the same, whether the men had been given sugar or protein.

More surprising, the men did not immediately put the weight back on after the study ended. “We thought they would overeat and regain the weight lost,” Dr. Calbet says. Instead, when the volunteers returned a month later, most had lost another two pounds of fat. And a year after the experiment, they were still down five pounds, mostly in lost body fat.

Dr. Calbet and his colleagues hope to study whether women respond similarly to men and whether repeated bouts of such a program might affect muscular health and appetite hormones.

But given the doleful statistics on weight loss — most people regain everything they lose dieting and more — these results are startling. They also, at the moment, are inexplicable. “The only explanation we can offer” for the sustained loss, Dr. Calbet says, is that the men were inspired by their hypercompressed success to change their lifestyles. The men moved more and ate less than before.

Хостинг сайтов Joinder.Pro

Well: Exercising a Fat Dog (and Yourself)

Photo

Credit Illustration by Ben Wiseman

From the Well archives.

The chubby, inert pet dog has become a familiar household sight in richer countries. And yet there lies a possible boon to the out-of-shape among us. A recent study suggests that being told one’s pet is dangerously overweight might provide the impetus that gets an owner moving.

It might seem that having a pet dog would result in considerable physical activity, and that’s true, broadly speaking. A 2013 review of studies related to dog ownership concluded that as a group, dog owners spend almost an hour more per week walking than people without dogs. Even so, a survey from 2008 conducted in Australia found that nearly a quarter of all dog owners reported never walking their pets. This population of dog owners, studies show, actually engage in less physical activity each week than people without a dog.

A majority of dog owners, of course, are deeply attached to their pets, whether they walk them or not. That bond prompted a group of scientists, veterinarians and physicians at the Uniformed Services University of Health Sciences, in Bethesda, Md., and other institutions to consider whether people might be willing to undertake a health-and-fitness regimen targeted at their dog, even if they had little enthusiasm for such a program for themselves.

The researchers recruited 32 dog owners who visited a veterinary clinic in Maryland. Their dogs varied widely in age, breed and size, but all were overweight or obese and, by and large, sedentary. So, too, were most of their owners (although the only criterion for their participation was that their dogs be rotund). Half the volunteers were told by a veterinarian to watch their dog’s nutrition and monitor its health. The rest were told that their dog was overweight and needed more exercise. These owners were given specific exercise prescriptions, which generally advised walking the dog for at least 30 minutes every day.

Three months later, the volunteers and their dogs were re-evaluated. Both owners and pets in the dog-walking group had lost weight. But more interesting, those who had been told only that their pets were worryingly heavy also began exercising their pets and themselves. They reported walking far more often than they did before they got health warnings for their dogs, and both they and their pets were thinner.

The upshot, says Capt. Mark B. Stephens M.D., a professor of family medicine at Uniformed Services University and a co-author of the study — it was published in September in the journal Anthrozoös — is that “love and concern for a dog can be a powerful motivation for exercise.” Which is not to say, he adds, that people should adopt a dog as a kind of fitness device. Unlike a treadmill, Marley cannot be abandoned in the basement when you tire of working out. On the other hand, no device will ever be so happy to see you lace up your walking shoes.

Хостинг сайтов Joinder.Pro