What I learned when I actually attended this new BMJ study for breakfast

Last week he saw the publication of a new meta-analysis by the BMJ on whether breakfast is useful for weight management. And, completely predictable, it was clickbait for journalists as well as for those who believe that the benefits of breakfast are a myth. The question that jumped in my mind when reading the cover was whether or not someone actually read the study. Why should I call it weak, at least in my opinion, it would be unbearably generous. But at least one person reads it. Finnish registered dietician Reijo Laatikainen, as he published his own thoughts on his blog, and so instead of writing my own, I called him to write here an English guest as guest guest.

The questioning of deeply rooted health beliefs is always welcome and refreshing, not something to be feared, but can the BMJ's new meta-analysis really come to a conclusion if breakfast benefits weight management?

The meta-analysis of randomized controlled trials about morning skipping was published last Tuesday along with a relative version of Tim Spector.

Both the meta-analysis and the piece of opinion criticize the dietary recommendations of many countries and organizations that promote the role of a balanced breakfast as an important part of a healthy diet. Interestingly, the role of breakfast on both BMJ papers is reduced to a weight management issue. Neither paper describes other possible effects of breakfast, such as blood glucose control, energy consumption, or lipid metabolism. On the contrary, without the data, the two papers seem indirectly to imply that breakfast has no health benefits.

But back to weight management that was the subject of the study. The first sentence of the conclusions of the meta-analysis states:

"This study shows that eating breakfast is not a good weight management strategy."

But is it? My belief is tested.

In order to understand the effect of any strategy, diet or other weight management, first and foremost, the study should be long enough, ideal years, and in fact this is often the case with studies of different types of diet. For example, there are several meta-analyzes of low-carbohydrate diet (LCD) RCTs with a minimum duration of 6 months, and there are even studies with perennial durations. This is natural, as the question is whether a particular diet has an impact on something that by definition is of a long-term nature, as the temporarily lost weight can not be lost forever.

This morning's meta-analysis is not like those compiled for LCDs. This includes a total of 13 studies, of which 4 do not last more than one day. In fact, none of the studies lasted even 6 months, with the longest time being 16 weeks and the lesser only 8 hours. Most studies lasted for 1-4 weeks. When all of these brief, heterogeneous studies merged, an increase of 260 kcal in energy intake and a body weight gain of 0.4 kg (0.88 lb) was observed in younger breakfasts compared to breakfast masters.

And if you are at the group's breakfast or not, I think everyone would agree that the studies included were of such short duration that they even were trained together, they simply could not reliably end up in anything about the usefulness of breakfast in long-term weight management.

So what about the actual content of the breakfast that was studied, what did people eat? This is explained (insufficiently) in Table 2. Usually the breakfast was cereal and / or white bread juice. In one study, breakfast is described as follows:

"Cereals from Bran from 7am to 8am and a biscuit covered with chocolate between 10:30 am and 11am"

Does anyone really assume that such a breakfast will benefit from weight management? In which country or diet organization is such a breakfast recommended?

Few other things are worth it. Studies in children and adolescents were excluded from the analysis. Similarly, studies of subjects with type 2 diabetes, where protein-rich mornings were presented to improve blood glucose control and reduce weight [ref, ref, and ref] excluded from this analysis.

As a result of these deficiencies, this study can not come up with anything about the impact of eating a breakfast-rich breakfast on any aspect of long-term health or weight management. His findings are also contradicted by cohort studies that provide some information on long-term skipping, which suggests that masters tend to be heavier.

If we overlook the problem by drawing long-term conclusions about short-term studies, at best the most generous conclusion that can be drawn from this BMJ meta-analysis is that a low-quality breakfast does not help with weight management and may even makes it harder.

In order to really decipher the role of breakfast in weight management and in health as a whole, randomized trials of at least 6 months are required with a balanced breakfast of protein-rich breakfast and attention should be paid to its effects on both healthy people and people with type 2 diabetes 2. In addition, changes in glucose metabolism and blood cholesterol should be monitored as a lack of breakfast may exacerbate glucose tolerance even in healthy opous and / or increase their cholesterol.

But one thing is for sure. This document certainly does not provide either a definitive remote answer to the question for breakfast. At best, it reveals how weak the current quality of randomized breakfast studies is.

PS. Just so there is no confusion I would like to say explicitly that breakfast is by no means a miraculous maneuver which is an unequivocal prerequisite for successful weight management. If you are the owner of your breakfast and your weight is satisfied, you are not struggling with dietary constraints in the evenings and your lipid and glucose prices are within the normal range, you are encouraged to continue skipping breakfast.

Reijo Laatikainen, PhD, MBA, is a registered dietitian at the Aava Medical Center and the Docrates Cancer Center in Helsinki, Finland. You will find it on Twitter @pronutritionist