Skipping breakfast may aid in weight loss

Did they evaluate how much people felt no energy, were totally unproductive, or got stomach ulcers from the coffee on empty stomach diet? Fewer calories =weight loss no kidding, but I'm betting this did not study an active healthy population of physicians who eat appropriately and exercise. So I, like you, shall continue my yoghurt oatmeal and eggies in the morning! And feel great all day as a consequence!

wow... never argue the importance of breakfast with an evidence based dietician... I brought this pearl to a colleague and she replied with the following stream of evidence, so robust that I felt I needed to post it:

"The Association between Breakfast Skipping and Body Weight, Nutrient Intake, and Metabolic Measures among Participants with Metabolic Syndrome"  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409723/
A study published Feb 2019 also concludes that skipping breakfast was associated with a worse lipid profile, blood pressure levels, insulin-resistance and metabolic syndrome: "A Systematic Review of the Association of Skipping Breakfast with Weight and Cardiometabolic Risk Factors in Children and Adolescents. "  https://www.ncbi.nlm.nih.gov/pubmed/30781797
See also "A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management"  concluding:  the evidence within this review shows positive to neutral support for the inclusion of breakfast for improvements in appetite control, satiety, and postprandial energy expenditure.  https://www.ncbi.nlm.nih.gov/pubmed/30204837
You may want to visit the PEN app in Novell at SJCG and search Obesity Treatment
such as https://www.pennutrition.com/KnowledgePathway.aspx?kpid=15329&trid=1679…
See excepts from PEN nutrition dated 2015 below:
Healthy Weight/Obesity - Dietary Approaches
Key Practice Points
Assessment
Q: Are adults who skip breakfast more likely to be overweight or obese than adults who eat breakfast?

Last Updated: 2015-03-17

Key Practice Point #1

Systematic reviews of observational studies found that adults who skip breakfast are more likely to have a higher BMI or to be overweight or obese than adults who eat breakfast. Consuming breakfast is also associated with a lower degree of weight gained over time.

The little RCT research in this area produced mixed results as to whether skipping or adding breakfast impacts weight loss.  

Grade of Evidence B
EvidenceReferences
Q: Does a high eating frequency (a grazing/nibbling eating pattern) compared to a low eating frequency (a gorging eating pattern) result in better control of serum lipids, insulin and glucose among adults who do not have diabetes?

Last Updated: 2010-04-26

Key Practice Point #1

Data from experimental studies that included a small number of subjects, suggests that a higher frequency of eating (six to 17 meals /day compared to one or three meals/day) results in modest decreases of total and LDL cholesterol (range: 4-13%) among normo-cholesterolemic men and women. [B]

However, research on hypercholesterolemic men and women is limited and does not currently support that a higher frequency of eating effectively decreases total or LDL cholesterol. [C] More research is needed.

Grade of Evidence B & C
EvidenceRationaleReferences
Key Practice Point #2
Research on the effects of frequency of eating (one or three meals a day versus three to 17 meals a day) on glucose and insulin control among normal and overweight adults is mixed. In some cases more frequent eating was associated with a more stable and less fluctuating glucose and insulin response, while other studies have not been reported this result.

Grade of Evidence C
Q: Are adults who have a higher eating frequency (>3 meals or snacks/day) more likely to gain weight compared to adults who have a lower eating frequency (≤3 meals or snacks/day)?

Last Updated: 2015-03-17

Key Practice Point #1

While the observational studies examining the relationship between eating frequency and the risk of weight gain were highly inconsistent, most RCTs did not find an impact of eating frequency on weight gain, weight loss or maintenance in interventions up to one year. Grade of Evidence B

Julie Besse, B. Sc. RD
Registered Dietitian (CDO)
Mental Health Outpatient and Chronic Pain Management Programs
Certified in Nutritional Pain Management (AIPM)
Member of "Project ECHO" Chronic Pain & Opioids (SJCG/TOH)
Member of the Chronic Pain Quality Standard Advisory Committee - Health Quality Ontario

St. Joseph's Care Group
St. Joseph's Health Center Site
710 Victoria Avenue East
Thunder Bay (ON) P7C 5P7

email: bessej@tbh.net
tel: (807) 624-3529
fax: (807) 624-3743

For more nutrition information, please visit www.UnlockFood.ca

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>>> Bryan MacLeod <bmacleod@nosm.ca> 10/04/2019 10:57 >>>
Thoughts?

Bryan MacLeod, MD, CFPC, FCFP
Medical Director, Chronic Pain
ECHO Chronic Pain Co-Chair
SJCG, Chronic Pain Mngt Program
St. Joseph's Health Centre
710 Victoria Ave E., Thunder Bay, Ont. P7C 5P7
 C): 807-621-0830  (F) 807-624-3522

Associate Professor
Northern Ontario School of Medicine
bmacleod@nosm.ca

Sent from my Samsung Galaxy smartphone.

-------- Original message --------
From: Joule - a CMA Company <cma.ca@mailer.cma.ca>
Date: 4/10/19 7:00 AM (GMT-05:00)
To: "Bryan Robert A. MacLeod" <bmacleod@nosm.ca>
Subject: POEM: Skipping breakfast may aid in weight loss

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Essential Evidence PLUS POEMs Research Summaries

Your daily update for the latest Patient Oriented Evidence that Matters
Skipping breakfast may aid in weight loss
Clinical question
Does skipping breakfast aid in weight loss?
Bottom line
This analysis of short-term studies questioned the sanctity of my favorite meal and found that, on average, breakfast skippers lost weight as compared with those who continued to eat breakfast. The difference may be explained by lower daily calorie intake (ie, they didn't make up those calories later in the day), but study results were mixed in this area. There is a competing theory that extended fasting—not eating between dinner and lunch the following day—produces a prolonged low insulin state that may be responsible for weight loss. Although breakfast may no longer be "the most important meal of the day," the prevailing research is not yet strong enough for me to put away my yogurt and granola. (LOE = 1a-)
Reference
Sievert K, Hussain SM, Page MJ, et al. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ 2019;364:l42.
Study design
Meta-analysis (randomized controlled trials)
Funding
Self-funded or unfunded
Allocation
N/A
Setting
Various (meta-analysis)
Synopsis
These authors searched several databases and identified 13 trials performed in high-income countries to determine the effect of breakfast consumption on either body weight or energy intake. Two reviewers independently extracted the data and assessed the risk of bias. The studies, as you might guess, were unmasked, so the behaviors as well as the subjective outcomes reported by the participants could have been affected. Most of the studies had unclear allocation concealment, meaning that patients could have been selectively enrolled in one group or the other. There was significant heterogeneity among results for energy intake, which the researchers attributed to the different populations being studied. All of the studies were only a few weeks in duration. Over this short period, breakfast-skippers lost an average 0.44 kg (1 lb) more that breakfasters, based on 7 studies of 486 participants. Overall caloric (energy) intake, evaluated in 10 studies of 930 participants, was an average 260 calories per day higher (95% CI 79 - 441 calories per day) in the breakfast eaters. There was no difference when considering habitual breakfast eaters versus skippers.
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Sets a bad trend....we have had decades of good, vetted information on the first meal of the day. Not enough info here on the quality of the meal. It is one of those quick things that patients latch on to and then add to their series of poor choices for diet.