The state of diet and nutrition reporting is horrible.
Remember the “chocolate makes you lose weight” claim that the media fell for all over the world—despite the fact it was a deliberate hoax to prove how bad the state of diet and nutrition reporting is?
Yeah. Totally happened.
Well, things haven’t improved much.
Take, for example, this piece by The Telegraph’s Saffron Alexander.
Saffron Alexander is a Food and Lifestyle reporter who posts pieces with titles like “How to choose the perfect armchair for your home” and “Chocolate, flowers, and cards: the best Valentine’s Day ideas.”
Okay, fine. Someone needs to write pieces like that. (I guess?)
But if you’re going to be writing pieces with headlines like:
Is skipping breakfast bad for us?
New study finds links with heart disease and obesity
Then you really ought to get the story right. I mean, you’re ostensibly giving people information about their health, and low-information news consumers will be making health decisions based on what you write.
So how well does this piece work?
It starts like this:
Skipping breakfast or eating late in the day could raise the risk of heart disease, diabetes, and obesity according to a new study.
Pretty scary, eh kids? A study showed that?
Except it wasn’t a study.
The piece in question was a “statement” published in the American Heart Association’s Circulation. The abstract, identifying it as a statement, is here.
To be clear, a statement is not a study. To put it in journalese, a statement is basically an editorial.
It does not represent original research. No new experiments were performed. While it does refer to previous studies, it’s an opinion piece that makes recommendations.
So we’re not off to a promising start.
The study [there’s that word again–ja] from a group of American researchers suggests that the time we eat our meal is equally as important as what we eat.
Writing in the American Heart Association journal Circulation, researchers from Columbia University said both meal timing and frequency are linked to risk factors for a variety of conditions including heart disease, strokes, high blood pressure, blood glucose levels, obesity, and reduced insulin sensitivity.
The researchers reviewed other current scientific studies concerning breakfast and heart disease and found that those who eat breakfast daily are less likely to have high cholesterol and blood pressure, while those who skip breakfast and instead snack and graze throughout the day are more likely to be obese, have poor nutrition, or be diagnosed with diabetes.
Okay! Hold your horses! We just hit the money quote.
The thing with all the scary health effects wasn’t just skipping breakfast.
It was skipping breakfast and then going on to “snack and graze throughout the day.”
That’s suggestive of an entirely different headline. Something like:
Snacking and Grazing Throughout the Day Will Make You Obese and Give You Diabetes, Strokes, and Heart Disease
Or perhaps the pithier:
Snacking and Grazing Throughout the Day Will Kill You
At this point, the article has basically gone off the rails, since it’s misframing the issue in terms of “skipping breakfast,” when what it should be focusing on is “snacking and grazing throughout the day.”
It does, however, go on to say a few good things. For example, it notes:
There is still some debate in the scientific community about the benefits of eating breakfast. In a 2016 study, research suggested that claims breakfast is the most important meal of the day have very little scientific basis.
That’s true. The idea that breakfast is a super-important meal is a nutritional myth.
But how does that square with the “skipping breakfast can kill you” narrative the article has been working so far? We’ve got cognitive dissonance here, folks!
The article doesn’t resolve this dissonance, though it does helpfully provide a little more on the subject:
Dr James Betts, a senior lecturer in nutrition at the University of Bath said the idea breakfast is inherently good for us may stem from marketing campaigns designed to sell us cereals, eggs and bacon, and the ‘benefits’ of eating early haven’t actually been scrutinised properly.
Breakfast isn’t the most important meal of the day—unless you’re a food industry marketer trying to get people to buy breakfast foods.
The article also notes:
The researchers from Columbia University writing in Circulation also found that eating late at night could lead to a greater risk of poor cardiometabolic health. In one of the studies analysed it was found that late-night snackers are more likely to be obese when compared to those who don’t eat after a certain hour.
That last phrase is very interesting. If you “don’t eat after a certain hour” then you aren’t “snacking and grazing throughout the day.”
And you know what they call it when you don’t snack and graze throughout the day but have defined eating periods between which you fast?
Intermittent fasting has a bunch of health benefits.
The classic “three meals a day with no snacks” model of eating is a form of not-very-restrictive intermittent fasting. It has three periods of eating (that’s the not restrictive part) embedded among three periods of fasting (since no snacks).
If you really want to identify whether skipping breakfast is harmful, that’s what you’d want to test it against: three meals a day with no snacks versus lunch and dinner with no snacks.
And there are stronger forms of intermittent fasting, such as eating once a day, once every other day, once every few days, etc.
If only the studystatement by the AHA said something about intermittent fasting!
Oh, wait! It did!
Saffron Alexander just didn’t tell us about it.
Here’s what it said:
There is evidence that both alternate-day fasting and periodic fasting may be effective for weight loss, although there are no data that indicate whether the weight loss can be sustained long term.
In addition, both eating patterns may be useful for lowering triglyceride concentrations but have little or no effect on total, LDL, or HDL cholesterol concentrations.
These protocols may also be beneficial for lowering blood pressure, but a minimum weight loss of 6% may be required to see an effect.
Intermittent fasting may also be effective for decreasing fasting insulin and IR [i.e., insulin resistance, the key factor in type 2 diabetes–ja], but fasting glucose remains largely unchanged.
Future work in this area should aim to examine whether these effects still persist in longer-term (>52 weeks) randomized, controlled trials.
So, wow. Intermittent fasting seems to have notable positive health results.
How does that compare to what it said about skipping breakfast?
In summary, the limited evidence of breakfast consumption as an important factor in combined weight and cardiometabolic risk management is suggestive of a minimal impact.
There is increasing evidence that advice related to breakfast consumption does not improve weight loss, likely because of compensatory behaviors during the day.
On the other hand, breakfast consumption can contribute to a healthier eating pattern that leads to slight improvements in cardiometabolic risk profile.
Additional, longer-term studies are needed in this field because most metabolic studies have been either single-day studies or of very short duration.
Got that? They say eating breakfast likely has “a minimal impact”—scarcely justifying the scare tactics used in the article about the “dangers” of skipping it.
Further, skipping breakfast won’t help you lose weight if you don’t also fast and instead engage in “compensatory behaviors during the day”—i.e., the “snacking and grazing throughout the day” referred to earlier.
And most of the studies related to this are basically junk science because they were either “single-day studies” (!) or “of very short duration.”
So Ms. Alexander’s article essentially misreads and distorts the AHA statement.
This is not to place all the blame on Ms. Alexander. The AHA itself has a history of bad diet advice.
My impression, upon reading the statement, is that it’s a transitional document. The benefits of not using the snacking/grazing strategy are becoming clear in the scientific data, but old habits die hard, and the authors of the AHA statement haven’t yet gotten to the point of flat out endorsing intermittent fasting.
Hopefully, they’ll get there.
Before a lot more people die.