Breakfast is a Dangerous Meal: Why You Should Ditch Your Morning Meal For Health and Wellbeing. Terence Kealey

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       Chaotic lives

      There is another explanation for the apparent paradox of breakfast skippers being large: they may be leading chaotic lives. So a Finnish study of some 5,500 16-year-old girls and boys and their parents found that breakfast skippers tend to come from families that self-harm by:

       smoking

       failing to take sufficient exercise

       neglecting education

       consuming higher intakes of high-sugar, high-carbohydrate, high-fat snacks

       drinking too much

       being overweight.1

      Extending those Finnish findings, a study from Rhode Island of nearly 10,000 adolescents showed a significant correlation between:

       breakfast skipping

       fast food eating

       weight gain.2

      But correlation is not causation, so we need to ask, is it the breakfast skipping or the fast food eating that is causing the weight gain in these adolescents? Dr Mark Pereira of the University of Minnesota has answered that question. Dr Pereira followed 3,000 young adults over fifteen years, showing that those who ate at fast food restaurants more than twice a week gained an extra 10 pounds (4.5 kg), and had a twofold greater increase in insulin-resistance than those who ate there less than once a week.³ Dr Pereira therefore confirmed that fast food is dangerous food, if only because it is so high in calories: ‘a single meal from one of these restaurants often contains enough calories to satisfy a person’s caloric requirements for an entire day.’⁴

      And who eats fast food? People who lead chaotic lives. Dr Pereira divided his subjects into blacks and whites, and because – for shameful historical reasons – black Americans are disadvantaged, Dr Pereira thus also provided a link between social class and fast food. And Dr Pereira found that, fifteen years into the study:

       black people were visiting fast food restaurants 2.15 times a week against 1.60 times for white people

       the black people in Dr Pereira’s study had nearly two years’ less education than white people

       black people took three-quarters of the exercise of white people

       black people watched nearly twice as much television as white people

       black people ate some 400 calories more per day than white people

       black people drank 50 per cent more soft drinks than white people

       black people ate 50 per cent more meat than white people

       black people ate significantly less fibre than white people.

      So the Rhode Island study on nearly 10,000 adolescents may have shown a significant correlation between breakfast skipping, fast food eating and weight gain, but from Dr Pereira’s research we know it’s not the breakfast skipping that is causing the weight gain, it’s the fast food. And the fast food eating and the breakfast skipping have a common root in a chaotic lifestyle, so we can begin to see how breakfast skipping and overweight are not causally linked but, rather, reflect the actions of a separate, third, cause: domestic chaos leading to unhealthy life choices:

      So we can see how breakfast skipping may be associated with, but not causative of, weight gain. Breakfast skipping per se, in isolation, will promote weight loss, but if it is linked with a package of weight-gaining activities, it will then be associated with weight gain, thus leading unsuspecting epidemiologists to suppose that eating breakfast causes weight loss.

      We might make a comparison with smoking and teenage pregnancy. Teenagers who smoke are more likely to become pregnant but no one has suggested that smoking causes pregnancy.⁵ Rather, dysfunctional teenagers are more likely both to smoke and to become pregnant, but the causative agent is the dysfunction. Here is a model that captures that story:

      The model is not:

      dysfunctional teenagers → smoke → get pregnant

      And to confirm that model of association, not causation, there has even been a report that Japanese girls who skip breakfast also start to have sex two years before their breakfast-eating sisters (at 17.5 rather than 19.4 years of age). The report has not got into an English-language peer-reviewed journal, but it came from the Japan Family Planning Association, which is credible.⁶ Here is a model that captures that story:

      The model is not:

      dysfunctional teenagers → skip breakfast → have premature sex

       Daniel, the lions’ den and the earliest clinical trial

      Epidemiology (from the Greek epidamia, the prevalence of disease) is the science of populations, but it’s too easy in epidemiology to confuse cause and correlation. So here is a claim of cause:

      eat breakfast → eat more → yet lose weight, paradoxically

      (or alternatively)

      skip breakfast → eat less → yet gain weight, paradoxically

      and here is a claim of correlation:

      Epidemiological studies that look only at breakfast and weight can easily confuse correlation with cause – except that the science of epidemiology has long generated a ‘hierarchy of evidence’ by which to distinguish them, and it is a theme of this book that epidemiologists have not always been sufficiently rigorous in applying that hierarchy.

      The hierarchy of evidence: Conflicts over diet are age-old, and some can be sourced to the Bible. Daniel was a Jew who had been captured by Nebuchadnezzar, the King of Babylon, and who was consequently condemned to various vicissitudes including the lions’ den (from which, happily, he was rescued). Daniel was also instructed to eat the food of the royal court, to which he objected on grounds of observance. Let Daniel I: 12–16 take up the story of how he asked that he and his fellow captives be given:

      nothing but vegetables to eat and water to drink. Then [Daniel said] compare our appearance with СКАЧАТЬ