My surgery discharge directions read "Eat 3 meals daily, eat slowly and chew food well; avoid skipping meals." The first meal of the day is Breakfast and generally it is the meal that many individuals skip.

A research study in Spain examined the possible link between breakfast consumption and obesity — especially abdominal obesity, which is the type most closely associated with the risk of type 2 diabetes and other metabolic problems.

This epidemiological study included 1655 adults, about half each of men and women. About 53 percent were between 18 and 49 years of age, and the rest were between 41 and 64 years old. Two-thirds reported that they were habitually inactive ('active' meant that they performed at least 30 minutes per day of physical activity as part of their daily life, or at least 2 hours per week of structured physical exercise), and about one-third overall said they were current smokers. Participants' height, weight, and circumferences were measured during personal interviews, and food consumption was assessed by 3-day dietary records.

Only a small percentage of participants reported never eating breakfast — 3.6 percent overall, while 82 percent said they always ate breakfast and about 14 percent said they sometimes ate that meal. Dairy foods with cereals were the most frequently reported items consumed for breakfast. Men with Wt: Ht ratios > 0.05 (i.e., abdominal obesity) were more likely to be breakfast skippers than their slimmer counterparts, and there was an inverse significant statistical association between always eating breakfast and the odds of abdominal obesity.

Participants who ate breakfast 'sometimes' and 'always' were less likely to report that they smoked (43 and 33 percent respectively) compared to those who never ate breakfast (51 percent): this difference was statistically significant. Furthermore, those who skipped breakfast were also more likely to have other unhealthy characteristics such as physical inactivity.

Thus, the authors concluded:

[T]here appears to be a greater likelihood of health-compromising behaviours in people who miss breakfast, including increased prevalence of smoking, poorer food choices and greater energy intake from snacks.

https://www.acsh.org/news/2017/12/02/breakfast-might-be-marker-healthy-lifestyle-could-it-prevent-obesity-12226

So generally it seems research points to the importance of breakfast (primarily because it kick-starts your day, and minimizes the temptation to snack).

See I look at this a different way...I just do not believe you can draw conclusions from this kind of study. We all know association never proves causation, so a cohort study can never prove that premise. Also, it's a 3 day, self-reported (from memory) recitation of meals--an activity rife with errors.

It's just as likely that a predisposed group of people: inactive, poor lifestyle habits, obesity-prone people evolve into making lazy, hedonistic food choices rather than...you take a healthy adult who decides to stop eating breakfast, starts gaining weight, quits exercising, and picks up smoking. It's a chicken or egg argument.

I'd argue that if you chose a different subset of people who don't eat breakfast: ie Intermittent Fasters who eat paleo and you will find, better health profiles as a result of skipping breakfast. They exercise (usually crossfit or HIIT) in gyms. They are rabid anti-smokers...and getting healthy is a priority. You could not draw the same conclusion with this subset of people.

That's why I think cohort studies are impossible to tools cuz you can never eliminate out the variables with any degree of certainty nor correct for the level of error--which is likely exponential. Cohort studies might have the advantage of being "large," but I'd rather have 20 subjects in a double-blind, controlled environment and read statistical, empirical evidence...

While this study may have some validity, the old 'correlation is not causation' mantra needs to be applied.

What I read in your post and not the entire study was ' mainly dairy and cereal for breakfast' and to me that indicates they know nothing about nutrition because that is a poor breakfast indeed. And exactly what are there other habits? Coffee and danish at 10AM, for bf #2? Fast food at lunch? If the study only examines whether they ate bf and not what they eat all day, it is worthless. Also do they eat all the way up to bedtime?

I do however believe eating breakfast wakes up your metabolism and is important. I also believe there is a relationship between being hungry and needing bf if you have had enough fasting hours and sleep prior to waking up.

BTW, @James Marusek have I told you lately that I you? I love when you post studies and articles! I adore debating this stuff and love that you make me think analytically. I learn as much from the replies as I do about the study or article! Thanks James!!

Saying you can't draw conclusions from an epidemiological study is hyperbolic. Yes, correlation is not causation, but that doesn't mean that you can't learn something from correlation studies. You absolutely can.

For example, this study doesn't prove that eating breakfast makes you healthier, but it does prove that skipping breakfast is not a great way to lose weight for most people. Because causation does indicate correlation; if skipping breakfast helped people control their weight, then skipping breakfast would be correlated with lower weights, and it's not. The opposite is true.

The authors found that people who skipped breakfast were more likely to make poor food choices and snack more, which is a fair hypothesis (untested here) for why skipping breakfast doesn't lead to weight loss for most people.

Intermittent fasting is a special case and not what this paper is about. Paleo/crossfit enthusiasts are a tiny subset of the population, and they aren't the focus of this study. Most importantly, they aren't just skipping breakfast - they're making sure not to overcompensate calories later in the day, avoiding all junk food and working out really hard.

I think it's important to understand that 'correlation is not causation' is not a blanket statement meaning that correlation studies are worthless. They aren't.

@loey13 I'm just a lay person who enjoys reading studies. I don't make up the rules for good science. But, I have come to trust a few very educated people who actually have extreme skill and education to discuss and evaluate science. I pretty much agree with what they're saying. Here's a very good discussion between Gary Taubes (a premiere science journalist and Mike, Eades, MD) about Causation/Correlation.

https://proteinpower.com/drmike/2008/08/16/running-from-the-proof-correlation-does-not-mean-causation/

And you actually made my point. In correlation studies it's easy to cherry pick a subset of the population...and it's impossible to correct for confounding variables. Totally impossible. The only thing correlations studies can do is suggest a direction to pursue...it's a broad brush approach like a shotgun approach to science.

Edited December 7, 20178 yr by FluffyChix

Yes you need breakfast. Simple and plain. I'm not a breakfast eater i hate it, but i know i have to so i do it.

It regulates your metabolism you know when to eat again due to hunger, not boredom. And it gives you the nutrition you need to keep going. Without it, i would have no energy in the am.

I take most studies with a grain of salt. You can say that a high percentage of people that skip breakfast are overweight, but is it really because they skip breakfast, or is there another reason? Do they really expect us to believe that if those people added a bowl of Frosted Flakes and whole milk to their diet, they would actually start to lose the weight? I doubt that.

I eat breakfast though. Not because I think it will help me to lose weight, but because my stomach yells at me if I haven't had something to eat by 10am.

51 minutes ago, DropWt4Life said:

I take most studies with a grain of salt. You can say that a high percentage of people that skip Breakfast are overweight, but is it really because they skip breakfast, or is there another reason?

This.

And if 82% eat breakfast - what are the other 18% doing?

In the end you don't know if you're in the 82% group or in the 18% group. You simply have to try what works best for you.

Oh, as far as skipping breakfast goes: I did that, too - because when I ate breakfast, my weight would climb up even higher.

Now I usually don't eat breakfast - or maybe I should rather say that I don't eat immediately after waking up? I usually get up a 6:30 and have a cup of coffee. I usually eat something between 9:00 and 10:00 when I'm actually getting hungry. I'm not a morning person.

I agree with eating breakfast (for me...mostly...at least for now and the short term future). Cuz my RD wants me too... hahahaha

My nutritionist told us that we need to eat something within 1 hour of waking up. That is a new one for me, as I would usually wait a bit before having breakfast. Something to do with metabolism. So if you wait, then your body thinks you are in a starve situation and the next food you eat will go into storage instead of into use. Negating your going through surgery.

If you can't stand to eat - then grab a protein drink. Just get something in your pouch.

I don't eat breakfast. My sleeve doesn't like it. It makes my tummy hurt. I have a protein shake for breakfast. Or a drink. And then start my solid food from lunch time. I know many who do this. It has not hindered my weightloss. I was at 60lbs at 4months. Just hit 5th month we will see what happens.

Sent from my Vivo 5R using BariatricPal mobile app

10 minutes ago, dreamingsmall said:

I don't eat breakfast. My sleeve doesn't like it. It makes my tummy hurt. I have a Protein Shake for breakfast. Or a drink. And then start my solid food from lunch time. I know many who do this. It has not hindered my weightloss. I was at 60lbs at 4months. Just hit 5th month we will see what happens.

Sent from my Vivo 5R using BariatricPal mobile app

I count anything with calories as breakfast, so a protein drink totally counts towards breakfast. My RD said it counts as well. Not that she's God or anything lol! *snort*

While I think the study is vague and poorly designed, I think breakfast is still hugely important for WLS patients. I know theres a reason that many weight loss programs usually include something along the lines of avoid going more than 5 hours without eating/drinking.

Considering that if youre sleeping and eating dinner at reasonable times, youre probably looking at a solid 10-12 hours of not eating from the time you had dinner to waking up. I think balancing your macros/nutrition adequately after WLS becomes substantially more difficult if you dont have breakfast. Even if its just a protein shake. Otherwise its going to get you into a cycle of starving and binging to catch up, which cant be good for the long term success of your WLS, and thats in addition to the previous mention of getting adequate and optimal nutrition.

The argument for/against breakfast in non WLS patients is probably far more complicated, especially once you factor in all these gimmicky things like IF KETO and all that ****. But with WLS patients I think the benefits of having breakfast are clear cut

I did my dissertation work on coral reefs, so I'm not a health scientist, but I did teach experimental design to undergraduates when I was in graduate school, my PhD is in biology, and I do get paid to write about health research for a popular audience. There is nothing wrong with the design of this research study.

Yes, 18% of people who skip breakfast are not fat; this is not an indication that skipping breakfast is a great way to lose weight. Maybe you gain weight when you eat breakfast, but you are a single data point and you are not proof that skipping breakfast is a great way for most people to lose weight.

It's awesome to read research, and it's immportant to be aware of the limitations of what research can tell you, but crapping all over a research study because you can't control for every variable in a correlation study or because it's not a double blind control study (very few studies are) is throwing out valuable information for no good reason.

Research studies are peer-reviewed, which means at least three expert epidemiology researchers read this paper and agreed that the study design was sound and the conclusions were reasonable. As someone who isn't an expert in this field, but who is familiar with how science works, I feel comfortable trusting the reviewers judgement.

That doesn't mean I believe eating breakfast will make me thin. It means on days I have to skip breakfast, I pay closer attention to my food choices, try not to over snack, and choose to eat breakfast most days so that I don't get over hungry and make poor choices.

Ya'll do what works for you.