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Do Big Breakfasts Win for Weight Control?
New findings support the case that bigger breakfasts and smaller dinners aid weight control

08/28/2017 By Craig Weatherby

The question posed in our headline has been hard to answer.

It seems clear that irregular patterns promote diabetes and weight gain.

That's because — as we reported in Mealtimes Matter to Weight and Health — they disrupt the body’s circadian rhythms.

And there’s some evidence that protein-heavy breakfasts help prevent overeating — see Protein for Breakfast Allays Appetites All Day.

Epidemiological (population) studies have generally linked eating patterns that feature big breakfasts and smaller dinners to better weight control.

However, clinical studies designed to probe this question — which are comparatively few and small — have produced mixed results.

Claims for big breakfasts began as a PR campaign
The idea that big breakfasts promote better health dates to the 1920s.

At that time, Edward Bernays — the so-called “father of public relations” — mounted a highly successful campaign for a pork producer, designed to promote bacon-and-egg breakfasts as healthful.

And the results of most epidemiological published in recent decades found that breakfast eaters tend to be leaner.

Even though epidemiological studies can’t prove cause-effect relationships, health authorities and food companies relied on those results to claim that big breakfasts aid weight control.

However, the mixed-to-negative results of clinical studies — in which people were assigned to either eat or skip breakfast — haven’t confirmed those claims.

Now, the results of a large epidemiological study suggest that several factors — including eating breakfast — appear to predict weight loss or gain.

Loma Linda study supports breakfast
The new epidemiological study was conducted by researchers from the Loma Linda University School of Public Health and the Czech Republic (Kahleova H et al. 2017).

For their study, they analyzed information previously gathered from more than 50,660 participants in the Adventist Health Study-2 (AHS-2).

These were the data points available for comparison:

  • Number of meals per day
  • Timing of the largest meal
  • Routine breakfast consumption
  • Annual changes in body mass index
  • Length of overnight fast (time between the last evening meal and the first daytime meal)

After comparing these factors — and adjusting their findings to account for lifestyle factors that might skew the results — the researchers linked four things to reduced body mass index (weight loss) over time:

  1. Eating only one or two meals per day
  2. Maintaining an overnight fast of up to 18 hours
  3. Eating breakfast instead of skipping it
  4. Making breakfast or lunch the largest meal of the day.

So, people for whom dinner was typically the biggest meal of the day gained the most weight over time.

And — among those for whom dinner was the smallest meal of the day —  people who typically ate big breakfasts showed bigger drops in BMI (weight loss) than those who typically ate big lunches.

Two factors were associated with bigger BMIs over time (weight gain):

  1. Making dinner the largest meal of the day.
  2. Eating more than three meals per day, with snacks defined as meals.

Based on these results, lead author Hana Kahleova, MD, PhD. made several recommendations:

  • Skip dinner
  • Avoid snacks
  • Eat breakfast and lunch
  • Fast overnight for up to 18 hours
  • Make breakfast the largest meal of the day

Kahleova says the findings affirm the wisdom of an ancient proverb, “Eat breakfast like a king, lunch like a prince, and dinner like a pauper.”

The study was co-authored by professor Gary Fraser, MBChB, PhD, of the Loma Linda University Schools of Medicine and Public Health.

Fraser noted that — rregardless of meal pattern — the average participant gained weight until age 60, after which most lost people weight every year.

"Before age 60, those eating [more of their] calories earlier in the day had less weight gain,” Fraser said. He added that, after age 60, the same behavior tended to produce above-averge weight loss, saying, “Over decades, the total effect would be very important.”

What does this study really mean?
The results of this study line up with those of many prior epidemiological studies.

And when the results of most of the epidemiological studies investigating a topic produce similar results, that consensus lends confidence.

However, that confidence can only be confirmed by clinical trials — and, given the mixed results of clinical trials, we should take the Loma Linda study's findings with a grain of salt.

However, those clinical trials have been of generally short duration, which calls their validity into question.

These weaknesses undermine many nutrition-health trials, whose high cost usually preclude the conduct of studies with sufficient size and duration to produce fully reliable results.

The situation is different when it comes to individual nutrients, such as omega-3 fatty acids, whose effects on health can be examined in of laboratory, epidemiological, and clinical trials.

When the results of all three kinds of research align, it’s possible to come to conclusions with strong degrees of confidence.

It’s much harder to obtain this kind of mutually supporting evidence when it comes to overall diet, which is affected by many factors, including the composition and timing of meals.

But because most epidemiological studies link big breakfasts and small dinners to better weight control, it makes sense to pay attention to their findings.

Studies suggest that protein-heavy breakfasts are more filling and satisfying, so it makes sense to follow that pattern (see Can Paleo-Style Breakfasts Curb Food Cravings?).

It also makes sense to include small amounts of filling, fiber-rich whole-grain carbs, which will provide quick energy after a night-long fast — and curb cravings for junky white-flour breads, bagels, and pastries.


Sources

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