There is a lot of information about the dangers of skipping breakfast on the Internet, and its health effects involve obesity, metabolic syndrome, diabetes, cardiovascular diseases, gallstones and so on. Why not eat breakfast will cause obesity, which will lead to a variety of chronic diseases? A reasonable explanation is that skipping breakfast makes people take the initiative to consume more calories, but the total calorie intake increases. Therefore, obesity occurs, followed by hyperlipidemia and hyperglycemia, and atherosclerosis and cholestasis slowly occur, laying a hidden danger for cardiovascular diseases and gallstones. These inferences sound reasonable and provide a lot of evidence, including from various websites and forums, and many from professional literature. But what is the real situation? If you give me this question mark, I have to return it to you, because from a scientific point of view, it's hard to say.

In the September issue of 20 13, the American Journal of Clinical Nutrition published an article, pointing out that although the public and many professionals believe that skipping breakfast will lead to obesity, this understanding is not based on evidence. This article analyzes a large number of published articles that discuss that skipping breakfast will lead to obesity, and finds that most of them only cite other people's research results without providing evidence, and some of them are not rigorous or even simply wrong. One of the most cited studies only shows that skipping breakfast is related to obesity. But correlation doesn't mean causality. Maybe skipping breakfast and obesity just appear at the same time, and when it is quoted, it is said that skipping breakfast will cause obesity, and the two are said to be causal. What's more, the unrelated research results are cited as relevant. From the medical point of view, it is impossible to draw a causal conclusion only by relevant observation. What can be used as strong evidence should be a prospective randomized controlled trial, so as to exclude the interference of other factors and reduce the influence of subjective knowledge on the research results. However, the results of existing randomized controlled experiments are actually contradictory.

In fact, it is very common that this kind of understanding transcends the existence of evidence, because people already have preconceived concepts. Breakfast is regarded as the most important meal in many cultures. Therefore, when receiving information, it will naturally accept the statement supporting the importance of breakfast and filter out the evidence to the contrary. As far as the author is concerned, before preparing to collect information and write this article, I have presupposed the position of finding evidence for the harm of skipping breakfast, so I unconsciously want to ignore some studies. For example, some studies have confirmed that the daily calories of skipping breakfast have not increased in revenge, but have remained constant or even decreased. Once this view is solidified, it will consciously spread the saying that skipping breakfast leads to obesity and disease, and after this statement is published, it will become a source of deepening understanding for others.

The statement that often skipping breakfast leads to diabetes, cardiovascular disease and affects learning ability, like obesity, is at most related, and it is difficult to establish causal relationship. In fact, skipping breakfast, as an act that affects health, may be one of the masterminds or just a soy sauce party. In the May issue of 20 13, the Journal of Nutrition published an observational study involving nearly 40,000 people, spanning about 30 years. The conclusion is that a person's eating habits, including total calorie intake, snack intake and the habit of skipping breakfast, are all related to his family's economic and educational conditions. The lower the economic status, the lower the education level, the more total calorie intake and snacks, and the more often they skip breakfast. This effect will last for at least 30 years. In fact, in developed countries, low socio-economic status and education level have been determined to be related to a variety of chronic health problems, including obesity, mental illness, diabetes, heart disease and so on. There, of course, is more than eating breakfast.

Another point to note is that even in the articles on the correlation between breakfast and many health problems, eating breakfast is rarely discussed alone, but often appears together with other dietary factors, such as the nutritional composition of food, the fiber content in food, the consumption of snacks and carbonated drinks, and so on. Therefore, it is also lazy to overemphasize the importance of eating breakfast or not.

In a word, although the harm of skipping breakfast is well known and widely recognized by the public, there is no reliable evidence to prove it from a scientific point of view. Too much emphasis on the harm of eating breakfast is unscientific and should be considered together with other dietary habits.

(Author: lw56 102, MD, attending physician in Department of Gastroenterology, Qilu Hospital, Shandong University)