I'd love to see the results parsed by reason for skipping breakfast.

I used to intentionally skip breakfast as a part of an intermittent fasting routing. I wasn't particularly strict about it, and I didn't really buy into the ketogenesis arguments. But it was a calorie restriction scheme that worked for my lifestyle.

Fast forward a few years, and while I still miss breakfast a lot, I find now it's because of work stress. It seems like I can't ever get out of bed in the morning without being immediately greeted by some "emergency" that popped up overnight, and jumping into that before I've really had any opportunity to start the day on my own terms.

I can't help but feel like the latter is going to be a lot more correlated with health problems down the road than the former.

I hear you and I have the same job as when I identified with what you're saying about not starting the day on your terms. However now I just start every day on my own terms and I am measurably getting more done overall. They just have to wait for me to get my morning routine done before they get replies to their slack beeps.

Yes there are exceptions to this rule but in general 'no' being my default until I'm up and running has basically only brought benefits. Hope things improve!

I like your line of thinking.

The mention of liver cancer makes me wonder if it's a hydration issue. Fasting intentionally shouldn't be correlated with dehydration, but missing breakfast due to crisis may mean you are skipping hydration and not making up for it.

How would hydration predispose to liver cancer?

It shouldn't, but dehydration might?

Why?

The liver filters the blood. Blood is mostly fluid.

Dehydration isn't good for you generally.

And when my dad was told to get his affairs in order, his cancer was going to kill him, hydration was a big focus for my parents. He lived another two decades.

So obviously I'm an idiot and it's "anecdata" and I can't cite any large scale studies, but I can wonder in good faith if hydration might impact cancer for more people than just my father.

And the Houston Clinic interviewed my mother on tape for two hours because they knew they didn't keep him alive, she did, and changed their practices because of what she said. So people with better medical credentials than "My daddy didn't die when he was supposed to" also thought maybe something my parents did was significant.

IANAN, but typically you're talking chronic kidney damage with regards to habitual dehydration, in a healthy person.

+100 on cancer support via nutrition and hydration though. Folks don't realize how many cancer outcomes are exacerbated by "I just won't get my nutrients checked and continue with my normal diet." Your body is fundamentally different, especially on chemo, and needs different support.

A quick search suggests kidney and liver problems are related and liver damage tends to precede kidney damage.

Maybe someone more invested in this question will go down a rabbit hole and share. I was just doing a gut check of my knee jerk reaction of "But what I know of the human body...."

They're both complicated enough systems that there can be independent or causal (either way) disease progression.

Something like hepatorenal syndrome [0] would be a liver to kidney collapse, but that's more to do with blood supply.

[0] https://my.clevelandclinic.org/health/diseases/23399-hepator...

Please take this the way it's intended: nurses and doctors study blood and internal organs for years, and diagnosis is still challenging. This is complex stuff.

I don’t know of any established correlation of dehydration to any of this. Our bodies evolved over periods of time when bouts of dehydration were much more common. I just thought that maybe I missed some recent counterintuitive discovery. Of course, please hydrate properly but if you don’t, no need to worry about future cancers.

Higher concentrations of bad things, for longer, in absence of water, and fluid movement.

I skip breakfast because when I wake up, I'm simply not ready to eat at all. I can force myself to eat breakfast, but it's unpleasant and makes me feel worse for the rest of the day. So I skip it. I do have a mid-morning snack, though.

There is a variety of confounding factors taken into account.

People with overall unhealthy lifestyle are more likely to be breakfast skippers, but even controlling for these variables, the effect remains.

So we are now off of fasting?

Not that I keep up with the (largely junk) nutritional studies, but this blurb surprised me:

>...In recent years, breakfast skipping has been proven to be associated with obesity,9 impaired glucose metabolism,10 cardiovascular disease,11 impaired cognitive function,12 and even cancer.13 Recently, a prospective study conducted in China found that habitually skipping breakfast is associated with chronic inflammation, as assessed by the C-reactive protein (CRP) concentration.14

Was this funded by the Chinese-Kellogg equivalent?

> breakfast skipping has been proven to be associated with obesity

Since there’s definitely a cohort that skips breakfast for health reasons, and has a healthy weight as a result, I’d wonder if the data is multimodal and there’s some other group that skips breakfast and is unhealthy that’s overshadowing the heathy modal.

I know someone that never eats breakfast. He does however eat a very big dinner and continue to eat late into the night.

Skipping breakfast is not necessarily a fasting technique, but a consequence of over eating.

Or it’s a consequence of just not feeling like a major meal in the morning. A lot of Europeans eat a pretty light continental breakfast down to a croissant and an expresso.

Not everything has to be a moral failing.

That's what I do, but I'm not over eating (just eating late) and I'm at healthy weight.

I also don't intentionally fast, I just eat when I feel like it.

Interesting, when I eat a larger number of smaller meals I do tend to be hungrier in the mornings.

For example smoking, which is known to be unhealthy, has a relatively high correlation with skipping breakfast.

https://pubmed.ncbi.nlm.nih.gov/19638728/#:~:text=Skipping%2...).

>>So we are now off of fasting?

Why not start the day with breakfast and not eat late in the evenings? Eating late is also often linked to poor sleep

False dichotomy. Fasting does not mean you have to eat up until your final waking moments.

I do not consider my lifestyle fasting, though I rarely eat breakfast and typically have dinner 6-7pm. Which is ~6 hours before I go to bed.

Having GI issues that end up becoming cancerous is also associated with not feeling like eating in the morning because you have GI issues.

N=1 here, but I have IBD and immediate family history of rectal cancer, and I definitely feel the worst in the mornings. That kind of pain is strongly correlated with not wanting to put food in my mouth.

My immediate thought as well. We already know that IBD (particularly unchecked IBD) carries an enormous risk of colorectal cancer... and my IBD is also consistently worse in the morning. Sometimes I skip breakfast when I have an early obligation and don't have time to play games with my gut.

Please, mind, this is only showing correlation. No cause/effect relation.

It might be that people who have GI problems are more likely to skip breakfast. Or there might be something else that causes both.

Be careful when reading studies...

Exactly. I have reviewed a few articles for Nature Medicine, Nature Communications, and twice for Nature.

In many cases, I found really absurd causal claims, plus a total ignorance of confounding and causal inference techniques.

It is shocking that many researchers in biology and medicine have never heard about many of the topics surveyed in e.g. Chapter 36 of Kevin Murphy's second book [1].

[1] https://probml.github.io/pml-book/book2.html

Even with confounding and causal inference techniques, I will never be convinced by studies that aren't double-blind RCTs or studies that show a direct causal relationship.

The reason is that the set of human behavior is so fast and unfathomably complicated. Any two aspects of life are surely correlated by many factors that are influenced by lifestyle.

For ethical reasons, it is not possible to perform some kinds of research with double-blind RCTs.

Besides, large biobanks provide a wealth of observational data which can be explored using causal inference. One can always use a RCT on promising hypotheses.

As someone with GERD… maybe I’m just putting too much weight in my life an experience, but this right here.

Turns out laying down for hours and having stomach acid wash up into your esophagus and irritating it makes it somewhat unpleasant to eat. It takes me a while after getting up for everything to settle before I can eat.

This also substantially raises my risk of GI cancers.

We know there’s a causal link between things like GERD and GI cancers. This could just be showing a relationship between GERD and skipping breakfast which has a much clearer method of action than “not eating food first thing in the morning gives you cancer”.

People with acid reflux, a disease that is more problematic at night, are also more likely to skip breakfast.

There, you have it.

It is extremely important to not overreact to reports of correlation without causation.

A report that something is linked to cancer can be worrying, but is not yet enough to make inferences.

Here is a list of things that are linked (correlated) to each other:

* years of experience programming and a chance of getting cancer

* number of births and chance of getting osteoporosis

* having a surgery and dying of surgery-related complications (can't have complications if you don't have surgery)

* GDP and a chance of getting diagnosed with cancer at a young age (generally, the higher GDP the higher the chance your cancer gets caught earlier or at all -- in many poor countries nobody cares what you died to)

Etc.

Can someone explain to me what "Is Associated" means in this context? I know there are always comments about correlation/causation here, but I genuinely don't have enough of a stats background to actually understand what they are claiming.

If they have tried to control for confounding variables (people who skip breakfast are generally more unhealthy/more likely to be drug users/more likely to smoke, etc), what are the methods they use? Are they reliable?

I find myself thinking about making serious lifestyle changes in response to these articles, but many of them contradict each other.

"is associated" means correlation, usually after whatever attempt (or no attempt, you have to read quite closely to tell) to account for confounding variables.

Even if they do make an attempt to control for such things, it's often useless. There's only so much you can do with limited data and if you're not of exceedingly high character, there's a lot of ways to cheat intentionally or accidentally.

So, this kind of result means very little. It _may_ be a thing that a better study could be based on, that's about it.

I personally would not be making changes in my life based on this type of result.

Associated typically means, "we saw these two things together". Maybe there is an underlying connection, but it at least looked funny (and/or enough to get a paper out the door).

Which is honestly about the best you can get from human behavior. Unlike rats, you cannot lock up humans for their lifetime, force-feeding them a diet of gruel for trial A meanwhile trial B gets a diet of corn-syrup and beer.

Better studies will try to subtract out meaningful differences (eg smokers vs non-smokers), but there is only so much that can be done when humans lie, cheat, steal, and misremember their behavior on questionnaires they fill out years after the fact.

How many random correlations did they try before they found this one?

Looking at Table 1, I wonder if this is an effect of increased variance in smaller populations? Table 2 kind of feels like it's trending that way.

Also, apparently in 2014 there was an article describing Xi Jinping's lifestyle, which reported he ate breakfast daily before dawn. This study started in 2014. Probably a total coincidence, but ...

https://www.latimes.com/world/asia/la-fg-glimpse-president-x...

Perhaps I missed it, but I couldn't see the bit where they controlled for other risk factors. So they basically just seem to be reporting a correlation.

Or is there more to this?

> In the mediation effect analyses, BMI, CRP, and TyG (fasting triglyceride-glucose) index did not mediate the association between breakfast frequency and the risk of GI cancer incidence (all P for mediation effect > 0.05).

Meshes with all of the other studies that show no benefit to TRF or IF unrelated to weight-loss (which can be achieved without TRF/IF), and the studies showing harm, like this one:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9182756/

and this one:

https://www.researchgate.net/publication/368542960_Insulin_r...

ITT: cope. Even if you still believe there are benefits to TRF that aren't just due to losing weight (and note that TRF causes a disproportionate amount of muscle-loss, not fat-loss, when used as a weight-loss tool: https://jamanetwork.com/journals/jamainternalmedicine/fullar...), Satchin Panda, arguably the foremost researcher in this field, has been unequivocal that early TRF is much worse than late TRF (i.e., skipping breakfast instead of skipping dinner) for metabolic health, probably due to circadian misalignment, so I don't see why you all find this result so surprising.

Apparently none of you have heard of Dr. Panda, which means you've done barely any research into any of this, and yet you're still smugly confident that TRF/IF are safe and healthy? Enough to nit-pick the studies saying otherwise, and downvote and flag those posting them?

skipping breakfast causes cancer? linked to obesity even? Did the study establish a causal relationship, or is it merely observing a correlation? A longitudinal study that tracks participants over time may provide stronger evidence than a cross-sectional study. Were other factors (e.g., smoking, exercise, diet, etc.) controlled for in the study?

sounds like bullshit.

When I look at paper titles I like to switch the words around to see if the paper is talking about correlation or causation. If the title was changed to "People with high GI cancer risk tend to habitually skip breakfast" does anything need to change in the paper?

The study is based on self-reported responses to “How many days do you generally consume breakfast in a typical week?” (in Chinese) ... it's an interesting question that clearly must have a customary/social component. As an annoying pedant I'd be compelled to answer "every day" based on the definition of breakfast as the first meal of the day. I don't know how the term or the custom translates to coal miners of eastern Tangshan province, though.

I'm scanning through the article but I cant find where they define what "breakfast" means in terms of portion size or caloric intake?

AFAICT it's a survey based study so there is no definition. It's whatever the participant thinks it means.

Given the esophageal cancer, I'm going to guess that most participants considered a hot drink to be skipping breakfast as a drink isn't food whether or not it has calories.

Good that they say 'associated' because causality is non-trivial to establish, at least given the current state of math frameworks.

But I thought intermittent fasting was the way to go?

I am pretty sure it still is. I used it to lose 75 pounds last year. I am certain even if there was an increased risk of GI cancer (which I don't believe there is, it only shows correlation and no causation), it still is well offset by my improved health.

Does skipping breakfast correlate with a lower daily intake of dietary fiber?

>...since skipping breakfast is associated with bad health behaviour anyways

I have never heard this.

In America, if someone says they are eating breakfast, I assume they are eating junk: bagels, McMuffins, cereal bars, etc. Not muesli.

what makes a bagel "junk"? or a McMuffin for that matter. they're both great on macros

There are all kinds of possible confounders or 3rd variables here, yes. This is more or less just a correlation -- it should not be read as evidence of causation.

Is a morning cigarette skipping breakfast?

Relevant comment. I was thinking “what is breakfast?”. In my case, usually, I eat my first meal of the day around 3-4 hrs after waking up. I’m not hungry before. Does that mean I’m skipping breakfast?

Whilst I can’t see the full paper, a lot of the time people refer to breakfast as a meal before lunch time (before midday), not as the first meal after you break a fasted state.

My dinner is breakfast then!