Effect of Breakfast Skipping and Late Night Eating on BMI with Type 2 Diabetes
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
No discussion of what they eat.
What a waste of time for everyone involved.
Can have higher BMI and lower bodyfat
I'm not convinced BMI is a useful metric
That might not be the case individually but with multiple people the few outliers don't matter.
It's not perfect, but it's a good metric.
I knew a guy who really wanted to join the fire service but couldn't meet the BMI requirements as he was in the 'obese' BMI bucket, In this case he was just very broad and very muscular (built like the colloquial brick shithouse). By their requirements jonah lomu would not have been able to join because he was 'obese'
If you’re not working out and fat, BMI is still not a good descriptor of “how fat” or “how consequentially fat”.
And yet you’ll still get scientists mapping out correlations and then it’s a shitty analysis because it does not show what the study assumes.
1. Being sub 12% body fat (the highest BMI that would be considered healthy) is arguably unhealthy in and of it's own
2. Being on the low end of healthy would be, if my math serves me, -2.5% body fat
3. BMI does not distinguish between unhealthy / overweight, and fit / healthy (which should be the primary goal of such a metric?)
4. BMI aligns the best outcomes with those that will minimize muscle mass
It's not that BMI does not have it's place, but let's call a spade a spade.
12% body fat isn't a BMI, what are you trying to say?
BMI is not supposed to bucket you into healthy or unhealthy. It is a ratio of your weight to height. You're right that there are a lot of people who are overweight but are perfectly healthy. I think your problem is that you're viewing BMI as some kind of blanket good or bad health number. It is what it is, and it's just one aspect of your physical health, which you probably shouldn't be trying to capture in a single number anyway.
Go get a physical exam from a doctor if you want something comprehensive. If you just want a general height/weight ratio, BMI is pretty good for most people.
it seems likely parent is talking about his* required body fat to be considered in the "healthy" BMI range (under 25 for males).
The musclebound people literally do not care about BMI because its irrelevant to them. Almost everyone else, should probably start eating less.
This couldn't be further from the truth.
How so? A couple years ago I was at 10% and running a ½ marathon three times a week. I felt pretty healthy.
Math reason: the square term for height is incorrect, people are three dimensional and a cube would be more appropriate (the formula is (lbweight/(inchheight^2 * 703))).
Check the BMI of tall and short people that you know in this chart:
https://www.cancer.org/cancer/risk-prevention/diet-physical-...
BMI and body fat are extremely strongly correlated. People with a very high BMI are all obese or morbidly obese. And people with a very low BMI are almost all underweight. BMI is a very simple, easy to calculate and useful metric. It works across countries and across time.
BMI is just one metric. It doesn't tell you everything and knowing only the BMI of an individual isn't proof of anything. But average BMI is higher in Texas than Vietnam despite Texas having way more more bodybuilders. People in Texas have higher BMI because people in Texas are fatter. That's the truth. BMI denialism confounds me.
That is tautological - obesity is defined in terms of BMI. BMI over 30 is obese.
Arnold Schwarzenegger is 6'2" and weighed 235lbs at contest (30.2 BMI) and 260lbs in the off season (33.4 BMI). So much for your "all" claim.
I'm about 16-18% body fat. I'm definitely muscular, but hardly in the .0001%. If I'm wearing a shirt, you can't really tell that I lift.
Hardly world class.
Most people aren't Arnold. Outliers don't count in studies, for very good reasons.
It is understood that when we say "all" we mean "close to 99%", and for 99% of the population with a BMI over 30, they are overweight.
I understand what you're saying, but I think a person that wins Mr. Olympia seven times is clearly a severe, severe, severe outlier. For a decade he was THE most well-built body on the planet. Literally ONE in 5 billion.
Obviously no measurement is "perfect" for "everyone", but BMI is a very good indicator for an extremely high percentage of the population.
For the average person that isn't doing something radical with their body for a specific goal (powerlifer, bodybuilder, olympian, etc.) BMI is a fantastic first pass indicator of how things are going general health/weight wise.
Congratulations on discovering that tail ends of distributions exist.
It doesn't invalidate anything in the comment you are responding to.
I'm far from a genetic outlier, but I go to the gym for 3-4 60-90 minute sessions a week. My program is efficient, I don't take steroids, and my nutrition is decent (but not great). I'm 5'10" and 202 pounds (29 BMI).
I find it disingenuous that people use the top performers as an excuse. There is a middle ground where a modest investment will reap significant returns.
If maintaining the healthy function of my body is skewing my BMI as to be useless, then perhaps BMI is a poor metric.
Even when you take a 1 in 5 billion outlier like Arnold he still doesn't come close to crossing this threshold, despite his high calorie body-builder diet.
"A metric have 0.1% outliers so it is bad metric" is a horrible take
There exist better metrics as well
BMI isn’t generally used as a picture of overall health anyway. More often, it’s used as a measure for health issue probability. As Texas BMI raises, it can be used to calculate the increasing chances of a huge variety of health problems.
You've already pointed out that it depends on what you're using it for, and that's it's not especially useful on an individual basis. Why the weird Holocaust association?
BMI isn't a great measure for a lot of reasons.
There's way too much variation in height and muscle mass. There's variation based on race as well, for example CMS has different standards for DPP eligibility if you're asian [1].
BMI was created in 1830, and has always been of limited usefulness. There are much better methods for measuring health in relation to total body fat.
It is completely reasonable to be critical of it [2] when it's used improperly (which is very common).
[1] https://www.medicare.gov/coverage/medicare-diabetes-preventi...
But on the other, so many people gloss over or are just blatantly unaware that NIH specifically doesn't endorse anything about anything published there, that they're just a clearing house. And then people either infer authority from the domain, or they use that to consciously or subconsciously push their belief.
The journal this article is from is from is Cureus: https://www.cureus.com/
Their tagline seems to be "publishing beyond open access" and to my eye at least looks like a 3rd tier journal.
But NIH really has nothing to do with it, they're just a catalog. Libraries have tons of bullshit in them. You are supposed to be the filter.
The authors found no correlation between skipping breakfast and HbA1c. That's also more relevant to people with Type 2 diabetes than the general population.
Managing type 2 diabetes can occupy a non-trivial amount of mental space. Though probably not as much as managing type one diabetes.
Not everyone is in everyone intended audience.
When I was in my 30s I was a typical woefully sedentary "IT potato" with more than a few extra kilograms around the waist, but today in my early 40s I manage to stay slim and free from diabetes despite being just as sedentary, and I'm convinced that my intermittent fasting is contributing to it:
These days I wait with breakfast until around lunchtime, and I have my last meal for the day between 6 and 8 o'clock in the evening. That is, instead of the usual pattern of eating during nearly two thirds of the day (16 hours) and fasting (sleeping) during one third (8 hours) I've turned it around so that I fast two thirds of the day, while still consuming the same amount of calories.
How did you eat before, if i may ask?
What I do now is to simply compress the same consumption (including the small snack after dinner) so that it fits in a span of 7 hours on average. I'm flexible with it since some days and schedules call for other plans. My goal is not complicated: eat nothing for an unbroken stretch of roughly 16 hours per day.
Now I've been having my first meal after lunch, exercising more by walking and snacking less. Too early to tell how it goes long term.
I'm trying to be a little flexible. So if it's 9am and I'm hungry, or I know I'm heading out the house for a busy morning, I'll eat fruit or vegetables. But no bread.
I think the connection between intermittent fasting and BMI is already well understood: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832593/. In addition, I frequently see incredible transformations on the IF subreddit. From an evolutionary perspective, it makes sense that our bodies were not designed to be consuming calories every waking hour.
When I get ravenously hungry in the morning (which is around 10-11 AM for me, the blessings of remote flexible work) I just get a coffee or a cocoa and that gets me by to the normal meal time (12-14).
I also tried to cut quickly metabolizing food like bread which just makes me hungry earlier.
It's pointless to draw any conclusions from this study. If you think otherwise, check https://www.tylervigen.com/spurious-correlations
Someday this will be cross referenced with genetics.
E.g. If you read about coffee, most report that it's a net positive. Drink more coffee. But if you're a slow metabolizer like myself, the caffeine stays in your system 4X the normal person and actually significantly increases your chance for a cardiac event.
So if you just read the pop-sci articles, kept drinking coffee, but you're the 1/3 of the population that's a slow metabolizer, you've been doing yourself a disservice your entire life. Worse sleep. More anxiety.
https://www.mygenefood.com/blog/why-coffee-is-bad-for-me-but...
No comparison across different demographic groups and countries? (for example, different food types being consumed at different times of the day)
No definition of what time and energy intake constitutes "late eating"? (see [1] for an example study that did define "late eating")
[1] https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2006.17
Looks like no control over food intake. For all we know, breakfast skippers might eat 2lbs of sugar for lunch in this study.
Let's break it down.
> Breakfast skipping was correlated with BMI (Wald, 5.481, 95% CI, 0.154-0.847, P-value, 0.019).
What that means is that breakfast skipping was correlated with somewhere between no BMI points and 1. We have no way of knowing which from this study. Basically, maybe your BMI goes up a little, but so little as to be irrelevant.
> A positive direct correlation was evident between late dinner intake, BMI, and HbA1c (Wald, 4.210, 95% CI, 0.743-0.993, P-value, 0.04 for HbA1c, and Wald, 6.777, 95% CI, 1.0221-1.165, P-value, 0.009 for BMI).
Maybe eating dinner late increases your BMI by 1 point or so. This is probably the same point they claim you gain from eating breakfast late. The A1c numbers are so close to being statistically insignificant that we can just ignore them.
And that's before you add all of the other problems with the study.
This study shows nothing. Yet another questionnaire based study about nutrition. I wish we could as a scientific community just ban this garbage.
I knew skipping breakfast (and often dinner too) had little effect on weight, after years of that habit.
What did work? Riding my bike on a week-long river-to-river 500 mile bike ride in Iowa this summer! That was a blast, I got stronger and I also lost a few pounds.
Not for everybody I know.
I had never heard of that before, but after looking it up I really wish I was close enough to participate. Sounds like a lot of fun.
In terms of physical effects, someone who is doing intermittent fasting is attempting to deplete their body’s glycogen stores: your body very carefully regulates blood sugar (glucose) and stores a bunch of extra blood sugar in these hairballs called glycogen, stored mostly in the liver and in the muscle: then when your body needs more blood sugar circulating, it chops sugar bits off of the ends of the hairballs, or if it has too much sugar it grows the ends of the hairballs.
The impact of fasting is a difference then between your activity and your intake, right? So if I want to really deplete my glycogen stores completely, I'll go run a marathon, that'll do it. Thinking really hard, like a game of chess, can too. Key to understanding the difference between fasting and late eating/breakfast skipping, is the fact that at night mostly we sleep or sit lazily in front of a TV or so. So by binging food late at night you are kind of doing the exact opposite of fasting, you are raising your blood sugar at the exact time that your body stops moving and your brain isn't thinking so much, so your body isn't processing that blood sugar. You fill up your glycogen stores this way!
What happens when they get too full? Your body raises its blood concentration of a hormone (signaling molecule) called insulin. Muscle cells can take in blood sugar whenever they want, but fat storage cells have a “lock and key mechanism” where the channel to let in the blood sugar is controlled by this hormone, they cannot take it in without the insulin. So you get this insulin spike while you sleep, body is saying “I have too much glycogen, please store some blood sugar as fat so that I can shrink these glycogens into the bloodstream.” And you put on weight. But, by itself this is healthy weight. This is what's called subcutaneous fat, the fat that's living out by the skin, in adipose tissue. What will kill you is the visceral fat, which is a distortion of this process.
To understand this, understand that a cell might not want to take on more blood sugar either. In programming terms, the bloodstream is a message bus, the insulin is a message on that bus, and the cell might want to NACK the message. A fat cell can only hold so much fat before it bursts, when it gets to bursting it needs to divide into two fat cells that are half full. So it needs to shut down, to say no no I am not taking the sugar in right now.
The difference between programming and biology is that these are analog signals, so rather than a binary on/off, ack/nack, the cell reduces its sensitivity to insulin, “I just won't take on so much blood sugar right now.”
Type 2 diabetes, what this study is talking about, is a disorder where you have a high blood sugar because your body is developing an insulin resistance. So if one cell down-regulates insulin, great, it is protecting itself. But if all your cells do this at the same time then the body can't clear the blood sugar. So what do you do? Analog system. You spike the insulin even higher. “But Mommy I don't want more”—“well TOO BAD finish your plate, we can't have this food going bad in the fridge and we don't want to attract bugs and DO AS I SAY!!”.
As this starts to happen, you start getting fat deposits in places that are not off in secure storage out by the skin, but are sitting close to the organs where they can do real damage to the ongoing function of your cells—visceral fat.
I hope that helps, the idea is that to first order there is no difference in the amount that you fast but only when you are fasting, and the serendipitous overlap of fasting with sleep and low activity is potentially disturbed by late eating and skipping breakfast, and that could be dangerous because if you are already in that hypernourished situation where you are putting on weight, then this puts potentially a larger strain on it during the night time, like it would be worse if you did late night snacking and also had breakfast, but the idea is that maybe even when you try to skip the breakfast to make up for it it isn't all a wash, it really matters when you eat maybe.
The issue is that it takes work to digest food. Your body does not get to rest as well when you eat late at night. You see it in your heart rate / hrv. Small amounts of carbs don't seem to matter much. A big protein meal is the worst.
Perhaps this might have more applicability to diabetic patients in Europe, specifically those who follow the Mediterranean diet due to socio-geographic reasons.
So they measured that if one doesn't eat breakfast they were more likely to be obese than people that did eat breakfast?
Anyway, let's say late night eating is bad. But many programmers I know (including myself) are more productive at night. But working = hungry. How do you handle this contradiction?
"I skip breakfast, so I am overweight."
or
"I am overweight, so I skip breakfast."
Why is breakfast so holy?
https://www.theguardian.com/lifeandstyle/2016/nov/28/breakfa...
It's in the same boat with IQ, it's a useful tool if you accept it has limited uses.
BMI can't distinguish between fat and muscle which is enough to disqualify it from any serious consideration.
IQ is similarly simplistic and attempts to measure something for which we don't even have an agreed-upon definition.
https://www.fatcalc.com/bf lists several alternatives, along with their estimated accuracies. BMI is the least accurate method short of taking a wild guess.
Saying its ironic that nih.gov has both articles is somewhat like saying its ironic that Google has any two articles.
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