Can Milk Be Bad For You?

November 18, 2014 by Dr. Steve Chaney

Got Milk? Maybe Not

Author: Dr. Stephen Chaney

You’ve probably seen the ads featuring your favorite celebrities sporting a white mustache and saying “Got milk?” Those ads all suggest that milk is essential for strong bones and a healthy body.

And you are probably aware of dietary recommendations from learned experts saying that you should be consuming at least 2-3 servings of milk every day – more if you’re over 65.

If so, you are probably really confused by the recent headlines saying things like: “Milk Consumption May Increase the Risk of Fractures” and “High Consumption of Milk May Increase Mortality Risk”.

Can milk be bad for you?

Before you pour all your milk down the drain and put Bessie the cow out to pasture, we should examine the study behind the headlines.

Does Milk Actually Increase Fracture Risk?

The study in question (Michaelsson et al, British Medical Journal, 2014; 349; g6015 doi: 10.1136/bmj.g6015) followed 61,433 Swedish women (aged 39-74) for an average of 20.2 years and 45,339 Swedish men (aged 45-79) for an average of 11.2 years. The women filled out two food frequency questionnaires, one at the beginning of the study and another approximately 10 years later. The men filled out one food frequency questionnaire at the beginning of the study.

Mortality and cause of death were obtained from the Swedish Cause of Death Registry. Bone fracture information was obtained from the Swedish National Patient Registry (In countries like Sweden big brother knows everything about you).

The results were pretty dramatic. When they compared women who were drinking three or more glasses of milk per day to women who drank less than one glass of milk a day, the highest level of milk consumption was associated with a:

• 93% increased risk of dying from all causes.
• 90% increased risk of dying from cardiovascular disease.
• 44% increased risk of dying from cancer.
• 16% increased risk of having a bone fracture of any kind.
• 60% increased risk of having a hip fracture.

In contrast, consumption of fermented milk products (cheeses, soured milk and yoghurt) was associated with a decreased risk of mortality and bone fracture in women (a 10-15% decrease in risk for every serving consumed).

What Are The Dangers of Drinking Milk?

The authors speculated that that the increased mortality and fracture risk was due to galactose (a sugar formed from lactose, the primary naturally occurring sugar in unfermented milk). Their argument supporting this hypothesis was four fold:

1) In our intestines lactose is split into two sugars, glucose and galactose.

2) In animal models (primarily mice and rats) lifelong consumption of galactose is associated with shortened lifespan caused by, among other things, oxidative damage and chronic inflammation.

3) There is a rare genetic disease called galactosemia in humans that is caused by the lack of a crucial enzyme required to metabolize galactose. Patients with this disease die at a very early age without treatment. Even with dietary restriction of galactose they experience oxidative damage, inflammation and an increased risk for chronic diseases, including osteoporosis.

4) In a subset of patients enrolled in this study, high milk consumption was associated with an increase in blood markers of oxidative stress and inflammation.

While the results seem clear and the hypothesis seems plausible, we should perhaps look at the limitations of the study before making significant dietary changes.

Limitations of the Study

There are a number of significant limitations to this study.

1) It simply measures associations, not cause and effect.

2) The statistics were not entirely consistent. For example, while consumption of three or more glasses of milk (average = 3.4 glasses/day) was associated with 90% increased risk of mortality and cardiovascular mortality in women, there was only a 15% increase in risk associated with every glass of milk consumed. 15%/glass times 3.4 glasses/day = 51% – not 90%. A little bit of higher math tell us that these numbers don’t quite add up.

3) In men the effects were much smaller to nonexistent. In men high milk consumption was associated with a 10% increased risk in overall mortality and a 16% increased risk cardiovascular mortality, but milk consumption had essentially no effect on cancer mortality, fracture risk or hip fracture risk.

4) The galactose hypothesis is interesting, but far from convincing. Mice and rats don’t necessarily metabolize galactose in the same way as humans. Furthermore, in humans galactosemia is a very rare disease, and there is currently no evidence that dietary galactose poses a problem for people without the genetic defect that causes galactosemia.

5) Most importantly, there have been a number of previous studies examining the effects of milk consumption on both fracture risk and mortality, and those studies have been remarkably inconsistent. Some show increased risk and others show decreased risk. Meta-analyses of all previous clinical studies have shown no significant association between milk consumption and mortality (American Journal of Clinical Nutrition, 93: 158-171, 2011) or hip fracture (Journal of Bone Mineral Research, 26: 833-839, 2011).

While some of the media articles were characterizing this study as ground-breaking and one that should lead to changes in dietary recommendations, the authors were far more cautious in their interpretation of the data. They said: “The results of this study should be interpreted cautiously given the observational design of our study. The findings merit independent replication before they can be used for dietary recommendations.” I agree.

Where Else Can You Find The Nutrients That Milk Provides?

In summary, there is no consistent evidence that milk consumption increases your risk of mortality and bone fractures. However, there is also no consistent evidence that milk consumption decreases your risk of mortality or fracture.

Since milk provides no proven benefit and may pose some risk many of you may be wondering where else you can get the nutrients that milk provides.

Milk is an excellent source of calcium, magnesium, vitamin D, protein and riboflavin. When you carefully evaluate alternative food sources for these nutrients you will quickly discover that your choices are not straight forward. You need to be a knowledgeable consumer and careful label reader. For example:

• Green leafy vegetables are a high in calcium, but many of them also contain oxalate, which chelates the calcium and reduces its bioavailability. In short, green leafy vegetables are a healthy source for some of the calcium we need for healthy bones, but they should not be our primary source because of the relatively low calcium bioavailability.

• Cheeses are an excellent source of calcium, but many cheeses are high in fat and sodium.

• Yoghurts and other fermented milk products are an excellent source of calcium, but many of them are high in added sugars and artificial ingredients, which I do not recommend (see my article “Do Artificial Colors Cause Hyperactivity?” (https://www.chaneyhealth.com/healthtips/do-artificial-colors-cause-hyperactivity/).

• Tofu and tempeh provide only 1/3 to ½ the calcium found in milk and provide no vitamin D.

• “Milk substitutes” made from soy, rice or other sources are often high in added sugars and may not provide the same nutrient profile as real milk. You have to read the labels carefully.

• Calcium supplements are an excellent source of calcium, but they have been controversial in recent years (see my article “Does Calcium Increase Heart Attack Risk?” (https://www.chaneyhealth.com/healthtips/calcium-supplements-increase-heart-attack-risk/). My take on the controversy is that the latest studies have shown fairly convincingly that calcium supplements do not increase heart attack risk. However, if there is any risk, it is associated with calcium supplements that were not designed properly for incorporation of calcium into bone. My recommendation is to only choose calcium supplements that have been clinically proven to increase bone density.

• Well designed protein supplements can also be a good source of calcium and vitamin D, but many of them contain artificial sweeteners, which I do not recommend (see my articles “Do Diet Sodas Make You Fat?” (https://www.chaneyhealth.com/healthtips/do-diet-sodas-make-you-fat/), “Does Sugar Cause Heart Disease?” (https://www.chaneyhealth.com/healthtips/does-sugar-cause-heart-disease/), and “Can Soft Drinks Cause Heart Disease?” (https://www.chaneyhealth.com/healthtips/soft-drinks-and-heart-disease/).

The Bottom Line:

1) A recent study suggested that high milk consumption (> 3 glasses per day) in women might be associated with a:

2) That study has a number of limitations and is not consistent with previous studies. Even the authors of the study stated: “The results [of this study] should be interpreted cautiously…”

3) Previous studies looking at the association of milk consumption and both fractures and mortality have been inconsistent. Meta-analyses of all previous studies show no significant association between milk consumption and either fractures or mortality.

4) In short, there is no consistent evidence to support the recent headlines suggesting that milk consumption might increase your risk of mortality and bone fractures, but there is also no consistent evidence that milk consumption decreases your risk of mortality or fractures.

5) Since milk provides no proven benefits and might pose some risk, you may be asking where else you can find the nutrients that milk provides. While there are a number of other dietary sources of the calcium needed for strong bones, each of them has potential limitations (for details, see the article above). You have to be a knowledgeable consumer and careful label reader if you are looking for non-milk sources of calcium.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

The Benefits of Sprint Interval Training

November 14, 2013 by Dr. Steve Chaney

Are You Still Doing Cardio?

Author: Kai Fusser, MS

Last month I told you about functional fitness training and why I think it is superior to workouts on the machines that fill most gyms and sports clubs. This month my topic is sprint interval training, and why it beats the traditional cardiovascular or aerobic exercises.

Walk into any gym and the first thing you see is people straddling treadmills, ellipticals or bikes for 45 minutes or more trying to burn calories and improving their aerobic fitness.

It is not an easy task for me to explain in a short fitness tip why we should stay away from the typical low to moderate-intensity continuous training (“CARDIO”) and instead do sprint interval training (SIT, or burst training), but here are the key points.

The Problem With Cardio Exercise

Slow cardio:

is very time intensive (the number one reason people skip their workouts)

only works on your aerobic fitness (and that fairly inefficient)

burns some calories during the activity but has no impact on your overall metabolism

stresses your joints due to repetitive impact (especially if you are running for your cardio)

increases inflammation

The Benefits of Sprint Interval Training

Now here is a solution for you. SIT (sprint interval training) training:

will only take about 4-8 minutes 3 days a week

works your aerobic and anaerobic system at the same time

will raise your metabolism for several hours after you have completed the exercise

is very effective for fat loss

will build “fast muscles”

reduces impact on your joints and helps reduce inflammation

Sprint training can burn the same calories as slow cardio in 1/15^th of the time! In addition, slow cardio exercise produces a lot of stress hormones (cortisol) while sprint training stimulates growth hormone (have you ever compared the physique of a sprinter to a marathon runner? It’s your choice).

It is the intensity, not duration that effects the adaptation to exercise.

Making Sprint Interval Training Work For You

There are different ways to implement SIT training:

It can be done on equipment like a:

treadmill (using a steep incline rather than high speed)
stationary bike
upper body ergo meter
or a X-iser

Or it can be done with no equipment at all, like

sprinting (athletes only)
running up a flight of stairs
running up a hill
or with full body calisthenics like a Turkish Getup.

I recommend that you start with 4 min workouts (add 2-3 min of warm up before) with a sprint to rest ratio of 1-3, say 10 sec sprint with 30 sec rest (slow pace). As you feel more comfortable you should work your way down to a ratio of 1-1 like 20 sec sprint with 20 sec rest. The maximum total time you would want to do is 8 min. (more is not better in this case).

Please remember that the sprints should be “high intensity” which is of course relative to your fitness level. The intensity will be different for a fully trained athlete than for a de-conditioned couch hugger.

The Bottom Line:

Sprint interval training (SIT) is a quick and efficient way to burn calories and get the cardiovascular exercise your body needs.

You will be surprised how quickly your:

body will adapt to the new and positive exercise stress
energy level will increase
performance will improve,
metabolism will pick up

You will save time and wear on your joints. Most of all, it can be fun !

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Are Fat Burning Sports Supplements Safe?

November 5, 2013 by Dr. Steve Chaney

It’s Buyer Beware in the Sports Supplement Market

Author: Dr. Stephen Chaney

For many athletes it’s all about being bigger, faster, stronger. That’s what makes the fat burning sports supplements so appealing. If you believe the ads, they will burn fat, increase muscle mass and give you an energy boost. But, are fat burning sports supplements safe? Are they effective?

What Are Fat Burning Sports Supplements?

Simply put, most of the fat burning sports supplements contain metabolic stimulants of some kind. That’s where the energy and fat burning claims come from. The stimulants range from clearly ineffective to downright dangerous.

Are Fat Burning Sports Supplements Effective?

Because sports supplements are considered to be foods rather than drugs, the FDA cannot require sport supplements manufacture to prove that their products are either safe or effective. As a consequence, most sports supplement manufacturers don’t conduct clinical trials to prove the effectiveness of their products. Their claims are based on animal studies and testimonials. However, in most cases there is no objective evidence that their supplements actually work.

Are Fat Burning Sports Supplements Safe?

All stimulants carry some risk. Even small amounts of caffeine can be problematic for some individuals, and many sports supplements contain massive amounts of caffeine. But, it is not caffeine containing sports products that are the most worrisome.

Many sports supplement manufacturers are firm believers in the “better living through chemistry” motto.

They start with an herbal ingredient that has stimulant properties
They synthesize what they think is the active ingredient
Perhaps they chemically modify it a bit….
..and, Voila! They have a proprietary new sports supplement
They label it a fat burner, prepare their claims and they’re ready to go to market

And, why bother testing it? Unless the product kills or seriously harms people, the FDA can’t step in and tell a manufacturer to take their product off the market.

And, if you think that the manufacturers and sellers of the product are looking after your best interests, think again.

Case Study #1: Jack3D and DMAA

I told you about this story last year, so I’ll just give you a brief recap here.

After a couple of marines died after using Jack3D prior to a workout, the US military ordered that the product not be sold on their bases. The manufacturer continued to make the product. GNC stopped selling it on military bases, but continued to sell it in all its other stores.
Eventually the FDA stepped in and recommended that Jack3D not be sold. The manufacturer claimed that the active ingredient, DMAA, was found in the geranium extract they used in their product. Since that was a food ingredient, they claimed the FDA did not have jurisdiction.
The FDA denied that claim based an extensive testing of geranium extract. At that point the manufacturer stopped making it (They have since resuming making the product with yet another poorly tested stimulant). GNC said they would stop selling Jack3D “as soon as their inventory was used up”.
The FDA finally had to raid the GNC warehouses to get the product off the market.

Case Study #2: OxyElite Pro and Aegeline

In case you thought that was an isolated case, the same sports supplement manufacturer has recently been involved in a second case that sounds all too familiar.

The FDA recently advised consumers to stop using OxyElite Pro after reports of 24 cases of acute non-viral hepatitis (a very rare disease) in users of that sports supplement in Hawaii. Two of those patients required liver transplants, and one of them died.
In this case the manufacturer stopped domestic distribution of the product, but argued that the product is safe. They claimed that counterfeit versions of OxyElite Pro were being sold in the US market.
On October 11, 2013 the FDA sent a warning letter to the manufacturer stating that the active ingredient, aegeline, was not a lawful dietary ingredient. The manufacturer replied that it was a natural constituent of the citrus fruit tree Bael. (I’m not sure why that makes it safe. I don’t know about you, but I don’t eat a lot of Bael fruit.)
As of a few days ago England, Denmark, Spain, Australia & New Zealand have warned consumers in those countries not to use OxyElite Pro.

It’s too early to tell how this story is going to turn out, but my money is with the FDA.

Case Study #3: Craze and DEPEA

And, in case you thought the problem was with a single rogue manufacturer, there is a developing story around yet another popular sports supplement, Craze, made by a different manufacturer.

Researchers from the NSF, Harvard and the National Institute for Public Health in the Netherlands recently published a paper claiming that Craze contained DEPEA, a methamphetamine-like compound.
The manufacturers claimed that the researchers did the chemical analysis incorrectly and their product actually contained a close analog of DEPEA that is found in dendrobium orchids. (Again I’m not sure why that makes it OK. I don’t think people eat a lot of dendrobium orchids either).

Stay tuned. I’m sure this story will have some interesting twists before it’s finished.

The Bottom Line:

1) In the sports nutrition industry, it is buyer beware. There are lots of rogue manufacturers out there who care more for their bottom line than your well being. Do your homework and search for reputable companies with a long track record of product quality and ethical standards. There are some out there.

2) Ignore the outlandish claims, no matter how appealing. Once again, stick with establishing companies with a track record of product integrity. Only use sports supplements that are backed by clinical studies showing that they are both safe and effective.

3) Be particularly cautious about sports supplements that claim to burn fat or give you energy. They generally contain metabolic stimulants, and often those stimulants are poorly characterized. Most have not been proven to be effective, and some have the potential to do more harm than good.

4) Fat burning supplements are often cross marketed as weight loss supplements. They are just as dangerous for dieters as they are for athletes.

5) Don’t assume that just because the ingredients supposedly come from a natural source (geraniums, Bael trees or dendrobium orchids, for example) they are safe.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Are High Protein Diets Your Secret To Successful Weight Loss?

October 17, 2013September 17, 2013 by Dr. Steve Chaney

Do High Protein Diets Reduce Fat And Preserve Muscle?

Author: Dr. Stephen Chaney

Are high protein diets your secret to healthy weight loss? There are lots of diets out there – high fat, low fat, Paleolithic, blood type, exotic juices, magic pills and potions. But recently, high protein diets are getting a lot of press. The word is that they preserve muscle mass and preferentially decrease fat mass.

If high protein diets actually did that, it would be huge because:

It’s the fat – not the pounds – that causes most of the health problems.

Muscle burns more calories than fat, so preserving muscle mass helps keep your metabolic rate high without dangerous herbs or stimulants – and keeping your metabolic rate high helps prevent both the plateau and yo-yo (weight regain) characteristic of so many diets.

When you lose fat and retain muscle you are reshaping your body – and that’s why most people are dieting to begin with.

So let’s look more carefully at the recent study that has been generating all the headlines (Pasiakos et al, The FASEB Journal, 27: 3837-3847, 2013).

The Study Design:

This was a randomized control study with 39 young (21), healthy and fit men and women who were only borderline overweight (BMI = 25). These volunteers were put on a 21 day weight loss program in which calories were reduced by 30% and exercise was increased by 10%. They were divided into 3 groups:

One group was assigned a diet containing the RDA for protein (about 14% of calories in this study design).
The second group’s diet contained 2X the RDA for protein (28% of calories)
The third group’s diet contained 3X the RDA for protein (42% of calories)

In the RDA protein group carbohydrate was 56% of calories, and fat was 30% of calories. In the other two groups the carbohydrate and fat content of the diets was decreased proportionally.

What Did The Study Show?

Weight loss (7 pounds in 21 days) was the same on all 3 diets.

The high protein (28% and 42%) diets caused almost 2X more fat loss (5 pounds versus 2.8 pounds) than the diet supplying the RDA amount of protein.

The high protein (28% and 42%) diets caused 2X less muscle loss (2.1 pounds versus 4.2 pounds) than the diet supplying the RDA amount of protein.

In case you didn’t notice, there was no difference in overall results between the 28% (2X the RDA) and 42% (3X the RDA) diets.

Pros And Cons Of The Study:

The con is fairly obvious. The participants in this study were all young, healthy and were not seriously overweight. If this were the only study of this type one might seriously question whether the results were applicable to middle aged, overweight coach potatoes. However, there have been several other studies with older, more overweight volunteers that have come to the same conclusion – namely that high protein diets preserve muscle mass and enhance fat loss.

The value of this study is that it defines for the first time the upper limit for how much protein is required to preserve muscle mass in a weight loss regimen. 28% of calories is sufficient, and there appear to be no benefit from increasing protein further. I would add the caveat that there are studies suggesting that protein requirements for preserving muscle mass may be greater in adults 50 and older.

The Bottom Line:

1) Forget the high fat diets, low fat diets, pills and potions. High protein diets (~2X the RDA or 28% of calories) do appear to be the safest, most effective way to preserve muscle mass and enhance fat loss in a weight loss regimen.

2) That’s not a lot of protein, by the way. The average American consumes almost 2X the RDA for protein on a daily basis. However, it is significantly more protein than the average American consumes when they are trying to lose weight. Salads and carrot sticks are great diet foods, but they don’t contain much protein.

3) Higher protein intake does not appear to offer any additional benefit – at least in young adults.

4) Not all high protein diets are created equal. What some people call high protein diets are laden with saturated fats or devoid of carbohydrate. The diet in this study, which is what I recommend, had 43% healthy carbohydrates and 30% healthy fats.

5) These diets were designed to give 7 pounds of weight loss in 21 days – which is what the experts recommend. There are diets out there promising faster weight loss but they severely restrict calories and/or rely heavily on stimulants, they do not preserve muscle mass, and they often are not safe. In addition they are usually temporary. I do not recommend them.

6) This level of protein intake is safe for almost everyone. The major exception would be people with kidney disease, who should always check with their doctor before increasing protein intake. The only other caveat is that protein metabolism creates a lot of nitrogenous waste, so you should drink plenty of water to flush that waste out of your system. But, water is always a good idea.

7) The high protein diets minimized, but did not completely prevent, muscle loss. Other studies suggest that adding the amino acid leucine to a high protein diet can give 100% retention of muscle mass in a weight loss regimen – but that’s another story for another day.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Staying Fit On The Road

September 12, 2013 by Dr. Steve Chaney

How Can You Work Exercise Into Your Travel Schedule?

Author: Kai Fusser, MS

Many of my clients ask me “How can I stay fit while I’m on the road?” If you are traveling for work or leisure, traveling and working out can be a challenge, finding a gym, time, convenience and more gets in the way. For my athletes exercise is a must and getting it done is part of their job even though they have the same challenges. But also for us non-athletes, we want to stay fit even during travel, it also makes us feel better and can help with jet lag and combat the effects of “travel” food.

Travel Exercise Tips;

Now we should realize that we don’t need a gym to get a good workout in, a hotel room or some outdoor space can be sufficient. We also don’t necessarily need any equipment although bringing along a jump rope and a rubber band can add to the variety of on the road exercises.

So here are some ideas for simple ways to exercise, feel free to be inventive, our body can move in many ways and we need to take advantage of that.

The power of walking: walking is one of the most natural and healthiest movements for us, it uses our whole body, stimulates the circulatory and nervous system, massages our organs and is relaxing. Take a 30-60 min. walk in a park, neighborhood or city, if done in the evening it will help you sleep better as well.

Use your own body: here we can take advantage of our own body weight and gravity, there are countless exercises that can be done in a tight space, try to do 3 sets of 8-15 reps for each exercise, alternating between different exercises will save time. Here are some good ones: pushups with different arm widths, lunges in all different directions, squats, crunches with different leg positions, dips on a chair, regular and side planks, wood chop up, shot put etc.

Use bands: attach it to the door or stand on it, curls, overhead extensions, pushing and pulling, straight rotations, shoulder rotations, pull downs, wood chops

Cardio: here I recommend the burst training as it is the most efficient in time and effect, 4-6 minutes alternating between slow and sprint pace at 20 sec. slow and 10-20 sec. sprint ratio. This can be done by running in place with use of arms, rope jumping, hotel stairways, shadow boxing (no worries you are alone in the room).

The ultimate way: if you really want a challenge and get things done quick do 3-5 sets of either Turkish get ups or pushups to jump (also called burpees) at high speed.

In the hotel gym: hotel gyms are often “compromise gyms” but most have a treadmill (turn the motor off and push the belt while holding on) or a bike where the burst training can be done which I recommend over the long slow cardio for its effectiveness and its much easier to convince yourself of doing a short 4-6 min. workout verses a 45-60 min. long haul.

It is best to keep the workout short in time but high in intensity according to your fitness level.

Also remember your nutrition during travel, I know it is very challenging as we get out of our routine, but making the right choices (why not stopping at the super market for some healthy snacks before checking in) and eating in moderation will go a long ways towards still feeling good when you get back home.

Remember to keep it simple and fun so traveling doesn’t have to be a threat to your health.

For some great exercise tips and ideas for different exercises please visit my website; www.kaifitnessforgolf.com

The Bottom Line:

1) Don’t neglect your health just because you’re on the road.

2) Even if the hotels where you are staying don’t have fancy workout facilities, you have plenty of options. Just choose the ones that fit you best.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Does Skipping Breakfast Increase Heart Disease Risk?

October 17, 2013September 10, 2013 by Dr. Steve Chaney

Should You Eat Breakfast Every Day?

Author: Dr. Stephen Chaney

Does skipping breakfast actually increase your risk of heart attacks? You’ve probably heard the saying “Eat breakfast like a king, lunch like a prince, and dinner like a pauper”.

You’ve probably also heard that skipping breakfast is associated with increased risk of things like:

obesity
high blood pressure
and diabetes

If you believe those associations are true, the latest study showing an association between skipping breakfast and heart disease risk just makes sense. After all, obesity, high blood pressure and diabetes all increase the risk of heart disease.

But, how good is the evidence skipping breakfast actually increases the risk of any of those things?

The evidence for the link between skipping breakfast and heart disease risk:

Let’s start with the current study linking breakfast skipping with heart disease (Cahill et al, Circulation, 128: 337-343, 2013) because its study design is similar to the studies linking breakfast skipping to obesity, high blood pressure and diabetes. This study surveyed the eating habits of 27,000 men (45+ years old) enrolled in the Health Professionals Follow-Up Study in 1992 and followed those men for 16 years.

The results were pretty dramatic. After correcting for other factors that might influence heart disease risk, the men who skipped breakfast were 27% more likely to develop heart disease over the next 16 years than the men who ate breakfast on a daily basis.

As impressive as the association between breakfast and heart disease was, there was an even more impressive association that never made it into the headlines.

There was no association between skipping breakfast and eating late in the evening. However, those men who ate late in the evening were 53% more like to develop heart disease than men who did not.

The pros and cons of the study:

The pros:

1) The strength of this study is that it is large (27,000 participants), long (16 years) and well designed. The results were statistically very significant.

The cons:

1) This study only shows associations. It does not prove cause and effect. Having said that, it would be really, really hard to design a placebo controlled study for breakfast versus no breakfast. So cause and effect is almost impossible to prove for this type of comparison.

2) The study did not ask what kind of breakfast the participants were eating. We don’t know whether the breakfasts were a Danish and coffee, an Egg McMuffin and hash browns or a high protein smoothie with perhaps some fruit or oatmeal– and, believe me, there is a difference among those three breakfasts!

The Bottom Line:

1) Eating breakfast is probably a good thing. Yes, the evidence that skipping breakfast increases heart disease risk is circumstantial, but it is also substantial. This is a large, well designed study.

2) Not all breakfasts are equal. You probably already knew that! I recommend a breakfast with fruit, nuts, whole grains in moderation and lean protein sources.

3) While this particular study only included men, previous studies suggest that the potential health risks of skipping breakfast are equally strong for women.

4) Finally, while skipping breakfast grabbed all the headlines, the data suggest that eating late at night is an even stronger predictor of heart disease risk.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.