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NUT118Homework#2 Title:Really?TimingofMealsAffectsWeightLoss Author:AnahadOConnor Source:TheNewYorkTimes Date:February4,2013 URL:http://well.blogs.nytimes.com/2013/02/04/reallytimingofmealsaffects weightloss/ Title:Timingoffoodintakepredictsweightlosseffectiveness Author:Garaulet,M,GomezAbellan,P.,AlburquerqueBejar,JJ,Lee,YC,Ordovas, JM,andScheer,FAJL Journal:InternationalJournalofObesity Volume:N/A(onlineaccess) Pages:18 Year:2013 Thestudydescribedinthejournalisanobservationalstudyof420subjects voluntarilyattendingnutritionclinicsinMurcia,Spain.Thestudywasbasedoffof datafromaplaninwhichpatientsfollowedaprogramforweightlossfocusingon fourmaincomponents:nutritioneducation,cognitivebehavioraltechniques, moderatephysicalactivityintervention,andthehallmark,theMediterraneanDiet. Anobservationalstudyisveryunlikelytodeterminecausationbecausethe researchershavenocontroloverassigningatreatmentoracontrolgroupasa baseline.Therearemanypossibleconfoundingfactorsthatcanoccurinan observationalstudythatmakeprovingcausationdifficult;forexample,studyresults couldbeduetothetreatment,butalsoduetoacombinationofvariablesinthe subjectslives.Anobservationalstudycanonlyimplyanassociationbetweena treatmentandresponse,assupportedbydata. Thenewsarticlepoorlyreflectsthedatapresentedinthefindingsfromthestudy. Specifically,theauthorsaid,Thesubjectsweresplitintotwogroupsandhadthe criticaldifferenceinthetimingoftheirmeal,implyingthatthesubjectswere prescribedatimetoeatandassignedanintervention.Thisstudywas observational;theresearchershadnocontroloverthesubjectsandonlycollected data.Thenewsarticlealsostatesthatthemostresearchtodatehasshownthat eatinglateislinkedtoweightgain,butlateeatersalsotendtoconsumemore caloriesoverall.Laterinthearticle,theystatethatinthestudy,[thesubjects]had similarcaloricintakesandexpenditures.Theauthorfailedtoindicatethatinthe study,thelateeatershadsignificantlylowerpercentageoftheirtotaldailyenergy intakeduringbreakfastandskippedbreakfastmorefrequentlythanearlyeaters,an effectthatcouldbecontributingtothedifferencesinweightlosswithlunchtiming (Garaulet,M.etAl.pg.45). OConnoralsoomitsthelinkbetweena,previoushumanstudy[that] showedthatcaloricconsumptionafter2000hours(8pm)wasassociatedwith increasedBMIindependentlyofsleeptimingandduration(pg.5).Inthestudy,the averagetimingofdinnerforthelateeaterswas9:30pm,clearlyintherealmoftime

whereanincreasedBMIwasindicatedintheaforementionedstudy.Another oversightbytheauthorwasthatthelateeatersinthestudyalsoweremorelikelyto havetheminorallele(G)thathasbeenassociatedwithobesityinpreviousstudies (pg.3). ThisnewsarticleintheNewYorkTimesisriddledwithcriticalomissions thatmakeitsintegrityquestionable.Eventhebottomlineofthearticle[the timingofyourmealsmaynotbeeverythingwhenitcomestoweightloss,butitdoes appeartoplayarole]ismuchmoredefinitivethaninsightsoftheoriginalstudy itself(OConnorpg.1).ThestudybyGaraulet,M.EtAlsuggeststhat,thecurrent findingsmayhelpinthedevelopmentofnoveltherapeuticstrategiesincorporating notonlythecaloricintakeandmacronutrientdistributionasclassicallydonebut alsothetiming(Garaulet,M.EtAlpg.7).Inthestudy,however,theyconcedethat therewerethreepossibleconfoundingfactorsincludingchangesinthechronotype, geneticbackground,and/orcircadiansystemfunction.OConnorcompletely disregardsmentioningtheseconfoundingfactorsinthenewsarticle. 6) OConnorleadsthepublicastraybynotmentioningthatthestudywasmerely observationalandidentifyingthatthesetypesofstudiescanonlyshowan associationduetopossibleconfoundingfactorswhichhappentobepresentinthe study.Fromthestudy,itiseasytodiscernthatthetimingofthelunchwasnotthe onlypossiblefactorthatledtothediminishedweightlossrateoroverallreduction inweight;therewereatleastthreeotherfactorsthattheresearchersconcededto outright. TheauthoroftheTimesarticleleftoutkeyportionsofquotesand characteristicsofthestudythatwouldhavemadethearticletobelessdefinitive.It iseasiertomakesweepinggeneralizations,andthatisexactlywhatOConnordid. Itisalsowellknownthatpeoplewhoskipbreakfastoreatapoorquality breakfasttendtoeatmorethroughouttherestofthedayand/orhaveslowed metabolism.InthestudybyGarauletEtAl,thelateeaterstendedtoskipbreakfast orconsumeabreakfastthatwascomposedofasignificantlyloweramountofthe dailycalories.Itwasnotedthatthetwogroupsstillconsumedsimilaramountof calories.Bycommonsense,itcanbediscernedthatsubjectsaretheneatinghigher concentrationsofcalorieslaterthroughoutthedayascomparedtothosewhodid haveanadequatebreakfast. 7) Inordertoprovideanhonestreflectionoftheresultsprovidedbythestudy,key wordssuchasassociation,confoundingfactors,andobservationalstudyshouldbe includedanddescribedinthecontextofthestudy.Also,theconfoundingfactorslaid outbytheresearchersshouldbeincluded,alongwithhowtheycouldaffectthe results.