LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Breakfast

The Diabetic Breakfast; Why You Should Avoid Oatmeal

by

breakfast options for diabetes
mariiya / Dollar Photo Club

This is not the first time I’ve debunked the idea that oatmeal and Cheerios are good breakfast options, despite the frequent recommendation.

Breakfast is, without a doubt, one of the most important health decisions you’ll make in a given day.  And that decision starts with actually having breakfast.  The decision to skip breakfast is one of the most common problems I find in patients.  Sometimes patients say they just aren’t hungry, don’t have time or are nauseous when they first wake up.

If you’re not hungry first thing in the morning, all it takes is a little amount of fuel to begin your day properly.  A handful of raw almonds or a tablespoon of real peanut butter can be enough to jump start your system.  Here’s the deal:  Your brain needs fuel in the morning whether you feed it or not.  If you choose to skip breakfast, your body will break down precious muscle to fuel your brain.

If you’re looking for the “less muscle, more fat” look, then by all means continue to skip breakfast.  If, however, this isn’t the look you are deliberately going for, then breakfast has to be on the menu, hungry or not.  Eventually, your body will get used to getting fed early and will let you know it’s ready for fuel from outside the body by stimulating hunger.

The time excuse is not a good one, either.  I’ve had patients use the time excuse but will run through the drive-thru of McDonalds to buy an Egg McMuffin, which arguably takes time as well.  Compare that to warming up an Amy’s breakfast burrito for 1 and a half minutes in the microwave (with the added bonus of being less expensive).  The same goes for the aforementioned handful of almonds or bit of real peanut butter.

As for the nausea, this boils back down to your body looking inside for fuel.  The sympathetic / adrenal pathway gets activated and this shuts down digestion, potentially leaving you feeling nauseous.  Again, within a short period of time your body will adapt to being fed and you’ll find yourself being hungry instead of nauseous at breakfast time.

Which brings us back to the all-important “what” for breakfast.  This has remained an avenue of very poor recommendations for a long time now.  Yogurt, with very few exceptions, is not a good option.  If you’re going to do yogurt, make sure you’re doing plain Greek yogurt with a higher protein content and lower calories (you’ll have to read the labels and compare…consider brands like Fage that can be found at Costco) only with a serving of fresh or frozen fruit added in.

Oatmeal, again with a few exceptions, is not a good option.  Certainly the instant Quaker-type oatmeals are absolutely off the list.  I’m usually ok with the steel cut, slow cooked oatmeal with some high quality protein source mixed in (real peanut butter, nuts, granola).  But the vast majority of the oatmeal that people seem to choose for breakfast doesn’t cut it.

In general, the anti-diabetic breakfast (which we should all be eating) should be protein-based or very high fiber (8 grams or more).  Good recommendations include:

  • Eggs, either scrambled in olive oil or hard-boiled
  • High fiber, unprocessed breakfast cereal in something other than cow’s milk (Nature’s Path, Cascadian Farms, etc…)
  • Real peanut or other nut butter (no added oils) in celery or on true whole-grain bread
  • Granola (just be careful of the calories!)
  • Steel cut, slow-cooked oatmeal with a high quality protein mixed in
  • Juicing (the blending type with the pulp included) so long as you add in some type of high quality protein like powered peanut butter, high quality whey or pea protein or high protein Greek yogurt.

Just how important are these breakfast decisions for fighting off or controlling diabetes?  This particular study gives us some insight.  In it, researchers looked at the effect of glycemic index (a score for how fast sugar shows up in the bloodstream after eating a meal, the lower the better) of 4 different meals on certain markers of diabetes in a small group of Type 2 diabetics.  Here’s what they found:

  • There was more glucose in the bloodstream in the high glycemic index diet with low fiber.
  • The amount of insulin after patients consumed the high glycemic index, low fiber diet was 13% higher than the low glycemic index, high fiber diet.
  • When consuming a low glycemic diet, the diet with high fiber led to 12% lower insulin levels after a meal.
  • Ghrelin (a hormone that helps increase hunger) dropped ONLY after the low glycemic index diets (both with high and low fiber).

Overall, it is very clear that your breakfast choices will have a clear effect on how well your body does or does NOT respond after the meal.  Choosing the options listed above will lead to a much stronger anti-diabetic effect and protect every other aspect of your health.

And you’ll notice that Cheerios, the go-to breakfast to lower your cholesterol (which is probably because you’re prediabetic…), in no way, shape or form fits these recommendations.  And you will also notice that fruit, by itself, is NOT on the list.  Nor is orange juice (all calories, little value).  These items have way too much carb content without the needed protein or fiber to balance it out.

 

Skip Breakfast or Not? 4 Reasons it’s a Bad Idea

by

There has been some confusion in the media lately when it comes to eating breakfast, suggesting that maybe we don’t really need to eat breakfast.

But rarely does the press report all aspects of a study, leading to confusion of the part of the public about what they should do.  “First they tell us one thing, then they tell us another thing.”  Not eating fish due to pesticides and avoiding fat are just two examples of messages that confuse the public.

That being said, this particular study looked at the effects of breakfast on a group of people ages 21-60 on several markers of health, including:

  • Resting metabolic rate
  • The amount of calories burned during physical activity
  • Caloric intake
  • Blood sugar responses to food

This group of participants were given either a daily breakfast (of at least 700 calories) before 11 AM or refrained from eating before noon for 6 weeks.   The idea was to see if the common notion that breakfast “revs up” your metabolism was true or not.  Here’s what they found:

  • Contrary to popular belief, there was change in the metabolic rate of those who ate breakfast.
  • There was actually a small increase in the amount of calories eaten in the breakfast group (539 calories per day).
  • There was no difference in body mass, fat mass or any markers of cardiovascular health.
  • However, the calories burned with exercise was quite a bit higher in the breakfast group (442 calories per day).
  • The breakfast group also had a slightly more stable blood glucose in the afternoon and evening by the final week of the study.

At first glance, it would seem that the breakfast group did not have much of an advantage over the group that skipped breakfast.  While you may be surprised, I do have a few comments on this…

First of all, breakfast supplies your brain with the energy needed to function.  If you do not feed your brain, it will use the hormone cortisol to break down muscle to provide glucose for the brain.  This study was done over the course of 6 weeks.  This is not long enough to follow the long-term damage caused by consistent, daily breakdown of muscle to replace the skipped breakfast.

Second, there was no mention at all about what types of foods were eaten for breakfast.  Frosted Flakes for breakfast is going to have a much different effect on the body than whole grain bread with real peanut butter spread on top of it.  I always steer patients towards a high fiber (6-7 grams or more) or protein-based breakfast (eggs, peanut butter, etc…).  Processed junk for breakfast is likely not any better for you than skipping breakfast.

Third, creating a more stable afternoon blood sugar is going to prevent cravings in the afternoon and help you make wiser food choices for dinner.

Lastly, while the breakfast group did take in more calories for the day, this was almost offset by the better calorie-burning response to exercise.  I would again point out that this was only a 6 week study and this is not enough time for patterns to fully change.  It would be reasonable to surmise that eating breakfast would preserve more muscle mass which would, in turn, lead to more calorie burning during exercise.  Given that it could take months to balance out the muscle-preserving effects of breakfast versus the muscle-destroying effects of skipping breakfast, it is likely that the effect on calories consumed and burning would favor the breakfast group over the course of months and years.  But this cannot be shown from this study and is merely my educated opinion on the process.

Overall, I would never consider skipping breakfast for myself on a regular basis.  In addition, ANY good parent would never let his or her child leave for school without eating a good quality breakfast.  Shouldn’t that say it all?

 

Skipping Breakfast? Combine with This to Make it a Worse Decision

by

Regular readers of the Rantings know that breakfast is not an option.  Skip it to increase your risk of obesity, diabetes and heart disease.

But some of you, despite this knowledge, seem to think that your physiology is different.  Just because they create Sumo wrestlers with the “skip breakfast and lunch” diet plan does not mean it will happen to you.

And let’s face it.  If I haven’t convinced you already of the need for breakfast you’re not going to change now.  Of course, we’re not talking about refined carbohydrate, junk breakfasts like Quaker oatmeal or Cheerios or even a bagel.  If covered good breakfast options in a recent blog post that can be read by clicking here.

Just in case you’re STILL not convinced, let me throw in another little nugget.

If you have children and breakfast is not a priority in your house, guess how important breakfast will be to them over the course of his or her lifetime?  You guessed it.  And just how important is it to you that little Johnny eats breakfast before heading off to school?  It’s funny how many moms would never dream of sending her child off to school without eating, and yet is perfectly ok skipping it for herself.

Ok, I’m off my soapbox and we can get back to this particular study.  Researchers looked at breakfast eating patterns in women (either infrequent at 0-6 times / week—basically NOT every day, or daily) and subsequent eating frequency over the rest of the day and how much it influenced diabetes risk.  Here’s what they found:

  1. Not eating daily breakfast increased risk of diabetes 28%.
  2. Compared to eating 3 times/d, those who ate 1–2 times/d had a 9% elevated risk, 13% risk at 4–5 times/d and no elevated risk for women who ate more than 6 times/d.
  3. However, among the irregular breakfast consumers, if they ate more than 4 times/d, their risk for diabetes jumped an impressive 47%.

So basically, if you’re going to continue to make the bad choice of skipping breakfast, if you decide to eat more times during the rest of the day, you’re pretty much giving yourself diabetes.

Want My Advice on Healthy Eating? This is the 1st Question I Ask

by

Somewhere along the lines, people trying to lose weight decided that skipping meals was a good idea.  Maybe it was the idea that fewer calories were better, but the advice is ill-founded.

Whenever I have a patient who needs or wants dietary advice (unfortunately, those two categories do not always go hand in hand) there is one question I ask that gives me the most information about where this patient is at on the healthy living continuum.

“What is a typical breakfast for you?”

It’s only on a rare occasion that I get an answer that is ideal.  It usually ranges from nothing to oatmeal to an Egg McMuffin.  Breakfast is something that many people think they are doing right, but most likely is a decision based on poor information from their doctor or excellent marketing.  Some less-than-ideal examples include:

  1. Skipping breakfast altogether will increase your risk of developing diabetes.
  2. Skipping breakfast will lead to higher calories being eaten at the next meal, again leading towards diabetes.
  3. High glycemic foods like bagels for breakfast throw off digestive and satiety signals and send you towards diabetes.
  4. Higher glycemic meals trigger addiction like reactions in the brain.

Here’s the rub–most oatmeal and certainly most junk breakfast cereals like Cheerios would fall under the category of “high glycemic” index foods.  Unless you’re eating the real heavy-duty steel cut oatmeal that takes forever to cook, you should be avoiding oatmeal.  Or, your breakfast cereal needs to have 8 grams of naturally occurring fiber or more.  Fiber One, for example, adds corn bran to get the fiber content up.  That’s cheating and doesn’t count.  (Even worse–ALL the Fiber One products have artificial sweeteners in them, so they’re off the list anyway).

The other option is a protein based breakfast.  Eggs, chicken, hummus, peanut butter (my particular favorite, on whole grain bread and a banana sliced on top) are good options.  There have been times when, due to time constraints, I have recommended that a patient just eat a small handful of nuts for breakfast.  It is not unusual for these patients to actually lose weight in the first month from actually adding food.

All of this brings us to this particular study.  Researchers looked at the eating habits of 26,900 health professionals over the course of some 16 years.  Here’s what they found:

  1. Men who skipped breakfast had a 27% higher risk of heart disease.
  2. Men who ate late at night had a 55% higher risk.
  3. Mostly, this association was due to BMI, hypertension, hypercholesterolemia, and diabetes mellitus.
  4. No association was observed between eating frequency (times per day) and risk.

As I sit here writing this blog post at 11 PM eating a bowl of air-popped popcorn sprayed with basil olive oil and sprinkled with garlic spices drinking unsweetened Teavana tea, #2 has me a wee bit concerned.  However, I’m pretty sure that the average late night snack is probably not quite the same as mine, so that makes me feel a little better.

Clearly eating patterns had a strong role.  The proverbial midnight snack was almost literally a killer.  Overall, though, knowing existing relationships between skipping breakfast and diabetes risk, the results of this study should be nothing more than a reminder of why you are already eating breakfast.

And, if you don’t eat breakfast, just make sure your life insurance premiums are paid up.

Are Bagels for Breakfast a Good Idea?

by

Breakfast is not an option (unless, of course, you are shooting for the sumo-wrestler look, then skip breakfast..), but what you choose can make all the difference.

At some point in the past 15 or so years donuts lost their attraction as the breakfast of champions.  All that hubub about too much fat and oils drummed up by the now defunct USDA food guide pyramid.

Thus began the rise of the bagel.

Granted, New York delis didn’t really create the bagel (its origins date back to the 1600’s), but they may have played a role in the increase in popularity of this little breakfast gem.

For many years following the switch from donuts to bagels, the health conscious breakfast consumer proudly purchased bagels in an attempt to follow the low fat craze.  Forget the fact that they are frequently coated in butter or cream cheese…

Here’s a shocker.  Bagels are not good for you.

There are almost always made with enriched wheat flour, which is a refined carbohydrate.  Refined carbohydrates are evil.

But just how evil is a bagel for breakfast?  I think you’ll be a little shocked.  But first, a little physiology lesson.

The term “incretin” refers to one of two hormones produced in the body that drastically effect how your body will react to the foods we eat.  There are two main types that have been identified:

  1. Glucose-dependent insulinotropic polypeptide (GIP for short) keeps blood sugars and insulin levels lower after a meal. However, it also speeds up gastric emptying time, which is generally not a good thing because slower digestion allows for sugars to trickle into the bloodstream instead of hitting in a rush.  GIP has no effects on hunger, desire to eat, fullness or eating again after a meal.
  2. Glucagon-like peptide-1 (GLP-1) also decreases blood sugar and insulin after a meal, but it increases gastric emptying time.  GLP-1 lowers hunger, desire to eat and eating again after a meal.

For those of you who recognize the term GLP-1, you’ve probably read previous articles that relate to fancy new diabetic drugs that hijack the pathway used by this hormone and the potential problems it may cause.  You can read one of these articles by clicking here.

All of this brings me to this particular article looking at how a low and high glycemic index breakfast affects GIP and GLP-1 levels.

Researchers looked at how a high glycemic index breakfast (think processed cereals, bagels and donuts) and a low glycemic index breakfast affected these hormone levels.  Here’s what they found:

  • On the high glycemic index breakfast, glucose, insulin and GIP were higher than in the low glycemic breakfast.
  • On the high glycemic index breakfast, GLP-1 levels were lower.

To put this in English, a high glycemic index breakfast, consisting of foods that will show up as sugar quickly in the bloodstream, raised the levels of GIP and lowered the levels of GLP-1.  Since GLP-1 is the heavy hitter in protecting us from diabetes, this is NOT a good thing.

In case you were wondering, the bagel, made of enriched wheat flour, falls under the high glycemic index breakfast.  Incidentally, for those of you who think that Cheerios are a good breakfast option–it’s high glycemic as well.  Did I mention that most oatmeals have a higher glycemic index?

Based on this knowledge, do you think that schools should remove bagels and other high glycemic index foods from the breakfast lineup?

Danger: Breakfast Linked to Type 2 Diabetes

by

Despite the common perception, diabetes is NOT genetic.  Actually, the problem with diabetes is one of storage.  Too many empty calories combined with too little demand for calories.  It is likely that our ancestors had little concerns with diabetes bacause starvation was the norm.  If our ancestors’ collective physiology did not experience diabetes, how on Earth could it be genetic?  That would be like saying “texting thumb” is genetic, like our ancestors were somehow developing thumb pain from too much cell phone usage.

Clearly our lifestyles are what is contributing the diabetes.  Food choices is a major contributor, but so is food / meal frequency.  Years past, women in particular seemed to think that skipping meals was a good way to lose weight.  Less calories leading to weight loss may sound like a good idea, but the body is much smarter than that.  In case you have ever read into the lives and development of a sumo wrestler, one of the key components has to do with skipping breakfast but eating a large meal for lunch followed by a nap.  So, if the “sumo” look is what you are going for, then by all means skip breakfast.

For the rest of us, skipping breakfast is out of the question.  I hear two reasons why patients don’t eat breakfast.  First is time.  That’s a simple one to fix because merely keeping a snack bag of raw nuts to bring with you in the car on your way to work can solve this one.  There are lots of other options, but this is the easiest fix.

The second reason is that some patients will get nauseous if they eat before some time in the mid morning.  This is likely happening because their bodies are looking inside for fuel for the brain.  In this case the body releases cortisol to break down muscles in order to create glucose of the brain to use.  In a healthy situation, our bodies are used to looking externally for energy to fuel our brain.

 This particular study looked at eating patterns that led to diabetes.  Skipping breakfast alone increased the risk of developing type 2 diabetes by 21%.  This doesn’t even address healthy dietary options (in previous posts, in was pointed out that oatmeal and many high fiber cereals are NOT good options for breakfast). 

In addition, eating 3 meals per day had a lower risk of developing diabetes then eating 1-2 meals per day.  Snacking did not have much of an impact beyond the contribution to weight gain, which of course, is then reflective of what we choose for our snacks.

Overall, skipping breakfast is not an option in a healthy lifestyle.  If you are not eating breakfast, you need to identify why you are skipping what is arguably the most important meal of the day and fix the problem.  And while we’re at it, if you kids are leaving for school without eating a good, solid breakfast you can pretty much assume that weight gain, obesity and diabetes is in their future.

WHY YOU SHOULD AVOID CHEERIOS, OATMEAL FOR BREAKFAST…

by

I hope we can skip the discussion about needing breakfast here.  It does still amaze me how many people skip breakfast.  Not enough time.  Not hungry.  Trying to cut calories.  However, with new patients coming into my office, I can say that few actually were eating an appropriate breakfast if they were even eating it.  Most are under the mistaken impression that something like Cheerios, Special K or oatmeal constitutes a good breakfast.

First, before we cover what a good breakfast consists of, let’s again stress just how darn important it is.  This particular study takes an interesting look at what happens to our physiology when we skip breakfast.  Researchers had participants divided into a breakfast (B) and no-breakfast (NB) group, then, 2.5 hours later, gave them a liquid drink.  Those in the NB group had all around worse response in their blood to the drink than those who did eat breakfast (higher sugar, higher insulin, higher fats, lower GLP, more calories at lunch).

Basically, skipping breakfast sent the participants physiology into a tailspin towards diabetes.  Pretty darn impressive for a single meal, huh?  Imagine when it is a pattern of lifestyle.

Now, on to the “what” portion of breakfast.  It should come as no surprise that dairy, refined carbs and artificial colors/flavors are off the list.  So this rules out the Special K cereals and pretty much 98% of what the big confectionery companies (Kellogg’s, Quaker, Nabisco, Kraft) produce.

I always steer patients towards a very high fiber (8+ grams) or protein based breakfast.  That means real peanut butter on true whole grain bread.  Omega 3 eggs cooked in olive oil.  A handful of nuts.  There are some very high quality cereals made by Kashi, Amy’s, Nature’s Path, etc, that meet the high fiber qualification.  Just add one of the many nut milks available (soy, hazelnut, almond, rice, hemp, etc…) instead of dairy.

You should note that this rules out all but the highest quality oatmeals.  Your typical “instant” oatmeals are not going to provide this high of a level of fiber and likely contain lots of added sugars.  You could, however, do a plain oatmeal and add in your own cinnamon, nuts and / or granola to improve the value.

Either way, careful attention to breakfast is absolutely critical towards a lifetime of diabetes avoidance and maintaining ideal body composition.