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January 2011: New Year’s Resolution… Rethinking Breakfast
We all know to eat a good breakfast: Breakfast gives a good start to the day and honors the body’s natural bio-rhythms and bio-chemistry (see November and December 2010 newsletters). But, somehow life takes over and breakfast is generally the meal that a busy schedule crowds out. Most people eat lunch because lunch hour is programmed in by schools and the workplace. Dinner becomes the major meal because it can be enjoyed without the time pressures of immediate commitments. Evening is often the only time to savor food with family and friends. So, it is only natural to eat the majority of calories in the evening when we are not rushed. And, it is only natural to eat an extra helping at night when we tell ourselves that we will make up for it by skipping breakfast the next morning.
What is a “good” breakfast? It is anything that sustains you throughout the morning. The test of a good breakfast is…How do you feel at 10-11 o’clock? If you do heavy outdoor physical labor, you may need relatively more carbohydrates (and fats in winter) than if you sit at a desk, where you may need slower-burning, sustaining whole grains, proteins and fats. In general, a good rule of thumb for any meal, including breakfast, is to aim for one-third of all calories to be spread evenly over the three macronutrients—proteins, carbohydrates, and (traditional) fats.
Eating “Upside-Down”
Planning to eat a good breakfast really begins the night before. We sow the seeds of a good breakfast when we eat early enough and lightly enough in the evening so that we wake up hungry. We also sow the seeds of a good breakfast when we retire 30-60 minutes earlier than we might otherwise so that we can use this time at daybreak for breakfast. Think of it as an investment in our morning productivity. The fact that more than 80% of retired people eat breakfast suggests that many more of us would eat breakfast if we allocated the time to do so.
Eating a good breakfast also starts with planning in advance, perhaps the day or evening or weekend before, to have something delicious to wake up to. This could be any balanced protein/fat/carbohydrate combination that appeals to you-- piping hot whole-grain porridge with dried fruits and nuts and butter/cream/milk; lentil or split pea soup with hearty whole grains or accompanied with whole grain bread, organic peanut butter muffins, or banana-nut oatmeal treats; a chicken sandwich on sourdough bread; a can of wild sockeye salmon mixed with whole grains and leftover soup or vegetables; or, of course, eggs fixed in any way to suit your fancy. Egg custard, a favorite of many children, can be breakfast with a whole grain muffin. One of my own favorites is to have a bowl of steel cut oats with a couple of poached eggs mixed in. Eggs are nutritious and the combination of protein and fat provides real staying power. Baking muffins and preparing soups can be done on weekends; whole grain hot cereals can be cooked overnight in a rice cooker or even in a thermos…thermos oatmeal…to be taken with you. If you are trying to cut back on coffee, think savory rather than sweet foods. A sweet muffin demands coffee far more than a bowl of lentil soup or a chicken sandwich. [See recipes that follow.]
Crowding out Breakfast
Skipping breakfast was rarely an issue a century ago when women worked at home caring for children and when homemaking was seen to have value. The tendency to skip meals traces the entry of women and mothers into the labor force. According to the most recent data from 2008, 60% of all women are in the labor force. Mothers with children under 18 have the highest participation rate of any broad group (71%), and of subgroups of working mothers, the highest rate by far (78%) is by mothers with children aged 6-17. [The next highest at 63% is by mothers with children under 6. The lowest rate, 53%, of any group is by women with no children under 18 in the household.]
Today, time-squeezed two-income households as well as the ready availability of boxed breakfast cereals, prepared breakfast snacks such as Pop-Tarts, and fast-food breakfast options help explain the movement of modern households away from the family breakfast table to a morning “grab and go” or just “go” lifestyle. Over 40% of Americans aged 18-54 regularly skip breakfast, and more than half of all adults view breakfast as a mere mini-meal, snack, or simply a beverage. Surveys also suggest that one-third of all teens and one-fifth of all children regularly skip breakfast, while half of all children report that they sometimes skip breakfast. Children are inclined to skip breakfast if their parents do. (Breakfast Research and Statistics).
Breakfast matters…for adults. Skipping breakfast is associated with eating more fat-rich, high-energy calories throughout the rest of the day. A Harvard Study suggests that people who skip breakfast are four times more likely to become obese. Avoiding breakfast is associated not only with weight-gain, but also with higher cholesterol and elevated insulin (National Heart Lung and Blood Institute Growth and Health Study), and even cancer (Cancer Research UK).
Breakfast matters…for children. Skipping breakfast is particularly hard on children, who cannot “limp” like adults through the morning on coffee. A Reading University study of 12-year-olds found that skipping breakfast caused reaction times to drop to the level of a typical 70-year old. On the positive side, a Harvard/Mass General study of school children in Baltimore and Philadelphia found that children who ate breakfast received better grades, were more focused, and showed improved psycho-social behaviors compared to children who rarely ate breakfast.
What do Americans typically eat for breakfast? For those adults who eat breakfast at home, coffee, boxed cereals (three-quarters of which are high in sugar), and fruit juice (75%- 80% sugar) head the list of products consumed most frequently (Breakfast Research and Statistics). For 6-12 year-olds who eat breakfast, three-quarters choose what they eat, with 90% regularly consuming ready-to-eat (RTE) cereals. According to a Yale University study, RTE cereal companies spend more than $160 million a year marketing breakfast cereals to children, who typically view 642 television cereal advertisements a year. The Yale study found that boxed breakfast cereals marketed to children have 85% more sugar, 65% less fiber, and 60 percent more sodium than those advertised to adults.
Clearly it is not enough just to eat breakfast, if by breakfast we mean stimulants and sugar in the form of coffee, cold cereal, and juice. Such a breakfast does not meet the 10-11 o’clock test criteria of a “good” breakfast: Research indicates that a high-glycemic breakfast such as a bagel, cold cereal, or instant oatmeal creates a blood sugar spike, followed by a sharp drop in blood sugar, a kind of hyper-/hypoglycemic rollercoaster. The body’s hyper-insulin response to the surge in glucose from a high-glycemic breakfast leaves blood sugar actually lower two hours after breakfast than at the fasting/waking level prior to eating breakfast (Lioger, et al., 2009). In other words, eating a high-glycemic breakfast can leave you hungrier by mid-morning than when you woke up, thus creating the desire for a high-energy mid-morning snack. Lioger found that subjects consuming a standard high-glycemic breakfast cereal consumed 53% more calories over the rest of the day compared to subjects who ate a whole-grain breakfast. Put simply, high-glycemic breakfasts lead to snacking and the tendency to over-eat at the next meal.
Boxed Breakfast Cereal—Century-Ago Good Intentions, a Modern Day Mixed Blessing
As often happens in life, innovative products developed for one problem can contribute to another. In 1863, Dr. James C. Jackson who managed the Sanitarium in Dansville, NY developed “Grandula,” the forerunner of our modern RTE cereal. A dense nodule of bran made edible only by overnight soaking, it was designed to relieve the gastrointestinal problems brought about by the low-fiber beef and pork breakfasts typically consumed by our ancestors more than a century ago.
In the years following the development of Grandula, the Kellogg brothers serving at the Battle Creek, Michigan Sanitarium worked on their own grain-based breakfast options. In 1896, they discovered a cereal flaking process and a cereal that Will Kellogg patented (1906) with its new name Corn Flakes. Soon thereafter came pasteurized milk and the development of waxed-paper box liners. With these, both Kellogg and competitor C.W. Post (Grape-nuts and Post Toasties) had the essentials to grow and expand the RTE breakfast cereal market into what we know today—a booming $10 billion business with a cereal for just about any taste and with expansive grocery store shelf space to dwarf most any other product category, with the occasional exception of cookies and soft drinks.
High-Glycemic Boxed Cereals…Blame not just Sugar, but also the Botanical Degradation of Grains
The problem with many RTE breakfast cereals is that because they are readily digestible, they inherently contribute blood sugar issues—and, elevated blood sugar over time can lead to insulin resistance and diabetes. Because RTE cereals generally lack protein and traditional fats they may be questioned as the building block of a sustaining breakfast, especially for children. The Center of Disease Control estimates that one of every three Caucasian children and one of every two children who are Black, Hispanic, Native-American, or Asian-American born in the United States after the year 2000 will develop diabetes. Boxed cereal can put children at risk of mid-morning hunger and fatigue and set the stage for caffeinated soft drinks and overeating later in the day.
The glycemic index (GI) is one way to assess RTE cereals. It was developed by D.J. Jenkins in 1981 to measure (on a scale of 0 to 100+, with glucose=100) the rise of blood sugar after ingesting a specific food. The glycemic index of a low-sugar breakfast cereal can exceed many of the high-sugar varieties: What elevates blood sugar is not just the sugar content of a cereal but also how the grains are processed to make them more quickly digestible. Rolling, flaking, puffing, and cooking (as in gelatinized oatmeal flakes) makes the starch in grains readily accessible to digestive enzymes and thus quickly digestible. Starch converts to simple glucose molecules more rapidly than fructose/glucose sugar.
Many favorite low-sugar cereals have high glycemic indices, which means that eaten alone, they can elevate blood sugar to leave behind hunger,hypoglycemia, and fatigue. This is because any process that alters the botanical structure of whole grains—rolling, flaking, puffing, milling, and cooking (as in the gelatinization of oat flakes)—renders carbohydrates more digestible. In so doing, the digestive system is called upon to do less work and expend relatively less energy in processing food, so glucose enters the blood stream with greater speed. This is why the blood sugar impact of a breakfast cereal cannot be gauged by its sugar content alone. Puffing oats for Cheerios or rice for Rice Krispies and Rice Chex; flaking corn for Corn Flakes; and shredding wheat for Shredded Wheat are all examples. Several ideas are illustrated in the table below: (1) low-sugar cereals,the first column, can have higher GIs than sugar-laden varieties listed, center; (2) aside from sugar, the degree of botanical degradation of a grain, in this case oats, (the first three cells of the right-most portion of the table), affects GI; and (3) simply puffing brown rice for rice cakes can increase the GI by 60% (last two table entries). The key idea is that just because a RTE cereal is low in sugar does not mean it will have a moderate effect on blood sugar.
Cereal / GI / Grams Sugar / Cereal / GI / Gr.Sugar / Cereal/Snacks/Grains / GI / Gr. SugarCheerios / 74 / 1 / Frosted Flakes / 55 / 11 / Steel-Cut Oats / 42 / 0
Rice Krispies / 82 / 3 / Raisin Bran / 66 / 20 / Old-Fashioned Oats / 50 / 0
Corn Flakes / 92 / 2 / Fruit Loops / 69 / 13 / Instant Oatmeal / 66 / 0
Shredded Wheat / 84 / 0 / Coco Pops / 77 / 11 / Rice Cakes / 80 / 0
Rice Chex / 89 / 2 / Corn Pops / 80 / 14 / Brown Rice / 50 / 0
Cooking also affects the GI of rolled grains such as rolled oats. Raw rolled oats (used in cookies) have a lower GI than when cooked. This is because, while starch granules are not water soluble, they easily absorb water and swell when heated. The structure is then altered in a process known as gelatinization. When gelatinized, as when raw rolled oats are transformed by water and heat into gelatinous oatmeal, the surface area of starch granules becomes greatly exposed to digestive enzymes. This increases the speed of digestion and absorption, resulting in an elevated glycemic response. Oatmeal is best topped with butter, a poached egg, cream, milk, nuts…any protein/fat combination of your choosing that will contain the blood sugar effect so that you are not left hungry by mid-morning.
“Thinking Out-of-the-Box”: Middle Ground Recipes between Pork Belly and RTE Cereal