Breakfast Smoothies

I have posted a few times about my quick, easy and delicious veggie eggs that I eat at least three days per week. As a response, many of you who aren’t big fans of eggs have reached out and asked for other options. First, I encourage you all to explore intermittent fasting at least two days per week. Another option is to turn to smoothies. Smoothies are a great way to get your greens and veggies, plus you can easily add healthy fats and proteins to start your day with balanced nutrition. Just don’t fall into the trap of the “easy” bagel, muffin or cereal! You can do better. Here is a link to a delicious Strawberry & Kale smoothie from Amy Krasner at Nourished Balance. It’s easy and very tasty. Give it a try!

http://www.nourishedbalance.com/recipes/breakfast/strawberry-kale-smoothie/

Breakfast, Fasting and Our Health

“Breakfast is most important meal of day.”- Said in a thick eastern European accent by Colossus in the movie Deadpool. The statement has become so ingrained in our society that even a CGI created super hero quotes it as if it were fact.

 

What if I told you breakfast was the most important meal to skip each day? Would you dismiss the comment since it goes against everything you have heard up until now? Well, it turns out, it may be true. And the science backs it up.

 

Science Quality Matters…A Lot

 

First, where did the concept of breakfast being the most important meal come from? Would you believe cereal companies, and other food companies who have a vested interest in more people eating cereal? Yep. Bias and hidden motives over-rides scientific evidence once again.

 

This article in the Guardian is a good summary of how this came to be. Additionally, according to the book Three Squares: The Invention of the American Meal, Abigail Carroll proposes that breakfast used to be comprised mostly of leftovers. There were no “breakfast foods.” It was simply another meal, nothing unique.  But it did not take long for Kellogg’s to start promoting breakfast cereals, and suddenly it was expected that we eat specific “breakfast foods.”

 

What followed was a collection of media talent and poor science to elevate breakfast from just another meal, to “The Most Important Meal of the Day.” In fact, the claims were clear. If you skip breakfast you will have no energy, your metabolism will grind to a halt, and you will suffer from low blood sugar. You will gain weight and over-eat the rest of the day.

 

Unfortunately, these drastic clams were derived from poorly run observational studies. Obese people skip breakfast. Therefore, skipping breakfast must make you obese, right? Not so fast.

 

Could it have been obese people try to reduce calories and therefore skip breakfast?

 

In an observational trial, we can’t prove which theory is correct. All it tells us is that obese people skip breakfast. It tells us nothing about why, and what effect that may have on their health.

 

But cereal marketing firms will jump on that evidence and claim that skipping breakfast makes you obese. That’s scientific hogwash.

 

Better Quality Science

 

Fortunately, we now have randomized trials to investigate these claims. One study demonstrated that eating breakfast had no impact on resting metabolic rate, and another demonstrated that eating or skipping breakfast had no direct impact on weight loss.

 

Not all the science is faulty. The claim that missing meals can slow your metabolism is true, somewhat. It turns out that prolonged starvation of more than three days triggers a survival reflex resulting in a reduced resting metabolism. But that goes way beyond simply skipping breakfast. In fact, resting metabolic rate INCREASES in the first two days of a fast.  So if we are only skipping breakfast, it is clear that our metabolism is safe.

 

The Case for Intermittent Fasting (IF)

 

Nail in the coffin. We can now put away the baseless claims that we need breakfast. But that still doesn’t mean we should skip it, right?  Why would we want to skip breakfast?

 

I’m glad you asked……

 

One main reason to skip breakfast is that reducing our insulin and glucose levels allows our body to start breaking down fat stores. To make it sound technical, the concept of skipping breakfast is referred to as intermittent fasting, and it comes with numerous potential benefits.

 

In addition, some scientists believe intermittent fasting is the closest thing to the fountain of youth. It turns out that calorie restriction has increased survival in all sorts of animals, and shows promise for humans as well. But who wants to severely restrict their calories every day? In modern day society, that becomes nearly impossible.

 

Enter intermittent fasting. IF allows us to experience the physiological effects of calorie restriction without having a critically negative impact on our social existence.

 

Here is how it works. You set up an “eating window,” noon to 7pm, and a “fasting window,” 7pm to noon the next day. The key is that our bodies don’t enter a true fasting state until more than 10 hours after our last food intake. This is the point where our glucose and insulin levels are low enough to allow for lipolysis (the body breaking down fat stores for energy instead of using glucose circulating in the blood). In the above example, the fasting window is 17 hours, thus giving you 7 hours of fat breakdown. There are other versions of IF, but this is the one that I have seen works best for most people.

 

Food Quality Matters…A Lot

Now that I have made the case for trying intermittent fasting, I should be honest and tell you that intermittent fasting will not work for most of you.

 

Not until you improve the quality of what you eat.

 

If you eat mostly carbohydrates, simple sugars, and processed foods, then you don’t stand a chance. These foods cause rapid spikes and falls in glucose and insulin, throwing you into a cascade of hunger and cravings without a chance at extending the time between meals.

 

So, before you try IF, make sure you are eating nutrient dense, low sugar foods. Focus on lots of veggies, healthy fats (nuts, olive oil, avocados), appropriate proportions of animal fats and proteins, and a small amount of complex carbs. Once you do this, IF will be easily manageable.

 

Tips

 

  • Choose your IF days carefully. Make sure you will have control over the timing and food content of your first meal. You don’t want to get stuck eating “whatever is around” when you are hungry at 1pm after an 18hour fast. For best results, that first meal needs to be a healthy, nutrient dense meal low in simple carbohydrates and sugars.
  • Give it time! The first few times you experiment with IF, you may feel hungry and feel like you can’t survive. That feeling quickly passes with physical and psychological adaptation.
  • The initial psychological barrier to IF seems imposing. In reality, it’s simple to implement and stick to. Once you get over the initial hurdle in your mind, you will see.
  • Embrace the psychological benefits. IF allows you to know that you are in control of your feelings of hunger. You do not have to react to every small pang of hunger or food craving. You are in control, not the food.

 

 

So, Colossus should have said, in his thick Eastern European accent, “Breakfast is most important meal of day to skip. If you want.”

 

Don’t get me wrong.  A few days each week, I look forward to my big plate of leftover veggies, spinach and kale over two eggs and a sprinkle of grass-fed cheese. It’s a great way to start the day. And the other three-to-four days, I look forward to skipping breakfast, knowing that I am burning my fat stores, lowering my insulin and glucose levels, raising my HGH, and possibly taking one step closer to the fountain of youth.

 

Give it a try and see what it can do for you.

 

Thanks for reading.

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action item:

Pick a day this week when you have complete control over the timing of your lunch. Commit to practice IF that day. Stop eating at 7pm the night before, and don’t eat again until noon or 1 pm the next day. Make sure both of those meals are nutrient dense, veggie based meals with high quality fats and proteins. Expect to feel hungry, and remind yourself that you are in control of your hunger, not the other way around. You can do anything for 1-day. Then pick 2-days for the next week to try again. The more you do it, the more you adapt to it and reap the benefits.

Take 2 Eggs and Call Me in the Morning

(For my easy to make veggie and eggs breakfast, see the video link here)

If I gave you this advice, how would you react? Would you think I was trying to harm you?

Or would you realize this is sound advice as part of a healthy nutritional strategy?

While the latter is true, most people likely fall into the first category. We can thank governmental and professional societal recommendations for that. For years eggs have been lumped into the “fat is bad” trend that ruled American nutritional standards.

Here is the truth. Eggs, including the yolks, can be an important component of a nutrient dense, vegetable based, real-foods style of eating that is beneficial to our overall health.

Mis-Guided Guidelines

As recently as 2000, the American Heart Association and American College of Cardiology guidelines recommended limiting dietary cholesterol intake to less than 300mg per day. Interestingly they followed that recommendation with the following quote: “There is no precise basis for selecting a target for dietary cholesterol intake.” Essentially they admit that they just made up the 300mg limit. That doesn’t appear to be the strongest of guidelines.

To be fair, they felt there was a legitimate concern.  Eating cholesterol could increase blood cholesterol levels, or so they thought. In addition, they pointed out that foods high in cholesterol are also high in saturated fat, and therefore should be avoided. In a way, dietary cholesterol was vilified because of the company it keeps. Of course, now we know the restrictions on saturated fat were also misguided (see the specific post here).

Fortunately, the ACC/AHA has come around and their most recent guidelines state “There is insufficient evidence to determine whether lowering dietary cholesterol reduces LDL-C.”

That has not kept cereal makers, bread and bagel companies, and others from continuing to promote eggs as dangerous to our health and something we need to avoid.

The interesting and often misleading intersection of health, food, and marketing rises again.

 Setting the Record Straight

It turns out, there are numerous studies that all draw the same conclusion: For the general population, egg consumption is NOT associated with an increased risk of cardiovascular disease, and does not adversely affect our cholesterol levels. In fact, there is some evidence to suggest it is beneficial to our overall health.

A look back at the Physician’s Health Study of over 21,000 people found that eating up to 6 eggs per week had no association with an increased risk of heart attack or death.  Eating more than 7 eggs per week in diabetics may have had an association, but beyond that, there appeared to be no harmful link.

Analysis of both the Health Professionals study and the Nurses’ Health Study concluded that eating one egg per day had no significant impact of risk of heart disease or death.

A large meta-analysis of 17 trials and over 4 million person-years showed higher consumption of eggs was not associated with an increased risk of heart disease or stroke.

In aggregate, there is no evidence in the general population that egg consumption increases the risk of heart disease or death. While those with diabetes may be an exception, that requires further investigation.

 

Is There a Benefit?

Just because something isn’t bad for us doesn’t mean we should flock to it and make it part of our regular eating habits. But is there evidence that eggs may be good for us?

It turns out there is.

For starters, eggs are packed with vitamins and minerals that our bodies need. One large egg has

  • 78kcal
  • 6gm protein
  • 5gm fat (1.6 gm saturated fat, 2 gm monounsaturated fat)
  • Fat soluble vitamins: Vit A, D, E, and K2 (K2 is very difficult to get from other common nutritional sources)
  • Vitamins B-6 and B12
  • Calcium
  • Amino acid leucine
  • Choline
  • Selenium
  • Omega 3 fatty acids
  • And more…

If you just eat the whites, remember that the yolk has all the fat-soluble vitamins and 90% of the B vitamins, calcium, fatty acids and other nutrients (aside from the protein).

Packed with that many vitamins and minerals, it makes sense that eggs would be good for us.

One additional benefit is that they help fill us up. Compared to a bagel breakfast with the same total calories, an egg breakfast increased the feeling of being full and reduced how many calories subjects ate the rest of the day.

And remember the concern that eggs worsen our blood cholesterol levels? It turns out that couldn’t be further from the truth.

Eggs may minimally increase total cholesterol, but more importantly, they increase HDL and thus maintain the total cholesterol to HDL ratio, a more powerful predictor of heart disease risk than total cholesterol alone.

Whole egg consumption, compared to an egg white substitute, improves the atherogenic lipid profile (that means it makes the cholesterol less dangerous).  

Eggs increase HDL, and can change the LDL from dense, more dangerous particles to large, less dense less dangerous particles.

None of this means that eggs have been proven to lower our risk of cardiovascular disease, but absence of proof does not equal proof of absence. In other words, since eggs haven’t been proven to be harmful, and there are plausible reasons why they could be beneficial, we should welcome them as part of a vegetable-based, nutrient dense eating pattern.

 

 Eggs Got a Bad Rap

So, in the end, it turns out that eggs got a bad rap.

They were innocent bystanders caught up in the marketing storm that followed poorly understood guidelines regarding dietary cholesterol intake.

Eggs can be an integral component of a nutrient dense, real-food way of eating.

They provide essential vitamins and minerals, they are filling and enjoyable, and they can improve our overall blood lipid profiles. While there is still some hesitation about individuals with diabetes consuming more than one egg per day, the rest of us can freely “Take two eggs and call me in the morning.”

Remember, however, the company they keep is still important. Instead of having two eggs with hash browns, pancakes and low-quality processed sausage at your local dirty spoon, try preparations like my simple eggs and veggie dish. It takes less than 5-minutes to make start to finish, it is delicious, and it is the perfect way to start your day. Here is the video link.

 Interested in Cholesterol?

If so, you’ll love my new program, The Truth About Lipids.  In this video course, I walk you through the evidence for and against lipids being a health concern, and I show how we can all better assess our cardiovascular risk. Learn more or sign up here.

 

Thanks for reading.

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action item:

Make it! You only need, eggs, avocado oil, a box of spinach, a sprig of kale, left-over veggies, celtic sea salt, and grass-fed cheese. It takes less than 5-minutes to make. And if you don’t have time to eat it, take it with you in a glass container. It even tastes great cold!

 

Bret Scher, MD FACC

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