Are Breakfast Cereals Healthy?

Long a cornerstone of the quick and “healthy” American breakfast, cereals overtook the home cooked meal at American’s tables many decades ago.  But the tide is turning on the idea that this is a healthy way to start the day. Recent research points us towards processed grains as a main culprit in our poor dietary health.  

Why did we start eating breakfast cereals in the first place? As the BBC documentary The Foods that Make Billions describes it, ready to eat cereals are the biggest success story of the modern food industry. In the early twentieth century, our understanding that fiber was good for digestion and a wealth of other health conditions drove many to promote and consume high fiber grains. Food manufacturers discovered ways to convert these grains into ready to eat cereals through applications of high heat and pressure – similar to the popping of a corn kernel.  This technique transformed the grain from a food that needed cooking into a commodity that could be packaged, transported, and stored. As questions about the health of eating too much animal fat penetrated the US consciousness, people moved away from their bacon and egg breakfasts to the grain based bowl of cereal and milk. While some of the advice to eat breakfast cereal was about health, much of it centered on marketing. Ready to eat cereals had a high profit margin and huge sums were spent on advertising to convince the public that they belonged on every breakfast table.

So we know this food worked well for the manufacturers, but what about our health? The health impact of eating cereal is dependent in part on what has been added to it and how much it has been processed. If the cereal has been refined to remove most or all of the fiber, we are left with little more than a box of white bread. If sugar has been added then we have a dessert masquerading as breakfast. As Dr. Lustig of UCSF puts it, “you can eat a bowl of sugar for breakfast or you can forget the sugar and eat a bowl of cereal, they are the same thing.” This is an argument that the digestion of these highly refined grains is little different from sugar: a large load of glucose (and/or fructose) is delivered to the liver, overwhelming our metabolic system resulting in spikes in blood sugar, insulin and triglycerides

So what should you eat for breakfast? While the whole grain or high fiber version of cereal is a better choice than the low fiber, high sugar one, for the health of your digestive system and your metabolism, a meal based on actual whole grains will serve you better. This can be as simple as oatmeal (that you cook yourself, not the instant variety) or more creative versions using whole grains like rice or millet. Try these grains hot, cold, savory or sweetened with fruit. The options are as varied and colorful as the cereal isle in the store and will save you money. Here are two of my favorite sources for breakfast ideas:

Happy eating,


The Impact of a High Fat Meal

You know that uncomfortably full feeling you get after eating a large meal? Especially if that meal is very rich like pizza or a cheeseburger and fries? While this feeling and the fatigue that often accompanies it is temporary, large quantities of unhealthy food may cause lasting damage to your organs. A recent study published in the Journal of Clinical Investigation indicates that normal liver function is disrupted by high amounts of saturated fat eaten over a short period of time.

Liver disease is a growing problem in the United States, it is estimated that nearly one in every four US adults has non-alcoholic liver disease. This is metabolic condition similar to diabetes, a dysfunction in how the body processes fat and carbohydrates that is often the result of the way we live our lives: inadequate exercise and unhealthy eating.

The study evaluated the metabolic impact of a single dose of palm oil in an amount similar to the saturated fat in a meal of pizza or fast food. In the 14 healthy adult male participants, liver function was overwhelmed by this “fat loading”:

  • insulin sensitivity decreased by 25%
  • fat deposits in their liver spiked by 35%
  • liver production of glucose increased by 70%

While a healthy adult liver could bounce back from this type of meal, repeated high saturated fat intake eventually causes the liver to become clogged with fat deposits while blood sugar levels climb, potentially leading to fatty liver disease.

We don’t know how long this fat loading impairment lasts or how many times eating a meal like this can be dealt with by the liver without long term consequences to your health. The answer is likely different for each individual depending on your genetics, how much you exercise, your body fat amount and location as well as other factors in how you live your life.

There is currently no medical treatment for fatty liver disease, so prevention is your best bet and like many conditions, if you catch the disease process early enough you can heal it through a healthy diet and active lifestyle.

Foods high in saturated fat:

  • High fat animal meats: beef, pork, lamb
  • The skin and dark meat of chicken and turkey
  • Butter
  • Dairy – cheese and milk
  • Coconut oil and palm oil

While decreasing saturated fat in your diet, make sure to replace it with healthy foods:

  • Unsaturated fats like olive oil, fatty fish, nuts, seeds, avocados, and beans
  • Complex carbohydrates in fruit, vegetables, grains, and beans.

Happy eating,


The MIND diet

Two studies published in Alzheimer’s & Dementia feature a comprehensive dietary approach to preventing brain related diseases and deterioration of memory and mental acuity with aging. Not surprisingly, the MIND intervention follows similar patterns as heart healthy diets and is in fact based on two well studied approaches to healthy eating: the Mediterranean diet and the DASH diet, both of which have been shown to reduce the risk of cardiovascular diseases- heart attack, stroke, and high blood pressure. The brain and the heart are both affected by chronic diseases that impair the function of blood vessels, causing clots and decreased delivery of oxygen and other nutrients to cells and tissues in these organs. So eating foods that improve vascular function will create healthier brains and hearts.

These studies found that closely following MIND, DASH, or Mediterranean diets provided protection against cognitive decline, however moderate adherence to MIND also provided protection. So if you are already eating closely to the DASH or Mediterranean diets, you are reducing the risk of developing brain related diseases. If you struggle to meet the guidelines, switching to the more focused MIND diet can also give you significant improvements to brain health.

The researchers followed 960 participants for an average of over 4 and half years and calculate that the brains of those who closely followed the MIND diet had an adjusted average age of 7.5 years younger and 50% lower risk of developing Alzheimer’s than those who had the least compliance with the diet.

The MIND diet is composed of ten “brain healthy” foods:

  • whole grains- 3 servings per day
  • leafy greens- daily
  • other veggies- daily
  • nuts- daily
  • beans- 4 servings per week
  • berries- twice weekly
  • poultry- twice weekly
  • fish- one serving per week
  • olive oil- daily
  • wine- 1 glass per day

The MIND diet also includes foods to avoid (consuming less than one serving per week)

  • red meats
  • fried and fast foods
  • pastries and other sweets
  • cheese
  • butter and stick margarine

Happy eating for your brain!



Blue Zones for Health

While traveling earlier this month I started seeing signs at restaurants and grocery stores for “blue zone approved” foods. While I was aware of the Blue Zone concept, I was happy to learn that this community adopted a plan to promote healthier eating with Blue Zone diet foods. This is a commitment by the community to make healthy choices easier through permanent changes to the environment, policies, and social networks. The goal is to create a community where healthy living is a way of live.

From the promotional materials displayed at the stores:

Join a global movement that’s inspiring people to live longer, more active lives.

What is the Blue Zone diet?

People in certain regions of the world live much longer, healthier lives than average. The Blue Zone diet is based on their health promoting and disease fighting lifestyle habits. These regions exist across cultures and climates:

  • Karia, Greece
  • Sardinia, Italy
  • Nicoya Peninsula, Costa Rica
  • Okinawa, Japan
  • Loma Linda, California

All of these regions eat diets specific to their cultures, environments and food traditions. However, they live there lives in some remarkably similar ways:

  • Eat whole foods – minimal processed foods, refined carbohydrates, and added sugars.
  • Follow a mostly plant based diet – limited animal meat and dairy.
  • Lots of variety – abundant colorful plant foods throughout the year.
  • Eating with the seasons – eating fresh foods grown locally.
  • Regular physical activity – while exercise does not need to be formal, these societies incorporate movement as part of daily life.
  • Strong social support – these communities are designed to encourage movement and healthy eating and social connections.

There is a book and a website based on these concepts. The authors created a list of ten guidelines for healthy eating based on their research of the practices of the blue zone communities. Here are my favorites:

  • If it’s manufactured in a plant, avoid it. If it comes from a plant, eat it.
  • 95/5 rule: 95% of your diet should come from fruits, vegetables, whole grains, and beans.
  • Sour on bread: eat authentic sourdough bread with live cultures or whole wheat breads. Limit bread to 2 slices per day.

Here are some recipe ideas from the project which are designed to take less than 30 minutes to assemble and taste delicious.


Happy Blue Zone eating!


Eating Together

During this week of presidential transitions and a clear change in political direction, I am making an intention that 2017 will be about fostering community. And what better way to connect than through food? Eating is something that we all share, we can all agree on the enjoyment of a good meal. Food is an integral part of connecting with family, friends, and culture. We pass down traditions and approaches to health through how and what we eat. Unfortuately, the tradition of the shared meal is weakening and this change is having a negative effect on our health.

The impact of this lost tradition has much to do with what has replaced it: fast food culture- the habit of eating quickly and spending little time on food prep. We know that fast paced meals are unhealthy and that fast food is unhealthy. We also know that meals cooked at home are a healthy solution to the poor quality of the standard American diet.

The simple act of eating together can benefit both our physical and mental health. Of the many ways that American eating habits have changed over the past fifty years, the disappearance of the family meal may be one of the most regrettable. Research from a wide variety of fields indicate the many benefits of eating together:
* healthier body weight
* improved inter-personal relationships
* children perform better in school
* lower incidences of drug and alcohol abuse
* improved nutritional quality of the diet

These benefits are independent of what is being eaten. However, people tend to make healthier choices when they eat together (especially when they serve themselves and the healthy options also taste good). Knowing that we will feel better, be healthier and that our family bonds will be stronger by eating together is one thing, but actually finding the time to cook is another. Most modern lives are structured for fast, efficient meals and it can be challenging to bring everyone together at the same time.

In a recent study of why parents buy convenience and frozen meals to serve to their families, researchers concluded that the perceived inability to cook a healthy meal within their time constraints resulted in frequent purchasing of less healthy prepared foods. So increasing interest in food preparation and skill in the kitchen is a key public health goal.

Promoting healthy cooking can come from many different places: government dietary guidelines, schools of public health, non-profit organiziations, and even corporations. While we won’t be seeing leadership on this issue from the Trump administration, a creative food program out of Canada provides one example of how industry can promote wellbeing. Under the name Eating Together, the Presidents Choice Corporation is fostering communal meals without emphasizing the nutritional quality of the food. This may reduce some of the pressure to make a “healthy” meal, allowing people to just focus on actually cooking. Studies show that people who eat together tend to make healthier choices and have more balanced meals. There is also a strong social media component to #EatTogether where participants post photos of the meals they share- another way to foster community. And the program does have a nutritional health aspect, offering recipes and cooking ideas for whole foods based meals.

For your health, the health of your family, children and community – join me in enjoying a meal together this week as you consider your intentions for the new political landscape.

Happy eating,

Happy Gut

Digestive dysfunction and discomfort is a common occurrence. These issues range from feeling bloated to severe abdominal pain.  According to the National Institute of Health:

  • 20% of U.S. adults experience acid reflux (heart burn) one or more times a week.
  • 63 million have chronic constipation
  • 3 million have irritable bowel syndrome
  • 9 million have irritable bowel disease (Chron’s or Ulcerative Colitis).

Lifestyle factors play a key role in digestive health. What you eat can either benefit your gut or irritate it.  Whole foods (especially complex carbohydrates) provide nutrients for healthy gut bacteria and along with adequate hydration keep bowel movements regular. Processed foods, refined foods, and excessive quantities can irritate the intestinal lining, leading to inflammation and poor absorption of food; which we may feel as bloating and pain or experience as constipation and diarrhea.

Anxiety and stress are also important factors that can send our digestive system into a tail spin. When we are under mental strain, the brain’s stress response system is activated, issuing a cascade of chemicals which impact nearly all of our organs and body systems. The digestive system appears to be highly sensitive to this in many people: the stress signals slow down stomach emptying while speeding up bowel movements in the lower intestine. The result is nausea, bloating and diarrhea. In addition, studies indicate the intestines are more sensitive at times of stress, so we are more likely to feel a pre-existing irritation.

The good news is that you can improve the health of your gut. Here are some steps that you can try:

  • Hydrate: aim for 2 liters (8 cups) of WATER per day.
  • Moving your body keeps things moving through the digestive tract. Taking a walk after eating helps relieve symptoms like gas and stomach discomfort.
  • Learn techniques to help you deal with the stress in your life like breathing exercises, meditation, and mindfulness practices. Establish a calm eating environment and use your meal time as a break from your day.
  • Eating foods high in fiber (vegetables, fruits, beans, whole grains) is essential for long term gut health. Adding 1 Tablespoon of ground flax seed or oat bran to one meal or drink per day may relieve digestive symptoms.
  • Digestive Teas. Drinking herbal teas before or after meals may help stimulate digestion, reduce intestinal irritation and keep you calm while you digest. Try teas with ginger, peppermint, or fennel.
  • Food Sensitivities. Try eliminating potential intestinal irritants like highly processed foods, lactose, and gluten.

And remember, mostly importantly- enjoy your food, nourish your body, mind and spirit and all of your body’s systems will work better.

Happy eating!


So Long 2016

There have been many interesting and some surprising nutrition research, films and stories over the past year. Some reinforced prior evidence, helping remind us of the importance of things like our gut bacteria, basing our diets on plants, and the catastrophic impact of consuming large amounts of processed foods. While others are by thinkers and activists helping us understand the impact of body weight and weight bias on emotional well-being and the essential importance of a healthy relationship to food for individuals and communities.

Here are some of the stories and ideas that caught my attention and helped to shape my thinking about nutrition and health this year:

  • The healing power of plants. You can make one change to your diet that will improve your mood, live longer, increase your energy, improve your sleep, decrease your risk for heart disease, diabetes, cancer, stoke…sounds too good to be true? This is what happens when you base your diet on plant food. So go ahead and make at least 1/2 your plate vegetables or follow this plan or this one  to boost your plant nutrients. Or take a cue from Pinterest and join the Buddha Bowl trend – a simple, flavorful plant based bowl of grub.
  • How we think about food and our bodies matters to our health. Of course eating healthfully is a key to living a healthy life, but how we relate to our food is also an essential component of wellness. Fat shaming and misunderstandings of the health impact of  body fat have wreaked havoc on the mental health of the American eater. Health is about so much more than a number on the scale. Focus your efforts on nourishing your cells with nutrient dense foods and your taste buds with flavors that you enjoy instead of just how much you weigh or how you look.
  • Food can be a way to unite us and bring healing to our communities. In healthcare we often take a narrow view of health as in the health of the patient. By widening our view we can look at the health of the community, the environment, and economies of the food system. This year saw some excellent examples of reclaiming food traditions to improve communities and bring people together.
  • Our understanding of the tangled relationship between metabolism, body weight and weight loss took a few halting steps forward this year. Sadly, follow up studies of Biggest Loser participants show a persistence of weight regain. This reinforces the importance of seeing health as more than body weight – fitness and learning how to eat with balance and a calm mind. This year we brought mindful eating to the clinic, and will continue in 2017. I hope you can join us.

Happy eating in the New Year!