Breakfasting For Health?
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Breakfast Time!
In yesterday’s newsletter, we asked you for your health-related opinions on the timings of meals.
But what does the science say?
Quick recap on intermittent fasting first:
Today’s article will rely somewhat on at least a basic knowledge of intermittent fasting, what it is, and how and why it works.
Armed with that knowledge, we can look at when it is good to break the fast (i.e. breakfast) and when it is good to begin the fast (i.e. eat the last meal of the day).
So, if you’d like a quick refresher on intermittent fasting, here it is:
Intermittent Fasting: We Sort The Science From The Hype
And now, onwards!
One should eat breakfast first thing: True or False?
True! Give or take one’s definition of “first thing”. We did a main feature about this previously, and you can read a lot about the science of it, and see links to studies:
The Circadian Rhythm: Far More Than Most People Know
In case you don’t have time to read that now, we’ll summarize the most relevant-to-today’s-article conclusion:
The optimal time to breakfast is around 10am (this is based on getting sunlight around 8:30am, so adjust if this is different for you)
It doesn’t matter when we eat; calories are calories & nutrients are nutrients: True or False?
Broadly False, for practical purposes. Because, indeed calories are calories and nutrients are nutrients at any hour, but the body will do different things with them depending on where we are in the circadian cycle.
For example, this study in the Journal of Nutrition found…
❝Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain.
Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.❞
Read in full: Meal Frequency and Timing Are Associated with Changes in Body Mass Index
We should avoid eating too late at night: True or False?
False per se, True in the context of the above. Allow us to clarify:
There is nothing inherently bad about eating late at night; there is no “bonus calorie happy hour” before bed.
However…
If we are eating late at night, that makes it difficult to breakfast in the morning (as is ideal) and still maintain a >16hr fasting window as is optimal, per:
❝the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake❞
~ Dr. Françoise Wilhelmi de Toledo et al.
So in other words: since the benefits of intermittent fasting start at 12 hours into the fast, you’re not going to get them if you’re breakfasting at 10am and also eating in the evening.
Summary:
- It is best to eat breakfast around 10am, generally (ideally after some sunlight and exercise)
- While there’s nothing wrong with eating in the evening per se, doing so means that a 10am breakfast will eliminate any fasting benefits you might otherwise get
- If a “one meal a day, and that meal is breakfast” lifestyle doesn’t suit you, then one possible good compromise is to have a large breakfast, and then a smaller meal in the late afternoon / early evening.
One last tip: the above is good, science-based information. Use it (or don’t), as you see fit. We’re not the boss of you:
- Maybe you care most about getting the best circadian rhythm benefits, in which case, prioritizing breakfast being a) in the morning and b) the largest meal of the day, is key
- Maybe you care most about getting the best intermittent fasting benefits, in which case, for many people’s lifestyle, a fine option is skipping eating in the morning, and having one meal in the late afternoon / early evening.
Take care!
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Needle Pain Is a Big Problem for Kids. One California Doctor Has a Plan.
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Almost all new parents go through it: the distress of hearing their child scream at the doctor’s office. They endure the emotional torture of having to hold their child down as the clinician sticks them with one vaccine after another.
“The first shots he got, I probably cried more than he did,” said Remy Anthes, who was pushing her 6-month-old son, Dorian, back and forth in his stroller in Oakland, California.
“The look in her eyes, it’s hard to take,” said Jill Lovitt, recalling how her infant daughter Jenna reacted to some recent vaccines. “Like, ‘What are you letting them do to me? Why?’”
Some children remember the needle pain and quickly start to internalize the fear. That’s the fear Julia Cramer witnessed when her 3-year-old daughter, Maya, had to get blood drawn for an allergy test at age 2.
“After that, she had a fear of blue gloves,” Cramer said. “I went to the grocery store and she saw someone wearing blue gloves, stocking the vegetables, and she started freaking out and crying.”
Pain management research suggests that needle pokes may be children’s biggest source of pain in the health care system. The problem isn’t confined to childhood vaccinations either. Studies looking at sources of pediatric pain have included children who are being treated for serious illness, have undergone heart surgeries or bone marrow transplants, or have landed in the emergency room.
“This is so bad that many children and many parents decide not to continue the treatment,” said Stefan Friedrichsdorf, a specialist at the University of California-San Francisco’s Stad Center for Pediatric Pain, speaking at the End Well conference in Los Angeles in November.
The distress of needle pain can follow children as they grow and interfere with important preventive care. It is estimated that a quarter of all adults have a fear of needles that began in childhood. Sixteen percent of adults refuse flu vaccinations because of a fear of needles.
Friedrichsdorf said it doesn’t have to be this bad. “This is not rocket science,” he said.
He outlined simple steps that clinicians and parents can follow:
- Apply an over-the-counter lidocaine, which is a numbing cream, 30 minutes before a shot.
- Breastfeed babies, or give them a pacifier dipped in sugar water, to comfort them while they’re getting a shot.
- Use distractions like teddy bears, pinwheels, or bubbles to divert attention away from the needle.
- Don’t pin kids down on an exam table. Parents should hold children in their laps instead.
At Children’s Minnesota, Friedrichsdorf practiced the “Children’s Comfort Promise.” Now he and other health care providers are rolling out these new protocols for children at UCSF Benioff Children’s Hospitals in San Francisco and Oakland. He’s calling it the “Ouchless Jab Challenge.”
If a child at UCSF needs to get poked for a blood draw, a vaccine, or an IV treatment, Friedrichsdorf promises, the clinicians will do everything possible to follow these pain management steps.
“Every child, every time,” he said.
It seems unlikely that the ouchless effort will make a dent in vaccine hesitancy and refusal driven by the anti-vaccine movement, since the beliefs that drive it are often rooted in conspiracies and deeply held. But that isn’t necessarily Friedrichsdorf’s goal. He hopes that making routine health care less painful can help sway parents who may be hesitant to get their children vaccinated because of how hard it is to see them in pain. In turn, children who grow into adults without a fear of needles might be more likely to get preventive care, including their yearly flu shot.
In general, the onus will likely be on parents to take a leading role in demanding these measures at medical centers, Friedrichsdorf said, because the tolerance and acceptance of children’s pain is so entrenched among clinicians.
Diane Meier, a palliative care specialist at Mount Sinai, agrees. She said this tolerance is a major problem, stemming from how doctors are usually trained.
“We are taught to see pain as an unfortunate, but inevitable side effect of good treatment,” Meier said. “We learn to repress that feeling of distress at the pain we are causing because otherwise we can’t do our jobs.”
During her medical training, Meier had to hold children down for procedures, which she described as torture for them and for her. It drove her out of pediatrics. She went into geriatrics instead and later helped lead the modern movement to promote palliative care in medicine, which became an accredited specialty in the United States only in 2006.
Meier said she thinks the campaign to reduce needle pain and anxiety should be applied to everyone, not just to children.
“People with dementia have no idea why human beings are approaching them to stick needles in them,” she said. And the experience can be painful and distressing.
Friedrichsdorf’s techniques would likely work with dementia patients, too, she said. Numbing cream, distraction, something sweet in the mouth, and perhaps music from the patient’s youth that they remember and can sing along to.
“It’s worthy of study and it’s worthy of serious attention,” Meier said.
This article is from a partnership that includes KQED, NPR, and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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From banning junk food ads to a sugar tax: with diabetes on the rise, we can’t afford to ignore the evidence any longer
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There are renewed calls this week for the Australian government to implement a range of measures aimed at improving our diets. These include restrictions on junk food advertising, improvements to food labelling, and a levy on sugary drinks.
This time the recommendations come from a parliamentary inquiry into diabetes in Australia. Its final report, tabled in parliament on Wednesday, was prepared by a parliamentary committee comprising members from across the political spectrum.
The release of this report could be an indication that Australia is finally going to implement the evidence-based healthy eating policies public health experts have been recommending for years.
But we know Australian governments have historically been unwilling to introduce policies the powerful food industry opposes. The question is whether the current government will put the health of Australians above the profits of companies selling unhealthy food.
benjamas11/Shutterstock Diabetes in Australia
Diabetes is one of the fastest growing chronic health conditions in the nation, with more than 1.3 million people affected. Projections show the number of Australians diagnosed with the condition is set to rise rapidly in coming decades.
Type 2 diabetes accounts for the vast majority of cases of diabetes. It’s largely preventable, with obesity among the strongest risk factors.
This latest report makes it clear we need an urgent focus on obesity prevention to reduce the burden of diabetes. Type 2 diabetes and obesity cost the Australian economy billions of dollars each year and preventive solutions are highly cost-effective.
This means the money spent on preventing obesity and diabetes would save the government huge amounts in health care costs. Prevention is also essential to avoid our health systems being overwhelmed in the future.
What does the report recommend?
The report puts forward 23 recommendations for addressing diabetes and obesity. These include:
- restrictions on the marketing of unhealthy foods to children, including on TV and online
- improvements to food labelling that would make it easier for people to understand products’ added sugar content
- a levy on sugary drinks, where products with higher sugar content would be taxed at a higher rate (commonly called a sugar tax).
These key recommendations echo those prioritised in a range of reports on obesity prevention over the past decade. There’s compelling evidence they’re likely to work.
Restrictions on unhealthy food marketing
There was universal support from the committee for the government to consider regulating marketing of unhealthy food to children.
Public health groups have consistently called for comprehensive mandatory legislation to protect children from exposure to marketing of unhealthy foods and related brands.
An increasing number of countries, including Chile and the United Kingdom, have legislated unhealthy food marketing restrictions across a range of settings including on TV, online and in supermarkets. There’s evidence comprehensive policies like these are having positive results.
In Australia, the food industry has made voluntary commitments to reduce some unhealthy food ads directly targeting children. But these promises are widely viewed as ineffective.
The government is currently conducting a feasibility study on additional options to limit unhealthy food marketing to children.
But the effectiveness of any new policies will depend on how comprehensive they are. Food companies are likely to rapidly shift their marketing techniques to maximise their impact. If any new government restrictions do not include all marketing channels (such as TV, online and on packaging) and techniques (including both product and brand marketing), they’re likely to fail to adequately protect children.
Food labelling
Food regulatory authorities are currently considering a range of improvements to food labelling in Australia.
For example, food ministers in Australia and New Zealand are soon set to consider mandating the health star rating front-of-pack labelling scheme.
Public health groups have consistently recommended mandatory implementation of health star ratings as a priority for improving Australian diets. Such changes are likely to result in meaningful improvements to the healthiness of what we eat.
Regulators are also reviewing potential changes to how added sugar is labelled on product packages. The recommendation from the committee to include added sugar labelling on the front of product packaging is likely to support this ongoing work.
But changes to food labelling laws are notoriously slow in Australia. And food companies are known to oppose and delay any policy changes that might hurt their profits.
Health star ratings are not compulsory in Australia. BLACKDAY/Shutterstock A sugary drinks tax
Of the report’s 23 recommendations, the sugary drinks levy was the only one that wasn’t universally supported by the committee. The four Liberal and National party members of the committee opposed implementation of this policy.
As part of their rationale, the dissenting members cited submissions from food industry groups that argued against the measure. This follows a long history of the Liberal party siding with the sugary drinks industry to oppose a levy on their products.
The dissenting members didn’t acknowledge the strong evidence that a sugary drinks levy has worked as intended in a wide range of countries.
In the UK, for example, a levy on sugary drinks implemented in 2018 has successfully lowered the sugar content in UK soft drinks and reduced sugar consumption.
The dissenting committee members argued a sugary drinks levy would hurt families on lower incomes. But previous Australian modelling has shown the two most disadvantaged quintiles would reap the greatest health benefits from such a levy, and accrue the highest savings in health-care costs.
What happens now?
Improvements to population diets and prevention of obesity will require a comprehensive and coordinated package of policy reforms.
Globally, a range of countries facing rising epidemics of obesity and diabetes are starting to take such strong preventive action.
In Australia, after years of inaction, this week’s report is the latest sign that long-awaited policy change may be near.
But meaningful and effective policy change will require politicians to listen to the public health evidence rather than the protestations of food companies concerned about their bottom line.
Gary Sacks, Professor of Public Health Policy, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What’s Missing from Medicine – by Dr. Saray Stancic
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Another from the ranks of “doctors who got a serious illness and it completely changed how they view the treatment of serious illness”, Dr. Stancic was diagnosed with multiple sclerosis, and wasn’t impressed with the treatments presented.
Taking an evidence-based lifestyle medicine approach, she was able to not only manage her illness sufficiently to resume her normal activities, but even when so far as to run a marathon, and today boasts a symptom-free, active life.
The subtitular six lifestyle changes are not too shocking, and include a plants-centric diet, good exercise, good sleep, stress management, avoidance of substance abuses, and a fostering of social connections, but the value here is in what she has to say about each, especially the ones that aren’t so self-explanatory and/or can even cause harm if done incorrectly (such as exercise, for example).
The style is on the academic end of pop-science, of the kind that has frequent data tables, lots of statistics, and an extensive bibliography, but is still very readable.
Bottom line: if you are faced with a chronic disease, or even just an increased risk of some chronic disease, or simply like to not take chances, then this is a high-value book for you.
Click here to check out What’s Missing From Medicine, and enjoy chronic good health!
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3 signs your diet is causing too much muscle loss – and what to do about it
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When trying to lose weight, it’s natural to want to see quick results. So when the number on the scales drops rapidly, it seems like we’re on the right track.
But as with many things related to weight loss, there’s a flip side: rapid weight loss can result in a significant loss of muscle mass, as well as fat.
So how you can tell if you’re losing too much muscle and what can you do to prevent it?
EvMedvedeva/Shutterstock Why does muscle mass matter?
Muscle is an important factor in determining our metabolic rate: how much energy we burn at rest. This is determined by how much muscle and fat we have. Muscle is more metabolically active than fat, meaning it burns more calories.
When we diet to lose weight, we create a calorie deficit, where our bodies don’t get enough energy from the food we eat to meet our energy needs. Our bodies start breaking down our fat and muscle tissue for fuel.
A decrease in calorie-burning muscle mass slows our metabolism. This quickly slows the rate at which we lose weight and impacts our ability to maintain our weight long term.
How to tell you’re losing too much muscle
Unfortunately, measuring changes in muscle mass is not easy.
The most accurate tool is an enhanced form of X-ray called a dual-energy X-ray absorptiometry (DXA) scan. The scan is primarily used in medicine and research to capture data on weight, body fat, muscle mass and bone density.
But while DEXA is becoming more readily available at weight-loss clinics and gyms, it’s not cheap.
There are also many “smart” scales available for at home use that promise to provide an accurate reading of muscle mass percentage.
Some scales promise to tell us our muscle mass. Lee Charlie/Shutterstock However, the accuracy of these scales is questionable. Researchers found the scales tested massively over- or under-estimated fat and muscle mass.
Fortunately, there are three free but scientifically backed signs you may be losing too much muscle mass when you’re dieting.
1. You’re losing much more weight than expected each week
Losing a lot of weight rapidly is one of the early signs that your diet is too extreme and you’re losing too much muscle.
Rapid weight loss (of more than 1 kilogram per week) results in greater muscle mass loss than slow weight loss.
Slow weight loss better preserves muscle mass and often has the added benefit of greater fat mass loss.
One study compared people in the obese weight category who followed either a very low-calorie diet (500 calories per day) for five weeks or a low-calorie diet (1,250 calories per day) for 12 weeks. While both groups lost similar amounts of weight, participants following the very low-calorie diet (500 calories per day) for five weeks lost significantly more muscle mass.
2. You’re feeling tired and things feel more difficult
It sounds obvious, but feeling tired, sluggish and finding it hard to complete physical activities, such as working out or doing jobs around the house, is another strong signal you’re losing muscle.
Research shows a decrease in muscle mass may negatively impact your body’s physical performance.
3. You’re feeling moody
Mood swings and feeling anxious, stressed or depressed may also be signs you’re losing muscle mass.
Research on muscle loss due to ageing suggests low levels of muscle mass can negatively impact mental health and mood. This seems to stem from the relationship between low muscle mass and proteins called neurotrophins, which help regulate mood and feelings of wellbeing.
So how you can do to maintain muscle during weight loss?
Fortunately, there are also three actions you can take to maintain muscle mass when you’re following a calorie-restricted diet to lose weight.
1. Incorporate strength training into your exercise plan
While a broad exercise program is important to support overall weight loss, strength-building exercises are a surefire way to help prevent the loss of muscle mass. A meta-analysis of studies of older people with obesity found resistance training was able to prevent almost 100% of muscle loss from calorie restriction.
Relying on diet alone to lose weight will reduce muscle along with body fat, slowing your metabolism. So it’s essential to make sure you’ve incorporated sufficient and appropriate exercise into your weight-loss plan to hold onto your muscle mass stores.
Strength-building exercises help you retain muscle. BearFotos/Shutterstock But you don’t need to hit the gym. Exercises using body weight – such as push-ups, pull-ups, planks and air squats – are just as effective as lifting weights and using strength-building equipment.
Encouragingly, moderate-volume resistance training (three sets of ten repetitions for eight exercises) can be as effective as high-volume training (five sets of ten repetitions for eight exercises) for maintaining muscle when you’re following a calorie-restricted diet.
2. Eat more protein
Foods high in protein play an essential role in building and maintaining muscle mass, but research also shows these foods help prevent muscle loss when you’re following a calorie-restricted diet.
But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado.
3. Slow your weight loss plan down
When we change our diet to lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several physiological responses to defend our body weight and “survive” starvation.
Our body’s survival mechanisms want us to regain lost weight to ensure we survive the next period of famine (dieting). Research shows that more than half of the weight lost by participants is regained within two years, and more than 80% of lost weight is regained within five years.
However, a slow and steady, stepped approach to weight loss, prevents our bodies from activating defence mechanisms to defend our weight when we try to lose weight.
Ultimately, losing weight long-term comes down to making gradual changes to your lifestyle to ensure you form habits that last a lifetime.
At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.
Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why Adult ADHD Often Leads To Anxiety & Depression
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ADHD’s Knock-On Effects On Mental Health
We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:
In women in particular, it can get missed and/or misdiagnosed:
Miss Diagnosis: Anxiety, ADHD, & Women
…but what we’re really here to talk about today is:
It’s the comorbidities that get you
When it comes to physical health conditions:
- if you have one serious condition, it will (usually) be taken seriously
- if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
- if you have three, people will think you are making at least one of them up for attention now
- if you have more than three, you are considered a hypochondriac and pathological liar
Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.
Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.
If this is you, by the way, we hope at least something in the following might ease things for you a bit:
- Stop Pain Spreading
- Managing Chronic Pain (Realistically!)
- Eat To Beat Chronic Fatigue (While Having The Limitations Of Chronic Fatigue)
- When Painkillers Aren’t Helping, These Things Might
- The 7 Approaches To Pain Management
It’s the same for mental health
In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.
(Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).
Why?
Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.
- “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
- “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
- “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.
Overwhelm and breakdown are almost inevitable.
And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.
Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).
What to do about it
How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.
Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.
Here’s a good starting point for that kind of thing:
When You Know What You “Should” Do (But Knowing Isn’t The Problem)
And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:
Behavioral Activation Against Depression & Anxiety
If things are already bad, then you might also consider:
- How To Set Anxiety Aside and
- The Mental Health First-Aid That You’ll Hopefully Never Need ← this is about getting out of depression
And if things are truly at the worst they can possibly be, then:
How To Stay Alive (When You Really Don’t Want To)
Take care!
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Cashews vs Peanuts – Which is Healthier?
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Our Verdict
When comparing cashews to peanuts, we picked the peanuts.
Why?
Another one for “that which is more expensive is not necessarily the healthier”! Although, certainly both are good:
In terms of macros, cashews have about 2x the carbs while peanuts have a little more (healthy!) fat and more than 2x the fiber, meaning that peanuts also enjoy the lower glycemic index. All in all, a fair win for peanuts here.
When it comes to vitamins, cashews have more of vitamins B6 and K, while peanuts have a lot more of vitamins B1, B2, B3, B5, B7, B9, and E. Another easy win for peanuts.
In the category of minerals; cashews have more copper, iron, magnesium, phosphorus, and selenium, while peanuts have more calcium, manganese, and potassium. A win for cashews, this time.
Adding up the sections makes for an overall win for peanuts, but (assuming you are not allergic) enjoy either or both! In fact, enjoying both is best; diversity is good.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Take care!
Don’t Forget…
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