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Hello and welcome to The Food Chain

from the BBC World Service with

me, Ruth Alexander.

In this episode we're asking should

you eat breakfast, and if so,

what?

Joining me is Courtney Peterson, a

researcher in intermittent fasting

and Associate Professor of Nutrition

at the Harvard TH Chan School

of Public Health in the US.

It's great to be here thanks for

having me. Also Professor Alexandra

Johnstone nutrition scientist

based at the Rowett Institute at

the University of Aberdeen in

Scotland. Hi Ruth, thank you for

inviting me to join you today.

And Marianella Herrera an

associate professor at Central

University of Venezuela and

visiting lecturer at Framingham

State University in the US.

Thank you for having me this is

a great opportunity.

Thank you.

So I have to of course start

by asking you each what

did you have for breakfast today?

I had a

very standard breakfast.

I had

a mini croissant,

some jelly,

a piece of turkey and

a coffee.

That sounds very nice and

a step up from my wholewheat

cereal with milk and a coffee.

Alex, what did you have?

Oh Ruth so I'm not actually in the

UK just now I'm in Paris

so I had

and I had to have, I was really

looking forward to it, a

coffee and a croissant and

I had a banana that I took in my

handbag that traveled with me so

and I've been looking forward it

all weekend to

to enjoy that it was lovely.

Wonderful.

I had a giant fruit smoothie

with bananas a

little bit of almond milk and orange

strawberries and some protein

powder.

Is breakfast the most important

meal of the day or is that a myth?

So we've had a lot of exciting

research over the

past 20 years and I'd say

we've learned the important finding

that not only what

you eat and how much you eat, but

when you eat matters. And we

sort of learned that there are three

core principles that really matter.

So the first is, how long

do you fast each day? And

the idea is that we need a longer

fasting period each night just like

we need a period to sleep to rest

and repair, we need a longer fasting

period to rest and repair.

And through my and others' research,

we found that typically fasting for

16 hours in the day can improve

health. Does that mean it could be a

good idea to skip

breakfast then?

Not necessarily.

But skipping breakfast may not be as

bad as you think. It sort of depends

what you do with dinner. And

I can come back to that.

So the second principle we've

learned is the time of day that

you eat matters. Where it's

better to eat earlier in the day.

So again this suggests that

breakfast actually is really

important because we find your

metabolism is higher earlier

in a day and that's due the

circadian system or your body's

internal biological clock.

And the sort of third principle

we've learned is having meals at

consistent times of the day really

matters, because your body adapts to

what you do on a habitual

basis.

So eating at consistent times your

body's not confused and it can start

timing its internal metabolism to

match that. So you can kind of mix

and match these principles.

So if you eat earlier in the day and

do intermittent fasting that's sort

of the best but you can potentially

skip breakfast and get some benefits,

but it's probably better

to

eat breakfast earlier in the day if

you can.

What are the benefits of

having an early breakfast,

and like how

early?

So your body has this internal

biological clock known as the

circadian system that makes you

better at doing different things at

different times of the day.

So for instance, in most people, they

have their best blood sugar control

in the mid- to late-morning.

So that's going to be around sort of

between maybe about 10 am

to noon time.

And so if you can eat a

large breakfast in the morning and/or

I would even say a large lunch

in the morning, your body's going be

better at metabolising that food.

And what that means is, your body's

going to actually, your blood sugar

levels won't spike as high.

You might burn slightly more

fat. You might burn

slightly more calories from eating

earlier in the day.

Whereas if you had, if you eat most

of your food later in the day, your

metabolism is actually slower later

in the day. So for instance, if you

ate the same, I don't know,

bowl of ice cream in the morning, the

afternoon, in the evening, your blood

sugar levels will spike

significantly higher in the

afternoon and the evening.

So as much as possible it is

better to eat earlier in the day.

And one last tidbit in that area

which is when it really

starts getting dark outside and your

body starts releasing the sleep

hormone melatonin, that actually

quite dramatically raises blood

sugar levels.

I have something to add to that.

Marianella.

Because because it's very

interesting.

Courtney is recommending in fact

that we eat as early as

possible.

And I'm just, but think

how important it

has been historically eating

an early breakfast for

the workers in

ancient times.

Breakfast was developed,

in fact,

to nurture those agricultural workers

that had to start very

early in the morning so they

felt that with breakfast

that would be better and

they could have a

better and

improved jobs

across the day, more effective,

more even more alert

across the

journey.

So that is very interesting,

I find.

So, people's...

even before scientists came along

and studied what was going on inside

our bodies, people just knew

that they needed a hearty meal

in the morning to set them up for a

day's work.

And if you skip

breakfast, what

health problems can arise? Alex?

I think it's first of all I want to

say that there is no

universal definition

of what is considered to be

a nutritional breakfast.

So to summarise that,

this is the working definition that

I use. It's the first meal of the

day that breaks the fast after

the longest period of sleep and

consumed within two to three hours

of waking.

So that gives quite a large

scope, doesn't it, for people to

achieve that.

Now, breakfast skipping is interesting

because my

own work would tend to suggest and

that sort of observational large

scale epidemiological

studies would also support this.

That people who

have a regular breakfast

are actually leaner.

And my own

work would tend to suggest that

having your largest

meal of the day in

the morning period

gives you a much better

appetite control, which

then means it's much easier

to control food intake

later in the day.

So really I am supporting

the meme breakfast like a

king and dine like a pauper.

So for you, then, breakfast

is the most important meal of the

day? So it's really important

particularly for people who

are trying to maintain a healthy

weight and people who were

trying to lose weight.

And I think one positive

message from the work that I've done

is that the time of

day does not, from

our own work, published on cell

metabolism, tend to influence

energy metabolism.

We looked at large

morning eaters and

large evening eaters.

And tried to look at whether it

impacted on metabolism

and energy balance and

we found that weight loss was

identical between

the groups. Now that is a really

important message, because

we see that around 30

to 40 per cent, depending on which

country you're based, of

the population are going to be

involved in shift work, who

are not able to comply

to that advice that Courtney just

shared about when to eat

during the light cycle and to sleep

when it's a dark cycle.

So that's actually a really positive

message to share, that it doesn't

matter what time of day

for losing weight.

That flies in the face, doesn't it, of

some of the

evidence you were talking about,

Courtney, that

actually eating earlier

tends to be better for

your health?

Not necessarily.

So I wouldn't

I wouldn't quite agree with that.

So I actually agree with almost

everything Alex says, perhaps

everything.

So she's done really phenomenal

research in this

work, and there's actually been some

fantastic studies out of Israel

testing the old adage of eating

breakfast like a king lunch like

a prince and dinner like a pauper.

And those studies do report

that when people eat most their

calories for breakfast, they

do lose more weight.

It lowers their blood sugar levels

it lowers their blood pressure

and the fascinating thing is, in

women, it even improves fertility,

which I think is absolutely amazing.

And what we've learned now is some

of these same genes and proteins in

our body that produce these

circadian rhythms are also involved

in rhythms that are longer and

shorter than 24 hours.

And one example of that is

actually the menstrual cycle.

So by optimising our circadian

rhythms, we may also be improving

the menstrual cycle,

men and women's hormones and so

forth.

So we definitely, I think there is,

you know, by and large there

have been meta-analyses finding that

eating early in the day does help

for weight loss.

Now, in the field of intermittent

fasting, interestingly, we find

that if people eat in an eight-hour

period, regardless of what

time of day that eight-hour period

is, they lose weight too.

And you might say, but didn't you

just say you need to eat earlier in

the day? But the interesting thing is,

this is where you go back to those

three core principles.

So if you also have a longer fasting

duration, you can still get benefits

for weight loss.

And so there are a lot of people who

like to do intermittent fasting by

skipping breakfast and they still

eat dinner at a relatively early

time.

So if your doing that, say if you're

skipping breakfast, starting to eat

at, you know, 12pm, and then

stopping eating at 8pm.

Or I guess you'd call it

is that 20 hundred hours

military time, that

you can still lose weight.

And it's about the same, roughly the same

size and effect.

So we're not talking about, you know,

dramatic you're going to, you know,

smash all your weight-loss goals.

But we're talking about losing maybe

an extra two pounds a month, or about

one kilogram a month, or one percent

of your body weight a month.

So both of these things are true.

Now the interesting thing is with

intermittent fasting we don't

really see big blood sugar benefits

or improvements in blood pressure

unless those eating windows are

earlier in the day.

And so it looks like they are for

some aspects of your health.

You really need to eat earlier in

the day to get those benefits.

And that seems to be particularly

true for blood sugar and blood

pressure.

But for weight loss, it looks

to be a little, you know, yes

eating earlier in a day you can get

weight loss benefits, at least from

my read of the literature.

But you can also skip breakfast and

lose weight as long as dinner is not

too late.

There's a really interesting study

out of Japan that showed this. They

found that among people who skip

breakfast, about half skip breakfast

and eat dinner late.

And in those individuals, they had a

much higher risk of cardiovascular

disease and having obesity.

But there's a second group of people,

roughly half the population, who skip

breakfast and eat dinner at a normal

time. And those individuals didn't

have much higher risk

of obesity and cardiovascular

disease.

So what that suggests to me is I

like to look at both breakfast and

dinner as very important.

They're both important.

Because dinner time is sort of, you

know, the time later in the night your

body's metabolism is slower.

So I think it's also very important

that we're mindful of what we do at

dinner time and either we make

dinner a relatively healthy meal or

we move it to earlier in the day.

So those are sort of my suggestions.

Then of course there is the question

of what we should be eating.

And we asked people who follow the

BBC World Service Facebook page,

what did you have for breakfast?

Hi I'm Andrea from New York City and

I'm here to talk about my breakfast

routine.

Almost every morning, I have a

smoothie. Frozen blueberries,

frozen spinach, protein

powder, chia seeds,

ground flax seeds, and almond milk.

And I put it all in this blender.

Sometimes I also add a banana to

it and I put in a big cup

and I drink it all morning long.

It's delicious.

It gets your fruits and veggies in

has lots of fibre and

I love it. It's so good.

My name is Joy.

I'm from Trinidad and

my breakfast consists of

local foods

mainly.

So right now avocados, or as we

call them zabocas are in season.

So zaboca on toast

with pawpaw,

that's papaya, or

pomeracks or five

fingers or whatever fruit is

in season, as well

as a nice big cup of coffee.

It's my breakfast of choice.

Good morning The Food Chain.

My name is Catherine and I'm from

south-east London in the

United Kingdom.

It's about 11 o'clock in the morning

here and I am just about to have my

breakfast my first meal of the day.

I have had some coffee I always have

a coffee first thing in the morning.

So this is what I'd like to call

my lush and healthy homegrown

breakfast.

There are two parts to it.

The first is an

apple. It's a huge pink lady apple

that a friend of mine

and I bought a big bag and split

between us. It's one tablespoon

of whole Greek

yogurt and those two little

raspberries are from my garden.

That's about all I've got left.

Earlier in the year I was using a

lot more Kent strawberries, which

were cheap in the supermarket and I

also had some tayberries that came

early in the year.

If I have nothing else this is what

I have in the morning at the

moment.

Following up from that and this is

what makes it lush is I

have a slice of wholemeal toast.

With a tablespoon of cream

cheese I've mixed in there

a mashed anchovy and some

chives and some small spring onions

again that I've grown in my garden.

I won't have many of those left.

This might be the last set that I

have of the small onions.

The cherry tomatoes also are

homegrown. So I'm very proud of

that. I've had a really good harvest

this year.

And on top of that is a boiled egg

and a little splash of

Worcestershire sauce.

Talk about

breakfasting like royalty.

What an absolute feast, Cath.

I would love to come to your house

for breakfast.

Alex, what does a healthy

breakfast look like?

What do we know about that?

The type of breakfast that we eat is

really incredibly important.

So I know from my own research

that appetite and

satiety are very

much influenced by the

macronutrient composition of the

food that we're eating and that

higher protein meals are more

satiating in the morning and that

allows you to feel fuller

for longer and

are perhaps more rewarding.

Which means you're much less likely

to give in to those food cravings

later in the day where you might

grab ready to eat

high salt, high sugar,

high calorie food

products.

So in the examples

you gave, they sounded very

appetising.

They also included

fruits, vegetables and

whole grains.

That's all really important

aspects of a healthy

diet.

Marianella, what do people typically

eat for breakfast in Venezuela

and Colombia, the Latin American

countries you study?

Well, the typical things

are one thing and the traditional

culinary dishes for breakfast.

So one thing you may have heard

about arepas, which is

the cornbread of

both countries.

And there is a controversial

issue like whether the arepa

is from Colombia or Venezuela.

It happens to be both

in the origin.

And they, you know, we

take it with cheese or

filled with shredded

beef or shredded

pork or shredded chicken.

And avocado.

The use of avocado and black beans

is important.

So that is how it looks

like.

The reality is very different for

the many poor people experiencing

hunger and food insecurity

across Latin America in

general. So we

definitely

will not hear as much.

And if we can see also,

as stated by the latest

FAO report, the Global

Food Security Report, one of

the main concerns across the globe

is food inflation,

which is reflected pretty

much everywhere.

We said we would love

to have healthy meals.

However, can we afford

those healthy meals?

And you can see pretty much across

Latin America,

South East Asia and

Africa, people cannot afford

buying healthier foods or

even their traditional foods.

So it's not only

an issue for

the health.

If we can see, I mean, avocados are

healthy, but they are expensive.

Black beans, even black beans and

rice, which is a very traditional

Latin American food.

They might be

not only

costly,

but it's the utilisation

is compromised, as there

might not be gas

or electricity available for cooking

those.

So we have a problem here

in terms of food security, in

terms of access to foods and

the utilisation of food.

So people neglect

those eating

patterns, not because they

want, because they,

they've been forced to

leave those behind.

Skipping breakfast because they have to?

They have to, and it's

mainly a coping strategy

during emergency. Mothers,

and this is really not a

nice thing, mothers will leave the

children sleeping until

pretty much the lunch hour.

So they skip breakfast and then go

directly into lunch.

And therefore we are saving

money for, of one

meal.

And the evidence says that

children need a good breakfast,

particularly if they are attending

school and therefore

eating at school becomes

an attraction

for keeping and

maintaining the scholar

activities

of the kids.

So because the kids are not only

going to school to learn,

but they're going to eat

at school. Courtney, where

you are in the US, people will

also have been feeling the

effect of rising food prices.

People also have

very busy lives.

And, you know, I

could imagine someone watching

this, listening to this and

thinking, well, how

can I fit in a really well-cooked,

wholesome breakfast early

in the morning?

I've, you know, I've

got to get up, get ready for work.

I've got to get my kids ready for

school. What practical advice

do you have for people who

are time-poor and

maybe short on cash as well?

Yeah, absolutely.

So I think one of the biggest thing

is to plan in advance.

So we find actually what's called

meal prepping or kind of

planning your meals in advance and

making multiple at a time is just a

huge strategy that helps people lose

weight and just sort of eating a

healthy diet.

So I'll give you an example.

You know, so for instance, you might

say every day I'm going to have a

smoothie.

Now what you eat every day might

vary. Maybe some days you'll throw

in banana.

Some days you might throw in, you

know, I don't know, pineapple

or something like that.

Berries tend to be more expensive,

but there are cheaper fruits.

You know, melon actually is a really

cheap fruit and extremely

nutritious. That's sort of related

to squashes in some sense.

And so the mineral content is

actually quite high and you can buy

watermelon relatively cheap, for

instance, and that can feed you for

several meals.

You could probably blend watermelon

with a little bit of berries or

something like that and bring some

of the cost down.

Blending in things like chia seeds

or flax seeds can work.

You can also blend in some yogurt,

obviously avoid the yogurts with

sugar.

You can blend in dairy.

You could make, you know, a

breakfast.

You know, eggs are now really

expensive in the US, but they used

to not be.

You know people get really creative.

They have these fantastic recipes

with slow cooked oats, which you

could just mash with some banana and

make into a pancake.

You could add a little bit of

protein power to that too, to get

some of the benefits that Alex has

talked about.

We've talked about the cognitive

benefits

and the health benefits.

Is there also a general

wellbeing benefit to taking the

time to sit down and have your

breakfast?

We have a wonderful study

that we did several years ago

in Venezuela when we

implemented

in a couple of family, low-income

setting families.

We implemented

the benefits of

sharing family meals at

the time of breakfast.

And we saw

an extended benefit,

not only in terms of nutrition,

the kids were

more alert while they

arrive at school and so on.

We have all these parameters being

measured, but the

interaction within the

family was

way better.

Communication with

parents were very,

very way much better

compared to the group that

didn't implement the breakfast

as such at

the time.

And therefore we can

see all the benefits

of family meals.

We have seen that in

for adolescents and we

can see how

even two or three family

meals per week will

lower the risk of engaging in

drugs for adolescents.

So that is fabulous.

That it's something that we

wouldn't want to miss.

If we have the opportunity as

parents to plan ahead.

I have to confess, I am one

generally for eating breakfast on

the fly.

But you have all convinced me to

make more time for it, which I think

is actually going to have to involve

a lifestyle change.

Going to bed earlier so that I can

get up earlier and take my time over

it.

But thank you to each of our

guests, Dr Marianella Herrera.

Thank you very much for having me.

I learned a lot in this fantastic

discussion.

Dr Courtney Peterson.

Thank you so much.

This was great.

And Professor Alexandra Johnstone.

Thank you for having me.

Some fantastic discussion today.

That's it for this episode of The

Food Chain from the BBC World

Service. Do please like and

subscribe and why not give the

BBC World Service a follow.

Happy breakfasting.

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