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Nutrition

A doctor’s recipe for a healthy breakfast

October 6, 2017

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Comments

Alice
November 2, 2017

Doctor, I’m sorry, but this doesn’t look very well balanced. This would not fly in a college Nutrition 101 course. This is why doctors should be required to take at least one accredited college nutrition course, and until they are required to, should not be charged with interfering with anyone’s diet or weight, and should make no comments related to nutrition or weight. It is deeply problematic that MDs are not required to take a nutrition course, which differs dramatically from the diet and nutrition advice in books and articles, even those from dietitians and especially those from MDs. Many dietitians write articles and provide menus that are not consistent with college nutrition courses. And even those courses typically include disordered eating-promoting advice. I have not once seen a nutrition book written by an M.D. that is sound advice. Not once! Most books by MDs promote disordered eating beliefs! The medical schools teach disordered eating! (If you don’t believe me, ask any dietitian or M.D. who has worked for at least one decade, full time, in an inpatient eating disorder facility, if they agree with that statement.) Simply eating the same breakfast every day is rather disordered andeating dogmatic. Most bodies crave more variety. That’s evolution’s way of ensuring we get in the necessary wide variety of nutrients.

To simplify meal planning and shopping, using an exchange plan, each week, I plan 2 breakfast menus, 2 lunch menus, and 2 dinner menus,
and alternate between the two during the week. (I use an exchange plan as the basis because I’m in recovery from decades of harmful medical advice to lose weight, which is terrible advice, there is no proven method of losing weight and keeping it off for even 5 years that works for even a tiny percent of a study population, destabilizes eating behaviors, and is more likely than not to promote weight GAIN, so NO such advice has been proven, and all should be treated as experimental and patients should be told they are being given advice – to lose weight – that has been shown to cause harm, and weight gain,.and not been proven otherwise. Until researchers can provide replicable studies showing that ANY weight loss method can result in at least 5 years of keeping the weight off for even a simple majority of study subjects, no patient should be told to lose weight, because they will have to resort to unproven or disproven methods in order to try to achieve an unachievable goal through unproven -and risky – methods that make their eating more disordered with each new attempt.) Patients should be encouraged to follow Health At Every Size®: for they and their doctors to shift from a focus on weight, to a focus on healthy llifestyle, and letting their weight fall where it may. Period.

Regarding the meal you described,
I’m concerned that 3 cups of fruit at one sitting is too much simple sugar for one meal. Is that amount of fruit at breakfast pleasurable? Don’t you crave some whole grain cereal or toast with it? Are you listening to what your body is asking for, and being kind to it, and responding to that?
That’s 6 servings of fruit at one meal, or over the course of the morning (1/3 of the eating day): breakfast and snack.

It would probably be healthier to have the meal be mostly whole starches (complex carbs), which act as slow-release carbohydrate, balanced with protein and fat, and some fruit for quick energy, fiber, vitamins, minerals and enjoyment. To get in enough protein from yogurt for one serving of protein would require a cup of yogurt (7 g of protein). Ideally, a meal (if eating 3 meals/day), would contain 1-2 servings of protein low in saturated fat (no more than 5-10 g sat fat per meal, on average). The meal also would not be the same thing every day. The motto of dietitians, taught on Day 1, textbook page 1 in a college nutrition course is “balance, variety, and moderation.”

The meal plan I follow, which allows a healthy.(for women) 2100 – 2500 calories a day, developed with my dietitian, who specializes in the treatment of eating disorders, so this is a sound meal plan for prevention of these serious and increasingly common conditions, is 3 meals per day, each consisting of the following exchanges (these meals can also be divided easily into 6 meals, eaten every 3 hours).

At each of 3 meals per day:

2 fruit exchanges (1/2 c or 1 small piece per exchange)
1 veg exchange (1/2 c cooked or 1 c. raw leaves)
4 complex carbohydrate exchanges (~1/3 – 1/2 c. raw grain or starchy veg per exchange)
2 medium-fat protein exchanges
2 fat exchanges

Within this meal should be ~1000 mg of calcium, on average, from dairy or non-dairy sources.

So here are a few examples of what that might look like:

1 c. carrot, tomato, or green veggie juice
1 c. dry oat bran or oatmeal, cooked (makes 2 cups)
1 diced apple
1/4 c raisins (these fruits stirred in and cooked, or raw on top)
1/4 c almonds or cashews stirred in and cooked
1 c low-fat yogurt

(Or instead, half the oat bran and yogurt, plus 2 servings of Shredded Wheat, Cheerios (which are whole grain and low sugar), or low-sugar granola, with 1/2 c. full-fat soymilk or low-fat (1.- 2%) cow’s milk).

Or:

1 c. veg juice
1 whole large banana or 2 small fruit
4 slices 100% whole grain toast
4 T nut butter

Or:
2 eggs scrambled with 1 c raw spinach or zucchini
2 servings of low-sugar cereal
1c. soymilk
2 whole grain toast
1 T butter
1 T all-fruit spread

Or

For the cereal or toast, substitute 1 large baking potato, diced, tossed in olive oil, rosemary, dried onion, and a pinch of turmeric and garlic powder, microwaved for 10 minutes in a covered casserole.) Or 1 c frozen corn, microwaved and buttered.

Or

1 c veg juice
2 whole grain pancakes
1 sliced apple or banana on pancakes
2 whole grain toast
2 veggie bacon (and occasionally the real thing)
1-2 scrambled eggs
2.T all-fruit

Or

2 fruit
4 100% whole grain tortillas
1c. shredded cheddar, Jack, or veggie cheese
1/2 salsa, or diced roma and small avocado
1 T oil of butter for sauteeing 2 quesadillas in

Or
1 c veg juice
2 fruit
2 servings low-fat, low sugar cereal
2 servings high fat granola

Or

1c. Veg juice
2 fruit
2 servings of low or high fat cereal, cooked or ready-to-eat
2 whole grain toast
2 T butter, fruit spread, or nut butter, depending on hunger level and taste preference.

What do you think of these?

These are designed to be balanced, ample, and pleasurable. Leftovers can be packed up and eaten as a mid-morning snack.

There is no one right way to eat. Some people may not like eating so much complex carbohydrate. (Following a low-carb diet for weight loss is NOT healthy, and is not a good reason to skip starch servings. I’m talking about this amount of whole starches being too filling for some people who dont eel physically comfortable eating that much starch, who might want more protein.) People should always eat until full, of what their body is asking for, at regularly scheduled meals. If meals are eaten at consistent times each day, the body will adjust the quantities to what keeps it satisfied until the next meal but not uncomfortably full, and this will be right for their body over time.

I urge everyone, especially doctors, to go to dietitian expert Ellyn Satter’s website, click the How To Eat tab, and read. Simple, brilliant, easy to follow, gentle principles, with eating disorder prevention and weight concerns in mind. She intentionally does not include dieting. Kind, genius advice.

Thank you for sharing your breakfast with us. Sorry to take it over the coals, but I have to wonder if you wouldn’t enjoy andthe crave more variety and balance with substantial complex carbohydrates, which is whatterrible most people in the world primarily eat for their meals: whole starches, with protein, fat, and fruit.

Alice
November 2, 2017

My apologies for the autcorrect typos! Please disregard the word “terrible” that snluck into the last paragraph. I was trying to to write that most people in the world eat meals of primarily complex carbohydrates.

Johanna
November 2, 2017

Where do you get the idea that bacon and animal fat goes into our arteries to clog them? Ridiculous!!
Good breakfast? Fried eggs and bacon! And NO carbs!
Our body doesnot know the difference between sugar or fruit!
All carbs raise insulin and that makes us fat and ill !

Monique Tello, MD, MPH
November 3, 2017

Well, enjoy, but do make sure to have regular medical care, as well.

Akhil Arya
October 28, 2017

A debt of gratitude is in order for sharing; I don’t generally like sweet sustenances at breakfast. My best breakfast it appears to inspire me to lunch is by all accounts an egg white omelet with an assortment of greens cooked with at least splash in the container.

Monique Tello, MD, MPH
November 1, 2017

Thanks and that sounds perfect– loads of veggies and egg, like the veggie omelet you describe, will also get you the fiber/ protein/fat combo you need at a meal.

Beth
October 27, 2017

My favourite breakfast is unsweetened museli with fresh fruit and plain yogurt

Monique Tello, MD, MPH
November 1, 2017

Sounds great, especially if the fruit are the bulk of the meal, the star of the show.

Carolyn Szlasa
October 27, 2017

Your recipe states to mix together all ingredients up to the cinnamon, but it does not tell me when to add the cinnamon. Please clarify and thanks for this great granola mix recipe!

Monique Tello, MD, MPH
November 1, 2017

Yes, someone else said the same- I meant including the cinnamon when I wrote “up to the cinnamon”. I will ask the editors to change it for clarity.

Suzanne Deliee
October 26, 2017

I don’t really like sweet foods at breakfast. (maybe I should try again), my best breakfast it seems to get me to lunch seems to be an egg white omelette with a variety of greens cooked with a minimum of spray in the pan. How bad is that.

Suzanne RN, RPH

Brenda
October 25, 2017

Hello doctor. ! Thanks for sharing ! Well , I like. Smoothies with kale , carrots , beets. Apple. 8 almonds For breakfasts Then plenty of water , small sandwich with protein for lunch like egg whites and vegetable Rice soup with fish or chicken for dinner . Some days I crave bread so I get a small toast with plain yogurt . I have hypertension and prediabetic, I eat kiwis . Persimmons apples and cooked vegetables. I go bad too with rice pancakes I’m in the gluten free zone . Then I drink black tea with almond milk with 1 or 2 cookies like 2 pm . I’m a nurse Lol.

Monique Tello, MD, MPH
November 1, 2017

Sounds very good except for a fair amount of processed carbs (bread, rice, if it’s white rice). If you can switch those out for more veggies, you may be able to improve your blood sugars and blood pressures.

Ila Lee Macik; confused consumer w/Prediabetes
October 25, 2017

How can the general public know what is healthy to eat with the medical community can’t agree? Thomas Turk…..where do you shop for groceries? Perhaps not where the general public can.
Very confusing all around!

J.M. Fenster
October 24, 2017

Wake up a little earlier and relax while having breakfast. The rush inherent in a routine based on words like “quick,” “grab,” and “transportable” is hard on the body. Stress is more dangerous than just about any foodstuff. My advice to you, Doctor, is to emphasize the “break,” rather than the FAST!

Monique Tello, MD, MPH
November 1, 2017

Point well-made! This working mom takes note.

John Rentschler
October 24, 2017

But isn’t there a lot of sugar in those yummy berries and doesn’t your body treat that just like desert as well?

Donubari Kogbara
October 24, 2017

Great question!

Thomas Turk
October 24, 2017

Hi Doc Monique. Thanks for allowing my contrarian comments. BTW my son is an MD doing research in new nano meds for childhood brain diseases at.. Johns Hopkins, Krieger Institute. Interestingly he received only 10 minutes of nutrition in Med School, (Vienna Med U)!

Monique Tello, MD, MPH
October 24, 2017

Thank you for your readership and commentary! I had a similar experience as your son– I don’t recall any nutrition instruction, and if there was any, it was minimal. Very sad. The times are changing, however, and we’re seeing nutrition included in the curriculum at more medical schools.

Dick
October 24, 2017

Confirmation that what I’ve been eating for breakfast for years is good for me, because that’s just about what I’ve been eating for the last 20 years for breakfast. The only thing I add is Konsyl fiber, one tablespoon, and a tablespoon of Chia seeds. I’m 70 yrs young & still going strong.

Monique Tello, MD, MPH
October 24, 2017

That’s great! Yes, adding some fiber and spices can make this even more healthful. Chia seeds as you do is a good choice. Ground flaxseed and cinnamon would be other additions, for omega 3 fatty acids, fiber, and the sugar-stabilizing effects of cinnamon.

mike pazda
October 24, 2017

I like to priase the health beneifts of eating ripe organic bananas with their skin – very high fibre, no pesticides. Note that ripe means with brown spots.. also kiwis.. great for digestive velocity 🙂

Monique Tello, MD, MPH
October 24, 2017

Thanks for the suggestions!

Rachel
October 23, 2017

Yogurt (and various other dairy products) don’t always agree with me, nor can I handle the ups and downs of caffeine. My blood sugar tends to stay even with a steady intake low fat animal protein. For what it’s worth, my daily breakfast of a large apple sliced, an oz. of mixed RAW nuts, two egg whites fried in canola or olive oil and water to drink (I know, pretty boring) can take me thru a good part of the morning. And to keep my cholesterol in check, 2 of those days each week I treat myself to scrambled eggs (whisking 1 of the egg yokes along with the 2 egg whites whilst adding a tablespoon of grated parmesan). This all may seem spartan, but it’s satisfying, and honestly I feel great!

Monique Tello, MD, MPH
October 24, 2017

All of that sounds very healthy, and delicious as well! Thanks!

Val
October 23, 2017

If I ate 3 1/2 cups of fruit at breakfast, all that fruit sugar would cause sugar cravings for the rest of the day! One half cup of fruit is about all I can eat in a day and not be subject to intense sugar cravings.

Monique Tello, MD, MPH
October 24, 2017

The natural fiber in most fruit will help with any sugar spike, and in this meal, the addition of plenty of protein and healthy fats will help as well.

Ces Fabian
October 23, 2017

Hello World,
I’m 67 yo, working 4-5 h/d at my desk. Heath wise, pretty good according to my yearly blood test. My HBP is under control with low dosage prescription. I practice TM (transcendental meditation), walk/run for about 1 h/day 4-5 days per week. Brekky, fruit juice (300 mL, pineable, paw paw, mango, strawberry, banana, honey, algarrobina). I add boiled water (100 mL) to raw oats (3-4 spoons), cacao (1/2 tea spoon), maca (1/2 tea spoon), bit of brown sugar and manuka honey. A cup of coffee with bit a bit o cacao, sugar and the honey. Lunch, just 2 or 3 fruits. Diner, anything, but I like fish at 5-6 pm. So I am still strong!! Cheers

Monique Tello, MD, MPH
October 24, 2017

That’s wonderful! Thanks for the healthful suggestions!

Doris Ryan
October 23, 2017

It surprises me greatly and concerns me deeply that a medical doctor associated with Harvard would suggest heating ANYTHING in a plastic container in the microwave. Here in Canada we have been warned for years about toxins being absorbed into our food from the plastic and have therefore been advised to heat food in microwaveable glass containers only. I’m all for healthy eating but contaminated food from the wrong container is unacceptable!

D. Diviney
October 23, 2017

I, too, was surprised by the use of plastic for heating food in the microwave. Depending on the length of the commute, the fruit may naturally defrost by the time one gets to work. Or, alternatively, put the fruit in the fridge the night before to begin to slowly defrost overnight. I would miss the whole grains of muesli, and would probably add some for some extra flavor and texture.

Paul Neymeyr
October 23, 2017

Agree Did you get a reply?

Thomas Turk
October 24, 2017

You have been misinformed. Microwave ovens should ONLY be used to sterilize glass bottles.. period. They were invented to get hot food for German troops in the field during WWII. After the war, the massive cancers in these troops was traced to the microwave ovens, which were later BANNED in the Soviet Union!

Sandy
October 24, 2017

Yes I was surprised by that as well. I would never heat anything in PLASTIC in the microwave. This seems so basic a thing NOT to do that it makes me take the rest of her advice with a grain of salt.

Monique Tello, MD, MPH
October 24, 2017

Happy to address this– the containers we use at home are BPA and dioxin-free, FDA-approved microwave-safe. I am not worried about leached carcinogenic plasticizers from microwaving foods in these products. I agree with you that not all plastics are microwave-safe, and one needs to read labels/ check the safety information. You can read more about plastics and microwaves on this recently updated article from our site: https://www.health.harvard.edu/staying-healthy/microwaving-food-in-plastic-dangerous-or-not

Monique Tello, MD, MPH
October 24, 2017

Happy to address this– the containers we use at home are BPA and dioxin-free, FDA-approved microwave-safe. I am not worried about leached carcinogenic plasticizers from microwaving foods in these products. I agree with you that not all plastics are microwave-safe, and one needs to read labels/ check the safety information. You can read more about plastics and microwaves on this recently updated article from our site: https://www.health.harvard.edu/staying-healthy/microwaving-food-in-plastic-dangerous-or-not

Noel
October 23, 2017

Monique: I looked at your granola recipe which looks very good but when do you add in the cinnamon?

Monique Tello, MD, MPH
October 24, 2017

The beauty is it all goes in the bowl at the same time. Toss it right in there and mix.

Carole Bienstock
October 23, 2017

Why not have a breakfast with oatmeal, lowfat milk and fresh fruit? This takes almost no time in preparation. Fresh fruits are readily available in most stores. These include blueberries, strawberries, oranges, apples, as well as peaches etc.

Fran Levin
October 23, 2017

I substitute Plain Old-fashioned Oatmeal for Granola and add a variety of nuts, cinnamon for variety with fruit and some plain yogurt for variety.

I also like to make yogurt cheese and add a variety of ethnic spices like
Za’atar, Chinese Five spice, fresh herbs, and or fruit – fresh or frozen.

Monique Tello, MD, MPH
October 24, 2017

Oats are a whole grain! Go for it! with plenty of fruit and some protein, even better.

Greg
October 23, 2017

Is there any research on the health ill effects from the stress of trying to adhere to spartan diets over a long period of time? It would be somewhat ironic if the health benefits of reducing fat and carbs in your diet were outweighed by the stress on your body (and mind) from denying yourself taste pleasures. Perhaps moderation is a more sensible and realistic goal.

Alan Andrus
October 23, 2017

Amen!

Monique Tello, MD, MPH
October 24, 2017

Wow! I never in a gazillion years imagined anyone would think of this hearty breakfast as spartan! Three raspberries and a cashew is spartan. This, on the other hand, is a pretty substantial morning meal.

Marcia
October 23, 2017

Kite Hill is a brand of an almond-milk based yogurt which comes in a plain unsweetened version and it is delicious.

Monique Tello, MD, MPH
October 24, 2017

Yes, I’ve seen that at our local market and been meaning to try! Will do!

NANCY FISHER
October 23, 2017

THANK YOU DOCTOR TELLO.

I PLAN TO TRY YOUR BREAKFAST WHICH SEEMED QUITE APPEALING TO ME AND LIKE YOU, I WOULD WANT THE YOGURT. AM PLANNING TO SHOP TOMORROW FOR YOUR HEALTHY BREAKFAST INGREDIENTS. THANKS AGAIN.

Monique Tello, MD, MPH
October 24, 2017

Tell us how it works for you!

Bliss
October 23, 2017

What about oatmeal??

Agatha
October 23, 2017

Has to be the real deal oatmeal, old fashioned Quaker or Irish style oats, not instant or sugared. For decades, I would fill a bowl of said oats, plus a tablespoon each of golden flaxmeal, wheat germ, raisins or currants and boiling water the night before, leave it covered on the counter at room temp. At bkfst time, boil more water for a cup of rose hip or hibiscus tea, a soft 4 min boiled egg, and to warm the oats. Add 1/4 cup of any fresh fruit and plain yoghurt or whole milk to the oats. Remained well fed from 6:45 a.m. till 2-3pm light lunch, paleo style supper in evening. Been my routine since 1980s when leaving home early a.m., commuting to work, etc.

Monique Tello, MD, MPH
October 24, 2017

Oats are a whole grain! The less processed the better. Look at my homemade granola recipe– oats!

Richard Harding
October 23, 2017

The carbohydrate load is irrelevant in the cause and treatment of diabetes. Diabetics have high levels of serum glucose because muscle cells are unable to access the glucose in the blood as a result of high lipid content inside muscle cells.

If a person reduces the carbohydrate load, then what do they eat – fats and proteins which created the problem in the first place.

Sweeney showed way back in 1927 and 1928 that a high carbohydrate diet did not contribute to insulin resistance but a high-fat and high-protein diets did. The mechanism for this was not described until the late 1990s. The last two papers below are freely available. The first two need to be purchased.

The article also states that “the insulin easily ushers all that sugar into your fat cells, where it becomes stored energy, also known as body fat.” Insulin can only usher sugars into cells when the muscle cells are not overloaded with fat AND sugars in humans are not readily converted into fat – they are converted to glycogen. Fats are stored as fats.

Richard Harding
wisenutritioncoaching.com.au

Sweeney, J. Shirley. “A Comparison of the Effects of General Diets and of Standardized Diets on Tolerance for Dextrose.” Archives of Internal Medicine 42, no. 6 (December 1928): 872–76.

Sweeney, J. Shirley. “Dietary Factors That Influence the Dextrose Tolerance Test.” Archives of Internal Medicine 40, no. 6 (December 1, 1927): 818–30.

Jacob, Stephan, Jürgen Machann, Kristian Rett, Klaus Brechtel, Annette Volk, Walter Renn, Elke Maerker, et al. “Association of Increased Intramyocellular Lipid Content With Insulin Resistance in Lean Nondiabetic Offspring of Type 2 Diabetic Subjects.” Diabetes 48, no. 21 (1999): 1113–19.

Bachmann, Oliver P., Dominik B. Dahl, Klaus Brechtel, Michael Haap, Thomas Maier, Mattias Loviscach, Michael Stumvoll, et al. “Effects of Intravenous and Dietary Lipid Challenge on Intramyocellular Lipid Content and the Relation With Insulin Sensitivity in Humans.” Diabetes 50, no. 13 (November 2001): 2579–84.

Patricia Mullan
October 23, 2017

I respect your expertise – but what is it that you do promote? What specific actions should we be taking?

Monique Tello, MD, MPH
October 24, 2017

Agreed, it’s not the carbs, it’s the type of carbs. Processed foods and added sugars= not good. I agree with your premise that saturated fats= not good either. I bet we agree that loads of plants=ideal.

Alice
November 2, 2017

This would explain why diabetics on Dr. McDougall’s high whole-starch, very low-fat, low protein diet have to cut their meds doses by at least half on the second day of his eating program to prevent low blood sugar.

Thanks for the pointer that it’s the fat and orotein that are the problem, and therefore to not restrict carbohydrate, resulting in increased (or moderate to high) fat and protein consumption. I’m going to (gently) experiment.

I have learned not to do extremes anymore. They just aren’t sustainable, and are disordered, especially when we are overriding what the body is telling us what it wants.

I agree with the poster above that the strain of Spartan eating is unhealthy. That’s the evolutionary wisdom of the body, seeking pleasure sure that coincides with our nutritional needs, if we consistently listen carefully enough. Evolution has made pleasurable to us what our bodies need. It’s when we restrict ourselves intermittently that causes the imbalances on what we crave. The meal-skipping I do that arose from medical advice to cut calories to lose weighttp (it’s complicated) causes allof kinds of nutritional imbalances and weight gain. And, a deeply ingrained fear of eating, which is why I skip meals. Telling people to lose weight, and to “eat less, exercise more” to do so, results in eating fears and restricting causes imbalances and poor health.

As Ellyn Satter, RD, says, “When the joy goes out of eating, nutrition suffers.”

Words to live by.

Linda
October 23, 2017

Thank you for your healthy suggestion; my breakfasts are similar, and I agree with your assessment of milk products. Due to osteoporosis, I try to eat, daily and spaced throughout the day, 5 servings of foods that will provide the equivalent of 1 cup of milk. For me this includes 2-3 daily dairy calcium servings (1 cup milk, 1 cup yogurt,1 oz swiss or cheddar cheese).

You mention that “We can get plenty of calcium and other vitamins from leafy greens and other veggies.” I do try to get my other 3-2 servings of calcium from plant based sources, or from calcium citrate in fortified orange juice. A nutritionist brought the issue of bioavailability to my attention, along with a concern about plants that contain oxalates – such as spinach, swiss chard, rhubarb – that inhibit absorption of calcium. Articles that I’ve read suggest that this undesirable aspect of oxalates can be mitigated by cooking. Bioavailability charts that I’ve found suggest that 1 1/3 cups of boy chop and 1 2/3 cups of kale equal 1 cup of milk (96 mg), while a whopping 8 1/6 cups of spinach are needed to provide that amount. I assume that refers to raw greens, but haven’t yet found information specifically on the bioavailability of specific minerals/vitamins in cooked green vegetables. The nutritionist also alerted me to the type of calcium (carbonate vs. citrate) in fortified drinks/foods.

It would be great if you could address the issue of bioavailability of minerals and vitamins in plant foods, and how best to prepare them (raw, cooked) to access the useful things that they contain. Or perhaps you already have in a post that I haven’t seen? Thank you for your suggestions and guidance!

Monique Tello, MD, MPH
October 24, 2017

Thanks for this detailed input! research supports that a wide variety of plant foods prepared many different ways can provide everything we need at baseline. However, for folks with medical issues, and osteopenia/ osteoporosis is a medical issue, you may need extra Vitamin D and calcium. For your specific needs, I really do recommend that you chat with your endocrinologist.

Kristin Kortgard
October 23, 2017

I cringe just a bit at putting plastic in the microwave. I realize it is just for defrosting but I’d go for a glass container.

Monique Tello, MD, MPH
October 24, 2017

Happy to address this– the containers we use at home are BPA and dioxin-free, FDA-approved microwave-safe. I am not worried about leached carcinogenic plasticizers from microwaving foods in these products. I agree with you that not all plastics are microwave-safe, and one needs to read labels/ check the safety information. You can read more about plastics and microwaves on this recently updated article from our site: https://www.health.harvard.edu/staying-healthy/microwaving-food-in-plastic-dangerous-or-not

N.G.
October 23, 2017

Heating the fruit in a PLASTIC container in the microwave is NOT a good idea.

Monique Tello, MD, MPH
October 24, 2017

Happy to address this– the containers we use at home are BPA and dioxin-free, FDA-approved microwave-safe. I am not worried about leached carcinogenic plasticizers from microwaving foods in these products. I agree with you that not all plastics are microwave-safe, and one needs to read labels/ check the safety information. You can read more about plastics and microwaves on this recently updated article from our site: https://www.health.harvard.edu/staying-healthy/microwaving-food-in-plastic-dangerous-or-not

Marc Fleisher
October 23, 2017

Can I assume that cereal with no added sugar, such as shredded wheat or certain brands of wheat squares, are good?

Monique Tello, MD, MPH
October 24, 2017

Weeellll there’s the whole processed carbs concern. Our body handles whole grains better. Oats — minimally processed ones, meaning, not instant packets with all the extra sugar! Can be fine. If you do cereal, I suggest adding alot of fruit and protein/ healthy fats.

Ruth Robinson
October 23, 2017

You don’t mention oatmeal. Please comment on oatmeal with fruit for breakfast

Monique Tello, MD, MPH
October 24, 2017

Oats are a whole grain! Add plenty of fruit, some protein and healthy fats, and that is a good breakfast. I suggest making the fruit the star of the show, however.

karin
October 23, 2017

don’t like yogurt….tried many times…any other options?

Monique Tello, MD, MPH
October 24, 2017

Nuts and seeds have protein and healthy fats. Eggs are a solid source of protein, if you eat eggs.

Thomas Turk
October 23, 2017

OJ for vitamin C? Fresh supermarket oranges have been measured with 0 vitamin C., which is highest when the fruit is freshly picked, at the end of a sunny day and then eaten! Precise bio-resonance testing has shown the CD4, CD 8 and CD14 leucocytes are fully revved-up with 3000mg of Vitamin C. (60 ‘fresh’ oranges). Clark H R, PhD ND 1995. Animal studies show that when we are sick we need up to 5X that much vitamin. I blend 1/4 complete pomogranate for several mins to get 3 gms of Vit C (+ a tablespoon of raw peanuts for the also needed germanium and selenium)

Pasteurized milk has had 90% of the phosphatase enzyme needed for calcium absorption destroyed. Cream and butter synthesize Vit.B6, B12 and folates in the gut, these needed to lower artery-clogging homocysteine. Malhotra S L, Dr. The Lancet. Pub.11X.

Over eating? Calories/portion size don’t count!! It’s the carbs that fatten. Digested carbs 1st top up muscle and liver glycogen, the rest rapidly converts to body fat in the mitochondria. Homeostasis mechanisms alter metabolic rate depending on what, when and how much is eaten. Thermic effect is bone structure dependent. Atkins R Dr. Passwater R PhD. ‘Human Physiology’, Vander MD, Sherman Luciano. U of VA.

Cholesterol is essential for life. Reduced intake compromises cell membranes, (those 40% cholesterol) allowing easy entry for DNA smashing dyes, metals, virus etc Clark PhD ND 1995. Plus needed for vitamin A and D synthesis , stress and sex hormones precursor etc.

Sodium. The kidneys control sodium within 2% whether 50mg or 25 gms is eaten. (Human Physiology) Commercial salt is heated to 1200C , the body does not recognize it, rapidly increasing BP in the sensitive. Only evaporated sea or mountain works well. Too little sodium is dangerous..

What no eggs.. with their phosphotidyls serine and choline for young and old brains, their anti-oxidants.. selenium, l-cysteine etc. that normalize LDL, stopping inflammation that leads to artery calcification from this cause?

There’s a whole world of alternative nutrition outside of Harvard Med School that is totally ignored, sorry Monique.

BTW at 80 I have clean arteries as shown by a high speed cam during a freebie heart scan.

Patricia Mullan
October 23, 2017

Understand and respect your expertise. But what then do you recommend??

Steven Marshall
October 23, 2017

From what I have read:

Monique Tello, MD, MPH,
YES to a bulk of whole-foods plant-based diet, then macros of other proteins/good-fats/good-oils
At least the berries v fruit are better for fibre, antioxidants, low-sugar-sucrose
This post is on Harvard. ed so think about reviewing/updating this article

Richard Harding, well OFF the mark… read the others.

Thomas Turk, YES, good post, well done 80 y/o

Mary V, YES YES fermented probiotics, not the dairy type..
.
Eyton Shalom, L.Ac. YES There are a few things I would also use from the Ayurvedic and Chinese Medicine standpoints.

Charles Crumpton, YES keep “trying to stop the Soy plate”

Gale NO

Sharon, YES, spike, and no mention of cinnamon splinkle to try help

Carol, YES breakfast eggs and spinach yes, with some good oils/fats, then similar protein/veg/good-fats-oils macros

Too much sugars and carbs are causing damage/diabetes/inflammation and leading to other complications…

Fats and whole foods (but be aware of grains), in moderation, are your functional friends, fermented foods as opposed to dairy also

Monique Tello, MD, MPH
October 24, 2017

Thanks for all your researched suggestions, and good to hear that you are in excellent health!

Mary V
October 23, 2017

Advice from a friend who equates good eating habits with healthy mind and body, (She’s a psychologist), says kefir offers more substantial probiotics than yogurt. (Also, kimchi and sauerkraut-fermented pickled foods having better health benefits in G.I. tract)

Monique Tello, MD, MPH
October 24, 2017

Yes, probiotics are important!

Charles Crumpton
October 11, 2017

Cholesterol, other high lipids, and blood sugar generally have a common cause, overeating.
The body has food priorities to ensure survival in the worst of times.
energy to keep going and stay warm
Build and repair damage
Store for lean times.

In the old days, there was seldom to much food available. For survival the body attempts to use everything we eat. As we know, fat is the number one and visible result. However excess food give the liver freedom to run wild and make to much cholesterol. Why? A small amount of cholesterol is needed in the human reproductive process. To keep this level in lean times there needed to be a little extra in our system to guarantee the survival of the human race. Now, there are no lean times in the USA but the liver does not know this so it keeps on adding to the overage overloading the need.

Cholesterol does not metabolize into energy so after going on the doctor recommended diet and exercise program expect results to be slow. It may take 9/12 months to reach healthy levels.

I was under the care of Dr. Evan Stein. My Chol. was 260 I entered his program of diet and exercise and 90 days later I was down to 258, heartbroken and convinced I had a heredity problem. He did the test-Negative. Dr. Stein told me to stick with what I was doing. 6 months 238, and then the 9 month check was a beautiful 180 and at years end 150. A 110point drop along with 20 pounds and 6 inches off the waist.

Larry Alpert
October 23, 2017

Tell me more. I’ll do it!

Thomas Turk
October 23, 2017

Loads of cholesterol folklore from Charles. Cholesterol is essential for life. In 1974 Drs. R Atkins MD,  and Richard Passwater PhD debunked the cholesterol myth, that based on the faulty 1953 study in Framingham MA, USA.  Cholesterol  makes up 40% of your double cell membranes in your trillions of cells. The more cholesterol in your diet the more integrity in the cell walls to stop carcinogenic dyes, heavy metals, viruses etc. entering cells to damage DNA.  (Clark H R, PhD ND, 1995). The nerves are sheathed in cholesterol. The sex and stress hormones need cholesterol as their base nutrient. Vitamins A and D need cholesterol for their synthesis. My last medical was a freebie in Hawaii in 1979 at a Fitness and Health conference. The doc said.. all is normal. I ventured that I ate up to 10 yolks a day, globs of butter and the fattest meat I could find. He said.. you’re joking of course. I wasn’t.

Monique Tello, MD, MPH
October 24, 2017

Good to hear that you’re in such good health!

Eyton Shalom, L.Ac.
October 11, 2017

There are a few things I would add from the Ayurvedic and Chinese Medicine standpoints.

First is that digestion is a warm process. Eating frozen cold foods damages the digestive fire which does not respond well to cold, especially when cold outside. . This is why all traditional cultures eat warming cooked foods for breakfast, from hot soy milk and left over rice with egg, vegetables and meat, or congee in China to steamed rice and lentil cakes Iddli and Sambar lentil and vegetable soup in South India.

Most fruit is cooling (raspberries are an exception, as are peaches), so to us, the amount of fruit recommended here might be a bit extreme and also too much sweet food at once. Fruit in Chinese Medicine and Ayurveda is generally recommended on its own, as well, as opposed to with yogurt. Mango Lassi aside, which is a between meal desert drink in hot dry weather, most yogurt eating cultures from Russia to Sri Lanka do not take yogurt and fruit at once, if anything they tend to drink their yogurt, Kefir style, with herbs and spices or plain. In India yogurt can be had at breakfast but its diluted with water and spice. Otherwise its taken at noon, when digestive fire is maximum.

Although frozen fruit does contain all the vitamins of fresh fruit, one thing missing in frozen foods is Qi. Compare a frozen peach to a fresh one, or even frozen banana to fresh. What’s missing is the aroma, the fragrance, the texture, the juiciness. Those are all evidence of what Chinese medicine calls Qi, like the steam rising off of freshly cooked rice. ,. Same thing with frozen organic t.v. dinners versus fresh made food. One fills the room with a wonderful fragrance, the other does not.

Yogurt is quite heavy and Kaphagenic in Ayurveda, which makes it unsuitable in the morning for folks with problems of mucus, like chronic asthma or sinus infections. They can have yogurt mixed with water and spices like cumin powder to increase digestability. This is called “buttermilk” in South India.

Since digestion is a process of warm transformation of food into energy, in Ayurveda we protect the digestive fire/Agni with judicious use of spices and herbs. In the case of fruit-nuts-yogurt, this is basically a sweet dish still. So it needs to be balanced with spices like ginger, cardamon, and cinnamon that stimulate gut fire to deal with the slightly cloying nature of that much sweet food at once.

We definitely do not recommend mixing green veggies like kale with sweet food like fruit. Kale and hearty greens are best cooked, in soups and stir fries or Indian style. Not overcooked, but cooked. Its cooking that breaks down the cellulose in vegetables. Some nutrients in vegetables are better absorbed when cooked, like carrots. Cooking with spices like cumin and coriander increase digestability. In fact hot soup is a great breakfast in cold weather, miso soup, or dal with rice or whole grain bread.

Myself, being a cold, thin, dry Vata type in Ayurveda, I like to make very low sugar “breakfast cookies.” Here’s one way, using dried Chickpeas and Nuts http://new.bodymindwellnesscenter.com/roasted-chickpea-nut-breakfast-cookies/

Chris Lazarus
October 23, 2017

I had seen an ayurvedic practitioner 20 years ago – diagnosed as vata (with some pita) but am not the thin, dry type (but I do everything fast, have nightmares of running away, keep very irregular schedule. ALso I have one kapha problem – sinus congestion). Now I am 65, still working part-time, and would like to know what ayurveda recommends for breakfast that is NOT sweet. As I have gotten older, I crave more savory/salty — not much sweet. American breakfasts are always so sweet. I am also trying to lose 15 lbs (would bring me back to the weight recommended by my ayurvedic MD who is now 3,000 miles away). I love eggs and nuts and grains, have very high HDL and am vegetarian/almost vegan (except for eggs and cream in coffee/tea — which I know as vata I should not drink, but feel so much better when I do).

Monique Tello, MD, MPH
October 24, 2017

Thanks for your thoughtful input!

Charles Crumpton
October 10, 2017

When we wake, our bodies are dehydrated, out of protein, carbs, and the entire system is full of junk that needs to be eliminated. The lymph system has been working hard all night and needs to cleaned and refreshed. Heart rate and breathing is low creating slow flowing low oxygen blood.
I am 77 and very active inspire of triple bypass and type 2. along with 6 back surgeries. I kept active after each. Getting up in the morning the day starts with 3 cups of room temp water. 30+ minutes of steady exercise. Shower and enjoy high protein cereal with protein Silk soy milk topped with 1/4 of walnuts and 1/2 banana. 1 cup of coffee ,stevia, trying to stop that, do a little exercise every 2 hours to circulate lymph fluids, diet is a no brainer. Salad with vinegar and oil with spinach, broccoli, etc. Small servings fish or baked chicken, No bread or potatoes. Drink pure water.
30 mins plus on treadmill watching 6PM news. Remember, all excess food will be processed into something resulting from survival needs of the past.
Providing the liver with extra food to play with can be dangerous in more ways than fat. Those of us who have type 2 or heart problems, must fight hard each and every day to control bad and promote the good. DIET AND EXERCISE DIRECTLY FIGHTS DISEASE INCLUDING SOME CANCER BY CREATING AND CIRCULATING IMMUNE AGENTS STARTING IN THE SMALL INTESTINES AND FLOWING THROUGH THE LYMPHATIC VIENS BY MUSCLE CONTRACTIONS ONLY!!!! weight loss and looking good is just a side benefit.
Charles Crumpton FB
.

Monique Tello, MD, MPH
October 11, 2017

Yes, a healthy lifestyle is good for just about everything! Kudos to you for being an excellent example for us.

Thomas Turk
October 23, 2017

Triple bypass equals total ignorance of the well documented causes of arteries calcifying. If you’ve left it late, explore EDTA a safe amino acid, protein, that even your body manufactures. EDTA cleans out 25miles of arteries and has 19 other GOOD side effects. Oral version is cheap takes 6M, IV is expensive and faster. but needs a friendly doc as it’s normally only prescribed for lead poisoning.

When we wake, our bodies are not out of anything.. still digesting last nights meal and all the food still in the gut that takes 2 days to transit and absorb.

Soy Milk? Only fermented soy is safe., that’s high in Vit K2. Open Soy alert, Westin Price. 9 harmful ingredients.. ie trypsin blocks protein absorption, etc etc.

Gail
October 10, 2017

I’ve read that recent studies show that dairy fat is not harmful in the way that fat from beef, pork, etc., is.

Monique Tello, MD, MPH
October 11, 2017

Agreed, but there is still some conflicting data. I love love my dairy, so truthfully, I hope the evidence shakes out on the side of yogurt.

Sharon
October 10, 2017

Three and half cups of fruit seems to be too much in one setting. Wouldn’t this spike your blood sugar a bit?

Monique Tello, MD, MPH
October 11, 2017

The fiber in the fruit plus the protein and healthy fats offset any sugar/ insulin spikes. The vitamins and antioxidants of the fruit also provide great health benefits.

Nancy
October 8, 2017

Can you mix a bit of water with the fruits?

Monique Tello, MD, MPH
October 11, 2017

Of course!

Monique Tello, MD, MPH
October 6, 2017

Hi Lisa, I’m happy to report that this is a healthy breakfast for people with diabetes. It’s not carbs that are the issue, it’s the type of carb. Refined carbs (flours and sugars) are associated with the development and worsening of diabetes. On the contrary, here we have abundant plant carbs in their natural form, as nature intended for us to consume. A whole-foods plant-based diet has been shown to be quite effective for the prevention and treatment of diabetes. For an excellent review on this topic see a recent research article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/
The authors also cite plenty of prior research, concluding: “There is a general consensus that the elements of a whole-foods plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of refined foods and animal products—are highly beneficial for preventing and treating type 2 diabetes. Equally important, plant-based diets address the bigger picture for patients with diabetes by simultaneously treating cardiovascular disease, the leading cause of death in the United States, and its risk factors such as obesity, hypertension, hyper-lipidemia, and inflammation…. While larger interventional studies on plant-based diets carried out for longer periods of time would add even more weight to the already mounting evidence, the case for using a plant-based diet to reduce the burden of diabetes and improve overall health has never been stronger.”

Chris Lama
October 23, 2017

What should Type 1 diabetics eat then?

Thomas Turk
October 23, 2017

Diabetes2. …There is a general consensus that the elements of a whole-foods plant-based diet—legumes, whole grains,.. Not quite.

All grains are high in lectin plant phenols, chemicals that desensitize cell membranes to insulin, causing insulin over production. Grains are also high in leptin plant hormones that interrupt signaling between the liver and pancreas, causing insulin disruptions. These 2 cause obesity and diabetes2.

Wheat and most other grains raise blood sugar. A slice of organic whole wheat bread raises blood sugar more than a candy bar.

Those on a zero grain and zero sugar diet have ‘kicked’ diabetes2 in 2weeks to a month!

Carol
October 6, 2017

I usually have a egg/spinach casserole for breakfast and your fruit/nut/yogurt bowl for my lunch or supper. Works for me!

Thomas Turk
October 24, 2017

Spinach is high in oxalic acid that blocks calcium absorption, and inflames kidneys. Intake should be 0. Yoghurt/Kefir should be eaten on waking when the stomach acid is neutral so as not to destroy most of the friendly bacteria. One of the main functions of the stomach acids is your 1st line of defense against bad bacteria, but it also whops the good. The acid also starts protein digestion breaking the larger bonds.

Lisa Paige, MBA, RDN, CSOWM
October 6, 2017

Thank you for making nutrition a priority. This does look like a healthy breakfast, except for someone who must control blood glucose such as a person diagnosed with diabetes. The foods in this breakfast combine to make a very large carbohydrate load. Please continue to provide nutrition guidance and consider the CHO content too. Thank you.

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