It’s been drummed into us that breakfast is the most important meal of the day, but new research suggests we may be better off skipping it altogether. In the wake of his own type 2 diabetes diagnosis, Professor Terence Kealey – an Oxford-educated biochemist and author of Breakfast is a Dangerous Meal published by HarperCollins – noticed his glucose levels were unusually high after eating first thing in the morning. If he continued to fast until lunchtime, however, they fell to a normal level.
His research flies in the face of some of the most widely adopted habits around starting the day in a healthy way. Indeed, instead of providing a nourishing boost, everyday breakfast choices such as cereals, toast and muffins are under the spotlight for sending blood sugar levels soaring and triggering us to consume even more calories over the course of the day.
Down with breakfast?
While Prof Kealey makes a compelling case, the jury is out on whether ditching breakfast is the answer for everyone.
“Everyone is different and while skipping breakfast may work for some, it’s not ideal for others. Take the link between the prevalence of diabetes in the UAE, for instance, and the culture of fasting during Ramadan, when people often find themselves putting on weight. What this research does help to highlight, however, is how making healthier food choices in general could help to reduce the risk of diabetes and related obesity,” says Rabia Cherqaoui, consultant endocrinologist, Mediclinic Welcare Hospital who reviewed the research. “I see lots of people who are overweight and struggling to lose the pounds and, after some investigation, the common culprit is being stuck in a vicious cycle of a diet that’s high in refined carbohydrates, which sends blood-sugar levels soaring, leading to an energy crash a couple of hours later and craving yet more sugary foods to feel better again. Of course, the journey starts at the breakfast table, but it continues throughout the day.”
Cherqaoui estimates that one in two patients she sees is borderline diabetic. “This metabolic condition, also known as prediabetes, is when a patient’s blood sugar levels are not yet high enough to be considered diabetes,” she explains. “It is closely linked to obesity and, if undiagnosed or untreated, it can develop into type 2 diabetes. The problem is that many people have prediabetes but are completely unaware of it. This is because the condition often develops gradually without any warning signs or symptoms. In many cases, the sufferer only learns of their borderline diabetic state once the symptoms of type 2 diabetes start to appear.”
With the number of diabetics in the UAE expected to hit 2.2 million by 2040*, raising awareness of this ‘silent’ condition, and how it develops, could help those at risk to kick bad habits into touch before they spiral out of control.
“There are several blood tests to screen for prediabetes,” says Rabia. “The oral glucose tolerance test (OGTT) in particular, like you receive in pregnancy, coupled with Insulin Response testing enables us not only to measure the body’s ability to process glucose but also to detect early stages of insulin resistance. This is easy to carry out and gives us the best indication as to whether a patient is affected.”
Start as you mean to go on
If you do find yourself on the borderline, the good news is that taking positive steps to improve your diet and lifestyle can help lower your risk of developing type 2 diabetes – and help you drop those excess pounds at the same time.
“Many people opt for cereals and juice to start the day,’ says Rabia. “Although heavily marketed as being healthy, most cereals are, unfortunately, highly processed foods loaded with added sugars, which is just like eating a candy bar for breakfast. It will spike your blood sugar and insulin levels, creating a vicious cycle of overeating and making it extremely difficult to stay a healthy weight. It’s much better to incorporate more brunch-type foods such as eggs or other protein- and fibre-rich foods at breakfast time to slow the digestion, increase feelings of fullness and reduce appetite. In turn, when you aren’t ravenously hungry, you’ll feel more in control of your food choices throughout the rest of the day.”
It’s something nutritionist Caroline Bienert agrees with: “In the morning, the body is detoxing, which means we should have a light, alkaline breakfast so we don’t disturb this natural process,” says Caroline, who works between Dubai, London and Munich (carolinebienert.com). “To avoid blood glucose levels soaring, throw out simple sugars and opt for herbal tea and fresh lemon juice, pure vegetable juice and cereals made from quinoa or buckwheat with fresh fruit, nuts and almond milk.”
It’s all about re-educating ourselves about what is ‘acceptable’ to eat upon waking and, crucially, looking beyond what you can find in the breakfast aisle at the supermarket.
“If we are used to having miso soup for breakfast, as is common China, then we would, so don’t be afraid to step outside your comfort zone,” says Caroline. “Of course, if we have a healthy breakfast, but a very sugary lunch, dinners and snacks in-between, then we’re more likely to experience cravings during the day and in the evenings, so it’s important to carry on this low-sugar approach by avoiding refined carbohydrates and processed foods in the long run.”
If you think you could be stuck in a sugar trap, see a doctor to be tested. Whatever the result, and, with some common sense and creative thinking, turning breakfast on its head could be one of the best things you’ve ever done for your health.
Take the test
You should consider being tested for prediabetes if you:
- Are overweight or obese.
- Have a close relative (parent or sibling) who currently has or has had diabetes.
- Have high blood pressure, low HDL (‘good’ cholesterol) or high triglycerides.
- Are over the age of 40.
- Have given birth to a baby who weighed over nine pounds (4kg).
“I burst into tears when i found out it wasn’t my fault”
An Aquarius reader tells about being diagnosed with insulin resistance:
“I have always been fit and healthy, but a few years ago I started to gain weight. Nothing seemed to stop it. I put it down to having an injury and not being able to exercise, but even after I recovered I couldn’t shift the pounds. I had been to see doctors who all told me I had a thyroid problem and to eat less and exercise more, which was frustrating as I knew deep down that wasn’t the issue.
“Through a chance conversation with a friend over lunch, my friend commented on how little I was eating. I said I was too scared to eat as I just kept gaining weight. My friend mentioned that she had been seeing a doctor for weight control and gave me the details. It took me weeks to pluck up the courage to go. I thought I was going to be put on a really low calorie diet and be told to double my exercise. I couldn’t have been more wrong.
“The clinic was really friendly. They did a body analysis, asked questions about my lifestyle, and then sent me for a blood test. It was the blood test that flagged up what was wrong – my body is highly insulin resistant and I was headed toward diabetes.
“I burst into tears when the doctor told me that it was a medical issue not a diet/exercise issue and that if I hadn’t been watching what I ate, or exercising the way I had been, the problem would have been much worse.
“Now I work with the dietician on what I can and can’t eat (you can eat far more than you think you can). I have to completely avoid all sugar, carbohydrates and lactose, which isn’t far off what I was doing before. I’m on medication to treat the condition and hope to get to the stage where the medication is no longer necessary.
“The clinic monitors you and are there for you every step of the way. It feels as though the weight of the world has been lifted from my shoulders – finding out that I wasn’t doing anything wrong and it was beyond my control was huge. Nothing that I was doing was working to get back to where I was comfortable with my body and I didn’t know why.
“I had been getting really self-conscious and had been at the stage where I was too embarrassed to leave the house and I’d avoid social situations. Now I happily eat everything I can and leave what I can’t. Just knowing what works for you and what doesn’t makes it easy. Thankfully I have the most supportive group of family and friends, which has helped.
“I still go to the gym and exercise, but the difference is I feel like I’m achieving something now. I no longer avoid social situations, I sleep better. I’ve lost 13kg since October and I’m loving rediscovering my wardrobe. I feel like
I’m back in control of my body.”
Five ways to a healthier breakfast
A healthy, well-balanced breakfast should be based on the main food groups and provide you with about 20-25 per cent of your daily nutritional requirements. Follow these top tips from the Imperial College London Diabetes Centre in Abu Dhabi…
- Avoid sugary cereal. Bread, cereals, rice and other starchy foods provide you with energy, B vitamins, iron and fibre. Choose wholegrain varieties when possible to boost your fibre and nutrient intake and avoid cereals that are coated in sugar.
- Add some protein. Opt for meat, fish, eggs and legumes for protein, iron and vitamins. Choose lean meat cuts and avoid high-fat foods such as processed meats and fried eggs. Choose healthy cooking methods such as grilling or poaching instead of frying.
- Say “yes” to dairy. Add some milk and dairy foods for more protein, calcium and B vitamins. Choose low-fat or skimmed milk and dairy foods. If you are not having cereal, drink a glass of milk on its own, have a cup of yoghurt or spread low-fat cheese or labnah on bread. If you are allergic to dairy, go for non-dairy alternatives such as spinach, kale, baked beans and canned sardines.
- Seek out fruit and vegetables. They are good sources of essential vitamins, minerals and fibre. Add peppers, broccoli, mushrooms or tomatoes to your egg or egg white omelette, or add strawberries or blueberries to your cereal or toast.
- Stay hydrated. Include a drink with your breakfast, such as water, milk or pure vegetable juice.
*Imperial College London Diabetes Centre in Abu Dhabi
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