Pros and Cons of the most Popular Trends in "Healthy" Breakfast Recommendations
These days, it’s easy to get lost in the nutrition noise put out on the Internet. One day you’re told fat is the devil and the holy grail of food is whole grains, and the next everyone has jumped on the Keto bandwagon and are tossing in their cereals for eggs and bacon. The truth is, there’s really not a “one size fits all” approach to nutrition. You have to weed through all of the trends, look at the latest research, and take a good look at your own habits and preferences to determine what is best for you.
Luckily, I’ve done much of the research for you. Here, I’ll outline the pros and cons for three breakfast “trends,” which you can use to decipher the best plan of action for yourself. After all, isn’t breakfast the most important meal of the day? Maybe not, if you’re a proponent of intermittent fasting… but we’ll get there.
#1: Eat fruit for breakfast on an empty stomach.
This is an age-old idea that dates back at least over 800 years ago when suggested by Maimonides, a doctor and Jewish philosopher in Egypt. He claimed that fruit should only be eaten in the morning or on an empty stomach. He believed that if you eat fruit after meals or combined with any other food, the fruit will be delayed in digestion and “spoil” in your stomach, therefore producing gas and other intestinal discomfort. However, although this theory is not based on scientific evidence, there does seem to be some benefits to eating fruit in the morning.
Many people often state that they are not hungry in the morning, or they are unable to stomach big quantities of food. Fruit is “light” and is often more palatable to people in the morning than heavier foods.
Fruit is easily digested. Fruit is comprised of mostly simple sugars (namely fructose, sucrose, and glucose) that is absorbed directly into the blood stream to be used by the body for energy. A study published in The Journal of Nutrition found that the addition of berries to an already high-carbohydrate meal actually reduced the amount of insulin needed to maintain a steady postprandial blood glucose level (10). This suggests that although fruit is high in sugars, it has a stabilizing effect on blood glucose.
Any amount of fruit, even amounts considered to be “excessive,” seem to have positive effects on the body. A study published in the South African Medical Journal in 1971 had subjects eating solely fruit juice, nuts, and 20 portions of fruit a day. The study found that the subjects did not have significant changes in their glucose tolerance, and most subjects reported increased stamina and physical performance. Systolic blood pressure also fell significantly. The subjects did lose a small amount of weight initially, but their weight stabilized over time (14).
A 2016 study published in Nutrients showed that fruit contains “anti-obesity factors (1).” Consumption of fruit is inversely correlated to weight gain, which researchers have attributed to the following possibilities: a decrease in total daily caloric intake, prolonged satiety, greater micronutrient and phytochemical intake, and modulation in gut ecology.
The same study mentioned above demonstrates that fruit positively enhances gut microbial activity: “Therefore, the incorporation of fruit in the diet drives the gut ecology toward an anti-obese condition by increasing the prevalence of lean-type bacteria but reducing that of obese-type bacteria (1).” Additionally, as your gut houses 70% of your immune system, maintaining a healthy balance of bacteria ensures a healthy immune system, helping to regulate and calm inflammation throughout the body.
One of the antioxidants found in many fruits known as polyphenols, have been shown to positively impact blood sugar (18) and our hunger hormones (19). This reinforces that fruit does not behave the same way in the body as processed flour and sugar; in fact, these refined carbohydrates have the opposite impact on insulin and hunger hormones.
A study published in the European Journal of Nutrition in 2001 found that individuals who self-reported consuming higher amounts of fruits and vegetables had lower mean HbA1c measurements than those who seldom or never ate fruits or vegetables (21). It is unclear if this is either a result of the fruit or the vegetables conferring benefits or somewhat of a “healthy user bias.” Therefore, this does not mean people should eat fruit with abandon.
One might think since fruit is high in carbohydrates, those who consume a high fruit diet would have an increased risk of diabetes. However, a meta-analysis from 2010 in The BMJ found that there is no “significant relations between the consumption of fruits, vegetables, or fruit and vegetables combined on the incidence of diabetes.” (15) The only statistically significant finding from this meta-analysis was that an increase in leafy green vegetable consumption is associated with a 14% decrease in incidence of diabetes. These studies demonstrate that fruit may not be exceedingly beneficial or damaging in regard to the development of disorders that impact blood sugar, like diabetes. Alternatively, increasing leafy green vegetable intake may have more of a preventative effect.
Those who struggle with blood sugar control may want to reconsider a carb centered breakfast such as fruit, which has a tendency to cause spikes in blood sugar compared to a protein centered breakfast.
A high-carbohydrate, low-protein meal is associated with more fatigue than higher protein meals (11). In addition, high-protein breakfasts are slightly more effective in sustaining performance and cognitive abilities than those primarily high in carbohydrates.
A breakfast high in sugar could wreak havoc on your adrenal system, potentially leading to HPA-axis dysfunction (directly impacting our energy). Meals higher in carbohydrates, such as a breakfast comprised of just fruit, significantly increases cortisol secretions when compared to meals higher in protein and fat (12). An excess of cortisol can ultimately lead to HPA-axis dysfunction due to a negative feedback loop that signals the adrenal glands to “turn off” as a protective mechanism to avoid excessive cortisol from dampening the immune system. This adrenal insufficiency ultimately leads to low cortisol output and symptoms of fatigue and hypoglycemia; these symptoms can encourage people to continually eat refined sugars and carbs.
Because fruit contains simple sugars that are absorbed directly into the blood stream, people may not feel satisfied for very long after consuming fruit. Carbohydrates are also the least satiating of the three macronutrients (protein is the most satiating followed by fat and then carbs. Pay attention to how you are feeling. If you are hungry soon after you eat, you may need to change up your breakfast.
The Bottom Line: If you’re someone who can’t tolerate a “heavy” breakfast, then opting for fresh, local, seasonal fruit for the first meal of the day could work well for you. There is no need to fear fruit, as it will not cause you to gain weight (when part of a balanced diet) and its phytonutrient and fiber content confers tremendous health benefits. If you’re someone who struggles with blood sugar control, you may want to stick to lower-sugar fruits such as berries, and avoid higher-sugar fruits like mango and banana. And remember; always listen to your body. If you become ravenous soon after eating fruit in the morning, you may consider eating a more substantial breakfast with some satiating proteins and fats.
#2: A high-protein breakfast with low carbohydrate intake.
This recommendation is primarily based off of the concept of macronutrient satiety. The most satiating macronutrient is protein, followed by fat, and then carbohydrates. By starting the day off with a protein-heavy meal, you will stay fuller longer, leading to fewer cravings and decreasing the likelihood that you will binge later. If you’ve ever eaten a bowl of Frosted Flakes or a similarly sugary cereal with skim milk for breakfast, you probably remember feeling ravenous just an hour or two later. This is because the cereal and skim milk offers very little (if any) protein or fat, and the simple carbohydrates are used up quickly in the body.
As I stated before, protein is the most satiating of all of the macronutrients; this will leave you feeling fuller for longer than if you had started your day with a carbohydrate heavy meal. A 2015 study published in Obesity found that a high-protein breakfast prevents “body fat gain, voluntary reductions in daily intake, and reductions in daily hunger” (2) in adolescents who previously skipped breakfast.
A low-carb, high-protein breakfast may be great for people with blood sugar control issues. A 2018 study published in The British Journal of Nutrition found that postprandial blood glucose and insulin decreased significantly in type-2 diabetics who ate a carbohydrate-reduced, high-protein meal, compared to those consuming a conventional diabetes diet (3).
Most of us believe that it’s best to eat carbs earlier in the day so that our bodies have time to “burn them off”. However, a fascinating study showed that you reap more benefits by consuming a low-carb, high-protein breakfast and waiting to eat most of your carbs for dinner (4). Specifically, subjects experienced more weight loss, satiety and improved metabolic markers when they followed this dietary pattern as opposed to eating small carb-based meals throughout the day. When you eat carbs at night, it is believed that hormonal changes occur, especially in regard to leptin, which signals our satiety. Interestingly, it’s extremely common for people to go most of the day feeling great without carbs and then crave them in the evening. This further emphasizes the need to listen to our body instead of fighting against its signals.
As stated earlier, a high protein breakfast has also shown to enhance cognition and decreased fatigue over a high-carb breakfast (11).
In general, preparing protein-rich foods requires more time and preparation than traditional carbohydrate-rich breakfast foods. You may feel like you don’t have the time to warm up a skillet for eggs and you’d rather just pour out some Fruit Loops or grab a few pieces of toast and jam.
For people who have difficulty stomaching food first thing in the morning, protein-rich foods are often too “heavy” and seem unappetizing to eat.
It is easy to skip the fruits and vegetables when you’re eating a plate of eggs and bacon – so, often times people are missing a great source of phytonutrients from greens and other plant foods if they have a protein rich meal.
The Bottom Line: Research has shown that a high-protein breakfast is the best way to stay satiated throughout the morning, preventing excess snacking later on in the day. Make sure you give yourself adequate time in the morning to prepare your protein-rich meal, or prep a large batch at the start of the week so preparation isn’t an issue. Also, make sure you are consuming plenty of vegetables and fruits throughout the day to ensure you’re getting adequate nutrients.
#3: Intermittent fasting
Did anyone ever tell you to eat every 3 to 4 hours in order to keep your metabolism revved up? Or maybe you’ve heard that if you go an extended period of time without eating, your body will go into “starvation mode” and store fat. The newest trend to hit the nutrition world is actually a practice that has been around since ancient times. In fact, fasting is an important practice in most of the world’s major religions. Today, intermittent fasting (IF) describes a brief fasting period of between 12 to 16 hours (or more!). Some of us may be doing this without even realizing. If you eat dinner at 6pm and avoid eating before you go to bed, when you wake up at 6am and eat breakfast, you have completed a 12 hour fast. Most fasting only includes water. However, many intermittent fasts allow things like bulletproof coffee (coffee with butter and MCT oil) or very low-carb green juice. Essentially you can have fat but not carbs or protein during the dedicated period of fasting.
IF can help with weight loss and insulin sensitivity. A 2013 study published in The British Journal of Nutrition found that when compared to subjects following a “daily energy restriction” plan (in other words: dieting in the form of reducing their daily calorie intake), those following an intermittent fasting plan saw greater insulin sensitivity and body fat reduction (5).
Prolonged fasting promotes stem cell growth and reverses immunosuppression (17). A study published in Cell Stem Cell in 2014 found that prolonged fasting (48-120 hours) “activates pathways that enhance cellular resistance to toxins and stress in mice and humans,” and leads to “signal transduction changes in long-term hematopoietic stem cells and niche cells that promote stress resistance, self-renewal, and lineage-balanced regeneration.” It is not suggested to fast for such a long period of time. However, some people are using the Fasting Mimicking Diet in the hopes to achieve these same immune benefits; there has been great feedback on this. This is a diet that is done for 5 consecutive days for no more than once a month maximum.
IF improves mental clarity. Intermittent fasting increases the production of brain-derived neurotrophic factor (BDNF), “which increases the resistance of neurons in the brain to dysfunction and degeneration (6).”
IF may promote the growth of new brain cells. A study published in the Journal of Cerebral Blood Flow & Metabolism found that intermittent fasting promotes neurogenesis in patients after suffering from ischemia (lack of blood flow to the brain) (7).
IF has also been shown to improve mitochondrial health, ensuring that dysfunctional mitochondria are destroyed and healthy, robust mitochondria thrive. Mitochondria are known as the powerhouses of the cell and their health is imperative to our whole body’s vitality.
IF has also been shown to modulate the gut bacteria, decreasing obesity.(20)
IF could cause hormonal damage in women if it is not done correctly. A study published in 2013 in PLoS ONE found that intermittent fasting negatively affected reproduction in young rats. The study states, “Significant changes in body weight, blood glucose, estrous cyclicity and serum estradiol, testosterone and LH level indicated the negative role of IF-DR regimen on reproduction in these young animals (8).” However, more research is needed since results from animal studies does not always translate to similar outcomes in human studies.
IF is difficult to maintain in social settings. Many cultures celebrate with food, and IF requires dedication to stick to your eating regime for it to work. Consider if you are willing to sit out on some food-centered celebrations.
There is a delicate balance you play when maintaining a healthy blood glucose level as a diabetic. You should be working with a skilled practitioner who is familiar with IF if you are a diabetic.
Consider what type of physical activity you do, as endurance training is often better suited to intermittent fasting than high-intensity metabolic conditioning (such as CrossFit). A study published in Cell Metabolism in 2016 looked at five separate studies of 39 high-performance endurance athletes, and found that “this unique metabolic state improves physical endurance by altering fuel competition for oxidative respiration” (13). Ketosis offers an alternate substrate for oxidative respiration, and also was found to decrease lactate concentrations. This study suggests that you may reap the most benefits as an endurance athlete if doing IF and keto, as you are utilizing an alternate source of fuel for your athletic endeavors.
For those who are not following a ketogenic diet but are doing IF, it is important to include a source of carbohydrate in your meal, particularly if you are engaging in resistance training and metabolic conditioning-type exercise, such as CrossFit. A study from the European Journal of Applied Physiology found that resistance exercise has been found to improve whole-body insulin sensitivity (16). In this study, muscle glycogen levels decreased significantly after exercise;researchers concluded that “glycogen stores are readily used during resistance exercise and this is likely associated with the reported increase in whole-body insulin sensitivity following resistance exercise.” Therefore, after doing this type of exercise, your body is primed to absorb glucose more readily, and you should replenish your glycogen stores in your muscles with a carbohydrate source and have your meal after you exercise.
The Bottom Line: If you decide to try intermittent fasting, be extra attentive to how you are feeling during the day. You may realize that your energy levels plummet and you may experience other changes due to negative hormonal reactions happening in the body. You should consider working with a trained professional (such as an RD or a physician) if you are a diabetic and considering doing IF, since you will need to pay more attention to maintaining healthy blood glucose levels. IF can be disruptive in social situations, and you’ll have to decide if you want to commit to such a restrictive eating plan.
For all three of the above breakfast options, you’ll have to play around to find the exact match that works for you. You may work with a combination of these three eating plans, depending on how your day-to-day changes and how you are feeling. Know that there is not one “perfect” breakfast, no matter how many health magazine headlines say otherwise.. Listen to your body, adapt and change as needed.