What is the best eating schedule? Three meals, many meals or even fasting? Reviewing common diet patterns and what may work best for YOU.

Question

It seems the “experts” are always changing their minds on what and when we should eat. Eat this. Don’t eat that. Stop eating that thing we told you to eat last year and eat this instead. Eat 3 meals a day. Eat 6 meals a day. Fast one day a week. Do intermittent fasting 3 times a week. Never eat after 5pm. Don’t skip breakfast. Actually it’s ok to skip breakfast. But don’t forget, breakfast is the most important meal of the day! My goodness, it’s enough to make your head spin.

A recent study (see link below) suggests eating within a 10-hour window each day may be ideal for reducing weight and metabolic disease. They don’t talk about the pattern within that window, but simply limiting the hours in which calories may be consumed. Interesting.

This adds to the piles of research and opinions around when to eat. Are you confused about the ideal eating pattern for you? Are you confused by all this talk of meal timing and intermittent fasting? If so, read on to break down some of these common suggestions. Hopefully you can come to an understanding of what sort of meal schedule will optimize your health and allow you to reach your goals, whether that’s weight loss, balanced blood sugar, improved mood, etc.

schedule

First of all, there is no ideal pattern for everyone. Let’s get that straight. The ideal eating times for you are those that work with your schedule and lifestyle. I’ve seen many eating patterns that work for people, from the regular 3 meals a day to 2 meals per day + snack, or 6 small meals, etc. The only reason to change a pattern is if it isn’t working for you or is clearly an unhealthy one (which usually you know if that’s you).

Before we even get too far, let me say up front I am not a fan of the 6 small meal per day sort of schedule. First of all it’s often quite stressful for people to be able to remember to eat as many time as they need do. Say you have a small breakfast before work but can’t take a break to eat 2 hours later because of a big meeting? Now you are starving and prone to make poor choices later in the day.

Also, blood sugar rhythms tend to follow a 3-4 hour cycle. When you eat a meal, typically, your blood sugar peaks about 1-2 hours later. Then it slowly comes down over the following couple hours and you gradually become hungry again. Now, if we are constantly fueling every two hours, our blood sugar is never given a chance to return as low as it should between meals. Granted a smaller meal is going to have a smaller blood glucose rise, but the point is that we aren’t following the natural rhythm of our glucose cycles.

Additionally, longer spaces between meals are really great for our digestion. I know I have written about this before, but we have this wonderful process in our small intestine called the migrating motor complex, or the MMC, for short. It’s role is to sweep clear the small intestine and increase motility, allowing things to move along and digest as they should. Thing is, this process only takes place about 60-90 minutes after eating, in a semi-fasted state. And it needs some time to work. If we are eating every two hours, we keep shutting this process down. For some, this sets them up for indigestion and bloating, and can even lead to microbial imbalances. Better meal spacing can help support the MMC and keep our digestion plugging along as it should.

Lastly, many of my clients who have tried the 6 mini-meal schedule are in actuality just snacking all day. Yes, it’s all small stuff, but it becomes a nonstop snack party. Many of those “snacks” are a lot higher in calories than one thinks, and instead of increasing energy and losing weight, it becomes an easy way to gain weight. Frustrating for many, to say the least.

snacks

Clearly I’m not a fan of eating multiple mini meals throughout the day. In my opinion, a 4 hour spacing (or 3 at the minimum) seems ideal. This solves many of the aforementioned issues and tends to fit well for our normal wake/sleep cycles.

What might this type of schedule look like. Certainly it can very, but let’s take an example from one of my days:

7am – Breakfast: 1 fried egg, 1 piece whole wheat toast w/ almond butter, honey, cup of black coffee
12pm – Lunch: Leftover beef and bean chili (1.5 cups) with 2 tbsp guacamole, 1 tbsp sour cream, a sprinkle of grated cheese, 1 orange, water.
3:30 – 4pm – Snack: 12 almonds, 1 banana
6:30pm – Dinner: 2oz baked chicken breast, 1 cup Puttanesca (spaghetti, sauce with anchovies, tomatoes, olives, garlic) ½ cup roasted broccoli, water.

You can see the spacing varies (and it does from day to day), but the goal is at least 3.5-4 hours between meals most of the day, with the evening meal being the least spaced given I can’t always control the exact timing of dinner (kids and hubby have a big say in that!). THIS is the schedule that works for me. You may decide to follow the same principles, but the exact execution may look different. That is a-ok.

Then the next question is, what about fasting or intermittent fasting?

Ah, great question. There is so much swirling around about restricted eating patterns to help you lose weight and even increase longevity.

Look, I have been reading this stuff too, and I won’t say that it doesn’t work. I am sure fasting has many amazing benefits. It is supposed to improve fat burning, boost the immune system, reduce the risk for cancer, raise growth hormone levels, improve brain function, and a host of other claims. It’s likely true. We see some of these in rat studies as the one previously mentioned.

There are various iterations of these fasting schedules. Some fast one day per week, others fast more than that, and others will have mini-fasts one time per week up to several times per week.

The real question with any of these is, is it realistic? Is this something you can stick with? Is this reasonable for your lifestyle and your family? If not, it’s just another fad that will leave you back at the same place you started. Think hard before you decide to go for these types of diets. Again, I’m not saying don’t do it, because the health benefits may be just what you need, but think hard about whether this is a change you want to keep for the forseeable future.

One tactic I personally employ is the same as hinted at in this article, a semi-restricted eating schedule that limits the hours of consumption. I think of it as “night” fasting. By increasing the hours without eating between evening and morning, you can achieve some of the same benefits of fasting and even help reduce weight, at least per this recent study. Also, this tends to cut out eating after dinner which for many is a huge calorie save right there. Per the article, this type of “fasting” can improve metabolism and reduce metabolic disease (reduce cholesterol, balance blood glucose, improve blood pressure, etc).

But the question is, is this realistic? I think for most it is. It’s a hard choice limit eating at certain hours (those cravings can be no joke!) but you can make that choice and stick with it, especially in the evening when work is over and most importantly, kids are in bed!

Not sure this is actually doable? Check out this schedule:

9am: breakfast
12pm: lunch
3pm: snack
6:30pm: dinner (goal of being done by 7pm)

OR:
7am: breakfast
10am: Snack
1pm: Lunch
5pm: Dinner

As you can see in both of these examples, the spacing is slightly less than the 4-hour window, however with the increase space between dinner and breakfast, you likely get many of the benefits as the article describes.

Remember my eating schedule as depicted earlier? You can clearly see that is not a 10-hour window there. I have implemented more of a 12-hour window. I have cut out any evening eating and made sure breakfast is time 12 hours after dinner. Maybe not as great as the article supports, but that’s where I am at!

Hopefully this slightly long-winded discussion gives you some points to ponder in figuring out the “right” plan for you. Whatever your health goal may be, meal spacing and limited eating hours during the day may be just what you need to start seeing the results you are looking for!

*If you have diabetes or any other condition that may require more rigid eating times, please do discuss any changes to your current diet with your medical practitioner first!

1. https://www.sciencedaily.com/releases/2018/08/180831130131.htm

Personalized Nutrition: There is No One “Right” Diet for Everyone

personalized nutritionIt seems everyone has an opinion on nutrition these days. It’s not even so much of an opinion anymore but a sort of dogma. “Thou shalt eat this way or risk ones health irreparably.” You read it all over the internet and magazines every day. There is always someone spouting the “real” healthy diet we should all be eating. For the average person, these diet wars are frustrating and confusing. To make matters worse, some of these seemingly healthy diets can be downright harmful, especially if someone is already at high risk for chronic disease.

The truth is, we are learning more and more about biochemistry every day, and what we are finding is that everyone’s body responds differently to different foods.  Part of this is genetics, part of it is diet, and part of it is a host of other factors such as lifestyle, environment, and even a person’s particular microbiome.

A recent study published in Cell Magazine provided great insight into this.1 Entitled “Personalized Nutrition by Prediction of Glycemic Response,” it looked at the glycemic response among subjects eating similar food items. They had 800 non-diabetic participants who agreed to eat a particular breakfast containing 50g of carbohydrate every morning for a week while having their blood glucose continuously monitored. The researchers look at post-prandial (post meal) glucose in the morning but also evaluated their blood glucose levels the rest of the day while eating their normal diets.

Surprisingly, many subjects responded very differently to the exact same breakfasts. When it came to other foods later in the day, there were stark differences as well. Some saw huge spikes in glucose after high carb foods such as ice cream or bread, while others showed only a modest increase.

While it was interesting that so many differences could be seen between the participants with the very same foods, it was also interesting to note that the glucose response within a particular individual remained constant, ie if they ate the same meal the next day, their blood glucose response would be roughly the same. The researchers could even start to predict what their post-prandial blood glucose would be based on the choices they made.

This really got me to thinking. For years we’ve been told by the American Diabetes Association how to educate Diabetics on their diet. If you’ve ever been in my office you may have heard me talk about carb counting, glycemic index, and balanced meals. It is a one-size-fits-all approach. Diabetics can have 45-60 grams of carb per meal, for example, and we usually talk about healthy ways to stay within those guidelines. While these still have their place, it’s clear the particular foods one chooses to meet those guidelines, and in fact even the guidelines themselves, are not set in stone.

That point has been made to me many times sitting in my office, listening to clients tell me how one bite of rice sends their glucose levels through the roof. Then another client tells me rice is fine, but heaven forbid if they have even a smidge of potatoes. First off, despite what my training told me, I believed them. I believed that for one of my clients rice was a huge no-no while for others it was not. While the standard ADA guidelines were no doubt helpful, I started to realize my approach had to change. I needed to understand my clients better to know how to direct them. I also needed them to understand their bodies so they could tell me what foods worked for them and what foods weren’t right, despite what the “rules” said.

I’m glad I believe this before there was solid scientific proof to make the case, as going by intuition has helped me help my clients make better choices. Now thankfully we are starting to see the science bear this out, explaining why one person reacts a certain way to particular foods or nutrients while another reacts the exact opposite. While much of this is genetic, we are also seeing that a person’s unique microbiome plays a huge role in how nutrients are utilized, even to the point of affecting body weight. Then of course there is stress, environment, exercise, and other lifestyle factors that play a role. It is so complex, and we have just scratched the surface.

Apart from Diabetes, there are also other conditions affected in varying ways by diet and lifestyle. Cardiovascular Disease is one such example. One particular way of eating may raise unhealthy cholesterol in one individual but have no negative effect in another.  Exercise might improve lipid profiles in one person but do nothing for another. Again, the one-size-fits-all diet approach has to be re-thought.

Admittedly I am still learning a lot about this as well, especially in regards to testing and corresponding diet recommendations. There are more and more tests coming on the market claiming to decipher your genetics and make diet-based recommendations for you. The challenge lies in understanding which tests are of value and worth the hefty price tag that often come with them.

For now, if you feel a particular diet is not for you, listen to your body. What your neighbor or coworker or family member eats may not be the best plan for you. Tell those Paleo fanatics to pipe down. Continue to keep tabs on your health (regular check ups, routine exams, etc) and if anything negative turns up, pay careful attention to your diet as a first step. You may want to consider additional testing as well to help guide that diet. A Functional Dietitian, such as myself, can be a great help in that area.

Clearly personalized nutrition is here. The idea of diets that work for everyone is on its way out. Healthy diet is still key, but how that looks may vary. Make the best educated choice for yourself and tune out the rest.

1. http://www.cell.com/cell/fulltext/S0092-8674(15)01481-6

Image courtesy of stockimages / FreeDigitalPhotos.net

Is Instant Oatmeal Evil?

OatmealAs I was pouring myself a packet of instant oats a few months back, topping it with scalding water and then other condiments, I got to thinking of a headline I’d read somewhere online about how seriously unhealthy instant oats were for you. I didn’t actually read the article, but the message stuck with me: somehow instant oats are bad. Bad like doughnuts? Bad like high fructose corn syrup? Bad like TV dinners? I wasn’t sure. I just knew that someone (and in fact many) had deemed it unhealthy. I bookmarked it in my brain to loop back around to that topic sometime in the future.

Well sometime in the future is now, and I’ve done quite a bit of reading about the ominous oat and its supposed character flaws. For example, instant oats are “high on the glycemic index.” Instant oats are often “full of added sugars and additives.” Its’ friendlier counterparts, Old Fashioned rolled oats and Steel-cut oats are lower glycemic and are typically purchased plain, eliminating those pesky added sugars and such. The winner seemed clear.

Now first let me say I was once a purist. I almost never purchased instant oatmeal because frankly I loved the taste of freshly simmered oats, especially when mixed with milk and stewed ripe banana or combined with home-canned peaches and roasted walnuts.

Then … I had kids. Kids do not care that good, wholesome food takes time, especially when they are infants and need you 24/7. They seem to care even less when they are two and wake up hungry, ready to consume anything they can find unless you put breakfast in front of them promptly (and they will find things, let me tell you). I went from slow cooking old-fashioned oats once or twice a week to going almost two full years without stirring a single pot of oatmeal over my beloved gas stove. I became “that” mom, chucking packets of instant oatmeal in bowls and praying the water would boil faster so we could eat and avoid meltdown or alternatively avoid destruction of my house while I was otherwise occupied with breakfast duties.

So I became an instant oatmeal junkie. But was that bad? I still wasn’t sure, even as a Dietitian. I mean yeah, I get the glycemic index argument. It measures the effect of a single food on our blood sugar level. High GI foods raise your blood sugar more quickly than other foods. White bread, for example, has a high GI. Quinoa, a whole grain, has a much lower GI. Whole oats are low-moderate in terms of GI, however instant oats are in the high GI category.

What GI doesn’t account for is what you eat it with. If you eat a bowl of plain, instant oats, the GI is fairly high. Not as high as white bread or white rice, but still high because it’s been broken down, “pre-digested” if you will, making the carbohydrates readily utilized by your body (and readily cooked by scalding hot water instead of 20+ minutes of cooking!). However, the GI changes if you eat those oats with other foods that take longer for the body to break down. Think nuts, seeds, fruit, etc. Once all that mush hits your stomach at once, it now takes longer for all that carbohydrate to hit your blood stream. Essentially, you can mitigate the high GI of oats by eating it with lots of protein and healthy fats.

So, while I agree that traditional rolled oats or steel cut oats are better for you and better for your blood glucose, let’s not demonize instant oats so quickly. What about those people, say new moms with demanding babies, or people who must wake up at some insanely early hour for work, or even teenagers who don’t have the desire or let alone knowledge to sit at the the stove for nearly half an hour stirring a pot o’ porridge? Clearly food combination is the key, and frankly that is the missing point in many articles that call out instant oats for being blood-sugar antagonists.

Maybe you are now saying “Alright, instant oats are a go! Where is my kettle?” Not so fast. Quality still counts. Remember that criticism that instant oats are loaded with sugars and additives? That part is very true. You have to read labels. Most instant oatmeals ARE loaded with extra freebies to improve your taste adventure, as those companies would likely call it. Often they add sugar, dehydrated fruit, and stabilizers such as guar gum in addition to coloring and synthetic vitamins. That added sugar can raise the GI even further and almost certainly make you feel hungry well before lunch time rolls around.

So next time you reach for that instant oats packet, make sure you add some healthy protein, fat and fiber to decrease the GI. Here’s a quick list of things I add, in various combinations, to my oatmeal:

Flax Seed
Chia Seed
Hemp seed
Chopped nuts (almonds, walnuts, pecans, etc)
Nut butter

And here is example of what my bowl o’ oatmeal often consists of:

1 packet of Maple Nut instant oatmeal by Natures Path
2 Tbsp Flax seed
1 Tbsp Hemp seed
¼ cup blueberries
2 Tbsp chopped, toasted Pecans
(and sometimes I even have a scrambled egg on the side which adds even more protein!)

You see? Now you don’t have to feel bad about your secret instant oatmeal fetish. It’s ok. Just pick up a few extra ingredients on your next Trader Joe’s run and you’ll be set. Then … enjoy!

Image courtesy of antpkr / FreeDigitalPhotos.net