Is it good to start the day with a coffee? Should you eat protein before carbs? What about drinking wine before or after a meal?
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Gerry Gajadharsingh writes:
“One of my lovely patients asked me to comment on this recent article with the title of the “New Rules on how we should eat (not what we should eat)”.
I make comments on the following:
If you’re drinking wine drink it as part of a meal, rather than before or after eating (unless you consume a small amount of protein before drinking the wine to minimise the effect of sugar)
The recent research on how drinking coffee first thing in the morning can often lead to a spike in sugar after eating breakfast is something I would tend to agree with.
I am a big fan of yoghurt in particular sheep milk yoghurt, not cows’ milk yoghurt, which tends to have a higher Beta Casein profile which is quite pro inflammatory. Although their recommendation is to eat yoghurt before your meal, often I’d suggest it to patients as a good healthy breakfast in conjunction with a small amount of fruit.
Eat protein before carbs, something that we’ve been recommending in Metabolic Balance for many years and so I would agree with that as it tends to lessen the sugar response. What doesn’t make sense to me is that paragraph above that one, which is talking about eating vegetables before the protein. I think they’re forgetting that all fruit, vegetables and starch are carbohydrates. People often think that it’s just starches that are carbohydrates. The idea is that if you start your meal with protein it tends to manage your blood sugar better.
Chew each mouthful of food for 30 seconds this concept has been around for many years and is really helpful.
It’s fine to drink some water with a meal but I wouldn’t overdo it.
Sit down to eat a meal and stand up to digest it, absolutely.
Eat three hours before intense exercise, this makes sense, but they slightly spoil it by the usual advice about carb loading before intense exercise. Many sports people who I’ve supported through Metabolic Balance find that they don’t actually need to do this if their metabolism works properly.”
As if thinking about what we should be eating isn’t stressful enough, scientists are increasingly coming up with rules about how we should consume food. And, indeed, what we should drink with it.
For instance, researchers from Tulane University in New Orleans recently presented findings to the American Heart Association’s epidemiology and prevention, lifestyle and cardiometabolic health conference that suggested if you want a glass of wine, it is probably best to drink it with a meal, rather than before or after eating.
In their study of nearly 312,400 adults from the UK Biobank, all described as regular but moderate drinkers — typically imbibing the equivalent one glass of wine or other alcoholic beverage daily for women and up to two glasses daily for men — they found that consuming alcohol, most notably wine, with meals is associated with a lower risk of developing type 2 diabetes over 11 years.
Over the course of the study, about 8,600 of the participants developed type 2 diabetes, but drinking wine with meals rather than without food was associated with a 14 per cent lower risk of the condition because of how alcohol affects blood sugar.
Alcohol interrupts the processes involved in the production of glucose and insulin, one of the hormones needed to regulate it, raising the risk of low blood sugar, or hypoglycaemia, which causes light-headedness and fatigue.
Advice from the charity Diabetes UK is that people with type 2 diabetes should “avoid drinking on an empty stomach, as this will quickly increase the amount of alcohol in your bloodstream”. However, the latest findings suggest having wine with meals might reduce the risk of getting the condition in the first place.
“The message from this study is that drinking moderate amounts of wine with meals may prevent type 2 diabetes if you do not have another health condition that may be negatively affected by moderate alcohol consumption,” said Dr Hao Ma, a biostatistical analyst and the study author.
Drinking with a meal slows the rate of absorption of alcohol by the body, says Ian Marber, a nutrition therapist. “Food helps to regulate the metabolism of alcohol so that the sugars in something like wine don’t have such a dramatic effect on blood sugar,” he says. “And the proteins, fats and fibre in food also help to slow down the absorption of the alcohol so that it is processed more slowly, meaning fewer of the after-effects.” Here’s how else you should be eating and drinking:
Don’t kick off the day with a coffee
If you head, bleary-eyed, for the coffee machine as soon as you wake up, it’s a habit you might want to consider changing, particularly if you have had interrupted sleep. Researchers at the University of Bath’s Centre for Nutrition, Exercise & Metabolism showed that drinking black coffee in an attempt to wake you up can have a negative effect on blood sugar control. In the British Journal of nutrition, the lead author Professor James Betts reported that slugging a coffee first increased the blood glucose response to breakfast by about 50 per cent, causing a sugar spike. “Blood sugar control is impaired when the first thing our bodies come into contact with is black coffee, especially after a night of disrupted sleep,” Betts says. “It’s better to eat something first and then drink coffee later if you need it.”
Eat yoghurt before a meal
Low in fat, rich in calcium, protein and gut-friendly bacteria, plain natural yoghurt is a great addition to your diet for many health reasons. And the best time to eat it could be before a meal, according to food scientists at the University of Wisconsin-Madison. Women participating in the trial, half of whom were overweight or obese and the rest a healthy weight, were asked to start with either a 226g dish of plain yoghurt (there’s usually 150g per small carton) or a non-dairy dessert followed by a large high-fat, high-carb breakfast of two sausage muffins and two hash browns, totalling 900 calories. This was designed to stress their metabolism to its limits. Results showed that not only did the yoghurt starter improve biomarkers of gut inflammation as the hefty meal was digested, but in overweight participants it helped reduce post-meal blood sugar spikes that, over time, “may help reduce the risk of cardiovascular and metabolic diseases”, the researchers said.
Eat green and orange vegetables before meat and fish
Selecting certain foods before others from your plate could make a difference to your health and weight. From a plate of meat or fish and green or brightly coloured vegetables, it is the veggies that should be eaten first. In a study of children those who ate the meat or fish at the start of a meal were found more likely to be overweight than those who stabbed vegetables with their forks first. And a Japanese study revealed that adults with type 2 diabetes who ate vegetables first had better blood sugar control. “Vegetables contain fibre which fills you up and helps to regulate blood sugar,” Marber says. “It makes sense to consume them first, although you’d need to do this every day for a significant effect.”
And eat protein before carbs
Put potatoes, rice, pasta and bread on the back burner until you have consumed the lean meat, fish, eggs, cheese or tofu on your plate. Researchers at Weill Cornell Medical College in New York suggest that the worst time to eat carbs is at the beginning of a meal or on an empty stomach, especially if you have type 2 diabetes or pre-diabetes, meaning your blood sugars are higher than they should be.
Twice, on separate days a week apart, participants were asked to consume carbs — in this case ciabatta bread and orange juice — before or after eating a protein-rich meal of skinless grilled chicken breast with a side serving of lettuce, tomatoes and cucumber. Results, published in the diabetes care journal, showed that eating carbs at the end, rather than beginning, of a meal led to significantly lower blood glucose levels. Other beneficial effects were seen for insulin, which was reduced, and the gut hormone glucagon-like peptide-1, known to reduce appetite, which increased. “Some carbs are broken down rapidly in the body and this produces blood sugar spikes,” Marber says. “Protein foods can help to slow this process if consumed first.”
Chew your food methodically for 30 seconds
Rushing food is a known route to indigestion, but researchers have also shown that chewing food thoroughly can help with weight loss and with prevention of metabolic syndrome, a cluster of symptoms including raised blood pressure and blood sugar, excess body fat around the middle and raised cholesterol levels, that put you at risk of heart disease and type 2 diabetes. Last year, in a paper published in Scientific Reports journal, a team from Waseda University found that in people who chewed their food once a second for 30 seconds, blood flow in the splanchnic celiac artery, which supplies blood to the digestive organs, also improved, resulting in better digestion. They also used up a greater number of calories metabolising the food. “While the difference in energy expenditure per meal is small, the cumulative effect gathered during multiple meals, taken over every day and 365 days a year, is substantial,” says Professor Naoyuki Hayashi, a researcher in the faculty of sports science who led the trial.
It’s fine to drink water with a meal
Your mother may have told you to avoid drinking water with a meal because it dilutes digestive juices, interfering with good digestion, and even prevents the body from absorbing nutrients properly. One of the few studies to look at the effects of ingesting water while eating showed it had no effect on the rate at which solids were moved from the stomach. “Your digestive system is highly attuned to adapting its secretions to fluids and foods,” Marber says. “Unless you drink several glasses of water with each meal, it will have little or no impact on digestion.”
Sit down to eat a meal, stand up to digest it
Eating your lunch on the run or grabbing a sandwich when there is standing room means you will likely eat faster and savour the food less, according to a team of psychologists from the University of South Florida reporting in the Journal of consumer research.
For their trial they asked 358 participants to rate enjoyment of a meal as well as the physical and psychological stress levels they felt while eating it sitting or standing in a laboratory setting. Those who ate while seated said they enjoyed their meals more. But once you have finished eating it is best to stand up and move around.
Men who lie down after eating took 54-102 per cent longer to digest their food than those who sat, stood up or moved about in one study. Those who walked around digested their meal most quickly, an average five-minutes faster than the sitters. “The differences in digestion while eating is minimal whether you sit or stand but moving about after you’ve consumed a meal is important for both digestion and blood sugar control,” Marber says.
Eat three hours before intense exercise
Planning meals around your workouts isn’t always straightforward. “Eating a meal too close to exercise can result in discomfort and indigestion as blood supply is diverted away from the digestive system to your muscles,” says Anita Bean, a dietician and the author of The Complete Guide To Sports Nutrition (Bloomsbury). “But leaving it too long can mean you start intense exercise feeling hungry and lacking energy.”
Bean says the consensus from studies is that performance in moderate to high-intensity workouts lasting 35 to 40 minutes is improved if you eat a moderately high-carb, low-fat meal three hours before. “Researchers at the University of North Carolina and at Loughborough University have shown that eating a carb-rich meal three hours before an activity, such as running or cycling, boosts endurance capacity by as much as 9 per cent compared to eating nothing,” she says. “Toast with nut butter, bananas or porridge and wholegrain cereal are all good options.”