September 2011 Issue

Rise And Dine! — A Breakdown of Breakfast’s Benefits With Experts’ Best Meal Suggestions
By Juliann Schaeffer
Today’s Dietitian
Vol. 13 No. 9 P. 44

We’ve all heard time and again that breakfast is the most important meal of the day, yet convincing the majority of Americans to make this meal top priority sometimes can seem like an impossible task.

According to a recent Kellogg survey of 14,000 people across the United States of various ethnicities, income levels, and geographic regions, slightly more than one-half of all adults said they’d like to eat breakfast every day, which seems to indicate people understand the value of cereal with fresh fruit, or even bacon and eggs.

However, only one-third of respondents found time to fit breakfast into their busy schedules, suggesting that more than information is necessary to buck the trend of missing this all-important meal. To help clients fit breakfast into the chaos of daily life, you’ll need strategies that will make it easier for them to prepare and eat this essential morning meal.

Keren Gilbert, MS, RD, president/founder of Decision Nutrition, says she’s heard every excuse regarding why people can’t get breakfast on the table most days of the week. “The top excuse is that there isn’t time,” she says. “The next is that they’re just not hungry. These are simply excuses. If you want to live healthfully, you have to make a commitment and always have some quick and healthy grab-and-go breakfasts on hand,” she often tells clients.

Giving specific examples to patients about why breakfast is so essential to their well-being can help. Here, experts break down breakfast’s benefits and offer their best meal suggestions and strategies for how clients can overcome the obstacles standing between them and the paramount morning meal.

Breakfast’s Benefits
Joan Salge Blake, MS, RD, LDN, a clinical associate professor at Boston University and an American Dietetic Association media spokesperson, says everyone can benefit from eating breakfast more often—and the sooner, the better. “Developing the habit of eating breakfast may help children and adolescents better manage their weight in their youth and instill a healthy habit that can be carried over into adulthood,” she says.

According to the 2010 Dietary Guidelines Advisory Committee Report, research suggests that children and adolescents who don’t eat a regular breakfast are at an increased risk of overweight and obesity. This can lead to an increased risk of, among other ailments, heart disease and type 2 diabetes, both of which are among the leading causes of death in Americans today.

“Rising and dining could be the best way to start the day and prolong your life,” Salge Blake says.

Some experts say the morning meal can benefit individuals in a multitude of ways, from jump-starting their metabolism to improving mood.

• Metabolism and weight: Megan Moore, RD, LD, CDE, of Aramark at Baylor Regional Medical Center at Plano, Tex., says eating breakfast regularly is in the best interest of your clients because it kick-starts their metabolism. “During the night when we’re sleeping, our metabolic rate runs slowly and conservatively, but once we’re awake, our bodies need to speed up and break out of its fasting metabolic state,” she explains.

This metabolic boost can help clients avoid weight gain. “Breakfast isn’t a meal to skip when trying to keep metabolism healthy and if you’re trying to lose or maintain weight,” Gilbert says. “Your metabolism slows down as you sleep, so there’s nothing like a healthy breakfast to jump-start it for the day.”

Moore says the National Health and Nutrition Examination Survey, which examined the diets of 4,218 adults, showed that breakfast eaters were more likely to have a BMI under 25.

Gail C. Frank, DrPH, RD, CHES, a professor of nutrition and nutritional epidemiologist at California State University Long Beach, agrees and refers to National Weight Control Registry data, which she says clearly show breakfast as a major reason individuals lose and maintain weight.

• Healthier diet: Research shows that people who eat breakfast more often also seem to have healthier diets overall, Moore adds. “There are many studies showing the relationship between breakfast eaters and a healthier nutritional intake,” she says. “People who eat breakfast are more likely to incorporate their recommended servings of vitamins and minerals each day and are less prone to overeat in the evening.”

Moore says cereal is one reason for this. “Specifically, those who eat cereal for breakfast tend to consume more vitamins and minerals per day,” she explains, referring to the fact many ready-to-eat cereals are fortified with additional vitamins. “Furthermore, we usually add milk and fruit to our cereal bowl as well, which increases the vitamins and minerals even more.”

“People who eat breakfast regularly get more vitamins, minerals, and other nutrients in their diets,” Gilbert says, “because there are wonderful food choices to include in this meal that are nutritionally dense, like fruit, whole grains, and lean proteins.”

• Fiber intake: Amy Hendel, R-PA, a physician assistant, host of Food Rescue, and a United Soybean Board Soy Connection expert, says breakfast can be the perfect vehicle for fiber, of which many Americans don’t get enough. “When you’re dealing with a populace that falls short of daily fiber requirements, recommending breakfast as a healthy habit and including berries, whole grains, vegetables or, in some cases, beans in a morning meal, you have a far better chance at achieving fiber goals,” she says.

To that end, Hendel likes to recommend clients add edamame or other bean varieties to omelets, egg scrambles, and breakfast wraps.

Gilbert also believes breakfast is a great time to include high-soluble fiber, but she advises clients against looking for this nutrient in cereals alone: “I tell clients to be aware that the amount of soluble fiber in one bowl of cereal often is less than 1 gram. To reap the benefits of lowering cholesterol, I recommend at least 3 grams of soluble fiber.”

Instead of the usual cold breakfast cereal, she recommends oatmeal and a cup of strawberries to reach this goal.

• Alertness and concentration: “Studies have found that eating breakfast may enhance memory, improve cognitive ability, and help increase attention span,” Salge Blake says.

Stabilized blood sugar could be the reason behind these benefits, according to Moore. “Because we’ve been fasting for eight to 12 hours, our blood sugar is low first thing in the morning, and low blood sugar results in lack of concentration, alertness, and energy,” she explains. “When a person’s blood glucose is low, they’ll feel lethargic, irritable, drowsy, restless and have difficulty thinking or recalling information,” adding that eating first thing in the morning can prevent these symptoms.

Gilbert adds that many nutrients are said to aid in brain development, memory retention, and concentration, so incorporating these into morning meals could achieve these results. Omega-3 fatty acids, a breakfast addition favorite of Gilbert’s, found in walnuts and chia seeds, is important for brain development.

“Some studies point to correlations between vitamins B and C and higher intelligence test performance,” Gilbert explains. “This makes sense, especially since vitamin C is required to make brain neurotransmitters. So berries, oranges, and grapefruit are all great breakfast sides. In addition, choline is a vital vitaminlike substance that’s important for the creation of memory cells. This can be found in egg yolks and nuts. Protein helps us to stay focused, so it’s also an important part of breakfast. Many nutrient-filled breakfasts are available that contain these important nutrients.”

• Mood: A better breakfast also can make for a better mood, Salge Blake says. “Research suggests that eating breakfast, specifically carbohydrate-rich cereals, can improve your mood. Eating in the morning after a night’s slumber will provide glucose to your starved brain,” she says, adding that most people “are also likely to be happier and less grouchy when [they] aren’t distracted by hunger pangs.”

Boon for Kids, Pregnant Women, and Seniors
In addition to these benefits, which apply to everyone, eating breakfast can be even more worthwhile for children, pregnant women, and older adults.

• Children and youths: Gilbert says eating breakfast has special significance for children and adolescents. “According to the American Dietetic Association, children who eat breakfast perform better in school and on the playground. They have better concentration, problem-solving skills, and eye-hand coordination,” she says.

“Children need specific nutrients in specific amounts on a daily basis to support adequate growth and development,” says Deirdre Pizzoferrato, RD. “But the key is making it a healthy and balanced breakfast. Research suggests a breakfast that includes a source of protein and whole grains and is low in sugar and artificial additives improves concentration, comprehension, and memory recall in school-age children. In addition, studies have shown that children who eat a balanced breakfast have more stable energy levels, which has a direct effect on mood and behavior.”

According to Hendel, studies have found that breakfast cereal in particular helps get nutrients into children who might otherwise miss out on certain crucial vitamins. “Breakfast is the optimal time to get calcium and vitamin D-rich milk or soymilk, which also contains calcium and vitamin D, plus fortified cereal, waffles, or bread and a fruit group into your child’s body,” she says.

Hendel adds that a balanced breakfast also can help kids avoid dips in blood sugar, which can contribute to poor concentration in the classroom. “And a balanced breakfast can help kids avoid hyperactivity or irritability due to significantly variable blood sugar levels,” she notes.

• Pregnant women: Breakfast is crucial for pregnant women, who are supporting the additional calorie needs of a growing fetus. For this population, “Breakfast is a vital meal to start the day with the proper balance of calories and nutrients,” Hendel says.

Specifically, breakfast can boost calcium and folic acid intake, both of which are imperative to a healthy pregnancy. Women who are pregnant require a higher-than-normal calcium intake, since a growing baby leeches calcium from their bones; plus folic acid helps prevent neural tube deformities.

“The folic acid issue is important when you’re either considering pregnancy or have an accidental pregnancy occur,” Hendel says. “So eating a balanced breakfast regularly maintains a healthy woman’s body as she even contemplates pregnancy, which is hugely important.”

Breakfast for this population, however, is key for other reasons as well. Pizzoferrato explains that prolonged fasting during pregnancy, such as longer than 12 hours, can have immediate and long-lasting effects on a developing fetus.

“Because a fetus relies on the nutrients obtained through the mother’s diet for development, a prolonged habitual fast can result in slow growth and preterm labor,” she warns. “In addition, research suggests that during the early stages of development, influences in the fetal environment could trigger genetic changes in order to adapt to life outside the womb. In this scenario, habitual fasting could interfere with a fetus’ normal metabolic programming in order to ‘adapt’ to the perceived threat of not having enough food in their outside environment.”

Pizzoferrato says extreme examples of such epigenetic changes have been studied in the offspring of women who were pregnant during wartime or in periods of famine. “Through cohort studies, researchers identified similar metabolic anomalies in glucose-insulin metabolism of the adult offspring, leading to obesity and diabetes,” she continues. “While skipping breakfast may not guarantee the same course of events for the child, permanent changes in metabolic programming can’t be ruled out.”

As an added benefit, Frank says including a starch at breakfast can reduce bouts of nausea, which is common for many pregnant women.

• Older adults: Because we lose our sense of taste as we age, which often prevents us from getting the adequate nutrition we need, “a tasty simple breakfast made with whole foods, such as fruit, whole grains and eggs, or calcium-rich plain yogurt can be essential in helping older adults meet their vitamin and mineral goals,” Hendel says.

“I also believe meeting protein goals are of particular importance in older adults, so a handful of roasted soy nuts or tofu marinated in a favorite sauce would be another great option,” she adds.

Moore explains older adults often eat less food at one sitting, which can hinder adequate caloric intake even further. “If they skip a meal, it can be hard to make up those calories later in the day,” she says, adding that older adults tend to have a bigger appetite early in the day, which is yet another reason to increase breakfast options for seniors.

What’s more, eating breakfast can assist older adults in taking the medications they may need in the morning as well as regulating bowels and stimulating taste buds, Frank explains.

Prep for Hectic Days
While clients may give many reasons for not eating breakfast, experts say lack of time is chief among them. “Ironically, people claim they don’t have time in the morning to eat breakfast,” Salge Blake says. “Truth be known, breakfast is one of the easiest meals to eat healthfully. The supermarket aisle is chockfull of whole grain cereals just waiting to be drenched with skim milk. Add a piece of fruit and you have the easiest meal preparation for the day.”

For clients armed with a list of excuses, offer some specific ideas and suggestions for how easy and attainable a regular breakfast routine can be.

Salge Blake says a healthy breakfast should contain a combination of nutrient-rich carbohydrates, such as whole grains; fruits and veggies; some lean dairy; and a smidgen of fat.

The key, Gilbert says, is planning so that foods amenable to the morning routine are readily available when needed. “If you have the grapefruit, berries, or apple [in your refrigerator], you’ll most likely have them with your oatmeal, cereal, or eggs,” she says. “If you have fresh vegetables, you’re more likely to whip up a veggie omelet. Preparation should be a top priority when you want to include fruits and vegetables in your meals. You can’t eat them if they’re not available.”

Hendel goes one step further and recommends that clients prep ingredients ahead of time—in bulk—so a week’s worth of meals are ready when the morning comes and the busy day begins.

Clients can add presliced and cut veggies to omelets and sliced fruit or tomatoes to the more time-consuming and less-healthful hashbrowns, says Silvia Veri, RD, nutrition supervisor at Beaumont Health System’s Weight Control Center in Royal Oak, Mich.

One of Gilbert’s make-ahead suggestions: morning gazpacho. “I have clients that enjoy adding some spice like horseradish. Consider it a healthy bloody Mary concoction and a great way to start your day with some raw veggies and zest,” she says.

Hendel recommends homemade muffins as a great on-the-go breakfast if clients can find the time to make them before the busy workweek starts. Fruit purées, ground nuts, and berries are all easy additions that can increase the nutritional composition of this breakfast fix. (See Wholegrain Flax and Berry Muffin recipe below.)

Some clients simply refuse to accept that cooking is an option early in the morning. For them, completely portable options they can grab and go and consume on the run may work best. Veri likes yogurt and yogurt smoothies as a convenient and portable protein option. “Anyone can run out the door with that in addition to a Kashi chewy granola bar for their carbohydrate serving and a banana for their fruit—all convenient and portable,” she says.

Individual portions of carbs such as Bear Naked cereals or Nonni’s Biscotti Bites pair well with Veri’s protein-packed Breakstone single-serving cottage cheese containers. You can substitute waffles as the carb, and instruct clients to use them as sandwich slices for peanut or other nut butter with bananas, Hendel suggests.

Clients also can premake yogurt parfaits “and add some additional protein by blending low-fat silken tofu with low-fat or fat-free yogurt in a plastic cup. They can layer berries, high-fiber cereal, and ground nuts,” Hendel says.

For the minimalist, Gilbert’s best breakfast suggestion is simple: an apple and a hard-boiled egg. For those who claim to have no time, she tells them, “Your breakfast doesn’t always have to be a whole production in order to get the benefits.”

Veri suggests clients hard-boil a carton of eggs at the beginning of the week to have one less worry in the morning. If clients don’t like apples, a whole wheat English muffin and another type of fruit will suffice.

Clients bored with regular breakfast fare can eat a wrap with mashed avocado or beans, low-fat shredded cheese and shredded veggies, or a homemade veggie pizza.

“Sometimes I have people flip breakfast and dinner, especially if they have a very long school- or workday,” Veri says. “A veggie burger or salad with grilled chicken or soybeans may sound crazy in the morning, but it works for some people, allowing for a lighter ‘breakfast-type’ dinner.”

Mornings can be especially hectic for moms, so Gilbert likes to suggest a meal similar to McDonald’s popular Egg McMuffin. “Take an egg and microwave it for 2 minutes in a mug that’s covered and place it in a high-fiber English muffin,” she explains. “You can top the egg with a slice of low-fat cheese for added calcium.”

To get kids more excited about breakfast, Hendel recommends an unlikely mealtime hero: edamame. “Kids love finger foods, so I recommend edamame mixed with high-fiber cereal on a child’s high chair tray—protein plus whole grain carbohydrates,” she says. “They love popping the pods or you can buy already shelled beans.”

Whether edamame or hard-boiled eggs, advise clients to serve themselves whichever mealtime hero is likely to make a more regular appearance on their morning plate.

— Juliann Schaeffer is an associate editor at Great Valley Publishing Company and a regular contributor to Today’s Dietitian.


Weekly Breakfast Meal Plan

• Monday: Frozen whole grain waffle, toasted and topped with low-fat cottage cheese and sliced fresh strawberries; 4 oz orange juice

• Tuesday: 4 oz peach Greek yogurt with 1 T chopped walnuts mixed in; hot tea

• Wednesday: Old-fashioned oats (prepared as directed) with diced fresh fruit and sliced almonds; 8 oz low-fat milk

• Thursday: Smoothie, prepared using skim milk, frozen berries, vanilla protein powder, and ice

• Friday: 1 cup high-fiber cereal with diced bananas and skim milk; coffee

• Saturday: Egg white and turkey sausage breakfast burrito with whole wheat tortilla, topped with fresh salsa; 4 oz orange juice

• Sunday: 1 whole egg plus 2 egg whites, scrambled with diced peppers and tomatoes; 2 slices whole grain toast topped with 100% fruit jam; 8 oz low-fat milk

— Provided by Megan Moore, RD, LD, CDE

Wholegrain Flax and Berry Muffins

1 cup whole wheat pastry flour
3/4 cup all-purpose flour
1/2 cup brown sugar, packed
1/4 cup flax seed meal
2 teaspoons baking powder
1 teaspoon baking soda
1/4 teaspoon salt
1/2 cup soybean oil
1 cup buttermilk
1 egg, beaten
1 teaspoon vanilla extract
11/2 cups blueberries, frozen

Streusel topping
2 tablespoons all-purpose flour
2 tablespoons brown sugar, packed
1 tablespoon soybean oil

Prep time: 10 minutes
Cook time: 20 minutes

Preheat oven to 375˚F. Paper-line or grease 12 muffin cups.

Combine flour, whole wheat flour, brown sugar, flax meal, baking powder, baking soda and salt in medium bowl; set aside. Whisk buttermilk, soybean oil, egg and vanilla in large bowl. Pour into flour-mixture and stir until just blended. Stir in blueberries until just blended. Spoon batter into prepared muffin cups, filling 3/4 full.

Mix Streusel Topping ingredients in small bowl. Sprinkle over portioned muffins.
Bake for 18 to 22 minutes until edges and tops are golden.

Nutrition Per Serving (1 muffin)
240 Calories, 4 g Protein, 30 g Carbohydrate, 2 g Fiber, 12 g Fat, 2 g Sat. Fat, 0 g Trans Fat, 20 mg Cholesterol, 280 mg Sodium

Created 2010 by Joy Blakeslee, RD; recipe courtesy of the United Soybean Board,

Berry-nana Soy Smoothie

1 cup vanilla soymilk
1 cup frozen blueberries or frozen berry mix
1 banana, sliced
1 tablespoon soy protein powder
1/2 cup ice cubes
1 teaspoon honey (optional)

Prep time: 3 minutes

Puree all ingredients in blender on high until smooth. Serve immediately.

Nutrition Per Serving
150 Calories, 7 g Protein, 27 g Carbohydrate, 4 g Fiber, 2.5 g Fat, 0 g Sat. Fat, 0 g Trans Fat, 0 mg Cholesterol, 80 mg Sodium

Recipe courtesy of the United Soybean Board,

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