Every year at about this time most of us resolve that this year we are going to do things differently. We are going to lose weight, we are going to get more exercise, we are going to learn a foreign language, we are going to…. The aims involved almost always are desirable and chosen from a list of things that, no doubt, we really should do. All too often, these resolutions also are carryovers from the past year or, worse still, past years. As a result, we may ratchet up the ante, as it were, with a virtual carrot or stick, such as buying new clothes that we intend to be able to wear after carrying out our resolution or taking out an expensive gym membership.

This time around, my suggestion is to remove the pressure and adopt one or more low stress health resolution that may achieve some important goals indirectly. This way, success will come almost as a surprise even as benefits emerge from changes in habits.

Experiments have shown that with identical meals, calories eaten entirely at breakfast can lead to stable or reduced weight whereas the same number of calories eaten at night can lead to weight gain. Never skip breakfast. If you skip breakfast, your body will take this as a sign that you are “starving” and slow down your metabolism. There may be other unwanted effects in the brain. Substituting a cup of coffee and a sweet roll for breakfast is almost as bad as not eating that meal.

Another finding is that eating a relatively high protein breakfast with a significant number of calories tends to reduce the number of calories consumed at the next meal and even the propensity to snack throughout the day. Advice varies, but the argument from a number of researchers is that protein should make up 25–30 percent of the calories and fat should make up 35–40 percent of the calories with the remainder consisting of slow digesting carbohydrates. Many will recognize that this conforms to the diet proposed years ago by Barry Sears. Interestingly, research following subjects for one or two years has not validated the low-fat-is-best hypothesis. Instead, a diet consisting of 25 percent protein and the rest low glycemic index (from mixed carbohydrate and fat components) spontaneously leads to weight loss in many subjects who started the diet while overweight.

Morning Exercise and Sunshine
Today, many or even most families have both parents working. Schedules often make it hard to send the proper signals to the body by getting a bit of sun before lunch. Those who live in the northern latitudes also can attest that the sun rises quite late in the winter. Nevertheless, even a little bit of sun in the morning helps to keep the body’s internal clock working properly.

Light exposure and exercise go well together. Exercise burns calories, but the greatest benefit comes after the exercise has ended. If you walk briskly for a mere 30 minutes per day, you will increase your calorie burning for an entire 24 hour period. Adding a moderate amount of upper body exercise or weight lifting will improve your energy expenditure even more by adding calorie-burning lean muscle tissue to your body. For weight loss, plan on walking briskly for at least 30 minutes every day. This is best done either before or after breakfast. A walk early in the day while the body’s temperature is still rising will invigorate you for the rest of the day. Taking a short walk (10 to 15 minutes) in the afternoon or before supper similarly makes it more likely that your body will burn calories rather than store them. Finally, another time for a walk is after your last meal of the day. Walking after meals is a particularly good practice for diabetics and for those genetically prone to developing diabetes.

Choose Dietary Fats Wisely
A recent survey found that approximately 95 percent of all Americans consume too little omega-3 fatty acids (fish oils, flax seed oil and a small number of other sources) in relation to their total fatty acid intake. Instead, we eat mostly omega-6 fatty acids because, quite simply, these are cheap to derive from canola, corn, peanut, soy and other sources. Unfortunately, omega-6 fatty acids in excess promote inflammatory processes in the body.

Dietary saturated fats, after 60 years in the wilderness, no longer are under blanket condemnation by the Food and Drug Administration (FDA) or several other “official” bodies. Today, it increasingly is admitted that the evidence against, for instance, the egg, does not stand up and eggs, in fact, are good for you even in relatively large numbers per week. Similarly, the short-chain fatty acids in butter and other dairy products are good for the health of the gut and another fat from full fat dairy, palmitoleic acid, is associated with slightly lower adiposity, with higher high-density lipoprotein cholesterol levels, lower triglyceride levels, a lower total cholesterol–HDL cholesterol ratio, lower C-reactive protein levels, and lower insulin resistance. Trans-palmitoleate also is associated with a substantially lower incidence of diabetes.

As with the consumption of full fat dairy in the form of cheese, milk and yoghurt (obviously, not lots of whipped cream with sugar!), the evidence supports that improving the ratio of omega-3 fatty acids in the diet may moderately improve weight and cardiovascular health.

Eat More Vegetables
Most readers automatically will think “eating more vegetables” means eating more fiber. This, however, is not the whole of the story by any means. Let’s take fiber first. Fiber slows down food consumption so that your body has a chance to signal that you have eaten enough. It adds bulk to the meal to give you a feeling of satisfaction at having eaten. It slows the increase in the blood sugar level that follows meals. Fiber carries waste products from the body and, especially if it comes from lightly cooked vegetables, it supplies important minerals and antioxidants. Try to vary your fiber sources. Avoid too much scratchy wheat bran, but add grains such as oats and barley and starchy vegetables such as sweet potatoes and yams (without added sugar) to your menu.

Clinical studies that came out earlier this year now have added another dimension to the story. It turns out that the plant hormone abscisic acid is present and active in humans! Abscisic acid can be found in many fruits and vegetables. In one study, microgram amounts of abscisic acid in a fruit extract improved glucose tolerance and reduce insulinemia in both rats and humans! Another clinical study found that there is an impaired increase in abscisic acid in the blood in diabetes and gestational diabetes. The upshot of these studies is “eat more vegetables!”

Old Fashioned Versus Fast and Prepared Food
Most studies on food and health focus on the big three nutrients (carbohydrates, fats and protein), the glycemic index and various isolated food components. One novel approach that breaks this mold looks, instead, at the issue of food processing. Many foods that we think are either good or bad actually owe their effects to how they have been refined, manufactured and prepared. To give but one example, steel cut oats are excellent food, but instantized oats designed to become oatmeal with the mere addition of hot water become a high glycemic food akin to white bread or sugar. One Brazilian researcher writes that the issue is “ultra processing” and its impact on food.

This commentary distinguishes between three types of food and drink processing, and in turn three groups of foods and drinks, depending on the nature, extent and purpose of their processing. The first group are unprocessed (as defined here) or minimally processed foods. The second group are processed culinary or food industry ingredients. The third group are ultra-processed products—two examples of which are ready-to-eat eat breakfast cereals and burgers.

Today, at least 50 percent of all meals eaten by Americans are consumed outside the home with a good percentage being eaten in fast food restaurants. Good health depends, at least in part, on reducing the amount of ultra-processed food in the diet.

Endnotes

1. Breakfast-skippers may over-eat to compensate for low dopamine levels. See Hoertel HA, Will MJ, Leidy HJ. A randomized crossover, pilot study examining the effects of a normal protein vs. high protein breakfast on food cravings and reward signals in overweight/obese “breakfast skipping”, late-adolescent girls. Nutr J. 2014 Aug 6;13:80.
2. Larsen TM, Dalskov SM, van Baak M, Jebb SA, et al.; Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance. N Engl J Med. 2010 Nov 25;363(22):2102–13.
3. Mozaffarian D, de Oliveira Otto MC, Lemaitre RN, Fretts AM, Hotamisligil G, Tsai MY, Siscovick DS, Nettleton JA. trans-Palmitoleic acid, other dairy fat biomarkers, and incident diabetes: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2013 Apr;97(4):854–61.
4. Magnone M, Ameri P, Salis A, Andraghetti G, et al. Microgram amounts of abscisic acid in fruit extracts improve glucose tolerance and reduce insulinemia in rats and in humans. FASEB J. 2015 Dec;29(12):4783–93.
5. Ameri P, Bruzzone S, Mannino E, Sociali G, et al. Impaired increase of plasma abscisic Acid in response to oral glucose load in type 2 diabetes and in gestational diabetes. PLoS One. 2015 Feb 27;10(2):e0115992.
6. Monteiro C. The big issue is ultra-processing. ‘Carbs’: The answer. [Commentary]/ World Nutrition February 2011;2(2):86–97.

Received wisdom is that breakfast is the most important meal of the day, an observation that most clinical studies support. However, there are doubters. Recently, the New York Times¹ ran an opinion piece by a professor of pediatrics at Indiana University School of Medicine that stated bluntly in its title, “Sorry, There’s Nothing Magical About Breakfast.” Unluckily for this professor, new research just published in the Journal of the American College of Nutrition (2016) yet again supports breakfast as being important for academic performance.² It also reports the significant finding that whereas greater consumption of whole grains at breakfast is a positive factor (because of the lower glycemic index/more sustained energy qualities of these foods), greater consumption of fruit juices (not whole fruit) exerts a negative impact on academic performance. In other words, basic sound nutrition plays a role in school performance.

Breakfast Supports Academic Achievement in Schoolchildren
In the current study, the authors sought to address a number of objections raised to the body of literature supporting the health benefits of breakfast. Critics have suggested that confounding variables, meaning issues such as total energy intake, parental education, and socioeconomic status, are largely responsible for the benefits of breakfast eating found in school children in past studies. The authors did not address the validity of such objections. Instead, they constructed a model population of students matched for gender, ethnicity, race, free/reduced-cost meals, parents’ education and household income. It began from baseline data from the Physical Activity and Academic Achievement Across the Curriculum (A+PAAC) study already available.

The investigation aimed to evaluate whether student breakfast consumers performed better on a standardized test (Wechsler Individual Achievement Test, WIAT-11I 1241) than did non-breakfast consumers and, among breakfast consumers, whether breakfast content influenced test scores. Three areas were of interest on the standardized test: spelling, reading comprehension and fluency, and mathematics. Physical data on differences in body composition (anthropometric data) and cardiovascular fitness also were assessed.

Immediately before taking the WIAT-111 test, participants completed a breakfast recall of all food and drink that they had consumed that morning. A total of 698 participants completed the breakfast recall; 617 participants were classified as breakfast consumers and 81 were classified as non-breakfast consumers. This allowed the determination that breakfast consumers did significantly better than non-consumers on all three portions of the test.

The percentage of calories from carbohydrates was positively correlated with the standard score for spelling, but other aspects of the macronutrient distribution of the diet were not significantly associated with any scores. In contrast, servings of fruit juice were not related to the spelling score, but were negatively correlated with reading comprehension and fluency and with mathematics performance. More servings of whole grains were significantly positively related to higher scores in reading comprehension and fluency, but not to spelling scores. In conclusion, the authors write, “[t]he present results suggest that … consumption of breakfast, high in whole grains and low in added sugars, may be beneficial for academic performance in elementary school students.”

Better Nutrition Extends Beyond Carbs, Fat and Protein
This 2016 Journal of the American College of Nutrition article examines the role of macronutrients consumption at breakfast in academic performance and supports the findings of a substantial volume of research literature to the effect that breakfasts based on substantial protein and/or substantial whole grain consumption are superior to skipping breakfast or eating breakfasts including high glycemic foods, such as sweet rolls and juice. But what about multi-vitamin and mineral supplements (MVM)?

The first question to ask about supplements is whether their use generally is safe. The answer to this question is that reasonably dosed supplements can help fill nutrient shortfalls without concern for long-term safety. A paper by Prof Hans Biesalski and Jana Tinz from the Institute of Biological Chemistry and Nutrition at the University of Hohenheim (Germany) concluded, “MVM are safe at physiological doses (100% DRI) in the short and the long term, whereas adverse effects may occur if single vitamins at high doses are consumed." "An MVM can help to improve the nutrient supply and overcome problems of inadequacy without concern for its long-term safety."³

The next question is, do vitamins and other dietary measures work? A number of studies indicate that the answer most certainly is "yes." Take, for instance, the scourge of modern American education, children with attention-deficit/ hyperactivity disorder (ADHD). ADHD poses a challenge beyond simply improving academic performance in the average student. In a report published just last year, the conclusion is that the "study demonstrates the clinical benefit, feasibility, and safety of broad-spectrum micronutrients in the treatment of childhood ADHD."⁴ More generally, taking a multi-vitamin supplement daily can improve cognitive performance in both children and adults. One trial found significant improvement in the areas of cognition and mood in healthy children with just 12 weeks supplementation and another trial turned in similar results in adults.^5,6

Other measures that can be adopted at the same time as adding micronutrients to the diet also may provide benefits. A Norwegian study of teenage males demonstrated that there is a positive association between the number of times fish are eaten per week at age 15 and cognitive performance measured three years later in both poorly and highly educated subjects. Frequent fish intake at age 15 was associated with significantly better cognitive performance three years later.⁷

Small Changes, Big Results
The take-away from these and many other studies is that relatively small and inexpensive changes in dietary habits can yield important results in children and adolescents. Various aspects of intelligence, emotional control and behavior in elementary school students and in teenagers respond positively to simple changes in diet and the use of vitamin and mineral supplements. These are easy tests for parents to try at home: put away the sugared cereals, substitute whole fruit for fruit juices, break out the eggs and whole grain breakfasts, and provide a serving of multi-vitamin/mineral insurance every morning.

Endnotes

1. The New York Times, May 23, 2016.
2. Ptomey LT, Steger FL, Schubert MM, Lee J, Willis EA, Sullivan DK, Szabo-Reed AN, Washburn RA, Donnelly JE. Breakfast Intake and Composition Is Associated with Superior Academic Achievement in Elementary Schoolchildren. J Am Coll Nutr. 2016 May—Jun;35(4):326—33.
3. Biesalski HK, Tinz J. Multivitamin/mineral supplements: rationale and safety—XA systematic review. Nutrition. Published online ahead of print, doi: 10.1016/j.nut.2016.02.013.
4. Gordon HA, Rucklidge JJ, Blampied NM, Johnstone JM. Clinically Significant Symptom Reduction in Children with Attention-Deficit/Hyperactivity Disorder Treated with Micronutrients: An Open-Label Reversal Design Study. J Child Adolesc Psychopharmacol. 2015 Dec;25(10):783—98.
5. Haskell CF, Scholey AB, Jackson PA, Elliott JM, Defeyter MA, Greer J, Robertson BC, Buchanan T, Tiplady B, Kennedy DO. Cognitive and mood effects in healthy children during 12 weeks¡¦ supplementation with multi-vitamin/minerals. Br J Nutr. 2008 Nov;100(5):1086—96.
6. Haskell CF, Robertson B, Jones E, Forster J, Jones R, Wilde A, Maggini S, Kennedy DO. Effects of a multi-vitamin/ mineral supplement on cognitive function and fatigue during extended multi-tasking. Hum Psychopharmacol. 2010 Aug;25(6):448—61.
7. Aberg MA, Aberg N, Brisman J, Sundberg R, Winkvist A, Toren K. Fish intake of Swedish male adolescents is a predictor of cognitive performance. Acta Paediatr. 2009 Mar;98(3):555—60.