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What Foods to Eat During the Day and Why Skipping Breakfast Is a Bad Idea: Interview with Eric Rimm

In the first part of his three-part interview with Flo, Dr. Eric Rimm, Professor of Epidemiology and Nutrition at the Harvard T.H. Chan School of Public Health, shares how to eat healthily during the day, why you shouldn't skip breakfast, what snacks are healthy, and how to pick products at the supermarket.

“To answer this question, I will try to focus on what I know from the science — the real science — as opposed to one small study that was done with twenty people,” begins Dr. Rimm. “I think the nutrition field is challenging because it's not one-size-fits-all. The answers might differ for a 25-year-old woman versus a 55-year-old man, for example.” 

Before sharing his general opinion based on science, Dr. Rimm warned that it might not work for some people, or the result may depend on your genetics, where you live, or the type of food that's available where you live.

The focus should be more on what you eat than on how many times you eat.

According to Rimm, how many meals to have per day depends on what you eat during those meals — three unhealthy meals isn’t better than eating two healthy meals. The focus should be more on what you eat than on how many times you eat. 

“That said, I do think it's important to eat in the morning,” says Dr. Rimm. “Most of our research suggests that people are able to keep a more stable weight if they have food in the morning.” And according to Rimm, there might be something to the old proverb “eat breakfast like a king, lunch like a prince, and dinner like a pauper” — if you’re trying to avoid gaining weight over time, there’s nothing wrong with going to bed a little hungry.

“I know some people suggest skipping the middle meal. So eating plenty in the morning, then eating some in the evening, and only having a very late lunch – I think that's fine. It depends on what you do during the day. Your brain needs energy, which is why it's important to have a meal in the morning. So, my answer would be eating three times a day is probably best,” he concludes.

He also advises that if you're going to have only two meals, it should be in the evening and in the morning. He also recommends spreading your calories throughout the day by having three meals and maybe a snack, just as long as the meals are small. 

Dr. Rimm says there are some scientific insights that explain the benefits of eating breakfast — “Let's start with children. Children who skip breakfast tend to perform less well at school. There's clearly something about brain function and the ability to pay attention that goes along with eating in the morning.” 

It's easier to keep your weight stable or not gain weight quickly if you have food in the morning.

And that's not just having a cup of coffee because a cup of coffee has almost zero calories, only caffeine. Dr. Rimm believes that it's important to have calories in the morning — “Again, all the science that we've done and that others have done would suggest it's easier to keep your weight stable or not gain weight quickly if you have food in the morning.” 

It's a tricky point, he says. It's important to have breakfast in the morning, but some breakfasts are better than others. “It's also good to have something that's not just refined carbohydrates because that may contribute to weight gain. This is especially true for children who may only have a bowl of sugary cereal or white bread toast.”

It depends on who you are and what you do during the day, Dr. Rimm suggests.

According to him, it's good to have a healthy breakfast that contains some healthy protein – in other words, not just white bread, a bagel, or a doughnut. “All the science suggests that if you include a protein, it shouldn’t be processed meat. So try to avoid sausage patties or bacon.” 

If you’re looking for good breakfast proteins, unsweetened yogurt is an excellent choice, and one or two eggs are also fine. 

The best way to start the day is to opt for healthy foods that don't contain refined carbohydrates

What are some breakfasts Rimm recommends? “Some people have fruit or fruit with yogurt. Some people have a whole grain, whether it's steel-cut oats or a small piece of a whole-grain toast, with fruit or an egg. Something that's a good balance of fat and protein and not just a refined carbohydrate is a good idea for a healthy breakfast.” 

According to Rimm, the answer depends on where you live, what foods you have access to, and what foods are part of your culture. 

“The best science on who lives the longest shows that it's people who eat meals similar to what people in the Mediterranean eat. The Mediterranean diet has a fair bit of fat in it, but most of it is healthy fat that comes from vegetable oils like olive oil or other liquid oils with healthy mono- or polyunsaturated fats.” 

And if you’re vegetarian, fear not: “If you are strongly opposed to consuming red meat, fish, or chicken and want to be a vegetarian, that's great. That means you'll eat a lot of fruits and vegetables,” says Dr. Rimm.

“We know vegetarians live the longest, at least from studies of people who have been vegetarians for 20 years. So that's great.” 

However, there is a healthy way and an unhealthy way to be a vegetarian, he adds. “An example of unhealthy vegetarianism is just having white pasta with a sugary beverage. It fits the definition but is not in the spirit of a healthy vegetarian diet.“

Dr. Rimm says that your daily diet should contain a fair bit of fruits, vegetables, and grains — mostly whole grains, not highly processed white bread. It's also important to have fish at least a couple of times a week. 

“After that, if you want other animal sources of protein, you can turn to unprocessed chicken, turkey, and other poultry.” 

He explains that there's a big difference between having sliced deli meat — which has been highly processed and salted and contains preservatives — versus chicken, turkey, or another kind of poultry that's roasted or baked and then sliced and eaten. 

According to Rimm, these are the main components of a healthy meal: fruits, vegetables, whole grains, healthy fats — not hydrogenated oils or a lot of dairy fat, but vegetable fats that you cook with or that you use for salads — and healthy animal products, if you eat them.

“I wouldn't stress about having exotic fruits,” says Dr. Rimm. “The research that we've done in the US shows that some of the healthiest fruits are berries: strawberries, blackberries, and blueberries. They are very high in polyphenols. They are natural and are highly beneficial. If you're getting berries, that's great.” 

Dr. Rimm often tells people to also eat apples or oranges because generally, they are a little less expensive. Apples and berries are the two fruits that are highest in polyphenols. However, if you're just eating apples all the time, you'll get the nutrients in apples but may miss out on some of the things in other fruits, so it’s best to eat a variety of fruits. 

What I recommend is to stick to fruits and vegetables that have colors. That's where you'll find the greatest benefits.

As for tropical fruits, Rimm says bananas are a great occasional choice because they’re a good source of potassium, but they don’t have much in the way of other nutrients. When asked about mangoes, Rimm said, “Do I think mangos are good? People don't eat them enough in this country to study their effects well. But I don't think you need to spend three times the amount of money to buy a mango versus getting berries.” 

Ultimately, his recommendation is to stick to colorful fruits and vegetables. That's where you'll find the greatest benefits.

According to Dr. Rimm, nuts are generally healthy. They’re a good protein source, and the fats they contain are healthy fats — mostly monounsaturated, but some nuts have polyunsaturated fats, too. This makes nuts an alternative source for healthy fats. 

If you like to snack on nuts, you don’t need too many — research has shown that the health benefits of eating nuts can be attained with just a handful a day. And having nuts for a snack might help you eat less during your next meal because they’re so filling. 

But is eating nuts a necessity? Rimm says, “I don't think you need to consume them if you're getting other sources of healthy fats, whether it's vegetable oils or whatever you cook with or make salad dressing with. You can get those healthy fats from other food sources besides nuts. So, I don't think they're a requirement.” 

When asked about frozen fish, Dr. Rimm confirmed that yes, it’s definitely healthy: “The most important aspects of fish are omega-3 fatty acids. You'll find this more in oily fish, like salmon or mackerel, or even small sardines that come in cans. Those are very high in omega-3 fatty acids.”

And these fatty acids are very stable when frozen, as is the protein found in fish. 

“In fact, I think frozen fish is the best way to eat,” says Dr. Rimm. “That way, you can have fish throughout the year without depending on when fish can be caught fresh in the sea. Nowadays, a lot of fish that's frozen gets frozen right on the boat. It's almost fresher than what you'd get in a market if it's been in the market for three or five days. I highly recommend this as an option.”

According to Dr. Rimm, it really depends on where you live. 

“I was just reading a new report that was put out by the World Cancer Research Fund. There is talk about different label changes that have been going on across the globe. Governments are trying to give people better warnings about what's in the product. Several countries use stoplights with a big black sign saying ‘Warning! This is high in sodium.’ I think it's important that countries require listing the ingredients of what's in the package.” 

Buying fresh food, fruits, and vegetables is best — if you're buying an apple, you don't need to look at the ingredients. Even buying frozen fruits and vegetables is fine, according to Dr. Rimm, as long as they don’t have a lot of added sugar.

Mind the order of the ingredients listed. In the United States, the order of the ingredients has to be in the same order as the proportionate weight of what's in the package.

Dr. Rimm recommends turning the package over and looking at the ingredient list to know what’s in your food.

He says, “That's just a good practice to learn anyway. Sometimes you don't realize what you're buying. You think you're buying frozen peas. You turn the package over and see it's frozen peas with added salt and other ingredients. You didn't realize that because you thought it was just frozen peas.” 

He also advises noting the order of the ingredients listed. “In the United States, the order of the ingredients has to be in the same order as their proportionate weight of what's in the package.” 

Often, when a product has a lot of added sugar, it’s listed as the second or third ingredient. For example, if you're buying a sweetened beverage, like cola, the first ingredient is usually water. The second ingredient is high-fructose corn syrup. That means that, by weight, there's a lot of sugar in there. 

“And, you have to be careful because there are 50 different ways to put sugar in a package,” warns Dr. Rimm. “You can call it sugar, but sometimes it's referred to as high-fructose corn syrup. Sometimes it's a chemical compound that is essentially the same as sugar. But if you're just looking for the word sugar, you don't realize it.” 

He also advises learning about what things are being added to the foods you eat. Often, companies put health claims or added nutrients on the label, but it is not until you read the ingredient list that you see a lot more has been added to the food to make it taste sweet, salty, or smooth. “Don’t let food companies trick you,” says Dr. Rimm, “read the package ingredients!”

One simple bit of advice from Dr. Rimm is to look at the package and find foods that only have a few ingredients. If there’s a long list of ingredients, it's usually because they're being preserved in some way. Or there are lots of other things that are being added to make it taste sweet or saltier. That's not as healthy. 

Every country has its own way of telling you how much sodium, saturated fat, and calories are in a product. It's important to pay attention to that if you're interested in nutrition and health. 

“We know there are some things that, in the long run, are not good for middle-aged women,” says Dr. Rimm. 

He says that most women in China, Russia, and the United States die of cardiovascular diseases — heart disease and stroke. That's driven by consuming high levels of sodium, saturated fat, and processed fat.

“It's important to at least start to think about the food you eat and to train yourself to eat healthily. For yourself or your children, it's good to have those habits in your 20s and 30s because you hopefully keep them up the rest of your life.” 

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