Is breakfast an essential part of your day? Well, if you’re a diabetic, perhaps you might want to reconsider. This according to a new book by Dr. Terence Kealey called, Breakfast is a Dangerous Meal: Why You Should Ditch Your Morning Meal For Health and Wellbeing. (Harper Collins, 352 pgs)
And while it’s certainly your right to disagree with Dr. Kealey’s conclusions, it’s certainly hard to easily dismiss them.
Dr. Kealey, who was diagnosed with type 2 diabetes in 2010, is a trained clinical biochemist who lectured at Cambridge before serving a 14-year stint as vice-chancellor of the University of Buckingham.
Going against conventional wisdom Dr. Terence Kealey believes that breakfast is easily the most dangerous meal in the diabetic’s day.
“Hardly anyone has heard of insulin resistance, yet its death rate can be compared to the death rates from the bubonic plague during the Black Death years of 1346-53,” Kealy writes.
Everyday Diabetes recently spoke with Dr. Terence Kealey about his diagnosis, his book, and his thoughts on the state of diabetes.
Can you tell us about your diagnoses and your reaction?
My diagnosis of diabetes was made on 24 May 2010 by my GP. I’d known secretly for a number of weeks that I must have been diabetic, as I was continuously thirsty (I would buy a litre of orange juice before embarking on a car journey, and I couldn’t sit through a lecture for more than an hour without having to excuse myself to pee and take a drink) and I was getting up several times in the night to pee.
Also I was losing weight, and my muscles were aching as they wasted. But I was working so hard that I simply ignored the symptoms (I didn’t have time to be ill) and it was only when my wife insisted on driving me to the surgery that a diagnosis was made.
What was your reaction to the diagnosis?
My reaction was anger: anger with myself for my stupidity in ignoring the symptoms for some weeks, but also anger at my body for letting me down. I’d been previously quite healthy before then (I was then 58 years old) and I’d barely see a doctor since my childhood. This is no exaggeration, I really had barely seen a doctor in 40 years, so I was angry that for no apparent reason (I wasn’t fat and I ran every morning) I had developed type 2.
I am actually a very conventional person who believes, as the Americans say, in motherhood and apple pie. I am not a natural contrarian, but on this occasion amended my opinion because of my personal experience.
These were, of course, the classic first stages of grief (denial and anger) but after a few months they faded, and I didn’t proceed into the remaining 3 classical stages of grief (bargaining, depression and acceptance) because instead, I decided to defeat the condition by taking control of my blood sugar level. Thanks to my glucometer I swiftly concluded that everything I was being told (namely to eat breakfast, to eat carbohydrates, to avoid alcohol) was wrong, and equally I decided that even though I was not large my early prescriptions for sulphonylureas were wrong, and I went over to Metformin.
How did it affect your daily life?
The impact was surprisingly small. Once I had got into the habit of skipping breakfast, cutting down markedly on carbohydrates, avoiding sugar like the plague (if it was in the Great British Bakeoff I avoided it) and eating lots of vegetables and nuts and all animal products except for red meat, my daily life proceeded apace. But that regime kept my blood glucose levels and HbA1c levels down below the diabetic range.
It turns out that the middle classes are slimmer than the working classes, and it also turns out that the middle classes tend to eat breakfast because they ‘know’ they should, while many working class people, who don’t like being told what to do, skip it.
On diagnosis I had a fasting blood glucose of 19.3 mM and an HbA1c of 13.3%, so I was pleased to have driven them down so easily below the diabetic range. Oh, and drinking alcohol was very good for my blood glucose levels (hypoglycemia is a recognized effect of alcohol) so I avoided carbohydrate-rich drinks like beer, but found wine to be very good.
Regarding your book. Who are you especially targeting?
There are millions of people on this globe who are not hungry in the morning yet who eat breakfast because they think they should. This book is specially targeted at liberating those people from that nonsense.
This was for me the most fascinating part of the whole exercise, I am actually a very conventional person who believes, as the Americans say, in motherhood and apple pie. I am not a natural contrarian, but on this occasion amended my opinion because of my personal experience. It’s been fashionable for so long (largely pushed by the cereal companies) to suppose that breakfast is healthful that scientists have simply not looked at the data.
I was on Radio 5 Live the other day, and Catherine Collins of the British Dietetic Association said that diabetics didn’t need to worry about breakfast because it raised blood glucose levels only by a tiny blip for 10 minutes. But that’s just not true. If Catherine (who by the way is a delightful and courteous person, this is not an attack on her, only on her repeating the standard view) had actually looked at the data (see page 7 of my book) she’d see that breakfast is easily the most dangerous meal in the diabetic’s day.
The persistence of the false idea illustrates how powerfully people will believe in false ideas in the face of evidence. There seems to be something wrong in our species’ ability to examine data!
But people don’t look at the data. Even diabetics who have glucometers (and by the way they should all have glucometers, which should not be restricted only to type 1s) seem to ignore their own data. But it seems that humans find it too easy to follow authority figures rather than the evidence of their own eyes.
Why do people suppose that eating breakfast reduces the total amount of food they consume over the day when the opposite is true?
This is an important question. It turns out that the middle classes are slimmer than the working classes, and it also turns out that the middle classes tend to eat breakfast because they ‘know’ they should, while many working class people, who don’t like being told what to do, skip it.
So scientists, when they saw the association between slimness and eating breakfast, assumed it was cause-and-effect (the supposed cause being post-breakfast satiety or fullness, which supposedly reduces the intake at lunch) rather than a social class association.
But when scientists tested the idea, by actually measuring what happened when people ate or skipped breakfast, they found that breakfast only increased our numbers of calories very considerably. But the persistence of the false idea illustrates how powerfully people will believe in false ideas in the face of evidence. There seems to be something wrong in our species’ ability to examine data!
Who should consider intermittent fasting by removing breakfast from their daily routine?
Everybody except for people who are slim, physically fit and young. Certainly, all diabetics should avoid it like the plague (sorry to use a cliché, but for diabetics, breakfast is indeed the plague).
In Britain today, two-thirds of people are overweight or obese, and in addition, others are hypertensive or have raised cholesterol or are prediabetic or have other conditions of overeating, and since only a handful of us are really fit, the reality is that only a handful of people can afford to eat breakfast. And even they shouldn’t unless they feel they really need to.
The only other category of people who should eat breakfast are that small proportion of people who really feel they need it and who are engaged in crucial jobs such as heart surgery or airline piloting. They have to put others before themselves. But they are a tiny minority.
Are the benefits solely for breakfast? What about other meals?
Two meals a day is almost certainly optimal, namely lunch and dinner, as long as there is not too long a time gap between these meals, say up to 7 hours. No late night suppers, though!
What are potential problems?
Some people feel they simply can’t skip breakfast. If they really can’t, then, of course, they must eat it, but in that case, it must be carbohydrate-free. I explain all this in the book.
On a more general topic. What are your thoughts on the state of diabetes awareness and efforts to stem the rise of cases?
People are bombarded by advertisements for food, and this is a health nightmare. Diabetes is caused by eating too often during the day, by eating too much, by eating too many carbohydrates, and by not exercising enough. I’m a great believer in freedom and in freedom of speech, but we have to recognize asymmetries in power, and we need to think very hard about food advertising, as we’ve effectively handed the nation’s public food education programs to corporations whose only imperative is shareholder value.
On the other hand, the government’s food education record is also poor (witness the 40-year misguided campaign against fat) and as I’ve chronicled in my book, the very worst breakfast offenders are the very best universities on the globe. It’s incredibly difficult to get good food advice at present, and that bothers me, but I think one solution would be to get a group of philosophers, physicists, and mathematicians together, supported by some first class statisticians, and get them to probe the data with a level of critical awareness we currently lack.
Before switching or trying any alternative diet plan, first consult with your healthcare provider on what is best for you. The opinions stated here are not neccessarily those of Everyday Diabetes.