How Circadian Rhythms Affect Blood Sugar Levels

How Circadian Rhythms Affect Blood Sugar Levels
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The same meal eaten at the wrong time of day can double blood sugars.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

We’ve known for more than a half century now that our “glucose tolerance” declines as the day goes on––meaning the ability of your body to keep blood sugars under control. If you hook yourself up to an IV, and just drip sugar water into your vein at a steady pace throughout the day, at about 8pm your blood sugars start to go up, even though you haven’t eaten anything and the infusion rate didn’t change. The same amount of sugar is going into your system every minute, but your ability to handle it deteriorates in the evening, but bounces right back in the morning. A meal eaten at 8pm can cause twice the blood sugar response as an identical meal eaten at 8am. It’s as if you ate twice as much!

Your body just isn’t expecting you to be eating when it’s dark outside. Our species may have only discovered how to use fire about a quarter million years ago. We just weren’t built for 24-hour diners.

One of the tests for diabetes is called the glucose tolerance test, to see how fast your body can clear sugar from your bloodstream. You swig down a cup of water with about four and a half tablespoons of regular corn syrup mixed in, and then have your blood sugar measured two hours later. By that point, your blood sugar should be under 140 (mg/dL). Between 140 and 199 is considered prediabetes, and 200 and up is a sign of full-blown diabetes.

The circadian rhythm of glucose tolerance is so powerful that a person can test normal in the morning, but as a prediabetic later in the day. Prediabetics who average 163 at 7am test out as frank diabetics by 7pm, at over 200.

Choosing lower-glycemic foods may help promote weight loss, but timing is critical. Due to this circadian pattern in glucose tolerance, a low-glycemic food at night can cause a higher blood sugar spike than a high-glycemic food eaten in the morning. We’re so metabolically crippled at night: researchers found that eating a bowl of All Bran at 8pm caused as high a blood sugar spike as eating Rice Krispies at 8am. High-glycemic foods at night would seem to represent the worst of both worlds. So, if you’re going to eat refined grains and sugary junk, it might be less detrimental in the morning.

The drop in glucose tolerance over the day could therefore help explain the weight-loss benefits of front-loading calories towards the beginning of the day. Even just an earlier versus later lunch may make a difference. People randomized to eat a large lunch at 4:30pm suffered a 46 percent greater blood sugar response compared to an identical meal eaten just a few hours earlier at 1pm. And a meal at 7am can cause 37 percent lower blood sugars than an identical meal at 1pm. Now there doesn’t seem to be any difference between a meal at 8pm and the same meal at midnight—they both seem to be too late. But eating that late, at midnight, or even 11pm can so disrupt your circadian rhythm that it can mess up your metabolism the next morning––resulting in significantly higher blood sugars after breakfast, compared to eating the same supper at 6pm the evening before.

So, these revelations of chronobiology bring the breakfast debate full circle. Breakfast-skipping not only generally fails to cause weight loss, but worsens overall daily blood sugar control in both diabetic  and non-diabetic individuals. See how the breakfast-skippers have higher blood sugars even while they’re sleeping 20 hours later? This may help explain why those who skip breakfast appear to be at higher risk of developing type 2 diabetes in the first place.

Breakfast skippers also tend to have higher rates of heart disease and atherosclerosis in general. Is this just because breakfast-skipping tends to cluster with other unhealthy choices, such as smoking and sicklier eating habits overall? The link between breakfast skipping and heart disease—even premature death in general—seems to survive attempts to control for these confounding factors. But you don’t really know, until you put it to the test.

Does skipping breakfast lead to higher cholesterol, for example? Yes, a significant rise in LDL (bad) cholesterol in those randomized to skip breakfast––about 10 points higher within just two weeks. The Israeli 700/500/200 study found that the triglycerides of the king-prince-pauper group got significantly better—a 60-point drop—while those of the pauper-prince-king group got significantly worse (a 26-point rise). So, consuming more calories in the morning relative to the evening may actually have a triple benefit: more weight loss, better blood sugar control, and lower heart disease risk. So, if you’re going to skip any meal, whether practicing intermittent fasting or time-restricted feeding (where you try to fit all your food into a certain daily time window), it would be safer and more effective perhaps to skip dinner rather than breakfast.

Please consider volunteering to help out on the site.

Image credit: Paul Hunt via pixabay. Image has been modified.

Video production by Glass Entertainment

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

We’ve known for more than a half century now that our “glucose tolerance” declines as the day goes on––meaning the ability of your body to keep blood sugars under control. If you hook yourself up to an IV, and just drip sugar water into your vein at a steady pace throughout the day, at about 8pm your blood sugars start to go up, even though you haven’t eaten anything and the infusion rate didn’t change. The same amount of sugar is going into your system every minute, but your ability to handle it deteriorates in the evening, but bounces right back in the morning. A meal eaten at 8pm can cause twice the blood sugar response as an identical meal eaten at 8am. It’s as if you ate twice as much!

Your body just isn’t expecting you to be eating when it’s dark outside. Our species may have only discovered how to use fire about a quarter million years ago. We just weren’t built for 24-hour diners.

One of the tests for diabetes is called the glucose tolerance test, to see how fast your body can clear sugar from your bloodstream. You swig down a cup of water with about four and a half tablespoons of regular corn syrup mixed in, and then have your blood sugar measured two hours later. By that point, your blood sugar should be under 140 (mg/dL). Between 140 and 199 is considered prediabetes, and 200 and up is a sign of full-blown diabetes.

The circadian rhythm of glucose tolerance is so powerful that a person can test normal in the morning, but as a prediabetic later in the day. Prediabetics who average 163 at 7am test out as frank diabetics by 7pm, at over 200.

Choosing lower-glycemic foods may help promote weight loss, but timing is critical. Due to this circadian pattern in glucose tolerance, a low-glycemic food at night can cause a higher blood sugar spike than a high-glycemic food eaten in the morning. We’re so metabolically crippled at night: researchers found that eating a bowl of All Bran at 8pm caused as high a blood sugar spike as eating Rice Krispies at 8am. High-glycemic foods at night would seem to represent the worst of both worlds. So, if you’re going to eat refined grains and sugary junk, it might be less detrimental in the morning.

The drop in glucose tolerance over the day could therefore help explain the weight-loss benefits of front-loading calories towards the beginning of the day. Even just an earlier versus later lunch may make a difference. People randomized to eat a large lunch at 4:30pm suffered a 46 percent greater blood sugar response compared to an identical meal eaten just a few hours earlier at 1pm. And a meal at 7am can cause 37 percent lower blood sugars than an identical meal at 1pm. Now there doesn’t seem to be any difference between a meal at 8pm and the same meal at midnight—they both seem to be too late. But eating that late, at midnight, or even 11pm can so disrupt your circadian rhythm that it can mess up your metabolism the next morning––resulting in significantly higher blood sugars after breakfast, compared to eating the same supper at 6pm the evening before.

So, these revelations of chronobiology bring the breakfast debate full circle. Breakfast-skipping not only generally fails to cause weight loss, but worsens overall daily blood sugar control in both diabetic  and non-diabetic individuals. See how the breakfast-skippers have higher blood sugars even while they’re sleeping 20 hours later? This may help explain why those who skip breakfast appear to be at higher risk of developing type 2 diabetes in the first place.

Breakfast skippers also tend to have higher rates of heart disease and atherosclerosis in general. Is this just because breakfast-skipping tends to cluster with other unhealthy choices, such as smoking and sicklier eating habits overall? The link between breakfast skipping and heart disease—even premature death in general—seems to survive attempts to control for these confounding factors. But you don’t really know, until you put it to the test.

Does skipping breakfast lead to higher cholesterol, for example? Yes, a significant rise in LDL (bad) cholesterol in those randomized to skip breakfast––about 10 points higher within just two weeks. The Israeli 700/500/200 study found that the triglycerides of the king-prince-pauper group got significantly better—a 60-point drop—while those of the pauper-prince-king group got significantly worse (a 26-point rise). So, consuming more calories in the morning relative to the evening may actually have a triple benefit: more weight loss, better blood sugar control, and lower heart disease risk. So, if you’re going to skip any meal, whether practicing intermittent fasting or time-restricted feeding (where you try to fit all your food into a certain daily time window), it would be safer and more effective perhaps to skip dinner rather than breakfast.

Please consider volunteering to help out on the site.

Image credit: Paul Hunt via pixabay. Image has been modified.

Video production by Glass Entertainment

Motion graphics by Avocado Video

Doctor's Note

Back with the next installment of the chronobiology series! We previously explored eating breakfast for weight loss (Is Breakfast the Most Important Meal for Weight Loss? and Is Skipping Breakfast Better for Weight Loss?), introduced chronobiology (Chronobiology – How Circadian Rhythms Can Control Your Health and Weight), and looked at the science on eating more in the mornings than the evenings (Eat More Calories in the Morning to Lose Weight; Breakfast Like a King, Lunch Like a Prince, Dinner Like a Pauper; Eat More Calories in the Morning Than the Evening).

Next up, you’ll see How to Sync Your Central Circadian Clock to Your Peripheral Clocks.

And the series will wrap up in the next couple weeks with:

Note: The Israeli 700/500/200 study that I mentioned is in the Breakfast Like a King, Lunch Like a Prince, Dinner Like a Pauper video in more detail. 

If you haven’t yet, you can subscribe to my videos for free by clicking here.

197 responses to “How Circadian Rhythms Affect Blood Sugar Levels

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  1. So what would be the recommendation for a shift worker who works, say, from 8 PM to 6 AM four days a week?

    (Other than “get a day-job”) :-)

      1. Kinda hard with 12 hrs night shifts…I didn’t always have time working NICU to even get a 30” dinner break, but by the time I got home about 8am I was hungry! If I didn’t eat, I couldn’t sleep well .

      2. I work nights and I have to eat in the middle of my 11pm to 7am shift or I will be ill by the time I get off because my job involves physical activity. I have hypoglycemia so my blood sugar dips too low if I don’t eat about 4-5 hrs into my shift. My husband generally doesn’t eat at all during the night and his job involves more walking around than mine.

    1. For shift workers, with my own thinking I would say just to make sure you’re putting lots of great stuff in you, WFPB and incorporating the many plant foods that are shown to be so incredible at controlling blood sugar such as beans/legumes for just one example and for another among many, high antioxidants alone. And probably a very good idea to take a teaspoon or two of vinegar with meals (no more than 2 tbsp a day).

      What would be interesting to know is would it be better to eat a large meal at midnight or 4am—when it gets closer to the day? I wonder if that has been looked at.

    2. Hi Darwin,

      I am a volunteer for Dr. Greger. Thank you so much for your question.

      Unfortunately, the research I could find on this topic is extremely weak. There are only a few clinical trials where this topic has been tested, and they have yielded mixed results.

      However, in Dr. Greger’s new book, “How Not to Diet”, he cites a study that suggests that minimizing overnight food intake can limit the negative metabolic effects of shift work. Research shows, however, that this can lead to individuals eating low-quality and higher fat foods after the shift (in the morning). The overall eating pattern that the science seems to be showing is that you should eat breakfast after your shift (around 7am) and then sleep after that meal. Upon waking, eat your lunch. Then, before your night shift, eat dinner. Overall, minimize calorie intake during your night shift, if possible. If you do want to eat during your night shift, stick to lower calorie, but higher fiber foods to help keep you satiated. Vegetables with homemade hummus (homemade to minimize the added oils) or edamame might be good choices. When you arrive home after a night-shift and possibly feel extremely hungry, make sure to focus on eating high-quality meals during that time as best as you can. For your days off, I would recommend sticking to a similar eating pattern, if possible, where you eat your meals around the same times on your off days as you do on your working days. Mixing up your eating schedules can possibly cause a sort of metabolic jet lag and possibly have negative health consequences.

      Here is an article on this topic by the British Medical Journal (BMJ) (https://www.bmj.com/content/365/bmj.l2143), which says many of the same things. This article highlights that food quality is extremely important, as it is for everyone, regardless of when their shifts are.

      I hope this helps answer your question, and I wish you the very best!

      1. “Mixing up your eating schedules can possibly cause a sort of metabolic jet lag and possibly have negative health consequences.”

        That is so interesting because I noticed when my hours drastically shifted and thus, my eating times, it seemed to take my body a bit to adjust even when my time shifted for the better in eating earlier after being used to eating late.

  2. I paused the video early just to smile and come down and tell you that you hit this one out of the park, Grand slam. (Sports radio is talking Red Sox right now, so my mind is generating baseball analogies)

    Can I just sit here and applaud how useful this type of video is?

    Hooray!

    1. I agree 100%. Every other animal on the planet attempts to do exactly this and succeed more often than not. Domestic animals are fed early in the morning as well. Nothing I can think of eats late meals continuously like we do, not even butterflies.

  3. I went back to the video and you answered the skipping breakfast health issues mystery for me!

    For 2 years, I have been alternating between reading about intermittent fasting benefits and the skipping breakfast detriments and the logic went back and forth and back and forth and you answered it in a way that I can really understand.

    The charts help me understand your words so much easier than just listening to your audiobook.

    Standing ovation again!

    I had been so confused by all of those studies and you just explained it in a way that it all makes sense.

  4. So should Late night food/a little before bed consist of fat? Maybe peanut butter or avocado or something of the sort?
    When I eat fruit at night and even whole grains my mind races through the night. So, what are ideal post 8pm vegan/vegetarian things to munch on?

  5. Darwin, if I remember correctly, Dr Greger answered that question in last month’s Q&A. (or we could just go buy the book! ) Eat a big breakfast after your shift anyway. There is a video coming up soon specifically about the health consequences of working night shifts.

    1. Barb, Thanks for the info. I was unable to watch the Q&A, but I will keep an eye out for the upcoming video.
      I think I might just by the book and give it to my friend who works night shifts and needs to lose some weight.

      1. Darwin, what a nice thing to do for your friend! I will buy the book also. I have made a ‘second career’ out of the topic of weight loss starting from when I was in elementary school, and Dr Greger’s information is a game changer for me. I lost 20 lbs as a teen, and although I never gained it back, it has been a real struggle – all day, every day. I’m just not an ‘eat all they want’ and stay thin type of person. It has taken focussed effort but all this information is making life so much easier. (and healthier!) ty Dr Greger

        1. Barb, I, myself, was always on the thin side growing up and as a teenager. Then when I first got out of college and earned enough money to buy processed food, the weight started creeping on. I kept the the extra weight until finally changing to WPF’s when the excess lbs just “melted” away. Now I’m thin again and can eat quite a bit of vegetables of all kinds and still maintain a thin profile. Maybe it’s genetic to a certain extent.

          1. Darwin,

            The question about genetic versus types of food versus time of day eating really has gotten more complicated since Dr. Greger’s series.

            The fact that people who eat earlier can eat 20,000 extra calories over the course of 6 weeks for the same weight change, that means that your night shift friend has to work so much harder to stay thin. Plus, missing sleep changes your body composition from lean to more fat and that means you burn fewer calories. Plus, it is hard to get on an eating schedule and you might be eating when it will spike your blood sugar. Plus, if you have a revolving schedule, it is harder to shop and cook and you are more likely to buy processed foods and Dr. Greger’s video on that was that even eating the exact same calories, the processed food eater gained weight and the whole food eater lost weight.

            That combination of factors really skews the odds against your friend even if the two of you ate the exact same.

            On top of that, the genes change based on what you eat and when you eat, so, yes, some of it will be which genes are turned on and off.

            1. Deb and Darwin, just to show how powerful this circadian thing is…. I was reading a study referenced by Dr Greger in one of these videos. Two groups of genetically (certain to be obese) obese young mice, and group 1 ate 80% of their food in the night (that is like us eating in the day because mice are nocturnal). Group 2 ate 80% of their rations in the daytime. At the end of the study, Group 2 was obese, and Group 1 was slim.

              I think sometimes we believe we can outsmart our animal nature… but we’re can’t! It seems that if we eat what we are supposed to eat , and when, things just work out better.

              1. Thanks, Barb!

                I am excited about these messages, even if it will be challenging for me to turn things around.

                It explains why I didn’t get results going WFPB.

                I have never been so excited in my whole life about concepts.

                When I was young, I could get away with skipping breakfast and eating junk food.

                Post-menopausal, I can’t get away with anything.

                1. I genuinely am so excited.

                  And I am managing to eat something for breakfast now and I am getting dinner in closer to 7:30.

                  Honestly, it used to be closer to midnight often.

                  I was pretty sure I had Diabetes and I know I really did, but the symptoms are gone.

                  I will be doing an A1C this year, but it just got moved a few months because I need to eat earlier first.

                  Today, I moved lunch earlier, too and honestly, think I ended up just kept eating until noon.

                  I might have eaten the 500 extra calories that way, not sure, but it was healthy food and I am trying to force things to change.

                  I can’t even thank Dr. Greger properly.

                  1. Great stuff Deb! It is exciting, I agree. I am enjoying the process of making these new habits, though I find it easier if I know in advance what I’m going to eat that day.
                    I panicked a couple of times too in thinking it was a long time until tomorrow’s breakfast lol but now I’m fine. Reading, doing jigsaw puzzles, drinking fizzy water keeps me occupied before bedtime. There are a few more videos to the series so we have more info to come and more ideas to try!

  6. My late evening meal usually consists of a bowl of frozen wild blueberries and frozen Dark Sweet cherries covered in almond milk. I seem to be doing alright with eating that, but I also am probably qualifying as being Calorie Restricted.

    I’m wondering how Calorie Restriction is affected by Circadian Rhythm eating.

    1. “My late evening meal usually consists of a bowl of frozen wild blueberries and frozen Dark Sweet cherries”
      – – – – –

      Yikes, Lonie, you can knock them off while they’re still frozen? *shudder shudder* My teeth would rebel, for sure! :-(

      I’ve always liked things (water, etc.) at room temperature, and my sister likes things right from the fridge. With ice cubes added, if necessary. Have they ever done a scientific study to see why some people like, for instance, hot drinks and others like cold drinks?
      I was never one for iced tea or coffee — would rather drink the hot stuff. (Not too hot to burn your insides, of course.)

      1. Yikes, Lonie, you can knock them off while they’re still frozen? *shudder shudder* My teeth would rebel, for sure! :-(
        ————————————————————————————————————————————————————–
        Heh, I hear ya’. But my tooth ‘-) is not the problem… I do actually shiver a bit in the winter when eating this. Oddly, the fruit gives up its frozen properties to the almond milk which welds the fruit together, but I can break it apart with a spoon into bite sizes and then chase a spoonful with room temp water.

        But back to the shivering, PhD David Sinclair of Harvard says to be uncomfortably cold and uncomfortably hot… as well as hungry, at times. Says this causes the body to adjust and adapt to outside of what has become the norm for most of us. I’ve been a believer in plants that go through difficulties produce healthier fruit, so I subscribe to his thinking vis a vis humans as well in regard to health.

        Our pursuit of living perfect is just wrong, IMO.

        1. “But back to the shivering, PhD David Sinclair of Harvard says to be uncomfortably cold and uncomfortably hot”
          – – – – –

          Heck, I know what both are like. I grew up in Wisconsin, where the temps can be extreme either way. But it’s not exactly balmy weather where I now live on the East Coast. This too shall pass, as they say.

          1. I grew up in Wisconsin, where the temps can be extreme either way. But it’s not exactly balmy weather where I now live on the East Coast. This too shall pass, as they say.
            ————————————————
            Heh, here in west Texas (please! no rotten tomatoes ambush’-) it was mid 70s a couple of days ago and 20s today, going down to 15 tonight, then back to the 70s over the weekend… about a half a foot of snow on the ground.

            But I’ve got my water distiller making distilled water and using my laser thermometer, I’m seeing my internal walls registering in the lower 60s in this one room. External wall is a few degrees cooler.

            Heh, just went and checked… walls in all the other rooms in the house clocked in at 44 degrees. IIRC, last winter during a prolonged cold spell the walls in the house outside my distilling room, registered in the mid to upper 30s. ‘-)

            And that too did pass. ‘-)

          1. Personally I’d prefer heat stress via sauna
            ————————————————————
            Gengo, I totally agree.

            Last winter I had one of those 10′ plastic teepees set up and would spend time inside when the sun was shining. It would get really hot inside when closed up.

            Later in the spring I left the door unzipped and a NE high wind came along an toppled it, ripping a big non-repairable gash in the cover. I set it back up and it works for cover from rain and snow for some stuff, but not for sauna use.

            So I bought a little 4×4 one person tent to use this year. Just got it recently and haven’t set it up yet while waiting for the weather to settle down. I hate breathing in a plastic enclosure, but for the short duration of a sauna, I guess I can risk it.

            There’s just no way I can afford one of those high dollar saunas.

            1. You certainly live an interesting life, Lonie. Coming up with new ideas and concoctions every day.

              As I posted before, you seem to be your own guinea pig. “lLet’s see if this kills me; if it doesn’t, I’ll try it again tomorrow.” :-)

              1. There’s a downside though… there are times I need something from another room and on my way there, I start thinking about something completely different. Then I end back up in the room I left before remembering I didn’t pick up what I left the room for in the first place. ‘-)

          2. gengo, this is so interesting! I use the sauna or steam bath 3 times per week after swimming – because it feels wonderful after a workout but also because of the studies on detox from metals. I wonder if that has anything to do with the lowered risk of Alzheimer’s ?
            Usually I do 2 or more sessions separated by cold showers and found that my heat tolerance has increased greatly over the years.

              1. I watched the second link and got a lot more of the details of sauna use. Originally I only learned about it from a brief read.

                And I really like the way Patrick does her videos. Very little talking with her hands… at least to the point where that is distracting. And putting definitions of terms in a box and easily understood test results in the forefront… well, that’s just a good read.

                I do wish she would get a better sound recordist. There should be a way to normalize the high and low sounds to meet in the middle and make the quiet responses louder.

            1. Speaking of Alzheimer’s disease, this 2020 study was encouraging for those on a well designed WFPB diet.

              https://n.neurology.org/content/early/2020/01/29/WNL.0000000000008981 “Antioxidant flavonol linked to lower risk of Alzheimer’s dementia.” Neurology, January 29, 2020.

              “Participants with the highest intake of total flavonols had higher levels of education and more participation in physical and cognitive activities. In Cox proportional hazards models, dietary intakes of flavonols were inversely associated with incident Alzheimer dementia in models adjusted for age, sex, education, *APOE* ɛ4, and participation in cognitive and physical activities. Hazard ratios (HRs) for the fifth vs first quintiles of intake were as follows: for total flavonol, 0.52 (95% confidence interval [CI], 0.33–0.84); for kaempferol, 0.49 (95% CI, 0.31–0.77); for myricetin, 0.62 (95% CI, 0.4–0.97); and for isorhamnetin, 0.62 (95% CI, 0.39–0.98). Quercetin was not associated with Alzheimer dementia (HR, 0.69; 95% CI, 0.43–1.09).”

  7. I wake up between 3 and 4 in the morning and I’m wondering if there is such a thing as having breakfast too early. Shall I wait to have breakfast between 6 and 8 am?
    Thank you

    1. Hello Nasser,

      At this point I don’t believe a “start time” has been determined for eating; however, the biggest concern would be the amount of sleep you’re getting. If you wake between 3-4AM, are you getting 7-7.5 hours of sleep or less? If you’re getting much less (eg. <6 hours), then there may be negative health consequences to that as well! It will be important to go to bed at a time that allows for a sufficient amount of sleep at night.

      I hope this helps,
      Dr. Matt

      1. Thank you for your response Dr. Matt. My personal suspicion is that optimal time for us to eat relates to when the sun rises. But this is not based in anything evidential that I can provide. Yes six to eight hours of sleep is essential! I often go to bed between 8 and 9. Practicing Yoga asana and meditation on a daily basis allows for effortless early sleep and waking.

    2. I think your answer lies in the graph at 0:45. Glucose tolerance weakens at 8 pm and does not get back to normal until 8 am. Thus, I’d wait to eat until 8 am.

  8. I’ve never been a breakfast person, and often feel nauseated if I eat too early or am MORE hungry throughout the day if I eat in the morning (sometimes I don’t eat until 11 a.m.). This will be a difficult shift for me to make but I’m going to try!

    1. Tonya, back when I was a “regular food” eater, eating breakfast always gave me more hunger at lunch. But if I skipped breakfast I could go well into the afternoon before eating. So I understand that feeling.

      But now I eat always eat breakfast and because it’s absolutely packed with fiber and nutrients, it holds me all the way until lunchtime. Whereas before I would need snacks if I had breakfast.

      My super loaded yummy breakfast (that I crave as soon as I get up, no matter the time now, is raw rolled oats (1 fat cup) and 3-5 servings of assorted fruit (always with some berries-this morning was two bananas, blueberries, a whole orange cut up), plus 1-2T flaxseed meal, plus 4-6 spices (turmeric, black pepper, clove, allspice, cinnamon, sometimes more), chopped fresh greens (usually spinach), Vit D and B12, and two T vinegar, ACV, or Balsamic. Plus nutritional yeast and I eat it Dry. I don’t add any plant “milks”, but some folks do.

      It’s a fantastic way to start the day. And being that well nourished, I’ll get hungry at lunchtime, but if I need to-can ignore the feeling and go right on with no problems at all. I’ve found that skipping any meal is easier now that I give my body so much nutrition at each sitting.

      I got the idea from the great videos by Jane Esselstyn and her mom, Ann.

      Other fruits I like in my breakfast mini feast: mango (the great sweet ones), pomegranate, cranberries, strawberries, avocado, grapefruit, grapes, raisins, apple, melon–just cut ’em up into bits. Also a sprinkling of walnuts when I have those handy.

      1. When I was eating cooked oatmeal, I always had some left over, and also ate less fruit and never greens in it. I’m using the same amount now and practically lick the bowl each time. My dogs aren’t so happy about this, so I add oats to their kibble most days.

      2. Gotta say, Wade, that your uncooked oats/greens/two bananas/a whole ‘effin’ orange/vinegar/black pepper/yada yada sure doesn’t sound yummy to me! :-P

        Proves yet again, “different strokes for different folks.”

      3. Wade–

        Thanks for sharing all of this great info! I do sometimes make oatmeal or groats and sometimes add flax and a little fruit and nuts on the side but nothing like this extravaganza you laid out here :) I LOVE it and am definitely going to try it out soon.

  9. Woah and WOW…I learned so much from this one. My husband and I have been big fans of time-restricted eating for the past couple of years, skipping breakfast, working out/HIIT in a fasted state, and having our first meal around 11am, with our second meal around 5pm. This (along with Dr. Greger’s recent videos on this topic) upends everything we thought we knew! Looks like it’s time to start eating, and finishing eating, earlier. Lol, now we have to tell friends and family that we can’t eat dinner with them…they already think we’re crazy. But we are committed to long-term health and so, we will see how this goes. Thanks Dr. G, as Deb said, you certainly did knock this one out of the park!

    1. “Woah and WOW…I learned so much from this one.”

      Yes, I have spent so much time looking at intermittent fasting information and Dr. Greger really did turn that topic on its head.

    2. I am struggling with this idea as well. Been doing intermittent fasting for a year, eating 11 am -7 pm. Now thinking I should change my window, but to what? Definitely going to have to spend sometime working this out.

  10. A little off topic here, but I finally got around to watching a recording of the State of the Union address last night. Besides being a very positive and inspiring speech, I was amazed by one of the guests.

    The President honored a Charles McGee who is a WWII veteran and who was a pilot with the Tuskegee Air Corp. It was fascinating that he had just celebrated his 100th birthday! And he appeared to be in excellent condition for his age. Being interested in nutrition, I immediately wondered, what was his diet?

    If anyone can find out his diet, please post it here. Thanks.

    1. Darwin,

      Four 100-year-old World War II veterans were involved in the Super Bowl coin toss.

      I thought, wow, 4 100-year olds. We are losing that generation, but I am so happy that some of them have stuck around.

      1. Deb, Unfortunately, I missed the Super Bowl so I didn’t know that. Yes, that generation is fading away rapidly. I would still like to know what these 100 yr old’s diet was/is. I suspect it includes a lot of basic plant foods to be able to live that long.

        1. Darwin,

          I did try to look it up for you and the closest I found was in an interview where Charles McGee was told not to eat fried foods for breakfast as a way to not get sick while flying and he stopped. That was early in his military career.

        2. I can’t speak for those veterans who hit 100 ….. but my mom is 98. I feed her Amy’s organic soups which she can heat up on her own…has up to 3/day. Most of these are lentils/beans/veg…and high fibre. Oatmeal for breakfast (organic with organic raisins, chia, quinoa). Dried fruit, regular fruit (peaches from Dole…cause they are soft), applesauce. Some chocolate (dark). She has not been hospitalized or required emergency visits in about 8 years. She is independent with care and has most of her wits about her.

      2. I thought, wow, 4 100-year olds. We are losing that generation, but I am so happy that some of them have stuck around.
        ————————————————————————————————————————————————————–
        Maybe everyone should use this as a teachable moment… that is, ask the older generations things. I remember things from my mother, like the purple prairie daisy was her favorite flower. I didn’t ask her that but she volunteered it during a conversation about our common love of wild flowers.

        And if you have a lot of things to share but no one is asking you, write it down or better yet, record it.

        Someday the stupid, dumb little shits will miss you when you are gone and will wish they had talked with you about whatever it is you have written down or recorded. ‘-)

    2. The oldest WWII veteran who is 109 tells people that his longevity comes from smoking 12 cigars a day, 4 cups of coffee with breakfast, whiskey, eating ice cream every day, eating lots of soup, and other things.

      Sometimes it is genetics.

      1. Deb, I do think genetics is involved to some extent, but how much is still unclear. My mom passed away at 95. Growing up on a small farm, she had plenty of healthy home grown vegetables, but later in life, began eating the SAD diet when she moved to a suburb. And she never liked the taste of meat, so hardly ever ate it.

        1. Darwin,

          My relatives who lived into their 90’s also ate a lot of fruits and vegetables and had a garden growing up and canned for the Winter. They ate a lot of beans and a lot of oatmeal. They didn’t have refrigeration for a long time but did do some hunting and fishing, but that wasn’t for their daily food intake.

          What my relatives have in common with your mother was that later in life they began eating the SAD diet when the community around them became a suburb. They didn’t have to move to the suburbs. It came to them.

      2. That was Richard A. Overton, he lived to age 112.

        George Burns age 100 said, “If I knew I was going to live this long, I would have taken better care of myself.”

      3. The oldest WWII veteran who is 109 tells people that his longevity comes from smoking 12 cigars a day, 4 cups of coffee with breakfast, whiskey, eating ice cream every day, eating lots of soup, and other things.

        Sometimes it is genetics.
        ——————————————————————————————
        Or maybe it is actually those things he is doing.

        Maybe cigar, coffee, whiskey, ice cream, soup companies and a vegan outfit (for controls) could get together and fund a study to see if what he does works?

        1. I think there’s something you can click in the email to unsubscribe, but it didn’t work in my email when I tried it. I just stopped subscribing and started checking back because it will definitely fill up.

  11. One of my sisters-in-law has gone on a medically supervised weight loss, paid for by insurance. It is Keto. Her doctor skews Keto. The doctors around here do seem to skew that direction. Everybody I know who is walking it through with a doctor ended up going Keto.

    She was the one who was eating SAD who got upset when I was cooking vegan for my brother. Keto logic is why she was upset. I didn’t know that she was reading Keto logic because she was eating SAD.

    Well, we talked about this topic instead of the Keto/WFPB debate.

    1. Deb,

      According to an article in the NYT online today:

      “A low-carbohydrate, high-fat ketogenic diet could alter bone health in athletes, according to a thought-provoking new study of elite race walkers and their skeletons. The study, one of the first to track athletes during several weeks of intense training, finds that those following a ketogenic diet developed early signs indicative of bone loss….

      Some studies have suggested, though, that low-carbohydrate, high-fat diets might change bone metabolism. Children with epilepsy who use the keto diet to control their condition tend to have low bone density, for instance. And in athletes, going for a day or two without carbohydrates can change some blood markers related to bone health.” https://www.nytimes.com/2020/02/05/well/move/could-a-keto-diet-be-bad-for-athletes-bones.html

      But I begin to think: who cares? Provide information and evidence to support it, and let folks eat what they want. But the problem with an animal product based keto diet (actually, any animal product based diet, but keto seems especially egregious) is that it’s unsustainable (it takes far more resources in land, water, and petroleum products to grow animals to eat than to grow plants to eat), it’s environmentally degrading, it emits far more GHG thus contributing far more to global warming, it’s cruel to animals and workers in the industry, and it is the major driving force in the development of antibiotic resistance. But, beyond that, it’s not worth arguing about.

      1. Dr J.,

        It is so hard.

        The thing is, I have friends on Keto and some have lost 50 pounds and one has recently gotten off insulin by being more perfect at not eating carbs and THAT is what the doctors are looking at.

        The doctors didn’t take nutrition courses and aren’t watching Dr. Greger videos.

        All they know is that they are using less insulin and losing weight.

        I see them ending up in and out of the hospital and my relative just got a glaucoma diagnosis, but they don’t have the information that I have been watching for the past 2 years and they don’t understand the whole Keto increasing insulin resistance and the whole acetone thing either.

        To be fair, Dr. Greger has a team of researchers and most doctors don’t even have a proper lunch break.

        But the doctors believing Keto is better is why they are choosing it.

        Watching even the adds to Rotten and seeing the animals already would be enough for me. I am still so deeply affected by the imagery of the animals being abused in Eating You Alive. I care about the environment, too, but looking in the animals’ eyes was enough for me.

      2. Dr. J.,

        I do think it is worth discussing.

        The problem is people are so defensive and what I have found is that timing is important.

        I can’t argue with my sister-in-law 3 weeks into her doing a medically supervised weight loss program.

        It would cause conflict in our relationship and pain.

        6 months from now, she may have lost 25 pounds and that would be a useless time to argue.

        1 year from now, she might start having the whole hunger hormone thing happening and THAT is when I can have a discussion.

    2. Seems crazy to me – even bumble bees are smarter enough to know better than to eat keto

      ‘”\The more fat the pollen contained, the less the bumble bees consumed that pollen,” Leonhardt concluded. Bumble bees actually accepted death over having to consume the high-fat pollen. The work group therefore concluded that fat in pollen adversely affects the bumble bees’ reproductive capabilities and survival, which is why it is being avoided.’

      https://www.sciencedaily.com/releases/2020/02/200205084209.htm

  12. Very interesting!
    I like to do sports in the morning and do not like to have s.th. in my stomach during the training.
    I love to have breakfast between 10 and 11 am.
    Is that still suitable?

    1. Chirstiane,

      I think it is covered in the video.

      I think the concept is that the earlier in the day you eat, the better, but it is more important not eating late at night.

  13. Hello, I am so grateful to have found this website and Dr. Greger’s book. My family and I have started to transition to a plant based diet and we love it. I do have a question regarding a recent study. My extended family questions whether a plant based diet can fulfill all nutritional needs. I reference back to information I find here often. The most recent question was regarding the study done that finds a decrease in heart disease in plant based diets, but an increase in strokes. Is this a valid study? If so, how do we mitigate that increased risk? Thank you

    1. Erica,
      Just watched Dr Fuhrman on The Real Truth About Health Conference 2020, and he explained why this is. It has to do with our salt intake. Keep your salt intake relatively low and this increase in “hemorrhagic” strokes in the plant based eater should not happen.

        1. Geez, YR, you’re sucha stickler for science!

          https://youtu.be/KWhyo9esvwM

          No references (it’s a Q&A session) but he spells out his thinking ~34 minutes. Along the way he destroys Gundry and whacks the ‘gurus’ who confidently tell people there’s no reason to supplement with DHA. Oh, he also whacks the anti nut eating contingent. Pure Fuhrman.

          1. One thing he mentioned got my attention: some people require more sodium than others. He recommends determining the level by testing (I don’t see my doctor willing to do that). I appreciated the fact he mentioned individual variation as that’s one of my pet peeves. One of my doctors recently advised me to increase my intake a bit to make sure I a avoid hyponatremia.

            1. Basic Metabolic Panel – This blood test gives information about your body’s metabolism, or how your body uses food for energy. It gives a snapshot of the health of your kidneys, your blood sugar levels, and the levels of key electrolytes, such as potassium and sodium. A basic metabolic panel test measures the levels of eight important things in your blood:

              My doctor does this panel routinely especially since I was diagnosed with hyponatremia a year ago. I have to work at taking in enough sodium to keep the blood test in the low normal range. I still have to shake myself from thinking I’m using too much salt (1800 mg daily) because of information from this site.

              1. I had a hyponatremia episode back in the summer of 2010. (Won’t go into the details, as I’ve done so before here.)

                What if you’re taking BP pills AND have continue to have low sodium readings when you have a blood test? Catch-22, or what?

                1. BP pills work in different ways. Is it a diuretic? or something else.

                  Over the 16-year follow-up period, the researchers observed that the participants who consumed under 2,500 milligrams of sodium each day had higher blood pressure than those who consumed higher quantities of sodium.
                  Research has shown that there is a “J-shaped relationship” between cardiovascular risk and sodium. This means that low-sodium diets and very high-sodium diets both carry a higher risk of heart disease.
                  https://www.medicalnewstoday.com/articles/317099.php#1

                  Hypertension- High blood pressure is common in people who are chronically dehydrated. When the body’s cells lack water, the brain sends a signal to the pituitary glad to secrete vasopressin, a chemical that causes constriction of the blood vessels. This causes blood pressure to increase which leads to hypertension.
                  I lost the site that put it this clearly.

                  1. CP, Thanks for bringing this up. I’ve wondered about the sodium J curve studies but am unaware that Dr. Greger or others have dealt with them.
                    I’ve read studies pointing out that low sodium intake can trigger the *renin–angiotensin system* (*RAS*), to increase sodium retention, and this is itself a stressor.

                    https://en.m.wikipedia.org/wiki/Renin%E2%80%93angiotensin_system

                    Under 2500 mg strikes me as a quite high lower bound, and begs the question as to whether that level is high enough to cause the kind of microvascular damage discussed by Dr.Greger and Dr.Fuhrman, or possibly to higher hemorrhagic stroke risk in vegetarians and vegans.

                    Sodium restriction is clearly important for those who are sodium sensitive, and it’s said most with high BP are. On the the other hand, there is no simple or reliable test for sodium sensitivity.

                    https://www.ahajournals.org/doi/full/10.1161/01.HYP.0000091267.39066.72

                    “Regarding consistency of response, systolic blood pressure change with run-in versus lower sodium was modestly correlated with systolic blood pressure change with higher versus medium sodium; systolic blood pressure change with higher versus lower sodium was similarly correlated with run-in versus medium sodium (combined Spearman r=0.27, P=0.002). These results show low-order consistency of response and confirm that identifying individuals as sodium responders is difficult. They support current recommendations for lower salt intake directed at the general public rather than “susceptible” individuals as one of several strategies to prevent and control adverse blood pressures widely prevalent in the adult population.”

                    leading to the general recommendations, and begging the questions associated with the J. curve studies and RAS activation. All of this makes me skeptical of general recommendations.

                    It seems to me there is still a lot of unclarity on this topic.

              2. Right. I do get a complete metabolic panel plus various other things annually. But to calibrate sodium blood serum levels with salt intake would require a fair amount of testing. My GP had recommended not adding salt b/c she has concerns it might raise my BP. I think she does not really understand how little sodium I would get if I added none, probably around 350 mg/d. I did go super low, ~ 400-600 per day. But at some point I was not recovering from exercise and got very fatigued and when I asked my sports medicine doctor about this, he said low sodium could be a reason. He tested my sodium level and it was low normal. However, I happened to have eaten restaurant food for several meals, which I do not do often, and that could have skewed it upward. On that basis, he recommended upping my intake a bit, which I am doing but it is still low (< 1000 mg). Juggling the various factors is a bit frustrating. I really don't want to go any higher than necessary, but mild, chronic hyponatremia is definitely something to avoid.

          2. “Geez, YR, you’re sucha stickler for science!”
            – – – –

            Actually, I said what I did with tongue firmly in cheek. I’ve read too many comments by Fumbles., the real stickler. *_^

            I agree with you that some people need more sodium than others. Pretty sure I’m one of them. :-(

            1. I do prefer to go with what scientific knowledge indicates rather then the claims of internet marketers, industry funded experts, New Age con artists and/or highly opinionated cranks. That must make me some kind of weirdo I suppose.

              1. Not at all, but you sometimes put those who have personal anecdotes regarding health issues into the same category as whackos.

      1. Dr. Greger, what about those of us who can’t afford the webinar (we are out there :( ), when and how can we get access to some of that very important sounding info being presented? I definitely want to know as soon as I can.

    2. Erica,

      Dr. Greger has a stroke Webinar coming up. I am already signed up. It is a suggested $20 donation, I think.

      The information will be on the site eventually.

      That being said, the overall stroke rate – meaning combining ischemic and hemorrhagic – it is the meat-eaters who have more total strokes. There is a subset where the vegetarians had more, but the study, the people were eating a lot of sodium and oil and weren’t eating much fiber.

      1. What I remember from when that study came out was that the Adventists didn’t have the same stroke rates as the vegetarian group in England and the Adventists are the ones who actually eat closer to WFPB.

      2. “That being said, the overall stroke rate – meaning combining ischemic and hemorrhagic – it is the meat-eaters who have more total strokes. There is a subset where the vegetarians had more, but the study, the people were eating a lot of sodium and oil and weren’t eating much fiber.”

        Deb, thank you for this info, so helpful!! I know you well enough to trust you’ve done your research so you know what you’re saying.

    3. https://www.bmj.com/content/366/bmj.l4897

      1. Vegans were lumped together with vegetarians because they were not large enough in number. Vegans made up only 2.8 percent of the total participants in the study, and only 12.1 per cent of the “vegetarian” group they were lumped into. There was no differentiation between healthy vegetarians and junk food vegetarians.

      2. The vegetarians ate 29% more cheese than the omnivore groups.

      3. The veg group actually had a lower risk of hemorrhagic stroke than meat eaters but their data were statistically adjusted because their average age was less than the carnivores and they were on less medication.

      4. The conclusion that stroke risk was significantly higher (20%) in the veg group (after statistical adjustment) was for the less frequent hemorrhagic stroke not for the more common ischemic stroke.

      5. The veg group had significantly lower ischemic heart disease. Further, there were over 9 times as many incidents of ischemic heart disease than hemorrhagic stroke.

      6. The authors say that vegetarians and vegans had lower levels of vitamin B12, vitamin D and long-chain omega-3s(EPA and DHA) and suggest that may contribute to the observed association. These data were collected 20 years ago in England and vegans are now more aware of the importance of vitamin B12. Public Health England has also changed its advice to suggest that everyone should take a vitamin D supplement. Similarly, omega-3 has gained attention and vegan EPA and DHA supplements are available.

    4. Erica – also, check out John McDougall, M.D.’s website. He was one of the original WFPB advocates decades ago, before Dr. Greger (he’s also older and got started earlier). But Dr. McDougall has a ton of medical information on his site as well. Huge amount of information there.
      https://www.drmcdougall.com/

    5. Erica

      You asked ‘The most recent question was regarding the study done that finds a decrease in heart disease in plant based diets, but an increase in strokes. Is this a valid study? If so, how do we mitigate that increased risk? .’

      First, it wasn’t really a study of people eating plant-based diets. It compared people not eating eat (whom it defined as ‘vegetarians’) with people who ate meat.

      Second, there were 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in ‘vegetarians’ than in meat eaters per 1000 population over 10 years. There were however three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke. In other words, these non-meat eaters actually had a net 7 fewer adverse events per 1000 population over 10 years than in meat eaters.
      https://www.bmj.com/content/366/bmj.l4897

      It’s fascinating how meat eaters only want to talk about the three more stroke cases, and ignore the ten fewer heart disease cases, found in non-meat eaters.

    6. Adding to what Deb has already mentioned, it seems clear to me that it was a bad study as the details provided by Dr.Barnard shows.

      https://www.pcrm.org/news/blog/meat-and-stroke

      “Well, it was not a randomized trial in which volunteers are assigned to groups and care is taken to ensure that the comparison groups are very similar. In this observational study, volunteers diverged on certain points.”

      “And the vegetarians ate more cheese—29% more than the meat-eaters. This is of concern, given that cheese is high in sodium (higher than potato chips, gram for gram), which is a leading contributor to stroke risk.6 Cheese is also high in saturated fat, which, along with sodium influences blood pressure and stroke risk.7″

      Possible overadjustments:

      ” In contrast to the headlines, there were ***actually fewer*** hemorrhagic strokes among vegetarians than meat-eaters. The actual risk was 0.00032 per person-year among vegetarians, compared with 0.00039 per person-year among meat-eaters. In other words, ****hemorrhagic strokes were slightly more common among meat-eaters and less common among vegetarians***. However, the researchers then made ****various statistical adjustments*** for age and other factors (which may have been entirely appropriate), which led to the report that this particular kind of stroke would be expected to occur less frequently among meat-eaters.”

      Finally note: “A 2016 report combining the results of the EPIC-Oxford cohort with the Oxford Vegetarian Study did not find a significantly higher risk of dying of a stroke among vegetarians or vegans, compared with meat-eaters”

    7. I’m glad you are transitioning to a WFPB diet and encouraging family members to educate themselves about the benefits and that you turn to this website for reliable information. As far as clear statements about if one is getting the proper nutrients on a plant based whole food diet, consider this for support:
      The Academy of Nutrition and Dietetics states in its position paper on vegetarian diets that “appropriately planned vegetarian, including vegan diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases.” The academy goes on to say “These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes.

      As far as stroke and wfpb nutrition, I’m not sure which study you are referring to. It may have been one hat was poorly designed or funded by Big Food companies. Certainly there are many well done studies showing that stroke risk goes down with a plant based diet.Here’s one: https://pubmed.ncbi.nlm.nih.gov/24964573-health-benefits-and-risk-associated-with-adopting-a-vegetarian-diet/?from_term=stroke+increases+on+plant+based+diet+study&from_pos=1/

      For more on how to reduce stroke risk with diet, see:
      https://nutritionfacts.org/video/best-foods-to-reduce-stroke-risk/
      How to Prevent a Stroke
      Preventing Strokes with Diet
      PREDIMED: Does Eating Nuts Prevent Strokes?
      Food Antioxidants, Stroke, and Heart Disease
      Chocolate and Stroke Risk
      Does Diet Soda Increase Stroke Risk as Much as Regular Soda?
      Lowering Our Sodium-to-Potassium Ratio to Reduce Stroke Risk
      Each of these studies will include citations to research studies to prove the point that plant based diets reduce stroke risks.

  14. Great video! I think this is stuff we have no idea about but really should! And this ties up some of the videos leading up to this from the last couple weeks.

    Question: What would you suggest to eat if you come home around 8pm hangry? Or should you tough it and go to bed hungry?

    P.S. I’m a new viewer and I’m enjoying!

    1. Victoria, I try not to eat anything after supper, which for me is early. I have seen 7pm mentioned as the ‘cutoff’ time too. I make a cup of herbal tea , or pour a glass of carbonated water to drink while I read before bed. I sleep better as a result!

  15. I don’t think it is reasonable to think a person will have their final meal by 4 pm. I’m just not convinced that a blood sugar spike at night is a reason to shift one’s diet to an earlier part of the day. I also believe Dr. Greger mentions in his book “How not to Diet” that by skipping breakfast, a person eats calories during the day, resulting in weight loss. Seems to be a contradiction here.

          1. ‘fewer’ refers to differentiated quantity, eg fewer bottles of water
            ‘less’ refers to undifferentiated quantity eg less water

            In other words, if you can count them it’s ‘fewer’
            If you can’t count it, it’s ‘less’

              1. OMG! I just now started watching the Fuhrman link that gengo posted, and when I heard the good doc say “less animal products”……:-O

                Just because they can stick an M.D. next to their names doesn’t mean they’re savvy in the grammar department! Dr. G. gets that right, at least.

    1. I’m just not convinced that a blood sugar spike at night is a reason to shift one’s diet to an earlier part of the day.
      ———————————————————————————————
      Good point… what if it turns out that a blood sugar spike at night is a healthy thing?

      And even if it is not, maybe there is something we can eat that actually attenuates the blood sugar spike.

      1. Lonie, It seems to me it would depend on the degree of the spikes. Over 140 is not healthy in general, at least if frequent and for a fairly long period as that’s the level at which damage to cells can occur and risk of disease goes up.

        https://www.drmirkin.com/health/diabetes/the-hidden-epidemic-of-early-diabetes.html

        “If blood sugar levels rise above 140 mg/dl (7.8 mmol/L) after you eat, the sugar in your bloodstream can stick to the outer membranes of all types of cells in your body. Once stuck on a cell, blood sugar cannot get off and it is eventually converted by a series of chemical reactions to sorbitol that destroys that cell.

        This month, researchers showed that people whose blood sugar levels rise above 140 one hour after a meal already have all the same markers of arteriosclerosis as proven diabetics, even though they may have normal fasting blood sugar levels and a normal glucose tolerance test ( *Atherosclerosis*, Jan 2017;256:15-20). Another study followed people with one-hour-after-eating-blood-sugar levels over 155 and showed that they die significantly earlier than those whose blood sugar levels do not rise that high after eating (*Diabet Med*, March 21, 2016. 10.1111/dme.13116).”

        1. This month, researchers showed that people whose blood sugar levels rise above 140 one hour after a meal already have all the same markers of arteriosclerosis as proven diabetics, even though they may have normal fasting blood sugar levels and a normal glucose tolerance test ( *Atherosclerosis*, Jan 2017;256:15-20). Another study followed people with one-hour-after-eating-blood-sugar levels over 155 and showed that they die significantly earlier than those whose blood sugar levels do not rise that high after eating (*Diabet Med*, March 21, 2016. 10.1111/dme.13116).”
          ———————————————————————————————————————————————
          Gengo, that is some scary stuff.

          But what I would like to see is a challenge test to the conditions above. That is, how would someone with those conditions react to eating a bowl of blueberries daily?

          IIRC, blueberries are supposed to protect against atherosclerosis, aren’t they?

    2. Mark,

      It isn’t a contradiction. People can eat fewer calories and lose weight, but the people who eat those calories in the morning will lose more weight and are more likely to have been A1C readings.

      If you watched the morning eating versus evening eating, the people who eat in the morning could eat an extra 500 calories per day – 20,000 extra calories in 6 weeks and still be at the same weight as the night eaters. That is a significant difference.

      People who are trying to lose weight or manage pre-diabetes or diabetes probably need the message more than other people.

      I think the fact that people are crossing into Diabetic sugar levels just by eating at night is so important.

  16. I was curious, did this study factor any variance into a person’s chronotype? I believe that there are studies that show, although most people tend to be “Morning Larks”, there are still are other chronotypes. I.e. “Night Owls”. And their circadian rhythm varries.
    I guess I’m wondering, is this based on a specific time of day, or is it relative to the time the person typically wakes up?
    Thank you for everything that you do! I really appreciate your vigilance for facts and scientific evidence for basis of health!

    1. Matthew,

      Good question.

      The last video had a test where they tested for night shift work, but Chronotype wasn’t specifically tested.

      My brother always was a night owl. From birth. Not related to night shift or partying. He just always was one.

      I have insomnia now, but when we tested chronotypes in school, I was sleeping at nught, but I functioned much worse on the morning tests.

      They did a battery of tests and even when I was going to bed by 8 pm, I failed the morning tests and did well at night.

  17. The higher blood sugar at night does not apply to all, I work nights and my blood sugar when I wake up at 8:30pm is only 110 or less. When I switch to being a “day” person on my days off or vacation time, my morning blood sugar is 126 or higher. And that is after a 10-14 hour fast!

  18. i have a question: to pursue health it’ s right to keep in mind “when” is correct eat sugar; but after a training for 2 hours at 11.00 in the morning, become correct to restore sucre in the liver and muscles during the next 8/10 hours? and in wich way (every 2 hours or …)

  19. After a training of about 2 hours at 11.00 in the morning it’ right to take sugars every 2 hours for 4/5 times ?
    And what kind of sugar?
    Thanks

    1. Daniele,

      You use the word “sugar” and I would switch your word to “carb” and say that whole foods like fruit versus simple sugar is always the Better choice.

  20. Hi, I’m working out every day at 20:00 until 21:30 aprox. So I’m having my last meal at 22:30 hrs aprox.
    What should I eat in my last meal in order to get the benefits of eating calories earlier in the day ? Some kind of protein and some fruit maybe? Thanks

    1. Leo, from what I have read on this topic so far, the only thing that will give you the ‘benefits of eating earlier’ is to in fact, eat earlier. Macros don’t enter into it. The studies mention eating before 7pm.

      There are more videos to come which may have information relating to your question. See under ‘Doctor’s Notes’ Stay tuned!

      1. Barb, thanks for the answer.
        The only way to get the benefits of eating earlier would be not eating anything after my workout until next morning. But I don’t know if this would be the way to go becouse I sometimes do high intensity cardio…
        Any ideas? I can not change my workout schedule

        Thanks

    2. Hi leo Quintana, well done for having a routine of working out! I would suggest some cooked lentils in a form of stew with some tomatoes and onion (1 tea spoon turmeric, pinch of curry powder and pepper ). You can add some cruciferous vegetable either broccoli or cauliflower and some sweet potatoes to it and serve it on a cooked basmati rice or Quinoa with salt and pepper to taste. This is my recipe I make sometimes. Wish you good health. I also include Dr Greger daily dozen link as your guide.
      https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist-2/

      1. I’ve found it difficult to do myself, but Dr Greger has said just dont eat after 19:00.

        The solution may be found in his other suggestions to work out before 12:00.

        He’s got an app Daily Dozen. it includes 21 Tweaks” .

        As one accomplishes the Daily Dozen recommendations items consumption, and the 21 tweaks items , you then check the box.

        The goal is to check all 33 boxes each day, and to record your weight twice, sleep in an interesting position, and to write and revisit life intentions.

        It ain’t easy but is helping me quite a bit.

        best of luck.

      2. Thanks for the answer spring! I also thought to eat something like some legumes with vegetables after my workout. And the next day I would have a big breakfast to fuel my muscles and get the benefits of eating earlier in the day.

        From all the videos I got the message of breakfast like a king and dinner like a pauper

  21. This is off-topic but people might be interested in a piece in Dr Mirkin’s latest newsletter (9 Feb 2020)

    ‘A study of 5571 adults found that people who have higher blood levels of vitamin B12 are more likely to die prematurely (JAMA Netw Open, 2020;3(1):e1919274). Compared to those with lower B12 blood levels, people with higher B12 levels (>455.41 pg/mL) were likely to:
    • be fatterwhave higher blood pressure, higher cholesterol, and higher blood sugar
    • die prematurely of any cause
    This study does not show that having high blood levels of B12 shortens lives. It is more likely that people with high B12 levels are doing something that both raises B12 levels and shortens lives’

    Biologically active B12 is found only in animals; it is not found in plants. You would expect people who eat the most meat to have the highest blood levels of vitamin B12, and eating meat daily has been associated with increased risk for premature death (Amer J of Clin Nutr, May 2019;109(5):1462-1471).’

    1. And also his latest piece in the newsletter on high protein diets.

      “*Why a High-Protein Diet May Increase Risk for Heart Attacks*

      A recent study in mice showed that increasing dietary protein from 15 percent to 46 percent of calories caused the mice to develop 30 percent more arterial plaques than mice on their normal-protein diet, even though they did not gain more weight (*Nature Metabolism*, Jan 23, 2020;2:110-125). Furthermore, the mice on the high-protein diet were at very high risk for heart attacks because the plaques were unstable .
      This study could explain why high-protein diets are associated with increased risk for heart attacks in humans.”

      1. Thanks, Gengo.

        That one scares me because my sister-in-law was talking about how much less hungry she and my brother are now that they eat so much protein on her medically-supervised diet.

  22. Hey , Dr. Greger, I’ve got to say I really like the speckled blue tie! Looks great! The green ones are trademark at this point, but honestly a little sensory-jarring.

    Love the chronobiology work, confirming what I’ve been preaching all along, only now your research findings back it up! You’re the best!

  23. Sorry to go completely off topic but since this is the newest video and I couldn’t find an answer to a question I have through researching this site,so I figured I would ask it here:

    ALL,

    Any information on GRAPESEED OIL?? Bad? nots so bad? good? heating it matters?

    Nothing here on nutritionfacts.org when I search “grapeseed oil”

    Thanks!

    1. Fender or upright jazz bass,

      Just stick to what has stood the test of time for thousands of years, extra virgin oil, you will do well.

      What nutritionally stomach churning bass lines do you prefer, Jaco Pastorius, Jack Bruce, Charlie Mingus or Paul Chambers?

      1. Thanks Yerky, its my go to oil if I do eat it, but in this case I really I just want to know if I can occasionally eat some yummy Veganaise (made with grapeseed oil), as I am trying to keep almost all added oils out, its nice to sometimes have that “treat”.

        Most my oils though, coming from nuts and avocado etc..

        Was Jack Bruce a jazz bassist? ( and of course, all of the above concerning the other 3 cats.)

    2. Jazz,

      Most of the plant based doctors say to keep all oils to a minimum.

      Most recommend oil-free cooking.

      If you go to Mic the Vegan’s interview with Dr Greger, he talked about how much oil people can get away with eating.

  24. A king-prince-pauper diet combined with the idea in Ex. 16, how would that diet fare to wfpb? Also, I’d like to understand how diet and sleep are related. What’s a great diet for sleep if for instance you lead a sedentary life but are otherwise not requiring medical care? I would like to get continuous sleep all night.

    1. Arthur,

      Dr. Greger has a video on pistachios as a source of melatonin versus pills. I think it was 2 pistachios gave similar melatonin to a supplement. There was also a Kiwi study with sleep. You can probably look up sleep in the topics.

      1. Something I found interesting in looking at the people living in countries without much sun in Winter and with a lot of sun in Summer was that it was Winter when they got insomnia. They call it “Winter insomnia” and that fascinated me.

        I would have thought they would have had trouble sleeping when it was light all of the time.

        When I was in Sweden during the midnight sun, I was walking around Stockholm at 3 in the morning watching the very big chess pieces – with a bunch of radical Muslims. I didn’t know that part until hours and hours into the traveling conversation where they talked about where they came from someone’s head was cut off for something. I was always very naive. But anyway, I thought I couldn’t sleep because it was light out and I thought “They must have a lot of Summer insomnia” but they don’t. They have Winter insomnia. Summer insomnia is considered rare. I wonder if that is related to Vitamin D.

        1. Experts are out there telling people to make sure the room is dark enough, but places with midnight sun don’t have insomnia during that season.

          That caused me to look up Vitamin D and insomnia

          https://n.neurology.org/content/90/15_Supplement/P5.320

          Symptoms were improved starting from the first week and there was no need of increasing the dosage or adding another hypnotic agent. No withdrawal effect was seen.

          They gave one dose of 50,000 IU followed by 1000 IU per day for a month.

          I know that I miss taking my Vitamin D half the time.

          I am going to see if I can get one mega dose and try what they did.

  25. I was over at YouTube and someone asked about places where it is dark all the time in the Winter and light all of the time in the Summer and I looked it up and found it interesting.

    Yes, it does affect you. It causes increased insulin resistance and elevated triglycerides.

    That links this video to the Vitamin D blog.

    Maybe.

  26. I wonder if these findings might lead to some insight into the French Paradox. Americans often finish the dinner meal with a high glycemic dessert while the French finish dinner with a salad.

  27. I have struggled with multiple sleep disorders my entire adult life. I have delayed sleep phase disorder (with a tendency to both long sleeping and non-24), sleep apnea, and my (latest) doctor also suspects I have idiopathic hypersomnia or narcolepsy. I’ll be having my 5th sleep study next month. I have other health problems as well and am “pre-diabetic”. I take a variety of medications. The time when “normal” people eat “breakfast” is the time of day I am least likely to be awake, and, if I am awake it’s likely because I am still awake from the day before so for me it is actually very late at “night”. Is there some way to apply the lessons from this video to my diet given my chaotic sleep schedule?

    1. Indigo55- It sounds as if you do have your challenges and I am glad you are working with a specialist to try improve your ability to get good sleep. Certainly you don’t want to be additionally worried about your sleep/food schedule or interrupt your sleep to force yourself to eat. While timing of your eating is important, remember the WHAT of your nutrition is even more important than the WHEN. You could certainly speak with your doctor to ask if you can help your body adjust to a more normal circadian rhythm, perhaps gradually going to sleep earlier. As a nurse I’m certainly hoping you are also focusing on the pre-diabetes diagnosis. For you focusing on a whole food plant based diet is especially important and may help you with the other health problems you mentioned. Please check out these videos: https://nutritionfacts.org/video/turmeric-curcumin-for-prediabetes/
      https://nutritionfacts.org/video/lifestyle-medicine-is-the-standard-of-care-for-prediabetes/
      https://nutritionfacts.org/video/how-to-prevent-prediabetes-from-turning-into-diabetes/
      While it sounds like you’ve had your challenges and difficulties dealing with the sleep issue, there are definite steps you can take to improve your diabetes risk which in turn may improve your overall health even your sleep. Best of success facing those health challenges.

    1. Hi there, if I’m correct in the graphic that you’re referring to, the purple bar is showing the eating time. So first he’s saying best to skip dinner, and the bar is from morning to early evening. Does that make sense?

  28. Brilliant info, but I so do wish they would do these kinds of studies on WFPB eaters… I highly suspect that while it wouldn’t change our incredible circadian rhythms, that the differences seen would be remarkable.

    There just aren’t enough studies on those eating WFPB—or as I say it, proper—diets. And you can’t compare the ongoings in the human body of those on westernized diets to those eating WFPB.. I mean obviously to a point.

    I do love the way I feel on an earlier schedule and not eating past 7 or at least 8, but I don’t worry about calorie timing, I just make sure I’m always putting really good stuff in me and that has worked fantastic.

    How does something like fruit or a bowl of brussel sprouts or something act when eaten late? Has this been looked into?

    Mildly off but still somewhat on topic: As someone who has lived as an extreme night owl on and off, I have noticed that I do so much better mentally on an earlier schedule regardless of how healthy my diet and lifestyle is.

  29. What foods should we be eating with this method? If we allocated say 900 calories for breakfast, 600 for lunch, and 500 for dinner… Is that 900 calories of breakfast foods like oats, fruits, whole grain breads… Or should we just swap dinner/vegetable type foods in place of breakfast?

    My guess is it would be whatever foods give the most energy and help clear brain fog for breakfast and lunch… Though im not too familiar with what foods are better for that.

    1. Kyle, I think it’s whatever you prefer so long as it’s whole plant foods.

      For brain fog, there is a lot of useful info here. I highly recommend his video on green tea and brain wave alteration (matcha helps me so much) and greens vs the blues I think the other is called. Wild blueberries are great for the brain as well, I would check out videos on that. And as Dr. Greger has always said, what’s good for the heart is good for the brain, so heart healthy keeps the brain healthy too. Hydration is important for avoiding brain fog too! Dehydration can cause brain fog I’ve always heard.

      1. Thanks for the reply!

        Taking that info, I got the idea to make a Matcha wild blueberry smoothy with some greens, seeds for fats/protein, fortified soymilk for protein/calcium/b12, dates for sweetness and a banana to smooth things out.

        Made this today and its pretty good ✌fills out the calories for breakfast. I also usually drink smoothies super slow for some reason and it keeps my hunger down as a result so I can eat less at lunch and dinner. Wins all around!

          1. Just to give all the info so you can decide what to do with it, there was an old video (2010) showing that in a petri-dish study, soy milk, like dairy milk, blocked some of the antioxidants in tea: https://nutritionfacts.org/video/soymilk-suppression/ However, when they tested soy milk in humans–using coffee in the human study–they found that while dairy did in fact block antioxidants in things like coffee, cocoa and tea, soy milk had a reverse binding process, so initially it bound to some of the antioxidants but then they were re-released back so there was no significant difference in the absorption of antioxidants with the addition of soy milk: https://nutritionfacts.org/video/does-adding-milk-block-the-benefits-of-coffee/ Great news! (plants are awesome). So soy seems to be in the clear in combining with these things. But I just thought I would give you the info if you haven’t seen it. It’s good to know the latest anyway because you never know when you’ll hear someone say soy blocks antioxidants of these things, now you’ll know where that’s coming from and what the latest and in-vivo human evidence shows.

  30. I’m curious if supplement takers (like me) are better off taking all our supplements in the A.M.? I do take many of my regimen before noon, a few more in the afternoon, then some others just before going to bed.

    But if they are better assimilated in the early hours, I could certainly change to getting more of them taken early on if I am benefiting by doing so.

    1. Just warmed up a can of Chicken and wild rice. Added various herbs and spices along with some hemp protein powder. I’m eating half of it now (late afternoon) and the rest tomorrow. Also eating a couple of Rye Crispbread boards (crackers) along with it.

      NOT Sorry! ‘-)

  31. I live in Singapore. We get lots of sunlight. That’s the vitamin D information. Lol.
    Now my question is that I work the night shift.
    My routine is as follows:
    Sleep at 3-4 pm till 10 pm.
    A fruit at 11 pm. Or a soup with lots of vegetables such as minestrone.
    Work till 5.30 am.
    If I get hungry during the work hours I eat another fruit….a banana, or orange, or an Apple, or guava.
    Herbal tea no sugar or sweetener of any kind. No milk.

    A glass of smoothie which is a mixture of fruits and veggies such as spinach, celery, Kiwi fruit, green Apple or pear, coriander leaves, mint leaves, cucumber, fresh lime juice. Or red Apple, beetroot, carrot, ginger, fresh lime juice. Or spinach, mint, coriander, blue berries, strawberries. Or spinach, mint, coriander, red Apple, red plums, peach.
    Go for 5 km walk or 8-10 km Cycling – 8 am to 9 am in the sun.
    Breakfast at 9.15 am. Breakfast consists of some sort of bean preparation with lots of veggies,fruits, a bowl of fresh home made yogurt.
    Mid morning ..eat a carrot or cucumber and sometimes a 3 in 1 coffee or black coffee with some sugar.
    Lunch at 1.30 pm. Lunch consists of rice, pulses or legumes, vegetables, a bowl of fresh home made yogurt. Yogurt is made from full fat milk.
    Most times no dinner.

    I am allergic to wheat so do not eat any wheat products.
    I do take a maximum of 1 tsp added sugar in my coffee if I have it in the day.
    No milk except in the occasional coffee or ice cream….once a week.
    I am a vegetarian. So my diet does not include any meat.
    I cook my food in almost zero oil. I cook my food in zero oil but my Husband cooks with a teaspoon of oil….hence almost.

    How does this kind of lifestyle work with the circadian rhythm?

    1. Tulika, just a suggestion… I’m not sure if they’re available where you are, but if so, I highly recommend trying some of the vegan ice creams out there to replace your once a week dairy ice cream. They’re actually really good! I don’t eat them anymore, but when I did, I found cashew ice cream, almond ice cream, and soy ice cream to be SO much better tasting than dairy ice cream. Coconut ice cream was never a favorite of mine, though, although it was still good.

      Another good replacement “ice cream treat” and a favorite of mine… freeze some bananas but wait until they get VERY ripe–lots of brown spots on the outside–blend up water and a bit of almond butter (makes almond milk) or any plant milk but that’s the method I use, frozen strawberries and frozen banana (amount depending on taste.. they sweeten it and add a thick ice cream-like consistency). You can make it thicker and eat it like ice cream or drink it like a milk shake.

      1. Indeed, vegan commercial ice creams are really quite good (I like the Soy Delicious brand, the ones using a cashew base (to stay away from the coconut fat), but the added sugar, palm oil, tapioca syrup, thickeners and other junk added to the concoction make it pretty unhealthy.

        I love and favor the frozen banana, frozen strawberries and dates for sweetness, all wizzed up in a Vitamix blender. Add cocoa powder (non-alkalized) to make it chocolate. Delicious and nutritious! I use two frozen bananas (cut up before freezing) and six frozen cored whole strawberries. Add dates. I soak, drain and then puree dates to make a thick paste, Vitamix again, and keep that in the fridge for general sweetener use. The soak water is like honey. Delicious. For the ice cream, I use three dates or three tablespoons of date puree.) Mixing in add-ins makes it even better. I make a Rocky Road by folding in nuts, seeds and raisins. Bananas, strawberries, dates, raisins, nuts and seeds … what could be better?! … just not late at night, as we have recently learned.

        This makes a great faux ice cream, best eaten right away. Since it does not have any fat in it, it gets quite hard when frozen.

        Sent from Mail for Windows 10

        1. Stephen, I love the rocky road idea, sounds good!! I agree, the commercial vegan ice creams aren’t exactly health foods (though better alternative to traditional dairy ice cream, for sure) and the palm oil is especially bothersome to me for moral/ethical and environmental reasons first and foremost. Coconut Bliss has surprisingly pure ingredients but I don’t like the coconut fat, however still better than dairy—their ice cream cookie sandwiches are AMAZING even though I no longer eat them lol. And I have found a pure cashew ice cream online without all the icky stuff, but I have yet to try it—it’s organic, too! I forget the name of their company but they also make vegan candy bars and they used to be (maybe still are, I haven’t checked) sold at the site veganessentials.

          But all the banana and berry nice creams are the best—a powerhouse of health while tasting like an indulgent dessert—I am a firm believer of having my cake and eating it too and find it quite easy to do as a WFPB vegan.

          1. What I especially like about the banana/strawberry/etc. faux ice cream is the fact that the whole thing is from whole foods (with the exception of cocoa powder, which in my mind is better than the whole bean since the only things removed are the fat- which is mostly saturated- and probably some fat soluble nutrients).

            Sent from Mail for Windows 10

  32. Brilliant. As always. I’m going to adopt the advice. And will continue to contribute and promote your videos. Problem: all that jumping around and hand motion was distracting. Keep up the great work!

  33. Agree. In an effort to continue this conversation forward … It seems most folks trying to stay up on the TRF literature understand that skipping dinner is the ideal, but in-practice many people find skipping breakfast is easier to implement because of family or other social reasons. The piece of information that hasn’t yet seemed to be included in the skipping breakfast studies is stripping out breakfast skippers that compensate with late evening meals. In other words, I am interested in data exploring skipping breakfast, but eat lunch and dinner in a narrow time window that is NOT late in the evening. Again, I think the data demonstrates this is not ideal, but I think it would be good to understand the practicality / efficacy trade-off.

  34. This explains why my son was diagnosed as diabetic at the age of 9 months, and last year at the age of 40. He’d eaten birthday cake the night before the blood test.

  35. If I combine a few information from the past videos on circadian cycles, given that there is a certain plasticity with the circadian cycles especially using the “internal” trigger of eating. If someone were to regularly skip breakfast, wouldn’t the body come to expect it and move the insulin cycle to fit it? As in what if the experiments were done on long time “LATE” time-restricted feeding individuals as opposed to regular people who eat three meals a day?

  36. While as a night owl, I appreciate your thinking, I’m afraid it may be more wishful thinking, or at least a big jump to think the body will adjust so much that the recognized circadian rhythm pattern would modify insulin cycles accordingly. Down the road there may be studies that look specifically at subjects doing TRE starting much after the sun is up (thus skipping breakfast) the research now if pointing towards front loading the eating as Dr. Greger says, much as those of us who are late eaters would prefer otherwise. Some experts minimize the importance of internal eating “triggers” or suggest we eat our lighter dinners earlier which may promote feelings of hunger earlier.

  37. I have become basically a vegan in the last three weeks. I’m finding it very difficult to lose or shed any weight. I’m 63 years old and I can’t seem to figure out how to lose any weight. I am so frustrated! Can you help me?

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