How to control between-meals grazing

HOPE WARSHAW
Last updated 05:00 21/05/2014
Snacking
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CHOCOHOLIC: Reaching for a sweet treat every afternoon? Read on to find out what you should eat earlier in the day to ward off those cravings.

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Q: I try to eat breakfast, usually yogurt and granola, right before I leave for work, but it seems like I'm hungrier by midmorning if I eat breakfast than if I skip it. Then if I eat my lunch by midmorning, I'm hungry again by mid-afternoon. What's your advice to control between-meal hunger?

A: Your dilemma with breakfast is common. If I were counselling you individually, I'd gather additional details about how much and what you eat. I'd determine your nutrition, weight and health status concerns and goals. Without these details in hand, I can offer general guidance.

Your breakfast, of yogurt and granola, probably totals 150 to 250 calories. The calories are mainly from carbohydrates, with minimal protein and fat. That's not much to get you through your morning.

People tend to eat a light breakfast or skip it altogether. Then we grab lunch on the run and end up eating the bulk of our calories in the evening - not generally a healthy pattern.

"Consuming minimal calories for breakfast as refined carbohydrate (starches or sweets) can leave you 'hangry,' meaning a person is so hungry they get angry," says Louis Aronne, physician and professor of metabolic research at New York-Presbyterian/Weill Cornell Medical Center specializing in weight management.

A number of hormones play key roles in whether we feel hungry or sated. They work in tandem like a well-oiled machine - that is, until their fine balance is disrupted.

This can happen with weight gain and/or insulin resistance, often the precursors to metabolic syndrome, prediabetes and/or Type 2 diabetes, which today affect millions.

Here's a basic primer on several key hunger and satiety hormones:

- Insulin: Produced and secreted from beta cells in the pancreas. Insulin plays a central role in the breakdown and processing of carbohydrates, protein and fat - the main calorie-containing nutrients from foods. It allows the body's cells to use glucose for energy. Its effect on blood glucose is opposite that of glucagon.

- Glucagon: Produced and secreted from alpha cells in the pancreas. If energy is needed because of lack of available glucose from foods, glucagon causes the liver to convert stored glycogen into glucose and release it into the blood to be used for energy. Thus its effect on blood glucose is the opposite of insulin's.

- Glucagon-like peptide: This is one of the best understood hormones in the group of so-called gut hormones known as incretins. They're produced in the intestine. This hormone increases when you eat. It stimulates the pancreas to put out insulin when blood glucose rises and it slows the rise of blood glucose after you eat. It has a satiating effect.

- Grehlin: Ghrelin is the hunger hormone. It's produced in both the stomach and the pancreas. Release of it increases before you eat and then decreases after eating. It works opposite of the way leptin does.

- Leptin: Leptin is the satiety hormone. It's made in fat cells (adipose tissue) and signals that you've eaten enough.

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Aronne explains being "hangry" like this: "People may have a rapid rise in blood glucose after eating, which in turn causes a rise in their insulin levels. This may be followed by a greater than normal drop in blood glucose. If glucose levels get down to normal or below normal too rapidly, glucagon will be produced and can cause increased hunger."

If you have this problem, the key is what and how much you eat for breakfast. You need to eat sufficient amounts of the right combination of foods.

"Foods with protein and fiber are the most satiating," says Anne Wolf, registered dietitian and owner of Anne Wolf & Associates (www.amwolf.com) in Charlottesville, Va.

A few breakfast suggestions:

- Combine one egg with egg whites and sauteed vegetables (onions, mushrooms, peppers, spinach). Or combine one egg with a part-skim cheese or cottage cheese and vegetables.

- Mix a high-fiber cereal like All Bran with other low-sugar cereals and fat-free milk or mix into plain regular or Greek yogurt. (Greek yogurt has a bit more protein.)

- Make a smoothie with fat-free milk or plain yogurt, fruit or vegetables and a small amount of protein powder.

- Have a bowl of oatmeal with the addition of a high-fiber cereal.

- Top a bowl of cottage cheese with a high-fiber cereal and berries.

- Spread peanut butter (or any nut butter) on whole grain toast with a glass of fat-free or low-fat milk.

Try a few of these combinations and determine which ones keep you sated during the morning. Then be sure to have the foods in your house and set the alarm clock to allow time to eat them before you fly out the door.

To curb your hunger between meals, you may find having small snacks in the midmorning and midafternoon, or on the way home from work, helps immensely.

Wolf suggests a guidepost for snacks of 200 calories each, with food pairings that provide rapidly available energy from healthy carbohydrates, along with enough protein and fat for satiety.

Try fruit and cheese, or a handful of nuts, or high-fiber whole grain crackers and cheese or nut butter.

Make your snacks count nutritionally: Use them as opportunities to eat more of the foods you're missing, whether they be vegetables, fruits, whole grains, low-fat dairy foods, nuts or seeds.

You're unlikely to find these foods in vending machines, coffee shops or convenience stores. So plan to snack healthfully.

Over time you will find the way of eating that works best for you. Although there are consensus guidelines for healthful eating, there's not one number of meals and/or snacks for everyone.

Through experimentation, find out what helps you squelch your hunger and keeps you satiated while you meet your nutrition and calorie needs.

- The Washington Post

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