THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 618.6 A

Guest: Dr. Suzanne Oparil, Director, Vascular biology and hypertension, University of Alabama at Birmingham. Past President, American Heart Association

Topic: Eating a good breakfast

Host/Producer: Steve Girard

NEMA: Do you eat breakfast regularly? Only about 37% of us do. And that's too bad...because it's the meal our bodies would rather not miss. In fact...we rarely miss supper, and that would be the meal we could stand to miss...or at least cut down on. So, today we'd like to try to convince you to focus a bit more on the morning meal. We'd like to welcome Dr. Suzanne Oparil, the director of the vascular biology and hypertension program at the the University of Alabama at Birmingham, and past president of the American Heart Association.

OPARIL: Yes, I think this is very concerning...that so few people eat breakfast, and if they do eat breakfast, they don't necessarily eat very healthy things - they eat sort or high fat, high calorie stuff. And it's very concerning to me that Americans are getting a lot fatter. The percent of people in the United States that are greater than 20% above ideal weight has gone from 25% 15 years ago, to about 33% in 1994. So that's a huge increase. Sedentary lifestyle, and bad nutrition. Too much food, too many calories and there's evidence that if you eat all your food all at once...a lot of people really only eat one major meal - at night, and that's the worst time. Eating a lot and then going to bed, you tend to put on fat.

NEMA: Let's talk about the things that may happen when we're in this kind of bad pattern of eating and nutrition...or how we might feel better if we made sure to get off to a good start...

OPARIL: If people focused on getting a good breakfast, they would highly likely have more energy, and tend to participate in physically active things, like walk to work, or walk up the stairs to the office. If you're a kid, you're more inclined to want to play sports...with a good start.

NEMA: Too many calories...too many of the wrong kind of calories. LetÕs help out by building a good breakfast...

OPARIL: The ideal breakfast is cereal...nice whole grain cereal, skim milk or 1% milk, some nice juice or fresh fruit, and maybe a little extra skim milk to drink. There has been recently a very interesting study called DASH, or Dietary Approaches to Stop Hypertension, and the idea here is to take people who already have high blood pressure or are somewhat on the verge...what we call "High normal blood pressure", which generally progresses to frank hypertension...take these people and put them on a feeding program. This was in house in four different institutions in the United States, in various different geographical areas. One was in Louisiana, one was in the Northwest, one was in the Northeast, for example. And so they used individuals of both sexes, they were all adults, but older people, younger people, African Americans as well as white people. There were three diets: one was the average American diet, which had a lot of fat grams in it, a lot of fat calories...the second was a diet that had a lot of fruits and vegetables....and the third had a lot of fruits and vegetables plus low fat dairy products. And they found that the blood pressure, even in normal individuals, went down five over three millimeters of mercury in the individuals that got the combination diet, that has lots of fruits of vegetables, lots of whole grain products, and the low fat dairy products.

NEMA: What does that mean in real terms...is that a big decrease?

OPARIL: Blood pressure went down quite a lot in the normal types of individuals, and in the people with high blood pressure, it went down so much...it went down about as much as it would go down if you took a sort of average dose of the first anti hypertensive drug. So that by proper eating, it's possible that many people with high blood may not have to take drugs for a while, or not have to take so many drugs.

NEMA: ...or postpone the onset of hypertension...?

OPARIL: Right...it's sort of a preventive kind of thing.Very impressive, and this happened without weight loss...and without changing salt intake. Salt was controlled for. So that a very good breakfast would be part of the DASH diet, with the whole grain cereal, with the fruit...with the orange juice, maybe...and with the low fat dairy products. Dairy products have been spurned in recent years, for a number of reasons. Number one, people relate them to calories and fat..but you can take all of the fat out of milk - skim milk has no fat whatsoever, and no cholesterol. Milk has 9 different nutrients, including calcium, vitamin D, but also a number of other vitamins... potassium, which is good for you. And it's good food, it's a beverage that's also food. We tend to consume beverages that have no nutritional value whatsoever...either the fancy waters, sparkling or clear...or low calorie sodas. And actually, there's some evidence that your body weight correlates very strongly positively with the number of diet sodas consumed, and fat people tend to always be consuming something.

NEMA: I guess then that for the kid or parent zooming out the door in the morning, who doesn't have time to get the fruit and the juice and the cereal and the milk down, an abbreviated breakfast would just include the cereal and the milk?

OPARIL: The cereal and the milk. Try to get them to drink milk as a beverage in between. Children have to eat in between meals, because they consume so many calories, and they're growing. Trying to get milk back into the diet is very important. We know now that as the population ages, particularly among women, there is a tremendously high incidence of osteoporosis, and we can again delay the onset of osteoporosis by putting a lot of calcium down the bone when we're young. That's not cardiovascular, but it does contribute to overall health.

NEMA: I think we're switching from eating poorly, and eating better when we get too heavy and want to lose weight....to eating conscientiously, better tuned to the idea that food is fuel for our bodies and our minds.

OPARIL: We try to encourage people to be more active, eat a good diet...to balance the diet out during the course of the day. And we've encourage the fruits, vegetables and low fat dairy products, because there's so many good things in there. I guess the major message is to try to generate a positive message about food and nutrition. Most of the public service announcements that we hear, and the advice from doctors is you can't do this, you can't do that ....and everything is bad. There are some things that are good for you.

NEMA: Our thanks to Dr. Suzanne Oparil, Director, Vascular biology and hypertension, University of Alabama at Birmingham...and past president of the American Heart Association. Remember, though our mornings seem to be the most hectic time of the day, it's important to our health and productivity to eat breakfast, and eat a good breakfast. They say we are what we eat...think about it in the progressive tense: We are becoming what we're eating. Think of that the next time you decide to wolf down a cinnamon bun or donuts and coffee to start your day.

Back in a moment with more....

SPOT: Small pages....big advice on parenting...from infants to teens. It's the new "Little Book of Parenting". What to expect, emotionally and physically, as your child grows. How to develop positive discipline,how to deal with kids and TV, adolescent issues, drug education, fighting, single and step parenting...it's all in the new "Little Book of Parenting, available through the National Emergency Medicine Association. Call 1-800-332-6362 for more information.

NEMA: Thanks for joining us for today's program. If you have any comments or suggestions, contact this station. Or visit our home page at:

www.nemahealth.org/

...for a look at transcripts of this or past programs, or to find out more

about the National Emergency Medicine Association. I'm Steve Girard at The Heart of the Matter.