How Important is Breakfast? Identifying and Avoiding Bad Nutrition Advice on Social Media. Does Milk Help or Hinder Bone Density?

the day? And why Hi. I'm Leanne Ward and I'm Susie Burrow, and as two of Australia's leading dieticians who specialize in weight control, we bring you the Nutrition Couch, a weekly chat on everything that is new in the world of food, diets and nutrition as well as meals.

Today we have a good chat about the growth of nutrition influences and how to sort the qualified from the not so qualified when it comes to dietary advice, and we also share some brand new research on the health of our bones and the roll of milk and dairy in our diet. But to kick us off today, Susie, it seems that every week there's a new expert, or a new book or a new program talking about nutrition.

So what we wanted to discuss today was the fact that there's a very big difference between the qualifications of nutrition experts and influence, and why it's important to be aware of the mass media and influences these days. But before we jump into what nutrition qualifications actually look like, Suzia found a really interesting article posted by the American

Council on Science and Health. So it was titled the Nutrition Analysis of food and beverages posted in social media accounts of highly followed celebrities, and I thought this was really interesting. So the article essentially surveyed the Instagram accounts of all of these celebrity influences and basically found what they were posting from a food and beverage perspective, and

I thought it was really interesting. So the article starts by saying that celebrities are particularly influential on social media. Celebrities are perceived as fellow users, but they also perceived as more credible than ordinary users and more trustworthy than television advertisements. So celebrity posts can influence viewers through their attitude alignment, social connection, and positive meaningful transfer from likable

people in the food and beverages that they depict. So this is, I guess, a real problem that we face in twenty twenty two, and research is now confirmed what we already know is that influencers are actually considered very credible and very trustworthy, and sometimes even more credible than actual credentialed people such as you and I, Susie, which kind of breaks my heart, but I guess you know, that's the reality of living with social media these days.

It's everywhere, and you know, celebrities are often sort of you know, thought of as more qualified than actual qualified experts, which is quite sad.

who have no real formal qualifications. Is that when you do study dietetics, which is the profession assigned to give prescriptive dietary advice and in a clinical or medical setting, there is it's a profession, so there's certain levels of accreditation, there's peer review, there's a very high level of accountability that we're held to, and so we are so aware of that, but then you have influences or even much more or less trained nutrition experts who aren't even aware

of that being out there. So I sometimes call it a little bit of the arrogance of ignorance because you're just actually not aware of that difference. And the example I like to use land is that you know, in the case of law, you would generally not have a legal secretary giving legal advice on a court case.

and it's a very highly skilled thing. So, you know, I don't disagree, but I think first of all, it really kicked off with the Internet because all of a sudden people had access to vast volumes of information, and more so now there's of course social media where it's so common. And the reason people go into nutrition is it's reasonably easy. We all eat, you easily, can take some great.

and accountability and an accreditation that's required. So you know, I think that a reference point I've been given to people lately is because as I get older, I feel more passionately about it, and I do get frustrated when I see really poorly low qualified people writing very prescriptive diets and dietary advice and having a voice, because I have noticed that in mass media and in publishing, they

don't necessarily check qualifications of people writing the book. So that's a concern in itself because that's obviously opening the gate to a flood of this information. And as soon as you've got access to mass media and be publishing houses. To me, that's a major concern, and certainly in past years we've seen the flow and effect of that with people, like without naming names, there's been a couple of high profile cases where people who weren't qualified were giving actually

dangerous nutrition advice. So you would think that really publishing houses would be a lot more across it. But the recommendation I give to people through my channels is that you want someone who has a tertiary qualification.

affects people's lives quite significantly long term. So I do feel it's really important that mass media publishing houses are taking their responsibility of making sure the people who are sending nutrition advice through their channels are appropriately qualified and

credit children. A certificate, a diploma is not enough. You need to be in an accredited profession as a nutritionist with the Nutrition Society of Australia or with the Dietitians Association of Australia, where you have that accreditation and accountability that you would have many profession whether you're a medical doctor, a lawyer, an accountant, because yeah, there's a certain level

of accountability. We all need to make sure that we are using evidence based practice and doing good for our clients and not unknowingly doing things that aren't great for them.

So going back to this article, Suzi, because I actually think that's really important for people to understand how influential celebrities are who have zero qualifications. You know, at least some people, even though they did have a little certificate, if they're posting recipes online, they're not giving out prescriptive nutrition advice or taking clients. At least that's something and they have a little bit of a baseline understanding of nutrition.

But a lot of these influences celebrities who are giving out nutrition advice or creating recipes or you know, showing what I eat in a day. You know, there's a lot of models who show what I eat in a day, and whether or not they mean to, they're basically portraying that this is what people should eat to get the body that they have. So it's a little bit sort

of a mind build on social media. But the reason that I really liked this article today and wanted to chat about it was because it really did it gave a really good analysis of some really large social media accounts. So basically, this article looked at Susie a combined following of what were they athletes, actors, television personalities, and musical artists on Instagram with a combined following of five point seven million followers. That is a lot of people and

a lot of people to influence. So they essentially broke down the nutritional value of these celebrity posts and they were, you know, they had an influence of five point seven million. I can't get over that back, guys, it's huge. So off the three thousand and sixty five media posts that they you know, looked at the nutritional value of twy four hundred of them were food based and twenty seven

hundred of them were beverage based. And among foods, there were posts for snacks and sweets and they were threefold more frequent than posts about fruits, vegetables, and grains. Among drinks, half of the drinks promoted on these celebrity accounts were alcohol,

followed by coffee, tea, sweetened beverages, and lastly water. So when they looked at the analysis of these celebrities, eighty seven percent SUSI offered less than healthy food advice and eighty nine percent of influencers offered less than healthy beverage advice online. And now male and female influencers were equally as unhealthy in terms of the advice or the products that they were promoting, and women tended to favor sugar a little bit more and men tended to favor salt

little bit more. And males of all of these celebrity accounts that they looked at actually posted more images of alcohol than females. So I think that there are a few, I guess conclusions that we can draw from this study, and I think the first one is, you know, if we believe that influencers post about their own experiences, whether that's sponsored or not, I think the nutritional choices are

a little bit problematic. I mean, eighty seven percent of them posted less than healthy food choices and eighty nine percent of them posted less than healthy beverage choices. So I think that's a sort of an issue in itself. But the second thing that I think is, you know, also an issue was that the article looked at posts with less than healthy nutrition scores and they were actually

associated with increased likes and comments from their followers. So basically, what this article is saying is that the least healthy food and beverages that these celebrities posted, the more you know, followers and engagement got and that sort of indicates a greater social approval. So posting something like a croissant or a muffin got them more likes, comments, and follows then posting some thing like a glass of water and a

piece of fruit. So whether or not these influencers understand it, they're sort of knowingly or unknowingly, you know, unknowingly using their influence to perhaps either harm or derail other people's healthy habits because they know that they're going to get more engagement, more followers, more likes with more unhealthy food posts. And I'm not sure if influencers actually realize this. I

think a lot of them do, Susie. I certainly know on my account that if I posted a recipe of a cake, I'm going to get a lot more engagement than if I post a recipe of a salad. I think a lot of people are aware of that, but I think that you know it is quite problematic when we look at you know it from an influenced perspective, because a lot of people the sure you know it

might be a musician, right, Susie. They're not saying that they're qualified in nutrition, but the fact that they're posting recipes, or the fact that they've got their own, you know, eight week healthy lifestyle program, or the fact that they're showing what they eat every single day and what I eat in a day videos, it creates this sense of you know, qualified enough to know what I'm talking about, and people sort of follow that with that whether or not these celebrities that me to do that.

but ultimately to get the engagement. And I think it really stands out for me when we're chatting about the promotion of different diets, you know, especially when they've got a really great body themselves and they're certainly selling whether it's a program or a diet or a product based on that. And that's where it gets quite complicated with sponsored type posts because obviously every professional two is going to have different criteria around what they are comfortable posting.

So you're absolutely right, one of you know, the issue in social media is it's just so freely available. Again, going back to the medical example or the law example,

you don't see lawyers or generally doctors. You may see plastic surgeons doing it a little bit before and afters, but you don't generally see you know, breast cancer surgeons or gut surgeons saying I just cured this person of cancer, because again they are aware that it's a lot more complicated than what you can communicate generally on social media, and so you will also this will also remind everyone that that is also one of the reasons you won't

see dieticians giving case studies or testimonials or before and after because of the potential issues with that when it goes into a mass media in a control format and very short number of words, when you don't have the context of patients and medical care and the complexity of

human beings, So you're absolutely right. I think that the main advice we can give people, or even at a broader level of communicating via than Nutrition Couch podcast, is that people whenever there's prescriptive dietary advice being given, diets, recommended products sold, it really needs to be under the

guidance of someone who is qualified. And when you take a deep dive, very very few of these people are and even if they have some qualification, it's often not an accredited profession where they're qualified to be giving prescriptive

dietary advice in a medical or health care context. So if you're battling any or even just for health long term or medical issues, or looking at supplements, all of that is very prescriptive dietary information that should be only I feel very strongly about that should only be given by someone who has a tertiary qualification in nutrition and dietetics.

And if you don't have that, I think that it's a big issue in general and really need to take a look at the potential follow on effect of giving that advice or if your advice or prescription gets into the hands of the wrong person because we are taught

as professionals it's actually not about us. Yes, of course we want to look fit and healthy, but you know, it's really about the people that we're sharing the information too and how that's relevant to them, as opposed to it's not about us in the center, and that's a very fine line at current time, where so much of social media requires it to be about us to remain

relevant in the market and to remain competitive. But really, as trained professionals, what we're taught is it's not about us, and that's where we get ourselves into trouble at time.

So my final I guess note on it given you know, it is quite alarming when you hear is check the qualifications of the people you're getting nutrition advice from, and if they don't have a science degree, they don't have an undergraduate and hopefully postgraduate and nutrition I wouldn't be listening to very much of what they had to say at all.

that as well. And Susie really a good example that sticks out in my mind is as a prominent Australian model who owns a I'm pretty sure it's a tequila company with her hobby, and she will constantly post all about it on her Instagram store worries, but never always like recipes or photos of drinks or using the tequila or that sort of thing, or promoting it, but very ever, rarely, I don't even know if I've ever seen her actually

post a photo of herself drinking that tequila. So we as you know, her followers and people have that perception that she drinks that and she's able to maintain this.

You know, rocking figures as a huge Australian model, but you know, I would really really has it a guess, Susie if she ever, if you know, actually drinks that tequila or drinks that amount alcohol that she sort of posts about and promotes so whether or not we we mean to sort of have this perception that she does that, so it's okay for us to go out and have a few alcoholic drinks every single weekend and try to

sort of achieve the body that she has. So I think it's really important to do a little bit of a sort of cleanup of your social media and just be aware of the people that you're following, and you know, if they're sort of having a negative influence on you, or you feel like they do post a lot about you know, what they eat and what they drink, all that sort of thing and it's not in line with, you know, the healthy life style that you want to live.

Just be a little bit wary of that and maybe do a little bit of an unfollow of so some social accounts if you don't feel like they promote positive nutrition messages on a regular basis or have the qualifications to do so.

we don't need breakfast anymore, and I'm fasting. But I don't know, you know, as I reflect on work I do with my clients, or actually recently I published a media story with your help to a number of dieticians asking them what they ate in the day, and you know, they all had.

to shift some people off a plateau. At times, I may use a five to two, but ultimately I'm using those programs to get my clients hungry in the morning because for me, you know, that is a well not even for me, for science, for physiology, the human body is program to burn calories in the first half of

the day. That's why if you have a big breakfast, you'll notice that you're hungry two or three hours later, which can be a bit disconcerting for people who don't like the hunger and handsome are more happier skipping breakfast so they don't feel hungry until lunchtime. But what I really like to share with my clients is that it's actually good to be hungry in the morning. It's a sign your body is burning your food well but nutritional lean.

The other issue I have when people skip breakfast is, of course they miss out on a lot of their dietary fiber, because in this time of carb cutting and fasting and Taiketo diets, low carb diets, our good old whole grain breads and cereals and even fruit can take

a bit of a beating. And it's not uncommon for me to have a client who is having maybe a coffee in the morning and a reasonably sort of not much at all until lunch, where they might go to a salad, but not having that whole grain bread or not having some oats in the morning or some good quality cereal or even some fruit means that their fiber intake takes a significant reduction, and that has long term consequences for metabolism and gut health and digestive comfort, because

they're the same clients who'll come back and say they're not going to the bathroom as frequently and they're feeling constipated. So I want to be really clear that I'm a big fan of breakfast. The issue I have often with breakfast is that people have too much coffee at the expense of breakfast, or use coffee to delay their hunger so then they're not having a proper and then they

hungry later in the morning. But my ideal breakfast for a client would definitely include some whole grain bread, a small serve of whole grain cereal, even if it's with yoga, alongside the coffee, because I really want to tick that box, particularly on the fiber that a lot of my clients who are cutting their carbs often don't get.

I myself at the moment, definitely, while breastfeeding, do I wake up starving, whether that's five am or six am, I'm generally starving. I'm not someone who tends to eat overnight if I have to feed, but I definitely do, you know, I want to eat first thing in the morning when I wake up. But pre me and pre pregnancy, I was someone that sort of doubled with a little bit of fasting some days just due to a busy morning,

I get up, I do it. A couple of early podcasts with some US also have some US clients, and by the time I even thought about food or had you know, a second to even take a take a breath. It was like nine ten, eleven o'clock in the morning. So I have sometimes adopted fasting if I'm not training early on, but majority of the time I do sort of eat breakfast because I am sort of feeling hungry

in the morning. And I agree with you, I think fiber for a lot of people, there's a large bulk of it found in our breakfast and I, for one, really like breakfast type foods. I love my opennight oats. I love nothing more than some eggs on some sourder or even something like a cheer pudding with some fruit and some yogurt as well. So I'm a big fan

of breakfast foods in general. I know you can eat breakfast foods anytime of the day, but it really is something that I, you know, take great pleasure in is actually eating breakfast. But I really do think it depends

on the individual and their circumstances. But for anyone who was training with a particular focus on performance or you know, actually improving their training, whether it's running faster, lifting heavier, you know that sort of thing, it is more beneficial to particularly your training first in the morning to actually have some fuel on board, or to have some fuel post that training session as well. So there are large

benefits from eating breakfast for many people. But as you said, from sort of a hormonal perspective, for some clients it may be beneficial to fast, but not sort of extended periods of fast, or if you're fasting and then you're someone who overeats at the next few meals, perhaps that's also not you know, not a great idea as well. So it's not a magic bullet, it's not a golden sort of a lixa that we can just do that

fasting helps with weight loss. It's very sort of individualized, and it does suit certain people, doesn't it.

to support metabolic rate. So I would be confident to adjust and sometimes that breakfast maybe an hour or two later because you're actually not that hungry, and that's okay too. But I generally encourage my clients once we've sort of re established some hungry in the morning and hopefully got them a little bit active too, you know, a twenty minute walk just to get things going, you know, and within an hour or two after waking, I would certainly want something to go in and I generally suggest to

my clients before eight. The trick is you've got to really cater for that coffee, because if you have a milk coffee, it will delay that hunger and that's when you'll find that delayed appetite through the day. So I do sort of with my clients now, I tend to be much more if you're having milk coffee, it has to be with the food. So you can't have the milk coffee and then have something an hour or two later.

Wait for the hour until you have the coffee if you can, which is better anyway, the longer you delay the coffee from a quarter doll perspective, you've already got natural quarters all floating around, so you're better to write off that and then have the coffee a bit later, but wait and then have them together as a meal so you're satisfied, and then you'll go the two, three, four hours until you actually have a meal again, rather than what I find is this drip feeding of food

or morning whether they'll have one mealk coffee and then a little bit of breakfast and then another coffee and it's been spread over two or three hours, when you're better to bring it together have a proper meal, because it plays games into your head because you're feeling like you haven't eaten, but you kind of have, as opposed to sitting down and consciously sitting down and having a

meal and the coffee together. And that's a really good trick if you're trying to identify and isolate that morning hunger, so you can actually enjoy a proper meal rather than snacking throughout the entire morning.

have like half a bickie or something like that. And just the nutritional profile of the foods that they're choosing aren't ideal, and they end up probably having the same amount of calories as what a good quality breakfast did, But the quality of the snacks that they were choosing all morning isn't anywhere near the quality of you know, a good breakfast could have been. So I really do think it's it's, you know, as we always say, it's

dependent on the person. And also it's not something that you can just say, oh, well, everybody should fast till ten am, right, because if you're a busy mum and you're you know, your breastfeeding mmy get up at four am. You can't wait till ten am. God, I'd want to eat my insides that I'd be so hungry, zoozy, i'd

feel unwell. Or if you're someone that you know does night shift and then doesn't wake up till nine o'clock, you might be able to, you know, delay breakfast because you're not genuinely hungry till ten thirty eleven or even twelve. So it really does depend on sort of our sleep wake routines for a lot of us, and also the amount of activity that we're doing. If we're going up and we're smashing an early morning, you know, a forty five class at five am, we're not going to want

to delay our breakfast till ten o'clock. That is not ideal in terms of recovery and fueling our body properly. But if we're getting up at nine o'clock and we're heading straight into work, we're not doing any activity at all. Sure eating at ten thirty eleven might be might be absolutely okay. So it really does, you know, I think we've dispelled that myths that breakfast is the most important meal of the day, But for a lot of it's breakfast can be a really important addition to an overall

healthy lifestyle. So I wouldn't say, as a general there's a most important meal of the day Sui. I'm a big believer that all our meals should be important. All our meals should be nourishing and contain a good mix of you know, carbohydrates, fiber, protein, healthy bats, of course our vegetables, and more color the better. So there's not one meal that is better as such, but it really

does depend on your lifestyle. And I feel like a nice balance of good quality meals throughout the day is probably more important than you know, one good quality meal or one this is the most important meal for the day.

forward to eating. And I think you know, once you have a delicious breakfast wrap or a chia yogurt overnight bowl, something that's really delicious and yummy and you look forward to it, it'll become an event in your day, as opposed to just throwing something in because you think you should or or as we've described, sort of skipping it through the time and then getting overly hungry.

dairy healthy? Should we be having it for calcium and doesn't have a negative impact on our guard house because you know, throughout university, SUSI, we very much learned that, you know, dairy had calcium which supported our bone health, and just I feel like in the last year or two there's been a lot of noise on social media and from you know, quote unquote experts, whether or not they're experts, it's essentially been saying that actually dairy.

meta analysis of randomized control trials. So what this means for our listeners at home, randomized control trials are our sort of best quality research that we could do, and a meta analysis is taking a whole lot of these ricts or these randomized control trials and analyzing them all together. So in terms of research, this is top quality. We really can't get much better than this. So a meta analysis of randomized control trials is about as good as

we can get. So I was really really excited when I saw this paper, Susy. And it's very recent as well, which is good. It's not something that's like ten years old. So essentially, what this paper showed us and what we know is that milk contains a number of you know, really healthy nutrients and a lot of sort of bone beneficial nutrients as well, particularly calcy and vitamin D that sort of thing. But there is a sort of a school of thought that milk, due to the deer galactose content,

may have some unfavorable effects on bone health. So this meta analysis looked at a number of different trial studies twenty ricts in total, and the trial duration from these studies was from one month up to thirty six months. So essentially what it looked at and what it wanted to clarify was the effects of milk supplementation on bone mineral density, bone turnover markers, and hormonal indices related to bone metabolism. So I think the results of this SUZI

were quite interesting. So what the studies found that basically, it came to the consensus that milk supplementation resulted in a small but significant increase in bone mineral density at the hip and lumber spine, but milk supplementation did not significantly affect whole body bone mineral density and femeral neck

bone mineral density. In addition to this, milk in the diet may potentially increase the likelihood of preventing bone loss by restoring bone homeostasis through the modulation of the calcium, vitamin D pth axis, bone remodeling rate, and growth hormonal IGF one axis. That's a mouthful. So essentially what this means, Susie, is that milk doesn't leach calcium from our bones. If anything, it may potentially help with reducing bone loss and providing

benefits long term. So I think the bottom line from this study and from the you know, it was sort of I had to take it a few times and read it over it really get my head around it. The bottom line is, if you like milk, drink it. It may have some good positive benefits. But if you don't like it from a taste perspective, from an ethical perspective,

don't drink it. It's absolutely okay. But I really don't think we can go around saying that milk is bad at leeches calcium from our bones, because this top quality research showed the opposite of that, if anything, milk is beneficial for our bone health. So did I summarize this pretty well? Susie? Are you a milk drinker? Do your twins drink milk? I know milk Mea is certainly a milk machine at the moment. A little thing or she does is drink milk. Do the twins drink it? Do you drink it?

the understood truth. I would be questioning it first and foremost. And the way I work it with clients now because there is a much greater interest in plant based diets, and of course we've spoken before on the podcast about plant based alternatives to milk. It's a bit like being

a vegetarian. It's a personal preference. But I am very conscious that I have a whole group of women who I believe are not getting enough dietary calcium, certainly nowhere near the recommendations of about thirteen hn milligrams for postmenopausal women. So I will just make a point that if they're choosing to not include dairy or to eliminate all milks,

to be aware of that. Now, we can have other forms of it, as we've discussed it previously, but as a dietitian, it's my job to let them know that their nutrient intake of that calcium is low, and I would be mindful that a significant number of Stralians have osteopenia and an osteoporosis. So I am a dairy drinker and my kids will have yogurt, cheese most days and milk, so they would have their three serves.

is genetics, and we don't know everything. But I will finalize this by saying that a few years ago, when I was working in elite level sport, I had an NBA basketballer come through the local basketball team and his career ended because of terrible stress fractures in his ankle. And I had just done an assessment on him and just out of interest, found out that he was a non dairy milk drinker because he was lactose intolerant and

had never actively supplemented calcium. And I thought regularly to myself, I wonder what had happened to his bones had he have had that nutrient looked after, because it ended.

our hearts. So if you're out walking or in the car or avoiding the children in your bedroom and you want to tag that you're listening to the Nutrition Couch. We love to get that feedback and we're really grateful, so thank.