This is not a bowl of oats

The Treachery of Images

Today's post is inspired by the Belgian surrealist artist René Magritte and his famous painting "The Treachery of Images" - a simple image of a pipe with the caption "Ceci n'est pas une pipe" ("This is not a pipe"). It caused quite a stir back in 1930 - but Magritte was just playing with the idea that the reality of things may be different from how our brain perceives them.

You probably heard that you should eat oats for breakfast because they are "heart healthy", have fibre and are just good for you. Instagram and YouTube are full to the brim with instant oats recipes of all shapes and sizes. If you are a health conscious person, you probably make a good effort in trying to incorporate them into your regime. You probably try to add things to them to make them taste nice and give them to your kids for breakfast, convinced that you are doing what's best for them (even if they don't share that opinion!). I, for sure was doing all these things. I was that health conscious mum starting my day with a big bowl of instant oats with berries and force feeding them to my kids - despite their best efforts to resist. I was doing that for years ... until one day I started wearing a continuous glucose monitor which enabled me to see instant oats for what they really are - not for what my health conscious brain was telling me they were. 

What are oats actually?

You see, what your brain sees in that image above is not a exactly a bowl of oats. This is not what oats look like. Oats (formally named Avena sativa), is a type of cereal grain.  The grain is the edible seed of oat grass. "Oats" are what is left when the inedible husk which surrounds the seed is removed.

Oats are a whole grain packed with good stuff like B vitamins (especially B1 and B7) and minerals like manganese, copper, zinc, magnesium and phosphorus. The super power of oats is that they are rich in a type of soluble fiber called beta-glucan. Beta-glucans are polysaccharides (i.e long chains of glucose molecules) that help slow digestion, increase satiety, and suppress appetite. They are particularly cool in that they bind with cholesterol-rich bile acids in the intestine and transport them through the digestive tract and eventually out of the body. This is where oats get their reputation as cholesterol lowering and thus "heart healthy".  Whole oats also contain certain plant chemicals known as phenolic compounds and phytoestrogens. These act as antioxidants and mitigate the damaging effects of chronic inflammation which is linked with various diseases like cardiovascular disease and diabetes.

The problem 

On paper oats have a good CV, but as in many things in life (and especially in the world of nutrition!) there is an important nuance which is often missed. 

What we find on our local supermarket shelves is a processed product in the form of oat flakes which you can prepare - as their name often suggests - in almost an instant. 

In order for the real oats to become flakes that can be consumed with minimal, if any cooking, they need to be steamed and then rolled out. The longer they are steamed and the more they are rolled the less cooking they require.  So you can find:

• rolled (or "old fashioned") oats, which have been steamed and rolled require some cooking, 
• quick oats which have been steamed longer and rolled even thinner so they cook very quickly, and 
• instant oats - which require no cooking, just the addition of some liquid and have often been flavoured with something to make them taste sweet. 

So what? one may say, Where is the problem? What's wrong with saving cooking time? 

The problem is that the more the oats are processed, the lower their content of the good fibre and the faster the starch in them is absorbed from your gut into your blood in the form of glucose molecules, giving you a nice big blood sugar spike ... and then, inevitably, a crash. 

The problem is that oat flakes have a very high glycemic load.

Pay attention to how you feel an hour or two after a breakfast made primarily of oat flakes, especially the quick or instant type. Pay attention to your hunger level and your mood and cravings. Are you dying for a snack by mid morning?

Back in 2018, I was having oats for breakfast regularly, as was my whole family. We were all hungry and crashing by mid morning but we persevered because, you know, "oats are healthy" and all. Then, after discovering I had type 1 diabetes, I started wearing a continuous glucose monitor. It was an eye opener on many fronts but oats flakes is what shocked me the most. The spike in blood sugar from them was just phenomenal! I might as well have been drinking sugar. They seemed to have no interest in making it down my intestine to feed my good bugs that lived at the end of the pipe. All they wanted to do is rush straight in, making my blood sugar rise to well over 200 mg/dl - i.e. about double the upper level of normal! 

Why would I care if I don't have diabetes? If you have the good fortune of having a working pancreas, what will happen after a breakfast of processed oats is that your blood sugar will also go up fast and,  in order to get that sugar out of your blood as quickly as possible, your pancreas will pump out a lot of insulin. How high your blood sugar goes will depend on how sensitive you are to the effect of this insulin. Unfortunately, unless you had your insulin sensitivity tested (in the way explained here), you will not know.  This is not something conventional doctors routinely check for. The more resistant you are to insulin, the higher your blood sugar will climb and the longer it will remain high before coming down. Guess what else contributes to high cholesterol, heart disease (and leads to diabetes)? You guessed it, a state of constantly high blood sugars as a result of insulin resistance. 

So, in a way, the "heart healthy" effect of the beta-glucans in oats is cancelled out when the oats are processed down to thin flakes that contain less of this good fibre and lead to blood sugar spikes.

What if I am insulin sensitive and can deal with the sugar spike fast? In that case your pancreas will still pump out a lot of insulin and in its attempt to get the sugar out of your blood and into your cells as fast as possible, it will do its job all too well. After a short amount of time, your blood sugar will crash to a level slightly below normal. This will trigger your stress hormones and your hunger hormones and off you go on a quest of something that will bring your blood sugar up quickly. These impulses are hard wired survival adaptations - which means forget willpower! If you are eating oatmeal as part of a healthy diet to lose weight - you can see how your task has just been made that much harder.

If at the moment the "sugar crash" happens you follow that instinct and reach for something that will bring your sugar up equally fast, you are off on a blood sugar rollercoaster that could continue the entire day. By evening you are starving and here comes the big dinner plus snack before bed time....  

The solution

To get the maximum benefit of all the nutrients and avoid the big blood sugar spike you would need to get hold of some real unprocessed oats. It is possible to get them online or in an organic foods store. Steel cut oats (where each grain is cut up in two or three pieces) are an alternative too - although their glycemic load is slightly higher.

The difference in the blood sugar spike is significant. The glycemic load of unprocessed oats is considerably lower. They will not give you a blood sugar crash and will keep you full for much longer.

They have a chewy, nutty taste and are quite versatile in that they can be used both in savoury dishes (as a substitute for your usual rice or pasta) or sweet dishes (by adding some cinnamon, nuts, honey and berries).

The downside is that they take longer to cook, but a bit of thinking ahead is all you need. You just need to soak them overnight (or longer if you want) and then rince and cook them by adding three times the amount of water. If you have a pressure cooker, they can be ready in 15-20 minutes, otherwise its about 30-40 minutes. You can leave them unsalted and decide later whether you want to have some of them as savoury or sweet. You can do this process once and freeze some batches that you can get out later.. 

Are processed oats the devil?  No - just think of them as dessert. 

• Choose old fashioned rolled oats if you can as they have a lower glycemic load than the quick ones. 
• Avoid the instant kind, which often come in plastic sachets with added sweeteners, 
• Try to eat rolled oats together with other foods that will slow the speed with which they go through your intestine. For example, nuts, seeds, or nut butters and, if you can tolerate it, some kind of dairy, like milk or cottage cheese or yoghurt.
• Don't forget that pinch of cinnamon for some extra antioxydant goodness.  

The amount of rolled oats you can tolerate without a blood sugar spike will depend on your how well you can convert the glucose from the oats to energy and on how insulin sensitive you are. To find that out, test, don't guess. I walk you through the options here. 

And next time you are walking down that supermarket aisle, remember Magritte 😉