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From: "Sbharris[atsign]" <>
Subject: Re: "home-brew" version of Ensure, Boost, etc?
Date: 31 Aug 2005 19:08:00 -0700
Message-ID: <>

         (c) 1995-05  Steven B. Harris, M.D.

For many reasons, breakfast is the most important meal of the day, just
as mom used to tell you.

For one thing, in the A.M. your brain's hormonally controlled desire
for sweets and carbohydrates is high, and for fat, is low. This makes
it easy to eat "good for you" low-fat meals in the A.M., but also makes
it increasingly difficult to eat virtuously as the day wears on.  We've
all had this experience.

For another thing, breakfast calories count less, as we know now.  As
it turns out, the popular idea that calories eaten in the evening are
more likely to get turned into fat during sleep, is an "old wives'
tale" which is perfectly true.  Eat calories in the morning so they
don't stay on you.

Which doesn't mean your body ignores A.M. calories.  Since your body
"counts" calories during the day, eating a significant amount of
calories (even low-fat calories) for breakfast offers you the
opportunity to have the willpower to bypass those nutritionally
disastrous foods which may be the only things you'll find in vending
machines, cafeterias, or fast food places while at work.

But many people don't eat breakfast.  They don't, because they don't
have much time in the mornings, and they mistakenly believe that they
should take advantage of the relative lack of appetite which many
people have just after getting up (sometimes boosted by coffee, or even
a cigarette).  But this strategy doesn't really work, and in fact tends
to backfire.  We know that the average overweight person does not eat
breakfast (beyond perhaps some wake-up coffee), has one or two high-fat
snacks during the day, then begins to eat high-fat foods continuously
from the time he or she arrives home from work in the afternoon, until
time for bed at night.  By which time they've packed enough food into
their stomachs to give themselves hiatal hernias and gastric reflux at
night (wearing away the lining of the esophagus, as in the Nexium
commercials). Obesity-wise, the results speak for themselves.
Sometimes people think that the results would be even worse for them if
they started their daily eating, at breakfast.  But with the right
breakfast, they are wrong.

   A decently-planned breakfast shake is an alternative to the daily
starve-and-then-binge cycle now trapping too many people in affluent
countries.  Such shakes are quick and easy to make with a blender, and
are also easy to design to near nutritional perfection.  The components
of a good shake are carbohydrate, protein, fat, fiber, and flavor-- and
with a blender it's possible to put in exactly what we need, and still
get something that tastes good.  And it's still possible to make a
product which is superior in nearly every way to canned supplements like
Ensure or Boost.



   A little sugar is necessary for a good shake, as it adds to the
taste. But there's no point in adding sugar per se, because there's
plenty in the yogurt and frozen fruit you'll be adding. Likewise, no
point in adding starches like maltodextrin (an earlier suggestion of
mine in early versions of this essay) because their glycemic index is
no different from pure sugar, and is surely higher than even the sugar
you'll get from the fruit. So add the fruit for the benefits of the
fiber and the pigments (anthocyanidins) and many other healthy things
that fruits contain. Berries seem to be highest in antioxidants, and a
mix of dark berries guarantees the highest dose of these. Other than
that, feel free to experiment. Stores like COSTCO now have a number of
frozen berry blends and tropical fruit chunk blends, at a very
reasonable prize. All you need is a freezer.

At this point, we should talk about the fruit every shake needs, which
is a banana. Not only are bananas the champs at keeping the human
digestive system smoothly operative (avoiding both constipation AND
diarrhea), but they also lubricate things mechanically when you make a
smoothie, and you'll notice the difference if you leave them out. So
unless you really hate the taste, figure on adding a banana to every

Some people complain that bananas are hard to keep around without going
bad. This is actually no problem. You simply wait till your bananas
reach the stage of ripeness where you like the flavor the best, peal
them, break them into thirds, put them in a freezer bag and freeze them
like any other fruit. When it comes to make your shake, simply add
chunks of frozen banana in.

You may have noticed that bananas turn dark rapidly when merely put
into a refrigerator. What you may not have noticed is that the color is
irrelevant: if you peel them, the insides are still perfectly fine.
That's another alternative.

      Here the choices are between soy, milk, and egg proteins. Soy
protein (available as 90-95% isolates in body builder sections of
health food stores) has a number of benefits, including low methionine,
unless methionine is added (look on the label).  You want to stay away
from extra methionine, since this amino acid causes generation of a
toxic metabolite called homocysteine, which probably does damage to
your arterial walls, and is involved in atherosclerosis and perhaps
even in Alzheimer's disease.  Soy is naturally low in methionine, and
that's great.  Though this is an essential amino acid, you're sure to
get more than you need the rest of the day. Methionine is great for
your cat, since the acid it makes helps him to keep from getting kidney
stones.  All that acid will merely wash out YOUR calcium, though, and
put you at risk for osteoporosis.

Soy also has low lysine levels, which help keep insulin levels low
(which helps hunger).  Soy is not quite so "balanced" in essentially
amino acid composition as milk and egg proteins,  but the differences
are mostly due to the very same limiting amino acids which may make soy
protein beneficial, and (in any case) limited protein is hardly a
problem in Western diets.

Soy products also contain other compounds like saponins and isoflavones
(principally a substance called genistein) which both decrease cancer
risk (prostate, breast, colon), and impressively lower cholesterol
levels (far better than equal weights of bran or corn oil).  Some of
the cholesterol and weight loss properties of soy appear to be is
related to soy protein's ability to mildly stimulate thyroid activity,
without doing so to a dangerous extent.

For fighting the major late life diseases, it's hard to beat soy
protein as a single food (it comes in with fish oil in that regard).
Soy and fish are probably a major reason why Japanese enjoy some of the
world's longest life spans, despite smoking and high blood pressure.

   Soy protein is also present in soy milk, which is available in
non-fat versions which have 6 or 7 grams protein per cup (don't bother
with the 3 g protein per cup versions, which are too watery for the
author's taste).  Soy protein isolates, such as soy powder and the soy
protein in soy milk, contain about 60 Calories per 1/4 cup (13 grams
protein). These soy isolates do not contain the high levels of protease
inhibitors which cause problems in animals fed raw soybeans as a single
protein source.

Processed soy products are perfectly good foods for human consumption,
as demonstrated by the diet and disease profiles of millions of Asians,
who use soy and soy products as major staples.  Read the label
carefully, and do not buy any soy milk product which contains
hydrogenated vegetable oils of any kind.

Some health food stores offer powdered soy milk, which is basically soy
protein plus some sugar.  If you buy this in bulk and follow the
directions, it can substitute for the soy milk liquid, although not (to
this author) as tastily.  If you use powdered soy milk, you should
still use powdered soy protein as above, to get the full protein power
of the recipe.

Recently, very inexpensive WHEY proteins have become available, and as
good sources of glutathione precuror amino acides, they have their own
health benefits. The are more soluble than soy and taste a bit better.
If you're not vegetarian, you can replace some of the soy with whey to
get the benefits of both. Don't overpay for WHEY protein. One of the
better tasting and easily disolved pure whey products on the market
(Vanilla Designer Whey) can be bought online in 5 lb containers for as
little as $30, or $6 a lb--- a third of the price it is sold at, in
health food stores. Use Google Froogle to find online sources of
nutrients you need-- it's the 21st century!


For those on a weight loss program, soy protein alone with soy milk and
fruit (and no added oil-- see below) can be used in the shake recipe to
make up a low fat, low calorie, "ketogenic" meal, and this can be taken
up to twice a day (no more).  Such low carbohydrate diets will, like
the Atkin's style diets, suppress appetite by making protein breakdown
products called "ketones" in the blood.  These ketones turn off some of
the brain's craving for fat.

Nuturitionists have generally not been happy with the Atkins style
diets, because they can raise cholesterol levels.  Such low fat
protein-rich meals are not optimal, nutritionally, but at least they
are safer than the meats recommended in the Atkin's diet programs
(since they have no cholesterol and very low saturated and hydrogenated
fat levels).

High protein diets are a strain on the kidneys, and are not recommended
for those with kidney disease.  Also, (again) the acid load to the body
associated with protein necessitates taking a basic salt of calcium
with the excess protein: an extra 500 mg of calcium as the carbonate or
citrate (these are essentially alkaline or basic forms of calcium)
should be taken with each shake, since soy itself is not high in
calcium.  Those who fail to supplement with calcium with high protein
meals, in theory risk loss of bone calcium after many years use of high
protein concentrates for weight loss.  Women especially, with their
higher calcium needs and greater risk for osteoporosis, should pay
attention to calcium supplementation when using high protein shakes.
Regular bone-density checks (such as DEXA scans) are a necessity for
women over 45 years of age.

On the other hand, for patients who are trying to gain weight, or
cancer patients or elderly patients having a hard time chewing, oils
and whole eggs can be added to this shake, without problems. For a
discussion of oils, see below. As for eggs, they are obviously not
vegan, but otherwise they are a pretty good food. Eggs have gotten a
bad rap because they are high in saturated fat and cholesterol, but on
the other hand, epidemiologically eggs are not really associated with
heart disease, so obviously they must have something in them which
makes up for whatever tends to raise blood cholesterol when you eat
eggs (this effect is small and is only seen in strict vegans, though).
Eggs do have benefits besides their proteins. They are a good source of
iron which is easier on the stomach than iron pills. They also are one
of the few foods high in both lutein and zeaxanthin, the carotenoids
which make the center of the retina yellow and protect it from blue
light. In eggs, these compounds are highly emulsified and optimally

Raw eggs have also gotten something of a bad rap because of scares of
Salmonella. But in modern facilities the changes of getting a
Salmonella-infected egg is less than 1 in 3,000 eggs, and people with
normal immune systems handle such things well. You'll have to decide if
you are at risk, but if you're an adult surviving outside a hospital,
you probably can eat raw eggs. If you cook them, you oxidize the
cholesterol anyway, and that probably DOES make them extra bad for your
heart risk.


    Polyunsaturated omega-6 fats (such as occur in corn or safflower
oil) lower cholesterol levels in the body, but apparently also
increase GI cancer rates when used as a major source of dietary fat.
On the other hand, most hydrogenated oils (such as hydrogenated Canola,
but not unprocessed Canola) contain trans-fats, which raise LDL
cholesterol levels-- a major risk factor for coronary disease.  Liquid
saturated fat oils tend to be short chain fatty acid oils, such as MCT
or palm and coconut oils (so-called tropical oils). These have also
gotten an unfairly bad rap in the past, merely from being saturated.
However, saturated fat intake, particularly of the short chain variety,
is more or less neutral in how it affects cholesterol. Populations who
live on tropical oils don't have lots of heart disease-- in fact they
have very little. So these short chain saturated oils are a safe source
of calories if needed.

The ideal fats to stave off fat-hunger and add calories are the
monounsaturate-residue triglycerides, which actually lower blood
cholesterol without causing cancer.  The best sources of these fats are
walnut oil, hazel nut oil, avocado oil, extra virgin olive oil,
macademia nut oil, and almond oil.  Of all these, the author prefers
almond oil, and finds that the many of the others have strong or
peculiar "olive-like" tastes which are hard to hide in a sweet
breakfast shake.

    For those vegans who are not going to be taking fish oil capsules
and would like to include their daily requirement of omega-3 fatty
acids (about 1 gram), Canola oil (watch the label carefully to make
sure it's unhydrogenated) can be used in place of almond oil, or for
part of it.  Or, one teaspoon of VERY fresh linseed/flax oil (cold
expelled oil, such as can be bought refrigerated in some health food
stores in a black bottle), can be used in the amount of 1 tsp of oil
with 2 teaspoons (10 cc) of almond oil.

The best quality unoxidized linseed oil has a nutty taste, and does not
hurt the flavor of shakes substantially.  (It must be kept refrigerated
and bottles replaced each month.  Empty or partly filled bottles must
be filled with water before discarding because they are a spontaneous
combustion hazard; remember this drying oil is used in paint thinners.

    Oil could of course be left out of a shake completely, but because
of  dedicated fat receptors on the tongue which are known to influence
the brain's satiety centers subconsciously, it's hard to fool the body
completely about fat in the diet.   Thus, any
shake which "sticks to the ribs" through lunch, must realistically
contain a little fat.  The 1 tablespoon of almond oil added to this
shake (14 g fat) represents only 120 Kcals.

Additionally, those who don't mind an extra 70 to 140 kcal can take
supplements of anti inflammatory oils with the shake as extra capsules.
The oils for this job are cold water fish oils (not cod liver oil, but
fish body oil, such as the Kirkland brands from COSTCO) PLUS borage
plant oil (Puritan's Pride is the least expensive source). Borage oil
supplies the same GLA as is found in evening primrose of black current
oil, but far less expensively.

These oils are not recommended to direct addition to the shake, but
they do add to the calories and to the shake's hunger-fighting capacity
if you take them along with the shake in the morning. Do not take
borage oil or GLA without fish oil, as the GLA in borage can be
converted to inflammatory arachadonate without the fats in fish oil to
block it. The anti inflammatory dose of fish oil is about 5 to 10 grams
of fishoil (supplying 1.5 to 3.0 grams EPA+DPA omega-3 fatty acids,
precursors to many anti inflammatory 3-series prostaglandins) and 2 to
4 grams of borage oil (supplying 0.5 to 1 gram of GLA, an omega-3
precursor to 1-series prostaglandins).

    A note about peanut oil: don't.  Peanut fats are atherogenic, even
though they contain all the right fatty acid residues.  The full
reasons are unknown, but it's not something easily fixable.  Do not eat
peanut butter or peanuts, except as flavoring agents.  Learn to
like sandwiches of other nut-butters (which taste better anyway), and
NEVER fry in peanut oil.

    For fiber and body in a shake it's hard to beat a banana, which not
only adds flavor, but also potassium and 100 nearly fat-free Calories.
 This, plus frozen berries (60 Calories per cup) and other tropical
fruits for cooling, and vanilla for additional flavor, completes our
The Soy protein, Whey protein, and borage oil can be purchased at
various outlets online. Fish oils and fruits are available least
expensively at COSTCO.


Banana-Vanilla-Berry Anti-Cancer Anti-Heart-Disease
Weight-Loss Breakfast Shake:

The frozen fruit and soymilk may be put in the blender pitcher the
night before and left in the refrigerator so the fruit melts (if you
like your smoothies not quite so cold). Or all can be done in the AM if
you like your smoothies cooler.

Put into the blender:

8 oz non-fat 6 or 7 gram protein per cup soy milk
      (author's favorite: SOY-MOO brand)
1 tablespoon almond oil (or hazelnut or walnut oil)
5 drops vanilla extract
1 large banana (partly for sweetness, and also consistency)
1 cup frozen berries (or frozen chunked mixed tropical fruits)
1/4 cup soy protein (get brands with no added methionine such as
CHALLENGE brand with 95% isolated soy).  Or a mix of soy and whey

Add the protein powder on top of the other ingredients (otherwise it
tends to stick to the sides of the blender), and blend until smooth (60
seconds or so), for a drink of 16 oz.
Chug it down, quickly rinse the blender before it becomes a problem to
wash (you can use soapy water and blend again for a few seconds), and
you can be out the door in a minute or two.

For other flavors, various mixes of  frozen whole organic strawberries,
peaches, blueberries, blackberries, or melon, can be added to taste.
Just keep small bags of frozen fruit in the freezer, and prepare and
use a cup of any mixed frozen fruits in your shake. The nutritional
analysis below has assumed a cup of frozen blackberries.

Don't be afraid to experiment with mixed fruits (the purple and blue
ones may make the shake look strange, but they taste good).  Bananas
are easy to freeze also, when they are ripe (never mind the dark
appearance of frozen bananas--they also taste fine after blending).
Epidemiologically, strawberries and melons top the list of anti-cancer
fruits, and huckleberries, blackcurrents, blueberries and blackberries
are highest in the bioflavonoids which possibly naturally prevent some
heart disease and thrombophlebitis problems.

For those mornings when a change from fruit is in order, Hershey
chocolate syrup makes for a health non-fat flavor, as (aside from
satisfying the odd craving that some people have for it) it contains
healthful flavonoids as well.  The banana- chocolate shake is

Nutritional Analysis (for the plain banana/berry/vanilla version):

Protein: 21 grams (about 1/3 of daily protein requirement)
Carbohydrate: 57 g (~ 40 grams simple sugars, no lactose)
Fat: 16 grams (70% monounsaturate, assuming almond oil)
Fiber: 8 grams
Energy: 450 Cals (Kcals), 27% from fat

Cost (Banana/Vanilla/berry): About $2.00, depending on where you shop
or mail-order.  This compares reasonably to $1.50 for 600 calories from
3 Carnation Instant Breakfasts with skim milk (200 Calories each).
Calorically, note that an "Instant Breakfast" is not much of a
breakfast, lacking the potassium, fiber, high quality protein and
phytonutrients of our shake.  It would be possible to duplicate the
approximate food value in the above shake in the same volume at about
the same cost with *two* Instant Breakfasts, condensed skim and regular
skim milk (50:50) to make 16 oz, and some almond oil. But the resulting
drink would have milk casein in place of soy protein and soy nutrients,
and also have a lot of lactose (unless you added lactase enzyme such as
Lactaid too...).   Generally, this would still be inferior.

If 10 grams of fish oil capsules and 4 grams of borage are taken with
this, add 14 grams of fat and 126 calories to the total above. If you
think you won't be able to take 14 capsules with a shake, try it. After
a week you'll be a pro.

Again, note that some fat and fat-calories have been added
deliberately, in order to avoid "daily Calories eaten late in the day"
trap.  There is no point in trying to make this a "low- calorie"
shake-- that defeats the entire purpose of it!

Also, vitamins, minerals, and omega-3 fatty acids have been not been
balanced, on assumption that supplement pills, fruits, vegetables, and
other fat sources will be added later in the daily diet.

Some health-seekers will immediately think of adding the traditional
things like brewer's yeast, vitamins, wheat-germ oil, and lecithin to
this recipe.  My best advice on this is: don't. These things taste
awful to many people!  It takes an unusual person to drink something
most mornings over the long run if it doesn't taste pretty good.  If
you make these sweet and tasty shakes correctly, however, you can drink
one every morning and never get tired of them.  The clean taste of
strawberries, several types of mellon balls, peaches, and almond oil in
a shake go particularly well.

Steven B. Harris, M.D.

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