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Study under review: Fasting Until Noon Triggers Increased Postprandial Hyperglycemia and Impaired Insulin Response After Lunch and Dinner in Individuals With Type 2 Diabetes: A Randomized Clinical Trial
The breakfast saga continues! Should you skip it? Should you eat it even if you’re not hungry? A new study on people with type 2 diabetes has shed new light on the lasting effects breakfast may have throughout the entire day, particularly on blood glucose maintenance after a meal. Postprandial hyperglycemia (PPHG), or excessively high blood sugar levels after a meal, can have a major impact on long-term health. In fact (as seen in Figure 1), PPHG is thought to be an even stronger predictor of future cardiovascular events than fasting blood glucose in people with type 2 diabetes, particularly in women. With that in mind, controlling post-meal blood sugar peaks seems to be a prudent target for nutritional interventions in people with type 2 diabetes. As you may have read in last month’s ERD, changing up food order is one way to affect the blood sugar response to a meal. Surprisingly, deciding whether or not to consume breakfast can also have strong implications for blood sugar control even later into the evening.
Reference: Cavelot et al. Diabetes Care. 2011 Oct.
In spite of the fact that intermittent fasting regimens that include fasting until lunch have become glamorized in recent years, skipping breakfast has long been associated with a variety of drawbacks (as seen in Figure 2) such as increased weight gain, greater risk for developing type 2 diabetes, and decreased cognitive function.
Controlled studies in people who generally skip breakfast have found that compared to eating breakfast (especially one that is high in protein), skipping breakfast often leads to increased hunger, reduced feelings of fullness, and greater energy intake later in the day. For people with type 2 diabetes, skipping breakfast is associated with significantly higher blood sugar levels, while consuming a larger breakfast with a smaller dinner has resulted in a significant reduction of blood sugar levels throughout the day. Somewhat paradoxically, eating or skipping breakfast had no effect on weight loss in overweight but otherwise healthy adults that participated in a 2014 study.
Although a growing number of studies are showing beneficial effects of breakfast on glycemic control in people with type 2 diabetes, the relationship between breakfast patterns and PPHG throughout the entire day is not clear. Breakfast skipping has been shown to cause a higher glycemic response after lunch in people with and without diabetes, indicating a second-meal effect. However, the glycemic response after additional meals had yet to be studied, and it was still unknown if breakfast can elicit an additional ‘third-meal’ effect. Therefore, the aim of this recently published study was to examine the postprandial glycemic responses to identical lunch and dinner meals in participants with type 2 diabetes, who had either consumed or skipped breakfast.
Blood sugar rising way above normal after eating (postprandial hyperglycemia, or PPHG) is strongly associated with future cardiovascular disease. While skipping breakfast has been observed to lead to stronger hunger and increased food intake later in the day, its effect on PPHG in people with diabetes isn’t completely clear. The goal of this study was to examine the effect of eating breakfast on PPHG in people with diabetes.
Other Articles in Issue #11 (September 2015)
A shot to the gut
Alcohol intake and gut impacts have been researched before, but we still aren’t sure what exactly goes on after people drink. This study looked at what happens with gut bacterial products when people have multiple drinks at one sitting ... aka “binge drinking”.
Tea time means only tea for optimal EGCG absorption
Many people drink green tea for health, and some take green tea or EGCG supplements in an attempt to shed extra fat. While these topics have been researched at length, there hasn’t been as much research on timing. This study looks at EGCG absorption with and without food.
Can omega-3s prevent cognitive decline?
One of the most important issues with aging is decreased cognitive ability and eventually dementia. Since the brain has such high omega-3 content, many people supplement for prevention of these issues. This large, multi-year study put that practice to the test.
The study that didn’t end the low-fat/low-carb diet “wars”
A recent metabolic ward study set the low-carb world on fire, and produced many inaccurate media headlines disparaging low-carb diets. We cover the study and its implications, detail by detail.
- Interview: Dylan Dahlquist, MSc(c)
What to Expect When We’re Expecting: Fetal Programming and the Development of Taste Preferences
By Margaret Leitch, Ph.D.
Gluten-intolerant? There’s a pill for that
Some people are lactose intolerant, but still drink milk thanks to the availability of lactase enzymes. That setup isn’t yet possible for those who don’t handle gluten well. This study examines the efficacy of a promising enzymatic adjunct to a gluten-free diet.
Vitamin D(efense) against Crohn’s disease?
Immune benefits are often listed among the multitude of possible vitamin D effects. Most of the time, this is simplified to “defense against colds and flu”. But many conditions have an immune component — this particular study examines potential mechanisms by which vitamin D may help Crohn’s disease.
Green tea: a potential pain in the neck
Though it may not be as effective for fat loss as early studies suggested, green tea is still seen as extremely healthy. But animal evidence has pointed to possible thyroid side effects from excessive green tea consumption. How convincing is this evidence?