How Your Breakfast Might Affect Your Blood Sugar

Type 2 diabetes patients had better blood sugar levels when they ate a high-energy breakfast and low-energy dinner

(RxWiki News) There may be more to healthy eating than vitamins, minerals, and fat and sugar content. How much you eat and when could have an effect on your blood sugar, too.

A new study from Israel found that when people who had type 2 diabetes ate a high-energy breakfast and low-energy dinner, their blood sugar control improved. People who did the reverse — low-energy breakfast, high-energy dinner — were more likely to have blood sugar spikes after the meal than the high/low eaters.

Meal timing may provide a way to help manage diabetes, the authors of this study said.

Dr. Barry Sears, an expert in anti-inflammatory nutrition, told dailyRx News that many patients may have trouble keeping to a set meal schedule. He said that "most patients have trouble with dietary compliance without adding the additional thinking about meal timing."

Also, if patients don't feel full after a meal, controlling calories could prove difficult, Dr. Sears said.

Daniela Jakubowicz, MD, of the Wolfson Medical Center at Tel Aviv University in Israel, led this study.

"The mechanism of better glucose tolerance after high-energy breakfast than after an identical dinner may be in part the result of [internal body] clock regulation ... Thus, recommending a higher energy load at breakfast … seems an adequate strategy to decrease post-meal glucose spikes in patients with type 2 diabetes," Dr. Jakubowicz said in a press release. "High energy intake at breakfast is associated with significant reduction in overall post-meal glucose levels in diabetic patients over the entire day. This dietary adjustment may have a therapeutic advantage for the achievement of optimal metabolic control and may have the potential for being preventive for cardiovascular and other complications of type 2 diabetes."

Type 2 diabetes is a condition in which people become resistant to the effects of insulin, the hormone that regulates blood sugar. People with type 2 diabetes still produce insulin — they just don’t respond to it as well as people without diabetes.

Dr. Jakubowicz and colleagues studied eight men and 10 women. All patients had type 2 diabetes and were being treated with metformin (brand names Glumetza, Fortamet, Riomet and Glucophage) or a prescribed diet.

Dr. Jakubowicz and team created two diets, called the breakfast diet (B diet) or dinner diet (D diet). The total calories in both diets were the same.

However, in the B diet, patients' meals contained 704 calories at breakfast, 607 calories at lunch and 205 calories at dinner. In the D diet, the calories were reversed, with 205 calories at breakfast and 704 calories at dinner. Lunch calories did not change.

In the first part of the study, half the patients ate the B diet or the D diet at the same times at home for six days.

On the seventh day, the test subjects ate their meals at the clinic, and Dr. Jakubowicz and team drew blood for testing before and after each meal. The blood tests were designed to measure blood sugar levels, hormones and insulin factors that indicate how well the body is processing sugar.

After two weeks, the study patients switched diets.

When they ate the B diet, they had lower blood glucose levels and higher insulin levels at the lunchtime blood draw. These results indicated that the energy content of the breakfast meal affected the patients' ability to regulate their blood sugar levels.

This study was published Feb. 24 in the journal Diabetologia. Dr. Jakubowicz and team disclosed no funding sources or conflicts of interest.

Review Date: 
February 23, 2015