Study found morning meal rich in protein, fat actually curbed hunger, helped control blood sugar levels

By Dennis Thompson, HealthDay reporter



THURSDAY, Sept. 26 (HealthDay News) -- A hearty breakfast that includes protein and fat may actually help people with type 2 diabetes better control both their hunger and their blood sugar levels.

Patients who ate a big breakfast for three months experienced lower blood sugar (glucose) levels, and nearly one-third were able to reduce the amount of diabetic medication they took, according to an Israeli study that was scheduled for presentation Wednesday at the European Association for the Study of Diabetes annual meeting in Barcelona.

"The changes were very dramatic," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. "I'm impressed with these findings," added Zonszein, who was not involved with the study. "We should see if they can be reproduced."

The researchers based their new study on previous investigations that found that people who regularly eat breakfast tend to have a lower body mass index (BMI) than those who skip the meal. BMI is a measurement that takes into account height and weight. Breakfast eaters also enjoy lower blood sugar levels and are able to use insulin more efficiently.

The trial randomly assigned 59 people with type 2 diabetes to either a big or small breakfast group.

The big breakfast contained about one-third of the daily calories that the diabetic patients would have, while the small breakfast contained only 12.5 percent of their total daily energy intake. The big breakfast also contained a higher percentage of protein and fat.

Doctors found that after 13 weeks, blood sugar levels and blood pressure dropped dramatically in people who ate a big breakfast every day. Those who ate a big breakfast enjoyed blood sugar level reductions three times greater than those who ate a small breakfast, and blood pressure reductions that were four times greater.

About one-third of the people eating a big breakfast ended up cutting back on the daily diabetic medication they needed to take. By comparison, about 17 percent of the small breakfast group had to increase their medication prescriptions during the course of the trial.

The people eating a big breakfast also found themselves less hungry later in the day.

"As the study progressed, we found that hunger scores increased significantly in the small breakfast group while satiety scores increased in the big breakfast group," study co-author Dr. Hadas Rabinovitz, of the Hebrew University of Jerusalem, said in a news release from the association. "In addition, the big breakfast group reported a reduced urge to eat and a less preoccupation with food, while the small breakfast group had increased preoccupation with food and a greater urge to eat over time."

Rabinovitz speculated that a big breakfast rich in protein causes suppression of ghrelin, which is known as the "hunger hormone."

The protein in the breakfast also likely helped control the patients' blood sugar levels, said Vandana Sheth, a certified diabetes instructor and registered dietitian in Los Angeles and a spokeswoman for the Academy of Nutrition and Dietetics.

"We know when you eat carbohydrates, they can elevate blood sugar within 15 minutes to an hour," Sheth said. "Protein takes longer to convert into glucose, as long as three hours, and not all of it goes to glucose. Some of it is used to repair muscle, for example. So it's not a direct effect -- 100 percent of the carbs you eat convert to glucose, while only a portion of protein you eat converts to glucose."

Zonszein said he has concerns about the study. For example, he said both the size and the length of the trial were insufficient, and he questioned why so many participants left before its conclusion.

However, he said the results were impressive enough that he might try the dietary strategy out in his own practice.

"It's a virtually benign manipulation of the meal pattern," Zonszein said. "I want to give it to my nutritionist to see what she thinks, and we may end up using it with several of our patients."



*The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.


SOURCES: Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; Vandana Sheth, certified diabetes instructor and registered dietitian, Los Angeles, and spokeswoman, Academy of Nutrition and Dietetics; Sept. 25, 2013, presentation, European Association for the Study of Diabetes annual meeting, Barcelona



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Best get ready for the s**t-storm, doctor, if there's saturated fat in that meal.

"Hell hath no fury..."

Wow, that's brilliant. It tests all kinds of hypotheses simultaneously. For example, the idea of ad libitum, or the idea of compensatory mechanisms. Eat big now, eat small later. Eat small now, eat big later. Ad libitum allows to eat big now (and every time), but with the natural tendency to eat small later. The idea of caloric restriction forces to eat small now, and every other time later, but that becomes difficult due to compensatory mechanisms. Automatic failure. Explains partly why low-carb is effective.

I think we discussed another study that looked at indulgence. I forget exactly which one. The point is that those who indulged had better success than those who didn't. The big breakfast contained more protein and fat, and this could be seen as indulgence, further explaining why it works better.

Doesn't this also do good things for leptin?

If I go out, I can have a big breakfast, enjoy it, and be satisfied until dinner. But at home, I take an hour to drink to my coffee, and don't get hungry until noon.

Situational hunger or something!

I eat a nice protein heavy & fat rich breakfast and my trigs and cholesterol improved GREATLY since the end of March. My doctor wasn't shocked but he was surprised by the rapid turn around. With our without saturated fat, it has made no difference to the improvement, all indicators are... well... IMPROVING. Trigs went from 505 to 190. Fasting blood glucose went from 101 to 94. My cholesterol number went from 254 to 194 (needs more work but hey, I'll take THAT number). My stable angina has completely disappeared to the point I can exercise a fairly regular and strenuous regimen. Inches are falling off fast (7 inches off the waist) and headaches, joint aches and general malaise are GONE. All from dumping carbs and burning fat instead. Wonder diet? Maybe not for the guy next door but for me, the carb intolerant one, yes. Wish I had tried it 10-15 years ago.

already proven false, so their credibility is already shot out of the gate.

Congratulations!
KUTGW.

I've always figured they had the cause and effect backwards on the breakfast thing. Fat people are on diets and less likely to eat breakfast, skinny people eat breakfast
Not eating breakfast didn't cause the fat people to be fat!

There's also another possibility. Fasting is easier, as a general rule for people who are overweight. Skinny people might just have a greater need to eat in the morning.