Big breakfast rich in protein and fat

improves blood sugar control and makes

people feel fuller than a small breakfast in
adults with type 2 diabetes
A big breakfast rich in protein and fat appears to offer more benefits to people
with type 2 diabetes than a smaller low calorie breakfast, concludes research
presented at this year's annual meeting of the European Association for the Study of
Diabetes. The research is by Professor Daniela Jakubowicz, Tel Aviv University,
Israel, and Dr Hadas Rabinovitz, The Hebrew University of Jerusalem, Rehovot ,
Israel, and colleagues.

Previous research has shown that people who regularly eat breakfast tend to have
lower BMI than those who go without, as well as more favourable fasting blood
glucose levels and post-meal insulin sensitivity. In this study, the researchers
analysed the effect of reakfast size and composition on blood glucose control, and its
association with hormone profile in adults with type 2 diabetes.

This randomised, controlled, open clinical trial, including overweight/obese, non-

insulin-dependent adults with type 2 diabetes. Participants were randomised to
balanced low calorie diabetic diets with either a big breakfast (BB) or small breakfast
(SB), (33% vs. 12.5% of total daily energy intake). The BB diet included a higher
percentage of protein and fat. Anthropometric measures were assessed every 2
weeks. Fasting markers of inflammation, hormones, and lipid profile were
performed at baseline and after a follow-up period (13 weeks later).

Of the 59 enrolled participants, 47 completed the study. At end of follow-up, greater

HbA1c and systolic blood pressure (SBP) reductions were observed in the BB than
SB group (HbA1c: -4.62% vs. -1.46 %; SBP -9.6 vs. -2.4 mmHg). Additionally,
diabetic medication doses were reduced in a greater proportion of the BB
participants (31% vs. 0%) while in the SB, a greater proportion of participants had
their diabetic medication dose increased (17% vs. 3%). Hunger scores were lower in
the BB group and greater improvements in fasting glucose were observed in the BB
group comparison to the SB group.
Dr Jakubowicz says: "A simple dietary manipulation of BB diet rich in protein and fat
appears to have additional benefits compared to a conventional low-calorie diet in
individuals with type 2 diabetes."

"We hypothesise these findings are related to reduction in markers of inflammation,"

says Dr Hadas Rabinovitz: "As the study progressed, we found that hunger scores
increased significantly in the SB group while satiety scores increased in the BB
group. In addition, the BB group reported a reduced urge to eat and a less
preoccupation with food, while the SB group had increased preoccupation with food
and a greater urge to eat over time It is possible that a big breakfast rich in protein
causes suppression of ghrelin secretion, which is reflected in enhanced satiety
ratings."

Dr Rabinovitz concludes: "Further research is required to confirm and clarify the

mechanisms by which this relatively simple diet approach enhances satiety, leads to
better glycemic outcomes compared to a more conventional dietary approach."

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