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Journal of the American College of... Apr 2019Skipping breakfast is common among U.S. adults. Limited evidence suggests that skipping breakfast is associated with atherosclerosis and cardiovascular disease. (Comparative Study)
Comparative Study
BACKGROUND
Skipping breakfast is common among U.S. adults. Limited evidence suggests that skipping breakfast is associated with atherosclerosis and cardiovascular disease.
OBJECTIVES
The authors sought to examine the association of skipping breakfast with cardiovascular and all-cause mortality.
METHODS
This is a prospective cohort study of a nationally representative sample of 6,550 adults 40 to 75 years of age who participated in the National Health and Nutrition Examination Survey III 1988 to 1994. Frequency of breakfast eating was reported during an in-house interview. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2011. The associations between breakfast consumption frequency and cardiovascular and all-cause mortality were investigated by using weighted Cox proportional hazards regression models.
RESULTS
Among the 6,550 participants (mean age 53.2 years; 48.0% male) in this study, 5.1% never consumed breakfast, 10.9% rarely consumed breakfast, 25.0% consumed breakfast some days, and 59.0% consumed breakfast every day. During 112,148 person-years of follow-up, 2,318 deaths occurred including 619 deaths from cardiovascular disease. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, body mass index, and cardiovascular risk factors, participants who never consumed breakfast compared with those consuming breakfast everyday had hazard ratios of 1.87 (95% confidence interval: 1.14 to 3.04) for cardiovascular mortality and 1.19 (95% confidence interval: 0.99 to 1.42) for all-cause mortality.
CONCLUSIONS
In a nationally representative cohort with 17 to 23 years of follow-up, skipping breakfast was associated with a significantly increased risk of mortality from cardiovascular disease. Our study supports the benefits of eating breakfast in promoting cardiovascular health.
Topics: Adult; Age Factors; Aged; Breakfast; Cardiovascular Diseases; Cause of Death; Cohort Studies; Ethnicity; Feeding Behavior; Female; Healthy Lifestyle; Humans; Logistic Models; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Risk Assessment; Sex Factors; Surveys and Questionnaires; Survival Analysis; United States
PubMed: 31023424
DOI: 10.1016/j.jacc.2019.01.065 -
Nutrients Dec 2022This study aimed to examine the effect of high protein breakfast diet with or without lunch on the postprandial glucose level during the day. A randomized, crossover... (Randomized Controlled Trial)
Randomized Controlled Trial
This study aimed to examine the effect of high protein breakfast diet with or without lunch on the postprandial glucose level during the day. A randomized, crossover design that recruited 12 healthy young participants (three men and nine women) was performed and four trials (normal breakfast + skipped lunch, high protein breakfast + skipped lunch, normal breakfast + lunch, and high protein breakfast + lunch) were conducted in two weeks. During each trial, breakfast, lunch, and dinner on the trial day, and dinner before the trial day, were provided as test meals, and the meal timing was fixed. Continuous glucose monitoring (CGM) was used to assess the blood glucose level during the whole experiment. Incremental area under the curve (iAUC) of the postprandial glucose level was calculated. The results suggested that compared with normal breakfast, high protein breakfast suppressed the 3 h iAUC of postprandial glucose level after breakfast (p < 0.05 or p < 0.0001) and 1.5 h iAUC after lunch (p < 0.01). During lunch, high protein breakfast diet suppressed the dinner and overall day postprandial glucose level (p < 0.05 vs. normal breakfast), but no significant difference was observed when skipping lunch. Our findings indicate that high protein breakfast could suppress the breakfast postprandial glucose level, as well as following lunch and dinner, but this effect on dinner was attenuated when skipping lunch.
Topics: Adult; Female; Humans; Male; Blood Glucose; Blood Glucose Self-Monitoring; Breakfast; Cross-Over Studies; Diabetes Mellitus, Type 2; Diet, High-Protein; Hyperglycemia; Lunch; Meals; Postprandial Period; Double-Blind Method
PubMed: 36615743
DOI: 10.3390/nu15010085 -
Nutrients May 2021Postprandial hyperglycemia (PPHG) is strongly linked with the future development of cardiovascular complications in type 2 diabetes (T2D). Hence, reducing postprandial... (Review)
Review
Postprandial hyperglycemia (PPHG) is strongly linked with the future development of cardiovascular complications in type 2 diabetes (T2D). Hence, reducing postprandial glycemic excursions is essential in T2D treatment to slow progressive deficiency of β-cell function and prevent cardiovascular complications. Most of the metabolic processes involved in PPHG, i.e., β-cell secretory function, GLP-1 secretion, insulin sensitivity, muscular glucose uptake, and hepatic glucose production, are controlled by the circadian clock and display daily oscillation. Consequently, postprandial glycemia displays diurnal variation with a higher glycemic response after meals with the same carbohydrate content, consumed at dusk compared to the morning. T2D and meal timing schedule not synchronized with the circadian clock (i.e., skipping breakfast) are associated with disrupted clock gene expression and is linked to PPHG. In contrast, greater intake in the morning (i.e., high energy breakfast) than in the evening has a resetting effect on clock gene oscillations and beneficial effects on weight loss, appetite, and reduction of PPHG, independently of total energy intake. Therefore, resetting clock gene expression through a diet intervention consisting of meal timing aligned to the circadian clock, i.e., shifting most calories and carbohydrates to the early hours of the day, is a promising therapeutic approach to improve PPHG in T2D. This review will focus on recent studies, showing how a high-energy breakfast diet (Bdiet) has resetting and synchronizing actions on circadian clock genes expression, improving glucose metabolism, postprandial glycemic excursions along with weight loss in T2D.
Topics: Appetite; Blood Glucose; Breakfast; Circadian Clocks; Circadian Rhythm Signaling Peptides and Proteins; Diabetes Mellitus, Type 2; Diet, Diabetic; Energy Intake; Feeding Behavior; Humans; Hyperglycemia; Meals; Postprandial Period; Time Factors; Weight Loss
PubMed: 34063109
DOI: 10.3390/nu13051558 -
The Journal of School Health Jul 2022Breakfast after the bell (BAB), an alternative way to deliver breakfast after the school day begins, has been shown to increase participation in the School Breakfast...
BACKGROUND
Breakfast after the bell (BAB), an alternative way to deliver breakfast after the school day begins, has been shown to increase participation in the School Breakfast Program. However, BAB occupies time that could otherwise be used for instruction and may affect academic performance. This study examined whether BAB affects math and literacy scores in third grade, an age not adequately studied in earlier literature.
METHODS
Using data on Arkansas students, we compared schools adopting BAB to corresponding "synthetic" control schools by minimizing preadoption differences in observables that can influence test scores.
RESULTS
We found little evidence of positive or negative effects on test scores. We also found little evidence of meaningful program effects over subsamples of schools by district enrollment size and BAB delivery method. Schools that adopted grab-and-go delivery and schools in districts with small enrollments, less than 600 students, showed statistically negative effects on math after BAB adoption. However, these effects were transitory and no longer present by the time the first fully exposed cohort reached third grade.
CONCLUSIONS
BAB can be incorporated into the school day without adversely impacting academic achievement, especially if adopting schools seek input from educators and nutrition personnel already experienced with BAB.
Topics: Academic Performance; Breakfast; Child; Food Services; Humans; Schools; Students
PubMed: 35289398
DOI: 10.1111/josh.13174 -
Diabetes, Obesity & Metabolism Feb 2021To evaluate the effect of oral semaglutide on energy intake and appetite in subjects with type 2 diabetes (T2D). (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To evaluate the effect of oral semaglutide on energy intake and appetite in subjects with type 2 diabetes (T2D).
MATERIALS AND METHODS
In this randomized, double-blind, placebo-controlled, two-period cross-over trial, 15 subjects with T2D received 12 weeks of treatment with once-daily oral semaglutide (4-week dose escalation from 3 to 7 to 14 mg) followed by placebo, or vice versa. Energy intake was measured during an ad libitum lunch, evening meal and snack box after a standard breakfast. Appetite ratings were measured using a visual analogue scale after standard and fat-rich breakfasts. Other assessments included eating and craving control (using the Control of Eating Questionnaire), and changes in body weight and composition.
RESULTS
Following a standard breakfast, total daily ad libitum energy intake was significantly lower (38.9%) with oral semaglutide versus placebo in 13 evaluable subjects (estimated treatment difference, -5096.0 kJ; 95% CI -7000.0, -3192.1; P = .0001). After a fat-rich breakfast, there were significant differences in favour of oral semaglutide versus placebo for measures of satiety, hunger and for overall appetite score, with no significant differences following a standard breakfast. Fewer food cravings and better eating control were seen with oral semaglutide versus placebo. Overall, mean body weight decreased by 2.7 kg with oral semaglutide and 0.1 kg with placebo, mostly attributable to body fat mass loss.
CONCLUSION
After 12 weeks of treatment, ad libitum energy intake was lower with oral semaglutide versus placebo, resulting in reduced body fat mass, and was associated with increased satiety and fullness after a fat-rich breakfast, and improved eating control.
TRIAL REGISTRATION NUMBER
NCT02773381.
Topics: Appetite; Body Weight; Breakfast; Cross-Over Studies; Diabetes Mellitus, Type 2; Eating; Energy Intake; Food Preferences; Glucagon-Like Peptides; Humans
PubMed: 33184979
DOI: 10.1111/dom.14255 -
The Journal of Nutrition Apr 2023There has been little investigation into how the timing of meals and eating occasions associates with postmenopausal breast cancer risk. (Observational Study)
Observational Study
BACKGROUND
There has been little investigation into how the timing of meals and eating occasions associates with postmenopausal breast cancer risk.
OBJECTIVE
We examined the association between the frequency of consuming breakfast meals and after-dinner snacks with the risk for postmenopausal breast cancer.
METHODS
A prospective analysis of 74,825 postmenopausal women aged 49 to 81 y from the Women's Health Initiative Observational Study cohort. Breakfast and after-dinner snack intake were assessed at year 1 examination. Risk for invasive and in situ breast cancer diagnosed before 28 February 2020 was modeled with multivariable Cox proportional hazards regression models according to breakfast and after-dinner snack consumption frequencies. The models were adjusted for age, self-identified race/ethnicity, education, income, physical activity, smoking, alcohol intake, diet quality score (Healthy Eating Index 2015), energy intake, diabetic status, hormone therapy, and BMI.
RESULTS
During the follow-up period, 5313 participants were diagnosed with invasive breast cancer and 1197 participants with in situ breast cancer. Compared with participants who did not eat breakfast, those with daily breakfast consumption was not associated with invasive breast cancer (HR: 1.04; 95% CI: 0.9, 1.19) nor in situ (HR: 1.25; 95% CI: 0.91, 1.74) breast cancer. There were monotonic higher point estimates of in situ breast cancer for each higher category of breakfast intake from 0 to 7 times per week (P-trend = 0.04, Wald test). Compared with consumption of daily after-dinner snacks, avoidance of after-dinner snacks was not associated with invasive breast cancer (HR: 0.97; 95% CI: 0.87, 1.08) nor in situ (HR: 1.12; 95% CI: 0.89, 1.42) breast cancer.
CONCLUSIONS
There was no association between intake frequency of breakfast meals or after-dinner snack habits and with risk of breast cancer in postmenopausal women.
Topics: Humans; Female; Breakfast; Snacks; Breast Neoplasms; Postmenopause; Feeding Behavior; Meals; Energy Intake; Women's Health
PubMed: 36828152
DOI: 10.1016/j.tjnut.2023.02.003 -
Journal of Anesthesia Dec 2019There is little evidence of gastric excretion after ingestion of solids. We examined gastric emptying times after ingesting normal breakfast in healthy adult volunteer...
There is little evidence of gastric excretion after ingestion of solids. We examined gastric emptying times after ingesting normal breakfast in healthy adult volunteer using ultrasonography. Eight adult volunteers fasted for 8 h, and we examined the gastric antral area in the right lateral decubitus position using ultrasonography. Sixteen adult volunteers ingested normal breakfast. We evaluated the gastric antral area in the same manner at two consecutive time points before lunch. Gastric volume was calculated by using an approximation formula based on the antral area. Correlation coefficients between gastric volume and fasting time were calculated. The calculated gastric volume from the gastric antral area after 8 h fasting was 53.1 ml. The gastric volume correlated significantly with fasting time (r = - 0.811, P < 0.001). The time when the attenuation line obtained from two measurements between breakfast to lunch in each subject overlapped the fasting stomach volume (53.1 ml) was taken as gastric empty time. The calculated gastric emptying time was 276.4 ± 58.9 min. This result shows that gastric emptying time was lower than 5 h average after a typical breakfast that contains various food in healthy adult volunteers. However, further research is necessary to establish the clinical safety implications of these findings.
Topics: Adult; Breakfast; Fasting; Female; Gastric Emptying; Humans; Male; Middle Aged; Stomach; Ultrasonography; Young Adult
PubMed: 31630260
DOI: 10.1007/s00540-019-02694-6 -
The British Journal of Nutrition Aug 2019Breakfast skipping has become an increasing trend in the modern lifestyle and may play a role in obesity and type 2 diabetes. In our previous studies in healthy young... (Randomized Controlled Trial)
Randomized Controlled Trial
Breakfast skipping has become an increasing trend in the modern lifestyle and may play a role in obesity and type 2 diabetes. In our previous studies in healthy young individuals, a single incident of breakfast skipping increased the overall 24-h blood glucose and elevated the postprandial glycaemic response after lunch; however, it was difficult to determine whether this response was due to breakfast omission or the extra energy (i.e. lunch plus breakfast contents). The present study aimed to assess the postprandial glycaemic response and to measure their hormone levels when healthy young individuals had identical lunch and dinner, and the 24-h average blood glucose as a secondary outcome. Nine healthy young men (19-24 years) participated in two-meal trials: with breakfast (three-meal condition) or without breakfast (breakfast skipping condition). During the meals, each individual's blood glucose was continuously monitored. Skipping breakfast resulted in a significantly higher (P < 0·001) glycaemic response after lunch as compared with the glycaemic response after an identical lunch when breakfast was consumed. Despite the difference in the total energy intake, the 24-h average blood glucose was similar between the two-meal conditions (P = 0·179). Plasma NEFA level was significantly higher (P < 0·05) after lunch when breakfast was omitted, and NEFA level positively correlated with the postprandial glycaemic response (r 0·631, P < 0·01). In conclusion, a single incident of breakfast skipping increases postprandial hyperglycaemia, and associated impaired insulin response, after lunch. The present study showed that skipping breakfast influences glucose regulation even in healthy young individuals.
Topics: Blood Glucose; Breakfast; Cross-Over Studies; Humans; Hyperglycemia; Male; Meals; Postprandial Period; Young Adult
PubMed: 31486356
DOI: 10.1017/S0007114519001235 -
The American Journal of Clinical... Jul 2023In type 2 diabetes (T2D), consuming carbohydrates results in a rapid and large increase in blood glucose, particularly in the morning when glucose intolerance is highest. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In type 2 diabetes (T2D), consuming carbohydrates results in a rapid and large increase in blood glucose, particularly in the morning when glucose intolerance is highest.
OBJECTIVES
We investigated if a low-carbohydrate (LC) breakfast (∼465 kcal: 25 g protein, 8 g carbohydrates, and 37 g fat) could improve glucose control in people with T2D when compared with a low-fat control (CTL) breakfast (∼450 kcal:20 g protein, 56 g carbohydrates, and 15 g fat).
METHODS
Participants with T2D (N = 121, 53% women, mean age 64 y) completed a remote 3-month parallel-group randomized controlled trial comparing a LC with standard low-fat guideline CTL breakfast. The change in HbA1c was the prespecified primary outcome. Continuous glucose monitoring, self-reported anthropometrics, and dietary information were collected for an intention-to-treat analysis.
RESULTS
HbA1c was reduced (-0.3%; 95% CI: -0.4%, -0.1%) after 12 wks of a LC breakfast, but the between-group difference in HbA1c was of borderline statistical significance (-0.2; 95% CI: -0.4, 0.0; P = 0.06). Self-reported total daily energy (-242 kcal; 95% CI: -460, -24 kcal; P = 0.03) and carbohydrate (-73 g; 95% CI: -101, -44 g; P < 0.01) intake were lower in the LC group but the significance of this difference is unclear. Mean and maximum glucose, area under the curve, glycemic variability, standard deviation, and time above range were all significantly lower, and time in the range was significantly higher, in the LC group compared with CTL (all P < 0.05).
CONCLUSIONS
Advice and guidance to consume a LC breakfast appears to be a simple dietary strategy to reduce overall energy and carbohydrate intake and improve several continuous glucose monitoring variables when compared with a CTL breakfast in persons living with T2D. The trial was registered at clinicaltrials.gov as NCT04550468.
Topics: Humans; Female; Middle Aged; Male; Blood Glucose; Breakfast; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Dietary Carbohydrates; Blood Glucose Self-Monitoring; Glycemic Control; Diet, Fat-Restricted; Glucose
PubMed: 37257563
DOI: 10.1016/j.ajcnut.2023.04.032 -
Clinical Physiology and Functional... May 2019Hemodynamics is subject to change after eating meals, which may be related to various postprandial physical statuses such as hypotension or daytime sleepiness. Previous... (Comparative Study)
Comparative Study
Hemodynamics is subject to change after eating meals, which may be related to various postprandial physical statuses such as hypotension or daytime sleepiness. Previous studies have shown that blood flow in the superior mesenteric artery (SMA) increases after meals, but conflicting results have been reported regarding blood flow in the common carotid artery (CCA). In those studies, the fasting interval before the meal was not taken into account. For example, eating breakfast shortly before lunch may affect hemodynamics in these vessels. The present study therefore investigated hemodynamics in the CCA and SMA after lunch, comparing cases with and without breakfast. Subjects comprised 24 healthy young adults (mean age, 22 ± 1 years). Duplex Doppler sonography was performed to measure blood flow values for calculating flow volume (FV) before and after lunch until 3 h postprandially, on each day with breakfast and without breakfast, respectively, in every subject. Net FV after lunch did not differ between cases with and without breakfast, either in the SMA or in the CCA. Blood FV in the SMA was significantly increased after eating lunch regardless of whether breakfast was eaten (P<0·05 each). However, FV in the CCA was significantly decreased until 1 h after lunch compared with the preprandial state in cases without breakfast (P<0·05), but not in cases with breakfast. In conclusion, a sudden decrease in FV in the CCA from the preprandial state is seen after lunch when breakfast is skipped.
Topics: Blood Flow Velocity; Breakfast; Carotid Artery, Common; Female; Hemodynamics; Humans; Lunch; Male; Mesenteric Artery, Superior; Postprandial Period; Regional Blood Flow; Splanchnic Circulation; Time Factors; Ultrasonography, Doppler, Duplex; Young Adult
PubMed: 30515951
DOI: 10.1111/cpf.12556