I'm diabetic. Believe me, you don’t want to have diabetes
Skipping meals has become more common - and more faddish. Breakfast is often a casualty of our modern lifestyle, and rising interest in the health benefits of fasting have pushed out other meals, such as dinner.
The most common set meal to be lost is breakfast. But is that always the best choice? The consequences of missing breakfast versus missing dinner are different. If you knew the different health consequences, would you make a different choice?
What choice would you make it you are diabetic like me, or potentially diabetic? Here's what I learnt from the research.
Confession: I didn't read the research with an open mind
Personally, I'm a "breakfast person". Until a few years ago I could not exercise without breakfast. If I were off for an early run or early to the gym, I would make myself get up even earlier to have a well-balanced light breakfast.
One day I got up too late and reluctantly headed out the door to the gym without breakfast. To my surprise, I felt fine. After a while, I realised that if I was doing intense work for an extended period that I just needed to have a banana or half-apple, or an orange before I left home. (I always have a protein shake when I get back, and later, breakfast.)
So I still always have breakfast, but these days the timing is different from my life-long attachment to having breakfast first thing every morning.
This is all a build-up to say that I would miss breakfast and find it hard to change if the research indicated that it was the best course of action. As a diabetic, every small sustainable lifestyle change that you can make is important. Attention to these 1% changes will keep you healthier for longer.
Here's what I learnt from the research.
Skip breakfast, or skip dinner?
Our habitual patterns of when and how much we eat have an impact on many health outcomes, including obesity and Type 2 diabetes. I was diagnosed with Type 2 diabetes more than 20 years ago (I'm sure it was not because of my love of breakfast).
The research (2017) compared the difference between skipping dinner with skipping breakfast on blood sugar, energy balance, and "inflammatory responses".
Inflammation is when our body has something out of balance, and our immune system takes action to put us back into balance - metabolically. Eating spikes various metabolic levers and our immune system responds by pulling those levers to normalise the balance, and to avoid chronic imbalances, e.g. in blood sugar levels. Chronic imbalances - chronic inflammation - causes dangerous diseases such as diabetes, Alzheimer's, arteriosclerosis, blood clots, and heart attacks
Lingering inflammation when breakfast-skipping
The goal of the research was to determine whether skipping breakfast, compared to skipping dinner, changed our ability to effectively stabilise our metabolic responses.
Here's the difference:
The higher blood sugar and insulin levels after lunch on the breakfast-skipping diet are examples of lingering inflammation caused by eating. This research indicates that our "inflammatory response" is impaired on a breakfast-skipping diet.
This type of post-lunch inflammation is dangerous - to quote the authors - as it "may in the long-term lead to low-grade inflammation and impaired glucose homeostasis". Translated, that means that his type of low-grade chronic inflammation raises your risk of developing diabetes.
The authors also note that "breakfast skipping also increased the inflammatory potential of peripheral blood cells after lunch". Translation: skipping breakfast raises the risk of cardiovascular diseases and brain degeneration.
Reinforcing metabolic inflexibility is a big negative
The post-lunch inflammatory response observed after lunch includes a delayed metabolic response to new dietary carbohydrate. Those on the breakfast-skipping diet were found to be still burning fat when, to prevent excess glucose in their blood, they should have been metabolising carbohydrate.
That's a big problem. It may predispose you to become diabetic, or exacerbate your existing diabetes.
Imagine that you are driving a hybrid car and it is running at traffic speed on the electric motor. You find yourself needing to accelerate rapidly, so you push the accelerator pedal to the floor. Typically the petrol motor would immediately switch in, start burning a load of gasoline and do most of the hard work accelerating your car.
If you have been on the breakfast-skipping diet - which is burning fat during the extended fast since dinner - then eating lunch is the equivalent of "flooring the accelerator pedal". Your body should switch quickly to burning the incoming carbohydrates. But it doesn't. The metabolism is stuck on fats. It is metabolically inflexible.
Compared with dinner-skipping, higher fat oxidation after lunchtime (after skipping breakfast) was observed in the study. The mitochondrial capacity to switch freely between oxidative fuels in the transition from fasting to feeding appeared to be lost.
In a healthy, metabolically flexible state, the consumption of a high-carbohydrate meal results in an increase in blood insulin concentrations and an "accelerated shift" from fats to carbohydrate oxidation.
The authors note that "the development of metabolic inflexibility in response to prolonged fasting that may increase metabolic risk over time".
I'm sticking with breakfast
If you have diabetes, like me, the development of metabolic inflexibility is unhelpful as it increases the risk of diabetic complications, e.g. blindness, limb amputations, kidney failure.
Recent studies (2020) have found that our circadian rhythm - how our metabolism flows through a 24-hour cycle - affects our digestive process. We burn less fat if we eat in the late-evening. Best not to snack after 9pm.
Another recent study (2020) found that greater energy intake earlier in the day was associated with higher insulin sensitivity in individuals without diabetes. This means that greater energy intake earlier in the day - having breakfast - may reduce the likelihood of developing diabetes. That's a good thing.
Therefore, I am sticking with eating a healthy breakfast (and a healthy-sized breakfast). Based on the results of the above studies this should minimise the adverse effects of post-lunch inflammation and discourage the development of metabolic inflexibility - both of which are risk factors for diabetics.
I'll also continue to avoid late-night snacks, as I already do. Conventionally, not eating after 9pm is regarded as best metabolically - although I'm sure that the French and Spanish cultures would dispute that :)
I hope this informs your choices as it has mine.
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> More posts to help you with DIABETES
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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or another qualified clinician. Disclaimer.
Since I was diagnosed at 50 with Type 2 diabetes I've been learning how to do bone-building fitness training which lowers my age. You can too. It's your choice. Walter