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Amy Campbell, Dietitian, C.D.E.
May 14, 2007

Getting Off to a Good Start with Breakfast: Part 1

Amy Campbell

Do you eat breakfast? If you don’t, you’re not alone. A poll done a couple of years ago by ABC News revealed that four out of ten people don’t eat breakfast. Not surprisingly, older adults and seniors are more likely to eat breakfast than younger adults, mostly because of time; according to this poll, only 53% of adults ages 18 to 34 eat breakfast, whereas about 83% of people over the age of 65 eat breakfast regularly.

It's not uncommon for dietitians to hear patients say, "If I eat breakfast, I'm hungry all day." Likewise, many people skip breakfast in an effort to lose weight. Some people with diabetes don't eat breakfast because they wake up with high blood glucose readings in the morning. What are your reasons for not eating breakfast?

I probably don't have to tell you that breakfast is one of the more important—if not the most important—meals of the day. Even the name "breakfast" implies that you're breaking the long overnight fast with a nourishing meal to help you face the day. Why is eating breakfast such a big deal? Well, research shows that people who do eat breakfast are more likely to:

  • Reach and maintain a healthy weight
  • Have better strength and endurance
  • Have lower blood cholesterol levels
  • Eat more nutritiously during the rest of the day
  • Focus and be more productive during the day

In fact, data from the National Weight Control Registry, an ongoing study of over 5,000 people who have lost weight and maintained a weight loss of at least 30 pounds for one year or more, shows that one key factor for these people's success is that almost all eat breakfast. One theory is that eating breakfast kick-starts your metabolism, helping your body start burning food for fuel.

Eating breakfast may also lower the risk of developing Type 2 diabetes by 35% to 50%, according to some studies. Why? People who are at risk for diabetes tend to have what we call insulin resistance syndrome (or metabolic syndrome), a combination of high insulin and glucose levels in the blood, high blood pressure, abnormal blood lipids (such as cholesterol and triglycerides), and too much abdominal fat. This combination of factors paves the way for diabetes. The majority of people who have insulin resistance syndrome tend to be overweight and therefore often skip breakfast in an effort to lose weight, setting themselves up for overeating later in the day or at night and making not-so-healthy food choices.

What if you already have diabetes? Well, eating breakfast won't make your diabetes go away, of course, but it's still important to eat something in the morning. If you typically forgo breakfast because your fasting glucose levels are high in the morning, it's time to take stock of the situation and address the real issue of why they're high. Typical reasons include: eating too much after supper (probably because you don't eat breakfast!) or not enough diabetes medicine, whether you take pills or insulin.

Insulin users commonly take basal, or long-acting, insulin at bedtime, whether that's glargine (brand name Lantus), detemir (Levemir), or NPH. High fasting blood glucose readings in the morning can indicate that the basal dose may not be high enough. Likewise, people who take diabetes pills may need a higher dose. If you suspect that this is the case, talk to your physician or diabetes educator. Bring a log of your blood glucose readings as well as a record of your food intake. Work on getting your fasting readings off to a good start, which will make it easier to control your blood glucose for the rest of the day. And because your body needs fuel to jump-start the day, you can then start eating breakfast without fear that your blood glucose levels will go sky-high.

Some people just aren't hungry first thing in the morning. That's understandable, but still not a good enough excuse to run on empty until lunchtime. Wait two to three hours after waking and then eat something, even if you have to bring it to work or school with you. This applies to folks who are running late in the morning—pack something the night before or stash some breakfast bars in your car, purse, or briefcase for a breakfast on the go.

Next week: breakfast ideas!

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How timely. I just wrote an entry on my blog this morning about how important breakfast is to getting myself healthy:.One thing I believe has really helped me is eating breakfast every morning. I used to not eat for several hours after getting up. Now, I eat a bowl of cereal everyday. Gets things started right, I think.

It seems to me that I have more energy and I feel better when I eat breakfast. Yes, I have been fighting those morning blood sugar readings but I finally said to myself: Those readings are in the past I'm on to the rest of the day.

You are right when I eat breakfast, I am less likely to overeat the rest of the day. Plus, my body gets used to expecting the cereal and it adjusts and says hoorah with me!

Thanks for the article.

Posted by: Priscilla | May 14, 2007 02:58 PM

You forgot to mention Dawn Syndrome. If someone's numbers are high in the morning, it could be because they went low in the night and their liver is dumping glucogen into their bloodstream. Eating breakfast will stop the glucogen dump. If you are worried about too many carbs because you are already too high, eat proteins (eggs or egg substitute, cottage cheese, or a piece of grilled chicken left over from supper!)

Posted by: Ephrenia | May 20, 2007 10:45 AM

Thanks Ephrenia. Actually, the dawn phenomenon is a rise in glucose levels in the early morning hours, usually due to a surge in certain hormones, such as cortisol and growth hormone. These hormones are responsible for raising glucose levels. The way to avoid this is to ensure an adequate medicine dose (insulin or pills), typically at bedtime. However, it's possible for people to go low (i.e., become hypoglycemic) overnight and then rebound, which means that they wake up with high fasting glucose levels (called the Somogyi effect). This is more likely to happen in insulin users or in people who use sulfonylureas. The key to avoiding this is to either decrease the evening insulin or medicine dose, and/or eat a small bedtime snack, for example. Also, while I like your suggestion of eating a higher protein breakfast in the case of high morning glucose levels, it's important to eat some carbohydrate if you take mealtime insulin.

Posted by: acampbell | May 21, 2007 02:00 PM

I am a T2 and my BG is closest to normal (6.1) in the a.m. only if I eat a snack about 3 a.m. I tried no meal after 6 p.m. I get 7.2 next morning. I tried a snack at bettime..still 7.2+ in the morning. I tried no medication at night same result, medication and snack at bedtime still 7.2*. I am within range at 3 a.m. whats happening here? Can anyone explain?

Posted by: juds | Oct 10, 2007 02:17 PM

Hi juds,
Many people with Type 2 diabetes (and even some with Type 1 diabetes) experience insulin resistance in the early morning hours. This happens due to the body's release of hormones that cause your liver to release glucose, thus raising blood glucose levels. It's very likely that when you eat a snack at 3 am, your pancreas is stimulated to release insulin and your liver shuts down glucose production; hence, your fasting glucose is lower. Since your fasting glucose is at the high end of normal on days when you don't eat a 3 AM snack, you might talk to your provider about possibly changing your diabetes medication. Metformin or even some bedtime long-acting insulin can help. You could also try eating something called an Extend bar at bedtime; this product can help stabilize blood glucose levels (go to www.extendbar.com for more info). Finally, take note of your HbA1c level - if it's at your target (usually less than 7% for most people), you're doing well with your treatment plan.

Posted by: acampbell | Oct 11, 2007 01:58 PM

I've been a type2 diabetic for 16 years and just recently asked about Byetta.I've been using Byetta for 5 months and have lost 55 lbs. It has helped tremendously also in conroling my #'s. A1C previously was 7,most recent results 6.2.I feel more energetic and find myself exercising almost daily. My husband and I ride our bike 3.5 miles a day, and I find myself wanting more. It.s great!!

Posted by: EJBritt | Feb 27, 2008 03:55 PM

I used to skip my breakfast and lunch i will finally eat before 4 pm. between my job and my 2 kids the stress that i have is too much to take. I found out that im diabetic when im in the waiting room before my surgery for ovarian cyst.
I lost 40 lbs. since then and eat breakfast everyday. Now i eat six times a day, and actually really help me to regulate my blood glucose.

Bing

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