When it comes to intermittent fasting, do breakfast, don’t do breakfast – it doesn’t matter just shorten the eating window. Timing matters if you’re diabetic.
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Diabetics should DO BREAKFAST
When it comes to intermittent fasting, do breakfast, don’t do breakfast – it doesn’t matter just shorten the eating window. Timing matters if you’re diabetic.
The idea that practicing some form of intermittent fasting is good for you is now pretty pervasive.
Lots of people are doing it.
And I think you should too – especially if you are metabolically challenged.
But you do need to consider WHEN you are doing it.
The contracting the eating window is the goal
A lot of the thinking is that it really doesn’t matter that much, what you’re trying to do is give your body an opportunity to clean house.
Do breakfast, don’t do breakfast. It really doesn’t matter.
The length of the window is key.
And shorter is BETTER.
But, research paper out of Venezuela tells a very different story. A story, you probably want to pay attention to, if you are metabolically challenged.
Diabetics should DO breakfast
The research team signed up 22 card carrying type 2 diabetics, who for the record were breakfast eaters. Now all the peeps were well controlled, with the average HbA1c clocking in at 7.7 %.
Quite a few of them (10) were managing to keep their sugar levels in check by managing their diet, the rest (12) were using a combination of diet and metformin, but the study was done DRUG FREE. All meds were stopped 24 hours before the study commenced.
NOTE : Since the half life of metformin is between 4 – 8 hours, the 24 hour break would mean drug levels would be negligible i.e. not high enough to impact the results.
Before the study
To make sure everyone was on the same page BEFORE the BIG DAY. The team provided meals for the 2 days leading up to the study.
Along with a list of dos and don’t.
The list included no alcohol & no excessive physical activity.
On test day
On the day of the test, participants arrived at the lab at 07h00 after an overnight fast. They were weighed and measured and hooked up to antecubital vein.
Those assigned to have breakfast tucked in. Those not doing breakfast had to wait around until lunch to grab a bite to eat.
The bites to eat were standardized. All the meals were 701 ± 8 kcal and the macronutrient ratio was 20 % fat, 54 % Carbs, 26 % protein.
NOTE : I would suggest you “Obey the Rule of Thirds” i.e. go 33 % Fat, 33 % Carbs and 33 % protein if you’re metabolically challenged.
Breakfast shifts the biology
Breaking the fast switched the chemistry up – no surprises here : as the food landed, fasting biology was abandoned.
Morning graphs for free fatty acids (FAA), glucose, insulin and C-peptide in people breaking the fast with breakfast, not breaking the fast with breakfast. © 2015 by the American Diabetes Association
The graph above shows this. When breakfast is consumed there is a drop in free fatty acids, in parallel to the rise in glucose. The glucose spike, prompted in insulin and C-peptide to rise.
The action in this story is not what happens when breakfast is consumed, it’s what happens AFTERWARDS…..
The second meal effect
The figure below shows what happened across the day to post prandial sugar spikes….
All-day graphs for glucose showing a second and third meal effect of eating breakfast © 2015 by the American Diabetes Association
The people who munched on breakfast, were able to put away the sugar a lot more efficiently than the breakfast skippers at lunch time. The sugar spike is much lower. The most likely explanation for this, is the insulin spike is superior. This is seen in the figure below, in round 2 the insulin level is higher and quicker.
Graph showing the insulin response in the second meal effect © 2015 by the American Diabetes Association
When insulin is out the gate in a jiffy, it is able to gets the job done quicker so sugar levels start to drop earlier.
But the benefits don’t stop here..,,
The third meal effect
Exactly the same pattern holds for dinner. Remember these people are eating EXACTLY the same meal. And the breakfast peeps have eaten more. Yup. The breakfasters ate more calories during the course of the day, while enjoying better sugar control.
More calories in, but better sugar control ! Yes, please.
It’s the second meal effect…..
Scientist have known about it for years. It happens in healthy people AND despite the odds, it also happens in people with diabetes. Of course, in healthy folks the disparity goes un-noticed – the sugar is ALWAYS handled. In the metabolically challenged the disparity is seen as an unwanted sugar spike. And sugar spikes ALWAYS come with LOTS OF DRAMA.
Why does it happen ?
There are a couple of theories….
Bright eyed and bushy tailed
The first one is that beta cells don’t wake up bright eyed and bush tailed.
When they turn in for the night, the insulin production machinery is degraded. Because…. There is no point in wasting resources when the insulin requirement is NEGLIGIBLE.
And it’s much easier to rest in SILENCE.
The problem with this strategy is can take a few moments to get back in the swing of things.
Basically beta cells need their morning coffee.
By eating early
They’ve been forced to get out of bed…
So when the next grocery delivery happens, it’s a synch to put it away, quickly.
It’s a good theory…………
No rest for the wicked
But, it’s unlikely to really explain the phenomenon in type 2 diabetics. Remember, their beta cells are SLEEP DEPRIVED, not nutrient deprived.
Eish ! Another related suggestion is that it takes time for muscle glycogen synthesis machinery to be turned on……….. i.e. muscles need a morning coffee too.
At this stage it’s a biological mystery….but it is biology you can use.
Diabetics should DO BREAKFAST
Metabolic pathways are controlled by the circadian clock and insulin IS NOT an owl, he is a lark.
So as the day progresses……….
The sugar spike to the exact same meal become higher and higher.
Eating breakfast will keep these spikes in check.
To create BETTER BODY CHEMISTRY when you are metabolically challenged, DO BREAKFAST and then CLOSE THE KITCHEN EARLY.
Need some advice on what TO DO FOR BREAKFAST. Visit the breakfast library page on the BETTER BODY CHEMISTRY blog or sign of for a one-on-one health conversation with Dr Sandy to get tips & strategies specific for your situation.
Further reading
Improving sugar control requires better pipes NOT MORE INSULIN
In people with poorer glycemic control the blood is not flowing as well – contributing to this problem is a collapse in the blood network infrastructure.
The pre-dinner snack that stops sugar levels spiking
We’re living on the run – so snacking is a cultural norm. Snacking is seldom GOOD FOR YOU, but exercise snacking is the exception, so go on, indulge yourself…
Deploying your body’s dustbin men will clean up your health
Your dustbin men sit tight, when you’re insulin resistant. So cleaning up barely happens. Wastes pile up and this has health consequences – diabetes, CVD, NASH