Breakfast Skippers Might Be At Higher Risk Of Metabolic Inflexibility And Inflammation

Hans

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Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk. - PubMed - NCBI
BSD: breakfast skippers
DSD: dinner skippers
"When compared with the 3-meal control, 24-h energy expenditure was higher on both skipping days (BSD: +41 kcal/d; DSD: +91 kcal/d; both P < 0.01), whereas fat oxidation increased on the BSD only (+16 g/d; P< 0.001). Spontaneous physical activity, 24-h glycemia, and 24-h insulin secretion did not differ between intervention days. The postprandial homeostasis model assessment index (+54%) and glucose concentrations after lunch (+46%) were, however, higher on the BSD than on the DSD (both P < 0.05). Concomitantly, a longer fasting period with breakfast skipping also increased the inflammatory potential of peripheral blood cells after lunch"

"higher postprandial insulin concentrations and increased fat oxidation with breakfast skipping suggest the development of metabolic inflexibility in response to prolonged fasting that may in the long term lead to low-grade inflammation and impaired glucose homeostasis."

Another study showing that skipping breakfast can promote insulin resistance
Fasting until noon triggers increased postprandial hyperglycemia and impaired insulin response after lunch and dinner in individuals with type 2 di... - PubMed - NCBI
OBJECTIVE:
Skipping breakfast has been consistently associated with high HbA1c and postprandial hyperglycemia (PPHG) in patients with type 2 diabetes. Our aim was to explore the effect of skipping breakfast on glycemia after a subsequent isocaloric (700 kcal) lunch and dinner.

RESEARCH DESIGN AND METHODS:
In a crossover design, 22 patients with diabetes with a mean diabetes duration of 8.4 ± 0.7 years, age 56.9 ± 1.0 years, BMI 28.2 ± 0.6 kg/m(2), and HbA1c 7.7 ± 0.1% (61 ± 0.8 mmol/mol) were randomly assigned to two test days: one day with breakfast, lunch, and dinner (YesB) and another with lunch and dinner but no breakfast (NoB). Postprandial plasma glucose, insulin, C-peptide, free fatty acids (FFA), glucagon, and intact glucagon-like peptide-1 (iGLP-1) were assessed.

RESULTS:
Compared with YesB, lunch area under the curves for 0-180 min (AUC0-180) for plasma glucose, FFA, and glucagon were 36.8, 41.1, and 14.8% higher, respectively, whereas the AUC0-180 for insulin and iGLP-1 were 17% and 19% lower, respectively, on the NoB day (P < 0.0001). Similarly, dinner AUC0-180 for glucose, FFA, and glucagon were 26.6, 29.6, and 11.5% higher, respectively, and AUC0-180 for insulin and iGLP-1 were 7.9% and 16.5% lower on the NoB day compared with the YesB day (P < 0.0001). Furthermore, insulin peak was delayed 30 min after lunch and dinner on the NoB day compared with the YesB day.

CONCLUSIONS:
Skipping breakfast increases PPHG after lunch and dinner in association with lower iGLP-1 and impaired insulin response. This study shows a long-term influence of breakfast on glucose regulation that persists throughout the day. Breakfast consumption could be a successful strategy for reduction of PPHG in type 2 diabetes.
 

Peatful

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Appreciate this.
 

rei

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When compared with the 3-meal control, 24-h energy expenditure was higher on both skipping days

This is all that was really needed to know if it was beneficial or not. Not continuously eating will give more energy for other than digestive processes which will end up increasing daily energy expenditure, making you healthier.
 
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This is all that was really needed to know if it was beneficial or not. Not continuously eating will give more energy for other than digestive processes which will end up increasing daily energy expenditure, making you healthier.

Inflammatory markers creep up as one does more breakfast skipping. Isn’t that something that is “really needed to know”?
 
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Hans

Hans

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Nice find. Makes sense - if you're reasonably healthy you would still have some glycogen stored from breakfast if you skipped lunch, so your body/brain would still be able to oxidize glucose and keep stress hormones down.
Indeed.

It's important to note that only the breakfast skippers had an increase in fat oxidation, whereas the dinner skippers didn't experience such an increase and the dinner skippers' energy expenditure was more than double that of the breakfast skippers.
I think one reason dinner skippers get away with intermittent fasting is because cortisol is lower in the afternoon and evening. As cortisol interferes with proper glucose oxidation, the lower cortisol levels later in the day didn't lead to any negatives, making skipping dinner safer. As cortisol is highest in the morning and glycogen low, it would be best to consume carbs to lower cortisol and replenish glycogen and then use that glycogen later in the day as a stress response is less imminent later in the day. This is shown in the study because the dinner skippers didn't have increased fat oxidation. Increased metabolic rate triumphs fat oxidation every time for fat loss and health.
Inflammatory markers creep up as one does more breakfast skipping. Isn’t that something that is “really needed to know”?
I think this is partly due to PUFAs being released, and I wonder if this inflammatory response would be less to a degree if someone was lean with only saturated fat in their fat tissue.

Another point is that people that skip breakfast are more prone to snacking and ingesting larger amounts of empty calories to stop the stress response created from skipping breakfast.
 
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Great find, Hans... longevity research also confirms this...
 

Cirion

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Indeed.

It's important to note that only the breakfast skippers had an increase in fat oxidation, whereas the dinner skippers didn't experience such an increase and the dinner skippers' energy expenditure was more than double that of the breakfast skippers.
I think one reason dinner skippers get away with intermittent fasting is because cortisol is lower in the afternoon and evening. As cortisol interferes with proper glucose oxidation, the lower cortisol levels later in the day didn't lead to any negatives, making skipping dinner safer. As cortisol is highest in the morning and glycogen low, it would be best to consume carbs to lower cortisol and replenish glycogen and then use that glycogen later in the day as a stress response is less imminent later in the day. This is shown in the study because the dinner skippers didn't have increased fat oxidation. Increased metabolic rate triumphs fat oxidation every time for fat loss and health.

I think this is partly due to PUFAs being released, and I wonder if this inflammatory response would be less to a degree if someone was lean with only saturated fat in their fat tissue.

Another point is that people that skip breakfast are more prone to snacking and ingesting larger amounts of empty calories to stop the stress response created from skipping breakfast.

When I used to do intermittent fasting, I always wondered though how people skip dinner and get to sleep. For me, when I'm not fed I have extreme insomnia. I have to eat a lot before bed. And then when you get no sleep, you would have elevated cortisol the next day, so not sure how that works? I admit I haven't looked at the study yet, but just burning more calories does not mean a better metabolism.

That being said, normally my eating pattern looks like this:

Eat a small amount in the morning, a bit more in the afternoon, and lots at dinner. A ramp up if you will.

Does this suggest that you want the opposite? A huge breakfast, less at lunch, and a small dinner? I don't see how that works though. My experience shows that this just doesn't work typically, when hypo and glucose storage ability is poor. I can't even last the night when fed, let alone the night plus late afternoon.

I did try that on IF protocol back in the day, but I probably was in too much of a calorie deficit for it to work right, so that come dinner time/going to bed, I was really hungry.
 
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Hans

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When I used to do intermittent fasting, I always wondered though how people skip dinner and get to sleep. For me, when I'm not fed I have extreme insomnia. I have to eat a lot before bed. And then when you get no sleep, you would have elevated cortisol the next day, so not sure how that works?
I too eat close to going to bed, just because I feel better that way too. Just to be clear I'm not advocating some kind of IF routine, the above study was just interesting as it showed all kinds of negatives from skipping breakfast. The skipping dinner part was just serendipitous and also definitely interesting. If skipping dinner was stressful in the study they would have experienced increased fat oxidation. Then I would have said that the increase in energy expenditure could be stress driven, but it wasn't. I think they experienced a boost in energy expenditure due to proper glucose oxidation. Big breakfast and big lunch promote greater satiety than ramping it up according to studies, but when it comes to each individual like you, that might not be the case. But the people in the study had a BMI of around 23 so I think that played a big role.
I admit I haven't looked at the study yet, but just burning more calories does not mean a better metabolism.
Fasting usually increases fat oxidation but does not lead to fat loss. Boosting the metabolic rate burns both glucose and fat and have many beneficial effects. So just burning calories can be beneficial if it helps to improve insulin sensitivity, etc. It would have been interesting if they measured hormones in that study too.
But ain't you trying to boost your metabolic rate? Eating lots to become lean?
 

TripleOG

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I remember @tyw posting this a few years back.

Probably the safest form of "fasting." Ingrains circadian rhythm with day-night cycle. Carb driven metabolism for the day's activity. Maintains metabolic flexibility. Sleep safely handles the bulk of night time stress.

Those "don't eat past 8pm" advocates may have been onto something.
 
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I tend to start eating more at the beginning of the day, and by later afternoon I eat lightly and a light dinner is best. I could skip dinner easily actually.
 

Cirion

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Fasting usually increases fat oxidation but does not lead to fat loss. Boosting the metabolic rate burns both glucose and fat and have many beneficial effects. So just burning calories can be beneficial if it helps to improve insulin sensitivity, etc. It would have been interesting if they measured hormones in that study too.
But ain't you trying to boost your metabolic rate? Eating lots to become lean?

I guess I was referring to some means to "boost calorie expenditure" such as excessive exercise, excessive caffeine intake (without the food intake to support it), which technically boosts calorie burn in the short term but destroys metabolism in the long term, yet are methods use to increase calorie expenditure so that they can lose weight. That's what I mean when increasing calorie expenditure does not necessarily mean improving metabolism (long term).

I remember @tyw posting this a few years back.

Probably the safest form of "fasting." Ingrains circadian rhythm with day-night cycle. Carb driven metabolism for the day's activity. Maintains metabolic flexibility. Sleep safely handles the bulk of night time stress.

Those "don't eat past 8pm" advocates may have been onto something.

I will say also that I think that its best to eat all of your food in a 16 hr window or less, and "fast" for at least 8 hrs (sleeping), because often times if I wake up hungry and eat something, it actually ruins my waking temp in the morning. I notice on weekends, that sometimes I'll wake up at like 3 am to eat something, then go back to sleep for 8+ hr and only feel good sleeping in until close to noon. This isn't a luxury I have on weekdays, being forced to wake up with less than 8+ hr after my last bite of food, and usually results in poor waking temps.

It's a huge catch 22, because in Hypo it's virtually impossible to go even 8 hr without food without a stress response, but then if you do eat in the middle of the night, it frequently causes problems, at least if you have to wake up for work within the next few hrs. I agree with what you say, but only when it comes to healthy people. Hypothyroid condition adversely affects ability to fast as well as ability to get restful sleep. Night time is extremely dangerous for hypothyroid people. Because hypothyroid individuals frequently generate lactic acid even while at rest in a low stress environment, it's exponentially worse at night.

Part of the solution is eating sufficiently high calories during the day, which is even more critical if you're hypothyroid and is why I frequently preach increasing calories in hypothyroid not lowering them, so that you have enough fuel to actually last through the night while fasting.

Not sure the answer to this dilemma. I know it has to do with liver health and liver glucose storage in part. I found out recently from tracking data from my personal database that there is a fairly strong correlation to Vitamin A intake and my waking body temperatures. By now most of you have probably seen the "VA is a poison" thread that has been floating around, and now I think it applies to me also based upon what I've looked at in my data. But, even so, even if VA is a poison, that's still just a tree in the forest. The forest is that the liver is a detoxifying organ and for many of us, overburdened, if not with VA, with other things, and the ultimate goal should be to fix the liver, which should fix many other problems downstream. It just so happens that I think I finally found out my liver is overburdened specifically with VA, but time will tell, as I need to clock some time on a low VA diet to see what happens but I can say for a fact that in the past month or two, some of my very high VA days also made me feel really, really bad and going back to March 31 of this year, when I felt the best I had in a while, also had almost a full week of low VA (not on purpose but accidentally) & the best health of my life 2 yrs ago, was also on zero VA diet (again, not on purpose but interesting to start drawing this correlations). Anyway, getting to the main point, the liver can't do its job (store glucose) correctly if it is overburdened with toxins, so until the liver is de-fatted and its burdened lessened, glucose storage will remain a problem. TL;DR -- stop poisoning your liver with toxic substances. A healthy liver is a happy liver.
 
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Abba

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This study says clearly 'patients with type 2 diabetes'.
Are there any similar studies for 'normal' humans?
Can results be extrapolated from 1 group to the next on a 1:1 basis?
 
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This study says clearly 'patients with type 2 diabetes'.
Are there any similar studies for 'normal' humans?
Can results be extrapolated from 1 group to the next on a 1:1 basis?

Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women
Background: Breakfast consumption is recommended, despite inconclusive evidence of health benefits.

Objective: The study’s aim was to ascertain whether eating breakfast (EB) or omitting breakfast (OB) affects energy intake, energy expenditure, and circulating insulin, glucose, and lipid concentrations in healthy women.

Design: In a randomized crossover trial, 10 women [x̄ ± SD body mass index (BMI; in kg/m2): 23.2 ± 1.4] underwent two 14-d EB or OB interventions separated by a 2-wk interval. In the EB period, subjects consumed breakfast cereal with 2%-fat milk before 0800 and a chocolate-covered cookie between 1030 and 1100. In the OB period, subjects consumed the cookie between 1030 and 1100 and the cereal and milk between 1200 and 1330. Subjects then consumed 4 additional meals with content similar to usual at predetermined times later in the day and recorded food intake on 3 d during each period. Fasting and posttest meal glucose, lipid, and insulin concentrations and resting energy expenditure were measured before and after each period.

Results: Reported energy intake was significantly lower in the EB period (P = 0.001), and resting energy expenditure did not differ significantly between the 2 periods. OB was associated with significantly higher fasting total and LDL cholesterol than was EB (3.14 and 3.43 mmol/L and 1.55 and 1.82 mmol/L, respectively; P = 0.001). The area under the curve of insulin response to the test meal was significantly lower after EB than after OB (P < 0.01).

Conclusion: OB impairs fasting lipids and postprandial insulin sensitivity and could lead to weight gain if the observed higher energy intake was sustained.
 

tankasnowgod

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I tend to start eating more at the beginning of the day, and by later afternoon I eat lightly and a light dinner is best. I could skip dinner easily actually.

Before I deliberately did IF, dinner was the meal I was most likely to skip, if I were to skip a meal. Sometimes, late in the day, I just wasn't that hungry.
 

tankasnowgod

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"Even on the mornings that you don’t drop dead, there is reduced adaptive capacity and functional impairment before eating breakfast. For example, men who went for a run before breakfast were found to have broken chromosomes in their blood cells, but if they ate breakfast before running, their chromosomes weren’t damaged. "

-Dr Ray Peat.
 

Abba

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Ecstatic,
Many thanks.
While the insulin response was better with the EB group, it's unfortunate they didn't measure any increase/decrease in metabolic rate.
High caloric consumption can be a good thing. Cholesterol is an overrated marker. [Also eating Peat-style could very well also influence markers]
 
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"Even on the mornings that you don’t drop dead, there is reduced adaptive capacity and functional impairment before eating breakfast. For example, men who went for a run before breakfast were found to have broken chromosomes in their blood cells, but if they ate breakfast before running, their chromosomes weren’t damaged. "

-Dr Ray Peat.

Thanks. Hilarious and informative.
 

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