On the other hand, intermittent fasting conflicts with everything we've been (falsely?) told about the benefits of frequent meals. Benefits of which SuppVersity readers know that they are quasi-non-existent, in most healthy individuals and sometimes even counter-productive in obese and diabetic individuals, where most studies refute that eating more frequently provides significant weight loss benefits in the context of a calorically restricted diet.
Now, a recent study from the Diabetes Unit, Wolfson Medical Center of the Sackler Faculty of Medicine at the Tel Aviv University, the Lund University in Sweden and the Hebrew University of Jerusalem (Jakubowicz. 2015) suggests that extending your overnight fast by skipping breakfast may have real (not just corollary) detrimental effects on habitual breakfast eaters (learn why this is important) who are suffering from type II diabetes (with glycated hemoglobin (HbA1c) levels of 7–9% (the subjects in the study at hand were more than just pre-diabetic).
In this group of subjects, skipping breakfast increases post-prandial hyperglycemia (PPHG) after lunch and dinner. It lowers the important GLP-1 response to the meals (learn more about how GLP-1 is important in "Eat More, Burn More and Lose Fat Like on Crack with GLP-1!?") and impairs the subjects' already messed up insulin response. More specifically,
Three meals may be ok, but six meals are actually counterprodutive in T2DM.
- the dinner AUC0-180 for glucose, FFA, and glucagon were 26.6, 29.6, and 11.5% higher, respectively, and the the 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), on the other hand
In conjunction with the 30% delayed insulin peak after lunch and dinner on the NoB[reakfast] day that's bad news for anyone who has pre-existing problems with managing his blood glucose levels.
|Figure 1: While the increased glucose and impaired insulin and GLP1 response to lunch and dinner are bad, the skyrocketing FFA levels (+1,787.1%) could be used as fuel - by metabolically healthy individuals (data based on Jakubowicz. 2015).|
|Adjusted linear regression coefficients for 24h EI in T2DM patients according to EI at breakfast in % of total EI (Jarvandi. 2014).|
|Figure 2: Hunger, satiety, plasma glucose and insulin in the Eaters and Skippers in the two conditions in Thomas (2015).|
- Jakubowicz, Daniela, et al. "Fasting Until Noon Triggers Increased Postprandial Hyperglycemia and Impaired Insulin Response After Lunch and Dinner in Individuals With Type 2 Diabetes: A Randomized Clinical Trial." Diabetes Care (2015): dc150761.
- Jarvandi, Soghra, Mario Schootman, and Susan B. Racette. "Breakfast intake among adults with type 2 diabetes: influence on daily energy intake." Public health nutrition (2014): 1-7.
- Pereira, Mark A., et al. "Breakfast frequency and quality may affect glycemia and appetite in adults and children." The Journal of nutrition 141.1 (2011): 163-168.
- Schlundt, David G., et al. "The role of breakfast in the treatment of obesity: a randomized clinical trial." The American journal of clinical nutrition 55.3 (1992): 645-651.
- Thomas, E. A., Higgins, J., Bessesen, D. H., McNair, B. and Cornier, M.-A. (2015), Usual breakfast eating habits affect response to breakfast skipping in overweight women. Obesity. doi: 10.1002/oby.21049