Effects of breakfast meal composition on second meal metabolic responses in adults with type 2 diabetes mellitus

Abstract

Objective: We tested the relative importance of a low-glycemic response versus a high glycemic response breakfast meal on postprandial serum glucose, insulin and free fatty acid (FFA) responses after consumption of a standardized mid-day meal in adult individuals with Type 2 diabetes mellitus (DM). Design: Following an overnight fast of 8-10 h, a randomized crossover intervention using control and test meals was conducted over a 3-week-period. A fasting baseline measurement and postprandial measurements at various time intervals after the breakfast and mid-day meal were taken. Subjects: Forty-five Type 2 DM subjects completed the requirements and were included in the study results. Interventions: Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests. Results: In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (Po0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (Po0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (Po0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type. Conclusions: These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal. Sponsorship: This study was supported with an unrestricted grant from Kellogg Company, Battle Creek, Michigan.

Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies

“…Breakfast consumption could result in an elevated postprandial glycaemic response and insulin sensitivity (25)(26)(27)(28)(29) , especially when the foods consumed are fibre-rich foods (i.e. whole grains, fruit and lowfat dairy) rather than refined cereals.…”

The effects of psyllium on lipoproteins in type II diabetic patients

“…An earlier study (Clark et al, 2006) using a test meal found no evidence of any postprandial improvement in free fatty acids with psyllium treatment, but provided no data on lipoproteins. In our study, psyllium did not seem to reduce postprandial cholesterol and triglyceride levels.…”

Psyllium Mucilage and Its Use in Pharmaceutical Field: An Overview

“…The capacity of soluble fibers to decrease the postprandial glucose reaction to meals eaten some hours after fibre ingestion (second meal effect) was shown previously in non-diabetic individuals. It also reduced insulin recruitment in patient with diabetes mellitus [32,42].…”