High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial
Open accessAbstract
Aims/hypothesis High-energy breakfast and reduced-energy dinner (Bdiet) significantly reduces postprandial glycaemia in obese non-diabetic individuals. Our objective was to test whether this meal schedule reduces postprandial hyperglycaemia (PPHG) in patients with type 2 diabetes by enhancing incretin and insulin levels when compared with high-energy dinner and reduced-energy breakfast (Ddiet).Methods In a randomised, open label, crossover design performed in a clinic setting, 18 individuals (aged 30-70 years with BMI 22-35 kg/m(2)) with type 2 diabetes (<10 years duration) treated with metformin and/or diet were given either Bdiet or Ddiet for 7 days. Participants were randomised by a person not involved in the study using a coin flip. Postprandial levels of plasma glucose, insulin, C-peptide and intact and total glucagon-like peptide-1 (iGLP-1 and tGLP-1) were assessed. The Bdiet included 2,946 kJ breakfast, 2,523 kJ lunch and 858 kJ dinner. The Ddiet comprised 858 kJ breakfast, 2,523 kJ lunch and 2,946 kJ dinner.Results Twenty-two individuals were randomised and 18 analysed. The AUC for glucose (AUCglucose) throughout the day was 20% lower, whereas AUCinsulin, AUCC-peptide and AUCtGLP-1 were 20% higher for the Bdiet than the Ddiet. Glucose AUC0-180min and its peak were both lower by 24%, whereas insulin AUC0-180min was 11% higher after the Bdiet than the Ddiet. This was accompanied by 30% higher tGLP-1 and 16% higher iGLP-1 levels. Despite the diets being isoenergetic, lunch resulted in lower glucose (by 21-25%) and higher insulin (by 23%) with the Bdiet vs Ddiet.Conclusions/interpretation High energy intake at breakfast is associated with significant reduction in overall PPHG in diabetic patients over the entire day. This dietary adjustment may have a therapeutic advantage for the achievement of optimal metabolic control and may have the potential for being preventive for cardiovascular and other complications of type 2 diabetes. Trial registration ClinicalTrials.gov NCT01977833 Funding No specific funding was received for the study.
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In a 7-days randomized open-label crossover trial with 18 subjects with T2DM, eating the majority of calories at breakfast (at 08:00) vs dinner (at 19:00) led to reduction in overall postprandial hyperglycemia.
“led to reduction in overall postprandial hyperglycemia [301].”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [301]
Having a caloric rich breakfast results in increased postprandial insulin secretion and GLP-1 responses, and smaller plasma glucose peaks after breakfast consumption; these effects are not present when the majority of calories is consumed at the evening dinner.
“Having a caloric rich breakfast was found to result in increased postprandial insulin secretion and GLP-1 responses, and smaller plasma glucose peaks after breakfast consumption [301]; these effects were not present when the majority of calories was consumed at the evening dinner.”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [301]
The effects of earlier increases in plasma insulin levels persisted after lunch aiding the glycemic management of the subsequent meals (the 'second meal effect').
“The effects of the earlier increases in plasma insulin levels persisted after lunch aiding the glycemic management of the subsequent meals (the “second meal effect”).”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [301]
In the human studies of timed feeding, there were no differences in self-reported physical activity level and caloric intake.
“In the human studies mentioned above, there were no differences in self-reported physical activity level and caloric intake.”
From Circadian rhythms, metabolism, and chrononutrition in rodents and humans (2016) · cites this paper as [88]
Timed feeding may enhance weight loss and glycemic control in humans.
“Although much work remains to be done, human studies already suggest that timed feeding may translate into a beneficial approach to enhance weight loss and glycemic control in humans (87)(88)(89).”
From Circadian rhythms, metabolism, and chrononutrition in rodents and humans (2016) · cites this paper as [88]
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- Authors
- Jakubowicz, D., Wainstein, J., Ahrén, B., Bar-Dayan, Y., Landau, Z., Rabinovitz, H. R., & Froy, O.
- Affiliations
- Tel Aviv University (IL)
- Hebrew University of Jerusalem (IL)
- Corresponding author
- Jakubowicz, Daniela
- Froy, Oren
- Venue
- Diabetologia
- Published
- 2015-03-01
- Volume
- 58
- Issue
- 5
- Pages
- 912-919
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2129496138
- Cited by
- 139
- References
- 32
- Citations by year
- 2026: 15 · 2025: 13 · 2024: 16 · 2023: 12 · 2022: 11 · 2021: 18 · 2020: 16 · 2019: 9 · 2018: 9 · 2017: 8 · 2016: 7 · 2015: 5
- FWCI
- 8.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Weizmann Institute of Science
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- type 2 diabetes, meal timing, postprandial hyperglycemia, incretins, glucagon-like peptide-1, insulin, C-peptide, glucose metabolism, dietary intervention, obesity, cardiovascular risk reduction, metformin, glycemic control, cardiovascular complications prevention, diabetes prevention
- MeSH terms
- Adult, Aged, Blood Glucose, C-Peptide, Energy Intake, Diabetes Mellitus, Type 2, Female, Humans, Hyperglycemia, Insulin, Male, Middle Aged, Treatment Outcome, Postprandial Period, Meals, Breakfast
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