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Fiftysomething Diet: Eat a Big Breakfast or Not?

Blood sugar levels can be greatly influenced by how much, and when, you eat

By Maureen Callahan

Breakfast is an important meal for cultivating good health, but a handful of recent studies seem to be building a case for it ranking as perhaps the most critical meal for fifty- and sixtysomething eaters, particularly when it comes to preventing and managing diabetes.
Since roughly one in four Americans over 60 have diabetes, and many others are prediabetic or on the way to developing problems with blood sugar, keeping up to date on the best breakfast strategies is smart.
Here, we take a look at two new reports that look closely at how the size and timing of breakfast influences blood sugar control throughout the day. But first, a reminder why it pays to be mindful of how skipping breakfast plays a role in messing up blood sugar levels and increasing your risk for diabetes.
To Skip or Not to Skip
Although most experts consider skipping breakfast a risk factor for developing Type 2 diabetes, research in this area hasn’t been all that consistent. Now, a large study from Japan heaps more evidence on the eating side of the “eat breakfast vs. skip it” argument. 

(MORE: Fiftysomething Diet: Make a Healthier Breakfast)
Researchers there followed nearly 5,000 middle-aged adults for almost a decade and discovered that breakfast skippers were almost twice as likely to develop diabetes.
Interestingly, breakfast skippers were also more likely to be smokers, shun fruits and veggies and be drinkers of alcohol and sugar-sweetened beverages. Yet the increase in diabetes risk appeared independent of all these other not-so-great lifestyle factors. Breakfast skipping, all on its own, was a significant risk factor for diabetes.
Go Big at Breakfast, Skimp on Supper
An unrelated 2015 study suggests the typical American habit of eating light at breakfast — a bowl of cereal or maybe just toast and coffee on the run — then following up with a big dinner is a bad idea for controlling blood sugar.
Researchers asked a small group of diabetics to eat the same amount of food (calories) for two weeks. After a coin flip, they randomly assigned participants so that one week, the volunteers ate their biggest amount of food (700 calories) at breakfast, followed by a moderate lunch and then a very small (200 calorie) dinner of sliced turkey breast, mozzarella, salad and coffee.

(MORE: 9 Foods that Keep You Feeling Full Longer)
The next week, the equation flipped, with the same volunteers eating the least amount of calories at breakfast and a bigger (700-calorie) dinner.
"We found that by eating more calories at breakfast, when the glucose response to food is lowest, and consuming fewer calories at dinner, glucose peaks after meals and glucose levels throughout the day were significantly reduced," said Professor Daniela Jakubowicz of Tel Aviv University.
Watching the (Internal) Clock
In other words, it’s advantageous to eat a bigger meal in the morning when the body is better able to process those calories. Scientists suspect these findings may be related to circadian rhythms, or how the body’s internal time clock triggers a response to meals.
So it should come as no surprise that researchers at Brigham and Women’s Hospital’s Division of Sleep and Circadian Rhythms are noticing this same kind of altered glucose response in healthy volunteers asked to mimic the eating habits of shift workers.
In their new report, these scientists do a similar kind of crossover study, but this time the 14 volunteers are healthy and free of diabetes.
Flipping Night and Day
In the first arm of the study, participants ate breakfast at 8 a.m. and the last meal of the day at 8 p.m. and then slept through the night with no abnormal blood sugar readings. When they reversed the scenario with the exact same number of calories but ate breakfast at 8 p.m., dinner at 8 a.m., and slept during the day, glucose levels were 17 percent higher in the evening.

(MORE: Do You Have Diabetes and Don't Know It?)
“Our study underscores that it’s not just what you eat, but also when you eat that greatly influences blood-sugar regulation, and that has important health consequences,” said study researcher Frank Scheer, an assistant professor at Harvard Medical School and director of the Medical Chronobiology Program at Brigham and Women’s Hospital.
“Our findings suggest that the circadian system strongly affects glucose tolerance, independent from the feeding/fasting and sleep/wake cycles,” Scheer said.
The Real Breakfast of Champions
In the end, there’s no getting around the fact that escalating blood sugar levels come with the territory as we age, typically increasing by 1 to 2 mg/dl per decade after age 30, according to the American Diabetes Association.
The problem with that scenario is that if blood sugar levels soar too high in later years they can cut life expectancy and also dramatically worsen quality of life.
The good news is that eating breakfast at the right time — particularly a big breakfast of healthy choices like oatmeal, eggs, yogurt and fruit — looks like it could be one of easiest, practical steps you can take to ward off blood sugar problems and diabetes, or at the very least, help manage them.

Maureen Callahan is a registered dietitian, recipe developer and lead author of the diet book review series. She is a two-time James Beard Award winner. Read More
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