Not sure how to start a low-carb lifestyle? Try cutting carbohydrates at breakfast first. A new study suggests that eating fewer carbs at the first meal of the day delivers significant metabolic benefits for people with type 2 diabetes. And the experts behind the experiment think that breakfast is the ideal meal for cutting carbs.
The new study, which was published in The American Journal of Clinical Nutrition, asked 60 participants with type 2 diabetes to follow a low-carb breakfast plan every day for three months. These volunteers were provided with a menu of healthy low-carb suggestions, such as an omelet with cheese and veggies, averaging a total of 8 grams of carbohydrates per meal. Meanwhile, a similarly sized control group was assigned to a healthy low-fat breakfast plan (think oatmeal with fresh fruit) with about 56 grams of carbohydrates every morning.
The results? The low-carb diet group enjoyed lower and steadier glucose levels across a variety of different measures of glucose metabolism, leading to an overall A1C drop of 0.3 percentage points. (This change was not statistically significant in comparison with the low-fat diet, which led to a drop of 0.1 percentage points. The low-fat diet may have also been an improvement for study volunteers over their usual eating habits.)
And the researchers were greeted with a nice surprise: Low-carb breakfasters reported that they ate a lot less food, and many fewer carbs, throughout the rest of the day. This change appeared to be quite natural — study volunteers were given no special low-carb training and were encouraged to eat normally after breakfast. Something about eating fewer carbs at breakfast seems to have set the volunteers up for healthier eating decisions for the rest of the day.
We spoke with one of the authors of the study, Jonathan Little, PhD, a professor at the University of British Columbia’s School of Health and Exercise Sciences.
Diabetes Daily: What’s your most important takeaway?
Jonathan Little: Eating a low-carb breakfast appears to be a simple way to prevent the largest glucose spike of the day, and improve overall glycemic control, in people living with type 2 diabetes.
DD: Why do you think the low-carb breakfasters ate less throughout the rest of the day?
JL: We do not know the answer to this … however, the higher protein and fat content of the breakfast may be the reason, as previous studies have found that higher protein and fat may make you feel fuller longer. It’s also possible that more stable blood sugar (and presumably insulin) in the morning after breakfast could play a role.
DD: Were the improvements in glucose metabolism clinically relevant?
JL: We think so. A1C was lowered by 0.3 percent in the low-carbohydrate group, which is generally thought to be the MCID [minimal clinically important difference] for A1C. And many of the CGM metrics that were better in the low-carb group would be considered clinically relevant.
DD: Is breakfast an especially good time of day to eat low-carb?
JL: Yes, for people living with type 2 diabetes, because they are the most insulin resistant and glucose intolerant in the morning (which is the opposite of people without type 2 diabetes). So, they tend to get the biggest spike in glucose after breakfast.
Also, our typical Western breakfasts are high in carbohydrates (think toast, cereal, oatmeal, fruit, muffins, etc.), which spikes glucose.
DD: Some people, even experts, are worried that low-carb diets are not really sustainable. Were your participants able to stick with it?
JL: We measured compliance, and it was very good. About 90 percent compliance over three months, based on taking photos of breakfast and uploading them for a study registered dietitian to confirm.
DD: Do you have any follow-up studies in mind?
JL: We would like to study this over a longer time frame — e.g., one year — and see if people can stick to this over the long term, and if it results in a lower A1C. We would also like to apply the concept to different cultures and ethnicities where we can think about “swapping” high-carbohydrate breakfast foods with low-carbohydrate foods in different populations.
DD: What practical advice would you give to patients with type 2 diabetes?
JL: If you want to try eating low-carbohydrate, consider starting by just switching to a low-carb breakfast. There are many healthy and delicious low-carb breakfast options (e.g., all the different ways of cooking eggs) and you can know that the research shows it should improve your glucose control.
And because most people eat breakfast at home and tend to eat the same thing most days, sticking to a low-carb breakfast is likely easier in the long term when compared with a full-on low-carb diet.