ADA: First Meal of the Day Decreases Risk for Type 2 Diabetes

Andrew Odegaard, PhD, an epidemiologist at the University of Minnesota, Minneapolis, presented the research at a poster session at the American Diabetes Association (ADA) 72nd Scientific Sessions.

Nutritional guidelines have long recommended that people eat breakfast, but there has been little research on the relationship between morning eating habits and development of T2D.

The researchers conducted an analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) study, which is a longitudinal study of 5115 black and white women between the ages of 18 and 30 years who were initially examined in 1985 through 1986. To date, participants have been reexamined at year 2, year 5, year 7, year 10, year 15, and year 20 (2005 - 2006).

Data collected include a number of cardiac risk factors, including smoking, blood pressure, and cholesterol, as well as behavioral and psychological data and a dietary history questionnaire that recorded dietary caloric intake and breakfast frequency.

In the current study, researchers looked at 3598 participants who did not have T2D at the time of their year 7 examination in 1992-1993 (age, 25 - 37 years; average age, 32 years; body mass index [BMI], 26.7 kg/m²; breakfast, 4.1 days/week).

T2D was defined as a fasting glucose level of 126 mg/dL or higher, 2-hour postchallenge glucose level of 200 mg/dL or higher, HbA1c level of 6.5% or higher, or taking antidiabetic medication. The researchers used Cox regression to calculate hazard ratios (HRs) for T2D, adjusting for year 7 age, sex, race, clinic, alcohol intake, smoking, physical activity, diet quality, fast food visits/week, and total energy intake.

For each additional day/week of breakfast intake, there was a 5% decrease in risk of developing T2D (HR, 0.95; 95% confidence interval [CI], 0.91 - 0.99).

Compared with participants who ate breakfast between 0 and 3 times per week, those who ate breakfast 5 times or more had a 31% reduction in T2D risk (HR, 0.69; 95% CI, 0.54 - 0.88). They also gained less weight (0.5 kg/m² less weight gain; P = .01).

Those with higher diet quality had lower incidences of T2D, but breakfast frequency was more important, as it predicted T2D risk across diet quality score quartiles.

When the researchers adjusted for year 7 BMI, the risk reduction for breakfast 5 or more days/week was less and no longer statistically significant (HR, 0.86; 95% CI, 0.68 - 1.10).

"Overall, our findings show an inverse relation between increasing breakfast frequency and T2D, probably mediated by BMI."

American Diabetes Association (ADA) 72nd Scientific Sessions: Abstract 1364-P. Presented June 10, 2012.