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Data shows the effect of high protein versus high carbohydrate breakfast intake on glucose levels.
Individuals with type 1 or type 2 diabetes who have bad metabolic control usually have increased protein intake requirements. Studies have shown that the normal amount of protein eaten by people with diabetes does not compensate for the increased protein digestion. Patients with diabetes need definite and sufficient information about protein and carbohydrate intake to base their meal plans and food decision making in general. This study focuses mainly on the impact of either a high protein or high carbohydrate diet and its effects on plasma glucose levels.
This randomized crossover study was conducted to examine and understand the effect of a high protein or high carbohydrate breakfast on the glucose and insulin response after eating breakfast, along with the proper response after eating lunch. Many patients have taken it upon themselves to properly understand how their bodies react to certain foods when eaten in intervals – there is provided insight into a patient’s regimen in the paragraph following.
Most patients with diabetes usually save their carbohydrates for rainy days. In a self-conducted study, a young female patient revealed her specific diet regimen in terms of what she chooses to eat and what she chooses not to eat. She would have pizza approximately three times per month, and burger night would be once per month. What she noticed when she took her HbA1C levels was that she managed to keep her level range between 5.5 and 6.5 just by sticking to her specific and strict diet regimen. It is learned and studied that by maintaining a low carb diet, that reduces your body’s need for insulin.
Twelve patients who eat breakfast every day were recruited for this study. There were two, seven-day conditions done in random order with a minimum of a 7-day washout period that was done in between studies. The patients recruited for this study had a diet that consisted of high protein or high carbohydrate intake for six days of getting used to. On the seventh day, the patients reported to the research lab at 7:00 AM after a 12-hour fast, which was done overnight. They had undergone forearm catheterization before baseline blood levels were taken. Those who participated in the study had eaten breakfast at 7:30 AM. Approximately four hours after breakfast, the patients ended up starting and finishing their lunch. Throughout this test day, blood samples were taken to examine any effects in their bodies due to food regimen change.
The two opposite arms of this study included: first eating a high carbohydrate, high protein breakfast, and then a high protein and high carbohydrate breakfast. The first comparator had the patient eating a 500 kcal carbohydrate breakfast followed by a 7-day washout period, and then seven days of eating a high protein breakfast. The second comparator had the patient eating a 500 kcal protein breakfast followed by a 7-day washout period, and then seven days of eating a high carbohydrate breakfast.
The primary outcome measure was the plasma glucose level post eating. The secondary outcome measures were post-meal of the glucose-dependent insulinotropic peptide (GIP), post-meal insulin levels and post-meal glucagon-like peptide-1 (GLP-1) levels. To be included in this study, patients had to be between the ages of 21 through 55 years of age, non-smokers, type 2 diabetes, had a fasting glucose level above 120 mg/dL, and an HbA1C between 6.5-9.0 percent.
For the primary outcome measure, the results showed a significant difference in the mean of patients who had eaten a high protein breakfast as compared to a high carbohydrate breakfast. The study measure showed that those patients who had a high intake of protein had shown little effect on blood glucose levels. Protein intake does not increase blood glucose levels as much as carbohydrate intake – and this could be due to a variety of reasons. A major theory as to why this occurs might be because the process of gluconeogenesis from protein occurs over hours, and glucose can be disposed of quickly if presented for utilization slowly over a long period. High protein breakfasts can increase the number of calories a patient burns, and they also aid in weight loss. Patients who eat high carbohydrates such as oatmeal for breakfast usually feel less full as compared to protein-full eggs for breakfast. Another added benefit of eating a high protein breakfast is that carotenoids (antioxidant substances in the blood) help improve cholesterol levels and other biomarkers for heart disease. This is very important for our patients with diabetes, as they should be properly counseled on their food decisions.
Practice Pearls:
- Patients who eat high protein foods feel full longer – which aids in weight loss and better overall quality of life.
- High protein diets do not affect glucose levels as much as high carbohydrate diets.
- Health care providers need to properly counsel patients on food decisions and why this occurs.
Franz, M J. “Protein: Metabolism and Effect on Blood Glucose Levels. “The Diabetes Educator, U.S. National Library of Medicine, 1997 Levels. https://www.ncbi.nlm.nih.gov/pubmed/9416027/.”.
“Impact of Breakfast Composition on Glycemic and Incretin Responses in Individuals With Type 2 Diabetes Study Results.” Study Results – ClinicalTrials.gov, Https://clinicaltrials.gov/ct2/show/results/NCT02180646recrs=e&rslt=With&cond=diabetes&draw=6&rank=114&view=results.
“Should You Eat Carbs or Protein in the Morning on a Diet?” LIVESTRONG.COM, Leaf Group,https://www.livestrong.com/article/484256-should-you-eat-carbs-or-protein-in-the-morning-on-a-diet
Hira Gohar, Florida A&M University, College of Pharmacy, PharmD Candidate’