Reducing morning carbohydrate intake helps control type 2 diabetes

According to an international team of researchers led by UBC Okanagan academics, people with Type 2 diabetes (T2D) can make a small adjustment to the first meal of the day to better control their blood sugar levels. In the UBCO Faculty of Health and Social Development, Barbara Oliveira collaborates on research projects with Dr. Jonathan Little’s Exercise, Metabolism and Inflammation Lab.
Their most recent research supports the idea that people with T2D can benefit from switching from a traditional western-style low-fat breakfast like oatmeal, toast and fruit to a low-carb meal higher in protein and fat.
Dr. Olivera said, “We're not talking about a complete diet overhaul. One of many complications for people living with T2D is rapid or large increases in blood glucose levels after a meal. Our research indicates a low-carbohydrate meal, first thing in the morning, seems to help control blood sugar throughout the day.”
Controlling glucose levels is critical for reducing the complications of T2D, including inflammation and cardiovascular disease--the major cause of morbidity in patients with T2D. "Treatment strategies that can help lower post-meal glucose swings and rapid changes in glucose are crucial to managing this condition," she adds. "We've determined that if the first meal of the day is low-carb and higher in protein and fat we can limit hyperglycemic swings.”
Their 12-week study had 121 participants split into two groups. One was advised to eat from a selection of low-carb breakfasts containing approximate amounts of 8g of carbohydrate, 25g of protein and 37g of fat. In comparison, the other was advised to eat from a selection of low-fat higher-carb options containing about 56g of carbohydrates, 20g of protein and 15g of fat. All the breakfast options in both groups provided 450 calories. Participants had various breakfast choices and were required to upload a photo of their meal, which a study dietitian reviewed to confirm compliance.
All participants were provided with a continuous glucose monitoring device they wore throughout the study. They also undertook A1C blood tests before and after the 12 weeks to measure their average blood sugar levels. They also measured their weight and waist circumference at the beginning and end of the trial. As the study continued, they reported feelings of satiety, energy and activity levels.
Dr. Oliveira notes while there were no significant differences between the low-carb and other group for weight, body mass index or waist circumference, the low-carb group did see a reduction in blood sugar levels, and some were able to reduce their glucose-lowering medication. The upward and downward swings in blood glucose levels, known as glycemic variability, with the low-carb group were also significantly lower, suggesting the benefits of a low-carbohydrate breakfast for stabilizing blood sugars throughout the day.
One interesting finding was that people with low-carb breakfasts self-reported lower calorie and carbohydrate intake at lunch and during the rest of the day. This could suggest that a breakfast rich in fat and protein, while lower in carbs, can impact daily eating habits.
"Having fewer carbs for breakfast not only aligns better with how people with T2D handle glucose throughout the day, but it also has incredible potential for people with T2D who struggle with their glucose levels in the morning," she adds. "By making a small adjustment to the carb content of a single meal rather than the entire diet, we have the potential to increase adherence significantly while still obtaining significant benefits.”