November 16, 2022
2 min read
Jeans M, et al. O-028. Presented at: ObesityWeek; Nov. 1-4, 2022; San Diego.
Jeans reports no relevant financial disclosures.
SAN DIEGO — Children in an underserved community who increased the number of times per week they ate breakfast had lower fasting insulin and insulin resistance than those who ate breakfast less often, according to a speaker.
In a cohort of predominantly Hispanic children in third to fifth grade who were taught lessons on how to eat a healthy breakfast, those who increased their frequency of eating breakfast by at least 2 additional days per week compared with the start of the study had improvements in several cardiometabolic measures, whereas children who decreased the number of days they ate breakfast by at least 2 days per week had increases in fasting insulin and homeostasis model of assessment for insulin resistance (HOMA-IR) compared with baseline.
“Circadian misalignment from breakfast omission may disrupt glucose metabolism,” Matthew Jeans, PhD, MS, MM, a nutrition scientist at the University of Texas at Austin, said during a presentation. “Also playing a part is caloric intake at the beginning of the day, where skeletal muscle, glucose and fatty acid oxidation is higher in the morning. Shifting our caloric intake to earlier in the day has been shown to align with the circadian rhythm a lot better in that regard and improving glucose metabolism.”
Researchers conducted an analysis of data from TX Sprouts, a school-based gardening, cooking and nutrition randomized controlled trial that included 1,417 children in third to fifth grade attending 16 schools in the Austin, Texas, area with at least 50% of Hispanic children receiving free or reduced lunch (53% boys; mean age, 9.3 years; 58% Hispanic). Outdoor teaching gardens were constructed at each participating school. Nutrition and garden educators taught 18 lessons to each class, with one of the classes focused on eating a healthy breakfast. Researchers analyzed data from 358 participants who consented to fasting blood draws. Glucose, insulin, HOMA-IR, cholesterol, triglycerides and HbA1c were measured from the blood samples. Children self-reported the number of times they ate breakfast per week in a validated survey at baseline and after the intervention. Children who increased their breakfast consumption by at least two meals per week from baseline were put in an increasers group, those who decreased their breakfast consumption by two meals per week were put in a decreasers group, and the remaining participants who ate a similar number of breakfast meals during baseline and follow-up were placed in a maintainers group.
Of the study cohort, 21% were increasers, 16% were decreasers and 63% were maintainers from baseline to follow-up. More than half of the cohort received free or reduced-cost lunch at school, and 44% had overweight or obesity.
At baseline, mean fasting insulin was 16.9 µIU/mL in the decreasers group and 19 µIU/mL in the increasers group. At follow-up, children who increased their breakfast consumption had a lower fasting insulin (18.7 µIU/mL vs. 21 µIU/mL; P = .01) than those who ate fewer meals. The increasers group also had a lower HOMA-IR at follow-up (4.5 vs. 5.2; P = .006) than those who decreased their breakfast consumption. Each one meal increase in breakfast per week was associated with reductions in insulin (beta = –0.44), HOMA-IR (beta = –0.11) and HbA1c (beta = –0.01).
Jeans said the improvements in insulin resistance with eating more breakfast meals per week may be due to the benefits of eating early in the day as well as the macronutrient component of what the groups were eating.
“Our increasers reported eating cereal with milk and yogurt twice as much as our breakfast decreasers,” Jeans said. “It was statistically insignificant … but it is still partially contributing to the results that we had. These foods are primary contributors to protein, whole grains and fiber at breakfast, particularly in this age group.”