Eating Breakfast May Lower Kids’ Type 2 Diabetes Risk

Regular breakfast consumption and type 2 diabetes risk markers in 9- to 10-year-old children in the Child Heart Study in England (CHASE): a cross-sectional analysis, by Angela S. Donin and colleagues. PLOS Medicine 2014;11:e1001703

What is the problem and what is known about it so far?

The large and growing number of people with type 2 diabetes is a serious public health issue. Learning more about the factors that can lead to diabetes and related diseases can help to prevent them.

People with type 2 diabetes have high levels of sugar (glucose) in their blood. Blood glucose is usually controlled by insulin, a hormone released by the pancreas. In people with type 2 diabetes, the fat and muscle cells that respond to insulin to control glucose stop responding well, a condition called "insulin resistance."

Research has shown that what people eat plays a major role in the risk of getting type 2 diabetes. Breakfast is an important meal because it provides a large portion of a person's daily energy and nutrition needs. What one eats at breakfast may also be important. Some studies have shown that eating breakfast cereal can lower a person's chance of getting diabetes and heart disease.

Adults who eat breakfast regularly—especially those who eat high-fiber cereals—are less likely to become overweight or to get diabetes. In adolescents, routinely skipping breakfast raises the chances of getting metabolic syndrome, a group of disorders that can lead to diabetes and heart disease. Whether routinely missing breakfast raises the chances of diabetes and heart disease in younger children is not known, and there have been few studies of the role of various types of food children may eat for breakfast.

Why did the researchers do this particular study?

The researchers wanted to find out if there are links between children's breakfast-eating habits (how often they eat breakfast and what they eat) and risk factors for diabetes. They were particularly interested in looking for links between children's breakfast habits and their levels of insulin resistance and high blood glucose, which can raise their risk of getting diabetes.

Who was studied?

The study included 4,116 9- and 10-year-old children from 200 schools in three cities in England. The children were of South Asian, black African-Caribbean, or white European background.

How was the study done?

Researchers collected information from participants about how often they eat breakfast, measured their body composition, and took fasting blood samples to measure their blood fats, insulin, glucose, and A1C levels. A subgroup of 2,004 children also worked with a nutritionist to complete a recall list of everything they ate for 24 hours. Researchers then looked at the results for possible links among participants body composition, their blood test results, how often they ate breakfast, and, for the subgroup, what they ate.

What did the researchers find?

Seventy-four percent of the children said they ate breakfast every day, 11% said they ate breakfast on most days, 9% said they sometimes ate breakfast, and 6% said they rarely ate breakfast. Those who did not usually eat breakfast had higher insulin levels in their blood and more insulin resistance than those who ate it every day. Children who ate high-fiber cereals had lower insulin resistance than those who ate other types of breakfast foods. The findings were true regardless of the children's family income (socioeconomic status), exercise habits or body fat levels.

What were the limitations of the study?

The researchers relied on children's reports of how often they ate breakfast, which might not have been accurate. However, their reports closely matched what the nutritionist learned from the students completing 24-hour food recalls. The 24-hour food recall was only done once, which may have been less precise than if it had been done more than once. Finally, although the design of this study worked well for finding short-term links between eating patterns and diabetes risk, it could not explain the nature of those links (in other words, which factors caused others to occur).

What are the implications of the study?

This study suggests that children who eat breakfast every day, especially those who eat high-fiber foods at breakfast, may be less likely to get type 2 diabetes than those who rarely eat breakfast. Although more studies are needed, getting children to eat breakfast each morning and encouraging them to eat high-fiber cereals could help to prevent type 2 diabetes.

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