Tuesday, December 17, 2019

Retrospective #304: I am not making this stuff up!

“Novel differences in the glucose response to HP [higher-protein] vs. NP [normal-protein] breakfasts were observed and were influenced by the frequency of habitual breakfast consumption in overweight adolescents.” This might have made a good tweet, but – and I am not making this up – that was the CONCLUSION from the Abstract of a recent article in the European Journal of Clinical Nutrition (EJCN). I saw this groundbreaking news in Diabetes in Control: “Breakfast Habits Affect Overweight Teen Girls’ Metabolic Responses to Protein-Packed Morning Meals.”
“The primary aim [of the study] was to examine the daily glycemic response to normal-protein (NP) vs. higher-protein (HP) breakfasts in overweight adolescents who habitually skip breakfast (H-BS). The secondary aim examined whether the glycemic response to these meals differed in H-BS vs. habitual breakfast consumers (H-BC),” according to the EJCN. If this sounds elementary, Watson, I’ll generously assume the research was intended to educate overweight/obese late adolescent girls in an online chat line or similar social media or some teen-oriented supermarket magazine. I just can’t believe it was intended to educate medical professionals. Or wait, could it?
The unsurprising outcome was that “those who typically ate a high-carbohydrate breakfast had improved glucose control after they ate a high-protein breakfast.” Quelle surprise!  But the researchers seemed surprised that “the habitual breakfast skippers experienced poorer glycemic control throughout the day when they consumed a high protein breakfast.” Hmmm. Hold the presses: any ingested food affects your circulating blood glucose! It disrupts a low serum insulin status from an overnight fast. It causes glucose, from any carbs and then some from glucogenic proteins, especially in any dairy consumed with breakfast, to enter your bloodstream, resulting in peaks and crashes!
The Abstract (you have to pay to access the full paper) does not tell us what a “normal protein” breakfast is (as compared to a higher-protein breakfast) but you can bet it contains lots of carbs too: juice, porridge (oatmeal) or other cereal with added sugar, yogurt and/or some bread product (bagel with Nutella?).
“These findings may indicate an increased inability among habitual breakfast skippers to metabolize a large quantity of protein,” the corresponding researcher told Diabetes in Control. “However, our data would suggest that once someone begins to eat breakfast, they should gradually transition to a breakfast with more protein – or about 30 grams – to elicit improvements in glycemic control,” the researcher said. Wow! Thirty grams is a lot of protein for breakfast. They must be growing girls.
I think the education of the researcher is a worthy cause and appears to be proceeding swimmingly. For example, among the paper’s findings: “Current scientific evidence shows that sustained elevations in post-meal glucose is a strong contributor of poor glycemic control and is associated with an increased risk for the development of Type 2 diabetes and cardiovascular complications. Because of the potential risk in the long term, identifying dietary strategies that individuals can begin when they are young to reduce post-meal elevations in glucose might prevent the occurrence of Type 2 diabetes and cardiovascular disease.” That’s a safe bet! And well said!
According to the Diabetes in Control write-up, the researcher suggested that “young women should routinely aim for a 350-calorie breakfast with approximately 30 grams of protein. To meet the recommended 30 grams of protein, [the researcher] suggested foods such as scrambled eggs, breakfast burritos with eggs and lean meats, or Greek Yogurt.” Interesting, my breakfast of 3 eggs, fried or scrambled, 1 strip of bacon, a 12-oz coffee with 1-gram of stevia powder and 1½ oz heavy whipping cream (full cream in the UK), and a 1-gram fish oil capsule is just 375 calories, but only 20 grams of protein, 31 grams of fat and 3 grams of carbs.
I also think the researcher needs to take another look at 1) gluconeogenesis and 2) the “standard lunch” the girls ate. But progress is progress.

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