A High-Protein Breakfast Induces Greater Insulin and Glucose-Dependent Insulinotropic Peptide Responses to a Subsequent Lunch Meal in Individuals with Type 2 Diabetes. Issue 3 (24th December 2014)

• Record Type: Journal Article
• Authors: Park, Young-Min; Heden, Timothy D; Liu, Ying; Nyhoff, Lauryn M; Thyfault, John P; Leidy, Heather J; Kanaley, Jill A
• Is Part Of: Journal of nutrition. Volume 145:Issue 3(2015)
• Page Start: 452
• Page End: 458
• Publication Date: 2014-12-24
• Subjects: GIP -- GLP-1 -- second-meal phenomenon -- type 2 diabetes -- postprandial glucose -- high carbohydrate -- glucagon; Nutrition -- Periodicals; Diet -- Periodicals; 613.205
• DOI: 10.3945/jn.114.202549
• Languages: English
• ISSNs: 0022-3166

Abstract

Abstract: Background: The previous meal modulates the postprandial glycemic responses to a subsequent meal; this is termed the second-meal phenomenon. Objective: This study examined the effects of high-protein vs. high-carbohydrate breakfast meals on the metabolic and incretin responses after the breakfast and lunch meals. Methods: Twelve type 2 diabetic men and women [age: 21–55 y; body mass index (BMI): 30–40 kg/m 2 ] completed two 7-d breakfast conditions consisting of 500-kcal breakfast meals as protein (35% protein/45% carbohydrate) or carbohydrate (15% protein/65% carbohydrate). On day 7, subjects completed an 8-h testing day. After an overnight fast, the subjects consumed their respective breakfast followed by a standard 500-kcal high-carbohydrate lunch meal 4 h later. Blood samples were taken throughout the day for assessment of 4-h postbreakfast and 4-h postlunch total area under the curve (AUC) for glucose, insulin, C-peptide, glucagon, glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide 1 (GLP-1). Results: Postbreakfast glucose and GIP AUCs were lower after the protein (17%) vs. after the carbohydrate (23%) condition ( P < 0.05), whereas postbreakfast insulin, C-peptide, glucagon, and GLP-1 AUCs were not different between conditions. A protein-rich breakfast may reduce the consequences of hyperglycemia in this population. Postlunch insulin, C-peptide, and GIP AUCs were greater after the protein condition vs. after the carbohydrate condition (second-meal phenomenon; all, P < 0.05), but postlunch AUCs were not different between conditions. The overall glucose, glucagon, and GLP-1 responses (e.g., 8 h) were greater after the protein condition vs. after the carbohydrate condition (all, P < 0.05). Conclusions: In type 2 diabetic individuals, compared with a high-carbohydrate breakfast, the consumption of a high-protein breakfast meal attenuates the postprandial glucose response and does not magnify the response to the second meal. Insulin, C-peptide, and GIP concentrations demonstrate the second-meal phenomenon and most likely aid in keeping the glucose concentrations controlled in response to the subsequent meal. The trial was registered atwww.clinicaltrials.gov/ct2/show/NCT02180646 as NCT02180646.