The effect of breakfast skipping and sleep disorders on glycemic control, cardiovascular risk, and weight loss in type 2 diabetes

• Published in: Clinical nutrition ESPEN Vol. 65; pp. 172 - 181
• Main Authors: Minari, Tatiana Palotta, Manzano, Carolina Freitas, Yugar, Louise Buonalumi Tácito, Sedenho-Prado, Luis Gustavo, de Azevedo Rubio, Tatiane, Tácito, Lúcia Helena Bonalumi, Pires, Antônio Carlos, Vilela-Martin, José Fernando, Cosenso-Martin, Luciana Neves, Ludovico, Nelson Dinamarco, Fattori, André, Yugar-Toledo, Juan Carlos, Moreno, Heitor, Pisani, Luciana Pellegrini
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2025
• Subjects: Aged; Blood Glucose - metabolism; Breakfast; Cardiovascular Diseases - etiology; circadian rhythm; clinical nutrition; descriptive studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Feeding Behavior; Female; food intake; Gastroenterology and Hepatology; Glycemic Control; Heart Disease Risk Factors; high density lipoprotein cholesterol; Humans; Intermittent Fasting; Internal Medicine; Lose weight; Male; Middle Aged; noninsulin-dependent diabetes mellitus; nutrition assessment; Nutritional intervention; risk; Skipping breakfast; sleep; Sleep disorders; Sleep Wake Disorders - complications; Sleep Wake Disorders - physiopathology; t-test; Type 2 diabetes; weight control; Weight Loss; Glycemic control; Type 2 diabetes; Sleep disorders; Lose weight; Skipping breakfast; Nutritional intervention
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2024.11.026

Meal timing is an emerging branch of science that investigates the influence of eating patterns on the circadian rhythm and overall health. There are still discrepancies in the literature as to whether late distribution of food intake and sleep disorders could impact biochemical, anthropometric, and cardiovascular markers. The objectives of this study were firstly observe skipping breakfast and sleep disorders over 12 months. Secondarily, analyze the individual influence of these findings on changes biochemical, anthropometric, and cardiovascular markers during the same period. This descriptive study is part of a tertiary analysis in a recently published study. This research recruited 84 participants with Type 2 Diabetes (T2D) who were divided: Control-40 participants received only medical care; Intervention-44 participants received the same medical care along with nutritional assessment. Consultations occurred quarterly over 12th months, and a follow-up was conducted after 3 months. For influence analysis, non-normal variables were compared using Mann–Whitney, while normal variables were compared using unpaired t-tests. In all instances, α = 0.05 and P < 0.05 were adopted. Analysis revealed a high percentage of patients in both groups who skipped breakfast, slept less than 6 h, and experienced nighttime awakenings during the 1st visit. By the 12th month, there was deterioration in all data in the control group and significant improvement in the intervention group. Those with sleep disturbances also had lower HDL-cholesterol (HDL-C) values (p = 0.0054). For the other analyzes no significant differences were found. Participants who skipped breakfast and had more nocturnal awakenings possibly had worse glycemic and weight control, but this difference was not statistically significant and only trends were observed. Sleep disorders could affect HDL-C levels. However, the influence analysis does not establish a causal relationship and more clinical trials are needed to analyze this topic on T2D. [Display omitted]