Abstract

Breakfast omission is associated with obesity and CVD/diabetes, but the acute effects of extended morning fasting upon subsequent energy intake and metabolic/hormonal responses have received less attention. In a randomised cross-over design, thirty-five lean men (n 14) and women (n 21) extended their overnight fast or ingested a typical carbohydrate-rich breakfast in quantities relative to RMR (i.e. 1963 (sd 238) kJ), before an ad libitum lunch 3 h later. Blood samples were obtained hourly throughout the day until 3 h post-lunch, with subjective appetite measures assessed. Lunch intake was greater following extended fasting (640 (sd 1042) kJ, P< 0.01) but incompletely compensated for the omitted breakfast, with total intake lower than the breakfast trial (3887 (sd 1326) v. 5213 (sd 1590) kJ, P< 0.001). Systemic concentrations of peptide tyrosine-tyrosine and leptin were greater during the afternoon following breakfast (both P< 0.05) but neither acylated/total ghrelin concentrations were suppressed by the ad libitum lunch in the breakfast trial, remaining greater than the morning fasting trial throughout the afternoon (all P< 0.05). Insulin concentrations were greater during the afternoon in the morning fasting trial (all P< 0.01). There were no differences between trials in subjective appetite during the afternoon. In conclusion, morning fasting caused incomplete energy compensation at an ad libitum lunch. Breakfast increased some anorectic hormones during the afternoon but paradoxically abolished ghrelin suppression by the second meal. Extending morning fasting until lunch altered subsequent metabolic and hormonal responses but without greater appetite during the afternoon. The present study clarifies the impact of acute breakfast omission and adds novel insights into second-meal metabolism.

Highlights

  • Breakfast omission is associated with obesity and CVD/diabetes, but the acute effects of extended morning fasting upon subsequent energy intake and metabolic/hormonal responses have received less attention

  • There is evidence in adolescent girls that breakfast consumption can reduce hunger relative to morning fasting, with high protein breakfasts reducing daily ghrelin (an appetitestimulating hormone[18]), increasing peptide tyrosine – tyrosine[19] (PYY; a hormone associated with satiety[20]) and reducing ad libitum lunch intake[21], but in both cases without reducing total energy intake (EI)

  • When comparing the EI at lunch in the two conditions, the additional EI of 640 (SD 1042) kJ (153 (SD 249) kcal) during the morning fasting trial accounted for approximately 33 % of the prescribed breakfast

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Summary

Introduction

Breakfast omission is associated with obesity and CVD/diabetes, but the acute effects of extended morning fasting upon subsequent energy intake and metabolic/hormonal responses have received less attention. To the authors’ knowledge, only two studies[15,17] have measured hormonal and appetite responses to breakfast omission/ consumption followed by an ad libitum lunch. These studies provide valuable information, but their designs included mid-morning preloads (i.e. a standardised feeding of 1050 kJ (250 kcal) and 1500 kJ (358 kcal) in all trials before lunch) such that the effects of unbroken overnight fasting prior to an ad libitum lunch were not a focus. That morning fasting would result in greater appetite sensations consistent with increased orexigenic (ghrelin) and lower anorectic (e.g. PYY) hormone responses throughout the day

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