Skip to main content Accessibility help

Association between breakfast skipping and postprandial hyperglycaemia after lunch in healthy young individuals

  • Hitomi Ogata (a1), Yoichi Hatamoto (a2), Yusuke Goto (a2), Eri Tajiri (a3), Eiichi Yoshimura (a3), Ken Kiyono (a4), Yoshinari Uehara (a2), Kentaro Kawanaka (a2), Naomi Omi (a5) and Hiroaki Tanaka (a2)...


Breakfast skipping has become an increasing trend in the modern lifestyle and may play a role in obesity and type 2 diabetes. In our previous studies in healthy young individuals, a single incident of breakfast skipping increased the overall 24-h blood glucose and elevated the postprandial glycaemic response after lunch; however, it was difficult to determine whether this response was due to breakfast omission or the extra energy (i.e. lunch plus breakfast contents). The present study aimed to assess the postprandial glycaemic response and to measure their hormone levels when healthy young individuals had identical lunch and dinner, and the 24-h average blood glucose as a secondary outcome. Nine healthy young men (19−24 years) participated in two-meal trials: with breakfast (three-meal condition) or without breakfast (breakfast skipping condition). During the meals, each individual’s blood glucose was continuously monitored. Skipping breakfast resulted in a significantly higher (P < 0·001) glycaemic response after lunch as compared with the glycaemic response after an identical lunch when breakfast was consumed. Despite the difference in the total energy intake, the 24-h average blood glucose was similar between the two-meal conditions (P = 0·179). Plasma NEFA level was significantly higher (P < 0·05) after lunch when breakfast was omitted, and NEFA level positively correlated with the postprandial glycaemic response (r 0·631, P < 0·01). In conclusion, a single incident of breakfast skipping increases postprandial hyperglycaemia, and associated impaired insulin response, after lunch. The present study showed that skipping breakfast influences glucose regulation even in healthy young individuals.


Corresponding author

*Corresponding author: Hitomi Ogata, fax +81-82-424-6589, email


Hide All

Hiroaki Tanaka, one of the authors of the manuscript, deceased on 23 April 2018.



Hide All
1. Leidy, HJ, Hoertel, HA, Douglas, SM, et al. (2015) A high-protein breakfast prevents body fat gain, through reductions in daily intake and hunger, in “breakfast skipping” adolescents. Obesity (Silver Spring) 23, 17611764.
2. Ferrer-Cascales, R, Sánchez-SanSegundo, M, Ruiz-Robledillo, N, et al. (2018) Eat or skip breakfast? The important role of breakfast quality for health-related quality of life, stress and depression in Spanish adolescents. Int J Environ Res Public Health 15, E1781.
3. Spence, C (2017) Breakfast: the most important meal of the day? Int J Gastron Food Sci 8, 16.
4. Smith, KJ, Gall, SL, McNaughton, SA, et al. (2010) Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the childhood determinants of adult health study. Am J Clin Nutr 92, 13161325.
5. Mekary, RA, Giovannucci, E, Willett, WC, et al. (2012) Eating patterns and type 2 diabetes risk in men: breakfast omission, eating frequency, and snacking. Am J Clin Nutr 95, 11821189.
6. Ma, Y, Bertone, ER, Stanek, EJ III, et al. (2003) Association between eating patterns and obesity in a free-living US adult population. Am J Epidemiol 158, 8592.
7. Song, WO, Chun, OK, Obayashi, S, et al. (2005) Is consumption of breakfast associated with body mass index in US adults? J Am Diet Assoc 105, 13731382.
8. Ballon, A, Neuenschwander, M & Schlesinger, S (2019) Breakfast skipping is associated with increased risk of type 2 diabetes among adults: a systematic review and meta-analysis of prospective cohort studies. J Nutr 149, 106113.
9. Bi, H, Gan, Y, Yang, C, et al. (2015) Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr 18, 30133019.
10. Haug, E, Rasmussen, M, Samdal, O, et al. (2009) Overweight in school-aged children and its relationship with demographic and lifestyle factors: results from the WHO Collaborative Health Behaviour in School-aged Children (HBSC) study. Int J Public Health 54, 167179.
11. Horikawa, C, Kodama, S, Yachi, Y, et al. (2011) Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: a meta-analysis. Prev Med 53, 260267.
12. Szajewska, H & Ruszczynski, M (2010) Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Crit Rev Food Sci Nutr 50, 113119.
13. Chatelan, A, Castetbon, K, Pasquier, J, et al. (2018) Association between breakfast composition and abdominal obesity in the Swiss adult population eating breakfast regularly. Int J Behav Nutr Phys Act 15, 115.
14. Brown, AW, Bohan Brown, MM, Allison, DB, et al. (2013) Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr 98, 12981308.
15. Betts, JA, Richardson, JD, Chowdhury, EA, et al. (2014) The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr 100, 539547.
16. Chowdhury, EA, Richardson, JD, Holman, GD, et al. (2016) The causal role of breakfast in energy balance and health: a randomized controlled trial in obese adults. Am J Clin Nutr 103, 747756.
17. Betts, JA, Chowdhury, EA, Gonzalez, JT, et al. (2016) Is breakfast the most important meal of the day? Proc Nutr Soc 75, 464474.
18. Ceriello, A (2005) Postprandial hyperglycemia and diabetes complications: is it time to treat? Diabetes 54, 17.
19. Shichiri, M, Kishikawa, H, Ohkubo, Y, et al. (2000) Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients. Diabetes Care 23, B21B29.
20. Stratton, IM, Adler, AI, Neil, HA, et al. (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321, 405412.
21. Hu, FB, Stampfer, MJ, Solomon, CG, et al. (2001) The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women: 20 years of follow-up. Arch Intern Med 161, 17171723.
22. Monnier, L, Colette, C & Owens, DR (2009) Integrating glycaemic variability in the glycaemic disorders of type 2 diabetes: a move towards a unified glucose tetrad concept. Diabetes Metab Res Rev 25, 393402.
23. Cavalot, F, Petrelli, A, Traversa, M, et al. (2006) Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab 91, 813819.
24. Siegelaar, SE, Holleman, F, Hoekstra, JB, et al. (2010) Glucose variability: does it matter? Endocr Rev 31, 171182.
25. Monnier, L, Lapinski, H & Colette, C (2003) Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c). Diabetes Care 26, 881885.
26. Ceriello, A, Colagiuri, S, Gerich, J, et al. (2008) Guideline for management of postmeal glucose. Nutr Metab Cardiovasc Dis 18, S17S33.
27. Kang, X, Wang, C, Lifang, L, et al. (2013) Effects of different proportion of carbohydrate in breakfast on postprandial glucose excursion in normal glucose tolerance and impaired glucose regulation subjects. Diabetes Technol Ther 15, 569574.
28. Pearce, KL, Noakes, M, Keogh, J, et al. (2008) Effect of carbohydrate distribution on postprandial glucose peaks with the use of continuous glucose monitoring in type 2 diabetes. Am J Clin Nutr 87, 638644.
29. Jovanovic, A, Leverton, E, Solanky, B, et al. (2009) The second-meal phenomenon is associated with enhanced muscle glycogen storage in humans. Clin Sci (Lond) 117, 119127.
30. Jakubowicz, D, Wainstein, J, Ahren, B, et al. (2015) Fasting until noon triggers increased postprandial hyperglycemia and impaired insulin response after lunch and dinner in individuals with type 2 diabetes: a randomized clinical trial. Diabetes Care 38, 18201826.
31. Kobayashi, F, Ogata, H, Omi, N, et al. (2014) Effect of breakfast skipping on diurnal variation of energy metabolism and blood glucose. Obes Res Clin Pract 8, e249e257.
32. Ogata, H, Kayaba, M, Tanaka, Y, et al. (2019) Effect of skipping breakfast for six days on energy metabolism and diurnal rhythm of blood glucose in young healthy Japanese males. Am J Clin Nutr 110, 4152.
33. World Health Organization (2019) Obesity and overweight. (accessed January 2019).
34. Chen, T, Xu, F, Su, JB, et al. (2013) Glycemic variability in relation to oral disposition index in the subjects with different stages of glucose tolerance. Diabetol Metab Syndr 5, 38.
35. Ministry of Health, Labour and Welfare of Japan (2018) The National Health and Nutrition Survey 2015 [in Japanese]. (accessed May 2018).
36. Hatamoto, Y, Goya, R, Yamada, Y, et al. (2017) Effect of exercise timing on elevated postprandial glucose levels. J Appl Physiol 123, 278284.
37. Rodbard, D (2016) Continuous glucose monitoring: a review of successes, challenges, and opportunities. Diabetes Technol Ther 18, 203213.
38. Service, FJ, Molnar, GD, Rosevear, JW, et al. (1970) Mean amplitude of glycemic excursions, a measure of diabetic instability. Diabetes 19, 644655.
39. McDonnell, CM, Donath, SM, Vidmar, SI, et al. (2005) A novel approach to continuous glucose analysis utilizing glycemic variation. Diabetes Technol Ther 7, 253263.
40. Service, FJ & Nelson, RL (1980) Characteristics of glycemic stability. Diabetes Care 3, 5862.
41. Peng, CK, Havlin, S, Stanley, HE, et al. (1995) Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 5, 8287.
42. Ogata, H, Tokuyama, K, Nagasaka, S, et al. (2006) Long-range negative correlation of glucose dynamics in humans and its breakdown in diabetes mellitus. Am J Physiol Regul Integr Comp Physiol 291, R1638R1643.
43. Ohkawara, K, Oshima, Y, Hikihara, Y, et al. (2011) Real-time estimation of daily physical activity intensity by a triaxial accelerometer and a gravity-removal classification algorithm. Br J Nutr 105, 16811691.
44. Bonuccelli, S, Muscelli, E, Gastaldelli, A, et al. (2009) Improved tolerance to sequential glucose loading (Staub-Traugott effect): size and mechanisms. Am J Physiol Endocrinol Metab 297, E532E537.
45. Wajngot, A, Grill, V, Efendić, S, et al. (1982) The Staub-Traugott effect. Evidence for multifactorial regulation of a physiological function. Scand J Clin Lab Invest 42, 307313.
46. Carey, PE, Halliday, J, Snaar, JE, et al. (2003) Direct assessment of muscle glycogen storage after mixed meals in normal and type 2 diabetic subjects. Am J Physiol Endocrinol Metab 284, E688E694.
47. Jovanovic, A, Gerrard, J & Taylor, R (2009) The second-meal phenomenon in type 2 diabetes. Diabetes Care 32, 11991201.
48. Nuttall, FQ, Mooradian, AD, Gannon, MC, et al. (1984) Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load. Diabetes Care 7, 465470.
49. Lee, SH, Tura, A, Mari, A, et al. (2011) Potentiation of the early-phase insulin response by a prior meal contributes to the second-meal phenomenon in type 2 diabetes. Am J Physiol Endocrinol Metab 301, E984E990.
50. Chowdhury, EA, Richardson, JD, Tsintzas, K, et al. (2015) Carbohydrate-rich breakfast attenuates glycaemic, insulinaemic and ghrelin response to ad libitum lunch relative to morning fasting in lean adults. Br J Nutr 114, 98107.
51. Nilsson, A, Ostman, E, Preston, T, et al. (2008) Effects of GI vs content of cereal fibre of the evening meal on glucose tolerance at a subsequent standardized breakfast. Eur J Clin Nutr 62, 712720.
52. Rahat-Rozenbloom, S, Fernandes, J, Cheng, J, et al. (2017) The acute effects of inulin and resistant starch on postprandial serum short-chain fatty acids and second-meal glycemic response in lean and overweight humans. Eur J Clin Nutr 71, 227233.
53. Nilsson, AC, Ostman, EM, Granfeldt, Y, et al. (2008) Effect of cereal test breakfasts differing in glycemic index and content of indigestible carbohydrates on daylong glucose tolerance in healthy subjects. Am J Clin Nutr 87, 645654.
54. Brighenti, F, Benini, L, Del Rio, D, et al. (2006) Colonic fermentation of indigestible carbohydrates contributes to the second-meal effect. Am J Clin Nutr 83, 817822.
55. Lunde, MS, Hjellset, VT, Holmboe-Ottesen, G, et al. (2011) Variations in postprandial blood glucose responses and satiety after intake of three types of bread. J Nutr Metab 2011, 437587.
56. Jenkins, DJ, Wolever, TM, Nineham, R, et al. (1980) Improved glucose tolerance four hours after taking guar with glucose. Diabetologia 19, 2124.
57. Jenkins, DJ, Wolever, TM, Taylor, RH, et al. (1982) Slow release dietary carbohydrate improves second meal tolerance. Am J Clin Nutr 35, 13391346.
58. Liljeberg, HG, Akerberg, AK & Björck, IM (1999) Effect of the glycemic index and content of indigestible carbohydrates of cereal-based breakfast meals on glucose tolerance at lunch in healthy subjects. Am J Clin Nutr 69, 647655.
59. Trinick, TR, Laker, MF, Johnston, DG, et al. (1986) Effect of guar on second-meal glucose tolerance in normal man. Clin Sci (Lond) 71, 4955.
60. Wolever, TM, Jenkins, DJ, Ocana, AM, et al. (1988) Second-meal effect: low-glycemic-index foods eaten at dinner improve subsequent breakfast glycemic response. Am J Clin Nutr 48, 10411047.
61. Arai, H, Mizuno, A, Sakuma, M, et al. (2007) Effects of a palatinose-based liquid diet (Inslow) on glycemic control and the second-meal effect in healthy men. Metabolism 56, 115121.
62. Granfeldt, Y, Wu, X & Björck, I (2006) Determination of glycaemic index; some methodological aspects related to the analysis of carbohydrate load and characteristics of the previous evening meal. Eur J Clin Nutr 60, 104112.
63. Liljeberg, H & Björck, I (2000) Effects of a low-glycaemic index spaghetti meal on glucose tolerance and lipaemia at a subsequent meal in healthy subjects. Eur J Clin Nutr 54, 2428.
64. Chen, MJ, Jovanovic, A & Taylor, R (2010) Utilizing the second-meal effect in type 2 diabetes: practical use of a soya-yogurt snack. Diabetes Care 33, 2552–2254.
65. Meng, H, Matthan, NR, Ausman, LM, et al. (2017) Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations. Am J Clin Nutr 106, 12461256.
66. Park, YM, Heden, TD, Liu, Y, et al. (2015) A high-protein breakfast induces greater insulin and glucose-dependent insulinotropic peptide responses to a subsequent lunch meal in individuals with type 2 diabetes. J Nutr 145, 452458.
67. Ando, T, Nakae, S, Usui, C, et al. (2018) Effect of diurnal variations in the carbohydrate and fat composition of meals on postprandial glycemic response in healthy adults: a novel insight for the second-meal phenomenon. Am J Clin Nutr 108, 332342.
68. Wolever, TM, Bentum-Williams, A & Jenkins, DJ (1995) Physiological modulation of plasma free fatty acid concentrations by diet. Metabolic implications in nondiabetic subjects. Diabetes Care 18, 962970.
69. Boden, G (1998) Free fatty acids (FFA), a link between obesity and insulin resistance. Front Biosci 3, d169d175.
70. Ferrannini, E, Barrett, EJ, Bevilacqua, S, et al. (1983) Effect of fatty acids on glucose production and utilization in man. J Clin Invest 72, 17371747.
71. Rabinovitz, HR, Boaz, M, Ganz, T, et al. (2014) Big breakfast rich in protein and fat improves glycemic control in type 2 diabetics. Obesity (Silver Spring) 22, E46E54.
72. Monnier, L, Colette, C & Boniface, H (2006) Contribution of postprandial glucose to chronic hyperglycaemia: from the “glucose triad” to the trilogy of “sevens”. Diabetes Metab 32, 2S112S16.
73. Anonymous (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe. Lancet 354, 617621.
74. Tominaga, M, Eguchi, H, Manaka, H, et al. (1999) Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 22, 920924.
75. Chiasson, JL, Josse, RG, Gomis, R, et al. (2003) Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA 290, 486494.
76. Nakagami, T; DECODA Study Group. (2004) Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin. Diabetologia 47, 385394.
77. Nyaradi, A, Li, J, Foster, JK, et al. (2016) Good-quality diet in the early years may have a positive effect on academic achievement. Acta Paediatr 105, e209e218.
78. Burrows, T, Goldman, S, Pursey, K, et al. (2017) Is there an association between dietary intake and academic achievement: a systematic review. J Hum Nutr Diet 30, 117140.


Related content

Powered by UNSILO

Association between breakfast skipping and postprandial hyperglycaemia after lunch in healthy young individuals

  • Hitomi Ogata (a1), Yoichi Hatamoto (a2), Yusuke Goto (a2), Eri Tajiri (a3), Eiichi Yoshimura (a3), Ken Kiyono (a4), Yoshinari Uehara (a2), Kentaro Kawanaka (a2), Naomi Omi (a5) and Hiroaki Tanaka (a2)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.