Allie S Carew1,2,3, Rania A Mekary4, Susan Kirkland1,2,3, Olga Theou1,2,5, Ferhan Siddiqi1,2, Robin Urquhart2,3, Michelle George3, Chris Blanchard1,2, Mary L Biggs6, Luc Djoussé7,8, Kenneth J Mukamal8,9, Leah E Cahill1,2,3. 1. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 2. QEII Health Sciences Centre, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 3. Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. 4. School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences University, Boston, MA, USA. 5. School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada. 6. Department of Biostatistics, University of Washington, Seattle, WA, USA. 7. Division on Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 8. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. 9. Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA.
Abstract
BACKGROUND: No evidence-based recommendations regarding optimal breakfast frequency and timing and type 2 diabetes mellitus (T2DM) exist for older adults because of limited studies. OBJECTIVES: We sought to prospectively assess relations between breakfast frequency and timing and T2DM risk among older adults and determine whether these depended on sex or cardiometabolic risk factors. METHODS: Weekly breakfast frequency and usual daily breakfast time were assessed by questionnaire at baseline in 3747 older adults (aged ≥ 65 y) from the Cardiovascular Health Study (CHS) who were free of cancer and T2DM and followed for 17.6 y. Multivariable-adjusted hazard ratios (aHRs) with 95% CIs estimated from Cox proportional hazards models were used to quantify associations with T2DM. RESULTS: Most CHS participants (median age: 74 y; IQR: 71-78 y) consumed breakfast daily (85.5%), and 73% had their first daily eating occasion between 07:00 and 09:00, both of which were associated with higher socioeconomic status, factors that are indicative of a healthier lifestyle, and lower levels of cardiometabolic risk indicators at baseline. During follow-up, 547 T2DM cases were documented. No strong evidence was observed linking breakfast frequency and risk of T2DM. Compared with participants whose breakfast timing (first eating occasion of the day) was 07:00-09:00, those who broke fast after 09:00 had an aHR for T2DM of 0.71 (95% CI: 0.51, 0.99). This association was present in participants with impaired fasting glucose at baseline (aHR: 0.61; 95% CI: 0.39, 0.95) but not in those without (aHR: 0.83; 95% CI: 0.50, 1.38). No associations between eating frequency or timing and T2DM were observed within other prespecified subgroups. CONCLUSIONS: Eating breakfast daily was not associated with either higher or lower risk of T2DM in this cohort of older adults, whereas a later (after 09:00) daily first eating occasion time was associated with lower T2DM risk in participants with impaired fasting glucose at baseline.This trial was registered at clinicaltrials.gov as NCT00005133.
BACKGROUND: No evidence-based recommendations regarding optimal breakfast frequency and timing and type 2 diabetes mellitus (T2DM) exist for older adults because of limited studies. OBJECTIVES: We sought to prospectively assess relations between breakfast frequency and timing and T2DM risk among older adults and determine whether these depended on sex or cardiometabolic risk factors. METHODS: Weekly breakfast frequency and usual daily breakfast time were assessed by questionnaire at baseline in 3747 older adults (aged ≥ 65 y) from the Cardiovascular Health Study (CHS) who were free of cancer and T2DM and followed for 17.6 y. Multivariable-adjusted hazard ratios (aHRs) with 95% CIs estimated from Cox proportional hazards models were used to quantify associations with T2DM. RESULTS: Most CHS participants (median age: 74 y; IQR: 71-78 y) consumed breakfast daily (85.5%), and 73% had their first daily eating occasion between 07:00 and 09:00, both of which were associated with higher socioeconomic status, factors that are indicative of a healthier lifestyle, and lower levels of cardiometabolic risk indicators at baseline. During follow-up, 547 T2DM cases were documented. No strong evidence was observed linking breakfast frequency and risk of T2DM. Compared with participants whose breakfast timing (first eating occasion of the day) was 07:00-09:00, those who broke fast after 09:00 had an aHR for T2DM of 0.71 (95% CI: 0.51, 0.99). This association was present in participants with impaired fasting glucose at baseline (aHR: 0.61; 95% CI: 0.39, 0.95) but not in those without (aHR: 0.83; 95% CI: 0.50, 1.38). No associations between eating frequency or timing and T2DM were observed within other prespecified subgroups. CONCLUSIONS: Eating breakfast daily was not associated with either higher or lower risk of T2DM in this cohort of older adults, whereas a later (after 09:00) daily first eating occasion time was associated with lower T2DM risk in participants with impaired fasting glucose at baseline.This trial was registered at clinicaltrials.gov as NCT00005133.
Authors: Erika F Brutsaert; Mary L Biggs; Joseph A Delaney; Luc Djoussé; John S Gottdiener; Joachim H Ix; Francis Kim; Kenneth J Mukamal; David S Siscovick; Russell P Tracy; Ian H de Boer; Christopher R deFilippi; Jorge R Kizer Journal: Metabolism Date: 2016-06-24 Impact factor: 8.694
Authors: Lona Mody; Douglas K Miller; Joanne M McGloin; Marcie Freeman; Edward R Marcantonio; Jay Magaziner; Stephanie Studenski Journal: J Am Geriatr Soc Date: 2008-12 Impact factor: 5.562
Authors: Elina K Nihtilä; Pekka T Martikainen; Seppo V P Koskinen; Antti R Reunanen; Anja M Noro; Unto T Häkkinen Journal: Eur J Public Health Date: 2007-06-11 Impact factor: 3.367