Updated October 21, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

You've likely heard that breakfast is the most important meal of the day: it starts your metabolism and can often set the stage for how good your meal choices will be for the remainder of the day. But the question remains: what should you eat for breakfast? Recent studies suggest that starting your day with a with a larger, higher fat, and higher protein breakfast can help to improve blood sugar control and aid in weight loss in people with Type 2 diabetes.

In one study, participants were randomized to either a smaller, higher carbohydrate breakfast or a larger, higher protein/higher fat breakfast (lower carbohydrate) for three months. The larger breakfast provided about 33% of total daily calories. Researchers found that those persons assigned to a larger, higher protein/higher fat breakfast saw greater reductions in hemoglobin A1c (-4.62% versus -1.46%; P=0.047) and reductions in systolic blood pressure (-9.58 versus -2.48 mmHg; P=0.04). Almost all of the overweight people with Type 2 diabetes in the big-breakfast group were able to reduce their medications, and none of the patients in the smaller breakfast group were able to meet this goal. Both groups lost about the same amount of weight (<1kg).

What Can We Make of This?

While the group who ate the larger, lower-carbohydrate, higher protein/higher fat breakfast was able to reduce medications and blood pressure, it wasn't because they lost more weight. One possible reason their blood sugars improved is that blood sugars tend to be higher in the morning and, if you eat a large carbohydrate meal when your blood sugar is already elevated, blood sugars can remain high throughout the day.

The liver produces sugar in the evening when you're in a fasting state. Some people wake up with a higher morning blood sugar – this is called the dawn phenomenon. Also, people tend to be more insulin resistant in the morning; insulin is less effective at bringing sugar to the cells to use for energy. Eating a lower carbohydrate meal means less sugar entering the blood stream and less insulin need. The end result is better blood sugars. Lastly, eating a high carbohydrate breakfast such as a bagel, or large bowl of cereal may actually cause more carbohydrate cravings throughout the day resulting in higher blood sugars. These types of foods cause blood sugars to spike at a quick rate. The aftermath is a drop in blood sugars which can cause cravings.  

How Can We Apply These Findings in our Day-to-Day Life?

It is hard to generalize when it comes to diabetes, but a lower carbohydrate, higher protein meal for breakfast is likely to be beneficial. It can help with morning insulin resistance and reduce cravings throughout the day. However, a lower carbohydrate meal, does not mean no carbohydrates. You don’t want to avoid carbohydrates altogether, rather aim to eat about 30g of carbohydrates for breakfast. As opposed to eating a high fat breakfast, aim to eat modified fat especially if you are trying to lose weight. Fat is an important nutrient, but has more than double the calories per gram than carbohydrate and protein. 

What Kind of Carbohydrates Should I Eat?

Complex carbohydrates that are rich in fiber and minimally processed are your best choices. Fiber helps to slow the rate at which glucose enters the blood stream, which can help to achieve good blood sugar control. Fibrous foods keep you full and can aid in reducing bad cholesterol. Carbohydrates rich in fiber include fruits, vegetables, legumes (beans), and whole grains. The American Heart Association says that a diet rich in whole grains can help to reduce the risk of heart disease.

Examples of High Protein, High Fiber, 30g Carbohydrate Breakfast:

• 3 scrambled egg whites + 1 whole egg, with ½ cup cooked spinach, ¼ cup shredded low-fat cheese and 2 slices of whole grain bread (100% whole wheat, rye or oat bread)
• 1 non-fat Greek yogurt mixed with ½ cup low-fat cottage cheese, ¾ cup blueberries and 2 Tbsp chopped almonds
• 1 whole grain English muffin with 2 Tbsp peanut butter and a few sliced strawberries, 2 slices low-sodium turkey
• ½ cup cooked oatmeal, with ½ cup sliced peaches, with 1 Tbsp ground flaxseed meal and 2 hard boiled egg whites

*Always consult with your Registered Dietitian or Physician before starting any new meal plan. 

Sources:

<sub>Rabinovitz, H. R., Boaz, M., Ganz, T., Jakubowicz, D., Matas, Z., Madar, Z. and Wainstein, J. (2013), Big breakfast rich in protein and fat improves glycemic control in type 2 diabetics. Obesity. doi: 10.1002/oby.20654

The American Heart Association http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Whole-Grains-and-Fiber_UCM_303249_Article.jsp Accessed December 15^th, 2013:</sub>