OR09-2 Metabolic Effects of Skipping Breakfast in Obese Women

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR09-Obesity: Physiologic Responses to Energy Balance Disruption
Clinical
Saturday, June 15, 2013: 11:30 AM-1:00 PM
Presentation Start Time: 11:45 AM
Room 307 (Moscone Center)
Elizabeth Anne Thomas*, Jamie L Bechtell, Janine Higgins and Marc-Andre Cornier
University of Colorado Denver, Aurora, CO
Breakfast skipping has been associated with higher BMI and metabolic derangements.  However, studies showing such associations have been either population studies or small studies done primarily in lean individuals. This randomized, cross-over trial was designed to investigate the metabolic responses to skipping breakfast in overweight and obese women. 9 women (29.2±2 years, BMI 31.4±2.7 kg/m²) were studied on 2 separate days approximately 1 month apart.  During the study visits they either ate breakfast (B), which contained 25% of daily energy intake (EI) or had no breakfast (NB), then consumed a standard lunch meal 4 hours later, which contained 35% of daily EI. Blood sampling for insulin, glucose, free fatty acids (FFA) and triglycerides (TG) was performed every 30 minutes for 3 hours following the lunch meal. Although pre-lunch insulin did not differ between conditions, the insulin total area under the curve (AUC) was higher in the NB compared to B condition (12322±3093 vs 8882±2803 µIU/mLx180 min, p=0.001). Similarly, pre-lunch glucose did not differ by condition, but glucose total AUC was higher in NB compared to B (20775±1194 vs 18126±1123 mg/dLx180 min, p=0.004). Pre-lunch FFA were higher in NB compared to B (705±121 vs 287±180 µEq/L, p=0.0002).The total AUC for FFA was higher in the NB compared to B condition (33980±8026 vs 25692±6503 µEq/Lx180 min, p=0.026). The incremental AUC for FFA was also greater in the NB compared to B condition (-92980±16973 vs -26008±27764 µEq/Lx180 min, p<0.001), suggesting it was not the pre-lunch FFA driving the increased AUC. Pre-lunch TG were lower in NB compared to B (85.7±37.8 vs 121.4±39.7 mg/dL, p=0.00954). TG total AUC was lower in the NB compared to B condition (17352±8484 vs. 24060±7147 mg/dLx180 min, p=0.0293), but the incremental AUC did not differ by condition, suggesting the difference was driven by the pre-lunch TG levels. The results of this study indicate that, in obese women, skipping breakfast results in acute relative insulin resistance, as indicated by the increased insulin AUC in NB. Additionally, the increased FFA AUC in NB suggests insulin resistance at the level of adipose tissue, as lipolysis is not appropriately down-regulated despite the higher insulin levels. In summary, these results indicate that skipping breakfast may contribute to the development of insulin resistance, which may predispose to further metabolic derangements and possibly progression to type 2 diabetes mellitus.

Nothing to Disclose: EAT, JLB, JH, MAC

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: 1. Fellows Development Research Grant Program in Diabetes, Obesity and Fat Cell Biology. Endocrine Fellows Foundation. Thomas (PI).  5/1/2012 – 4/30/2013.   2.  NORC Pilot Project 5P30DK048520 Nutrition Obesity Research Center.  Thomas (PI).  8/2012 – 7/2013.