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    Betts, James A. Chowdhury, Enhad A. Gonzalez, Javier T. Richardson, Judith D. Tsintzas, Kostas and Thompson, Dylan 2016. Is breakfast the most important meal of the day?. Proceedings of the Nutrition Society, p. 1.

    Chowdhury, E A Richardson, J D Tsintzas, K Thompson, D and Betts, J A 2016. Effect of extended morning fasting upon ad libitum lunch intake and associated metabolic and hormonal responses in obese adults. International Journal of Obesity, Vol. 40, Issue. 2, p. 305.

    Clayton, David J. and James, Lewis J. 2016. The effect of breakfast on appetite regulation, energy balance and exercise performance. Proceedings of the Nutrition Society, Vol. 75, Issue. 03, p. 319.

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    Dhurandhar, Emily J. 2016. True, true, unrelated? A review of recent evidence for a causal influence of breakfast on obesity. Current Opinion in Endocrinology & Diabetes and Obesity, Vol. 23, Issue. 5, p. 384.

    Emilien, Christine H. West, Robert and Hollis, James H. 2016. The effect of the macronutrient composition of breakfast on satiety and cognitive function in undergraduate students. European Journal of Nutrition,

    Gonzalez, Javier T. 2016. Effect of breakfast omission: Constrained to morning?. Nutrition, Vol. 32, Issue. 2, p. 287.


Carbohydrate-rich breakfast attenuates glycaemic, insulinaemic and ghrelin response to ad libitum lunch relative to morning fasting in lean adults

  • Enhad A. Chowdhury (a1), Judith D. Richardson (a1), Kostas Tsintzas (a2), Dylan Thompson (a1) and James A. Betts (a1)
  • DOI:
  • Published online: 25 May 2015

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.

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      Carbohydrate-rich breakfast attenuates glycaemic, insulinaemic and ghrelin response to ad libitum lunch relative to morning fasting in lean adults
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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*Corresponding author: Dr J. A. Betts, fax +44 1225 383833, email
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