Reducing A1C With a High Protein-High Fat Breakfast

As is the case for most people, for those with type 2 diabetes, breakfast arguably is the most important meal of the day. Research suggests starting the day with a substantial meal that's relatively high in fat and protein and low in carbohydrates can help to improve blood sugar control throughout the day and aid in weight loss.

Plate with an egg, ham, and a tomato on it
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In one randomized study, participants ate either a small, high-carb breakfast or a larger, high protein/high fat breakfast for three months that provided about 33% of total daily calories. The people who ate the high protein/high fat breakfast had greater reductions in hemoglobin A1C (a measure of blood glucose levels over three months) as well as in systolic blood pressure than those who ate high carb breakfasts

What's more, nearly all of the people with type 2 diabetes who were overweight who were in the big-breakfast group were able to reduce their reliance on medications. 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 achieved lower blood pressure and reduced their reliance on medications, 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 bloodstream and less insulin needed. The end result is better blood sugars. Last, 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.

Applying These Findings

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 30 grams of healthy-source 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 - particularly for breakfast. Fiber helps to slow the rate at which glucose enters the bloodstream, 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, 30-gram Carbohydrate Breakfast:

Below are some examples of ideal breakfast options for people with diabetes, but be sure to consult with your Registered Dietitian or Physician before starting any new meal plan as individual needs do vary:

  • 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 
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  1. Rabinovitz HR, Boaz M, Ganz T, et al. Big breakfast rich in protein and fat improves glycemic control in type 2 diabetics. Obesity (Silver Spring). 2014;22(5):E46-E54. doi:10.1002/oby.20654

  2. American Heart Association. Whole grains, refined grains and dietary Fiber. Updated September 2016.