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Diabetes is a health condition that involves two things: (1) sugar and (2) your body’s ability to process it. Diabetes is a very common disease that affects over 34.2 million people in the USA alone! 34.1 out of the 34.2 million were aged 18 years and older, a whopping 13 percent of adults in the United States in 2018. What’s even scarier is that 21.4 percent of diabetics did not know they had diabetes and likely did not know how to adjust their lifestyles, namely their diets, to manage the condition.  Diabetes was responsible for around 1.5 million deaths (worldwide) in 2019.
To further explain what diabetes is and how it affects your body, you have to know what specific organ in the body it targets. Diabetes mellitus is a disease that affects the pancreas. The pancreas is an organ that is found in your abdomen, just below your liver. It’s pretty flat, roughly 6 inches long, and its main function is to produce insulin. 
There is a common misconception that insulin is a drug or medication given only to diabetics to help control their blood sugar. Insulin is not just a man-made drug, it is a naturally occurring hormone that regulates the amount of glucose or sugar in the blood. When our body absorbs glucose from the carbohydrates in our food, insulin works by allowing the glucose to enter our cells. The glucose is then used and turned into energy. 
In diabetes, your pancreas is unable to produce enough insulin to meet the demands of your body. Without enough insulin, glucose remains circulating in our bloodstream instead of being used by our cells, causing very high blood sugar levels.
Type 1 and Type 2 Diabetes: There are two types of diabetes. Type 1 is less common and is characterized by an auto-immune process, wherein the body’s immune system starts attacking the cells in the pancreas that produces insulin. A person with type 1 diabetes has little to no insulin to regulate their blood glucose levels.
Type 2 is more common, affecting 90-95% of people diagnosed with diabetes. In Type 2 diabetes, there are two problems: (1) Your pancreas does not produce enough insulin to meet the requirements of the body and (2) your cells do not respond adequately to the insulin, making them unable to absorb the glucose in your blood. A mix of genetic and environmental factors are thought to cause both types of diabetes, including one the biggest risk factors: Diet. 
For many people, breakfast is the most important meal of the day. It helps kickstart your metabolism and gives you enough energy to do your daily tasks. However, not all breakfast food is created equally – especially for diabetics. We reviewed the important video by popular “health Youtuber” Ken D Berry, MD – and added significant notes / scientific study references to help you understand in-depth the best and the worst choices are for your first meal of the day.
The 5 Best Breakfasts For Diabetics
One of the suggested diets for diabetics is the Mediterranean diet, which suggests eating an egg a day (limiting to four eggs, or specifically four egg yolks, per week if you have high cholesterol). Eggs in particular are a great source of nutrients, especially essential fatty acids and amino acids. They are high in omega-3 fatty acids, which help boost cardiovascular health by lowering cholesterol levels and protecting the walls of our arteries. Essential amino acids are very important players in our diet because our body does not produce them naturally and we have to source them from food.
There are 20 amino acids altogether, and nine of them are regarded as “essential”. Did you know that eggs contain all nine of the essential amino acids? They have lysine, histidine, leucine, isoleucine, methionine, threonine, phenylalanine, tryptophan and valine! All of these help with important processes in the body, like cell and tissue repair and immunity. 
For years, eggs have been given a bad rep because older studies showed that they can increase your risk for heart disease or diabetes. However, more recent studies have been showing the opposite. Geiker, et. al. found that the risk factor for diabetes and heart disease previously attributed to eggs was actually because of dietary intake of other food typically eaten with eggs, like bread which is high in carbohydrates, and other risk factors like having a sedentary lifestyle (which led to weigh gain). The researchers’ final recommendation included up to seven eggs per week, provided that a person practices a holistic lifestyle that includes exercise as well. 
In another study, Richard, et. al. found that consuming 6 to 12 eggs weekly did not have a significant effect on fasting glucose, insulin or c-reactive protein, or cholesterol. In fact, consuming eggs actually increased HDL (high density lipoproteins), also known as “good cholesterol”. Furthermore, the study concluded that a diet with 6 to 12 eggs per week did not increase the risk for cardiovascular disease among people with pre-diabetes and diabetes mellitus.  Similarly, Mozaffarian recommended considering eggs as healthier alternatives to harmful foods like grains and carbohydrates. 
The advent of Instagram brought with it a millennial and Gen-Z favorite – avocado toast! While bread is something you would want to skip if you are diabetic, definitely give avocados a try. Similar to eggs, avocados are a good source of essential fatty and amino acids – omega-3s and 8 of the 9 essential amino acids. They are also great for promoting cardiovascular health and can actually help with weight loss. Avocado has only 8 grams of carbs per 100g serving.
In the context of diabetes, innovative research has been done on avocados and showed how they can actually help reduce post-prandial hyperglycemia or the elevation in blood sugar that occurs after eating: A recent study published by Abd Elkader, et. al. in November 2021 focused on the polyphenols from avocados, which are micronutrients though to help with oxidative stress (or “cell stress”) and inflammation, two major contributors to chronic disease. The active polyphenols from avocados showed that they could actually be used therapeutically in managing hyperglycemia, meaning they could potentially be used in the treatment of diabetes. The study concluded that the avocado fruit inhibited an enzyme called α-amylase, which is responsible for breaking down carbohydrates from food and turning into glucose. The inhibition of this particular enzyme slowed the process of turning carbohydrates into glucose, causing lower-blood sugar levels after eating. 
The result of Abd Elklader, et. al’s study was also seen in an earlier study published by Ezejiofor, et. al. in 2013, wherein the avocados were shown to have both hypoglycemic, or glucose-lowering, and tissue-protective effects on diabetic rats. 
Bacon is a complicated food choice because while it tastes great, people sometimes shy away from it because of its fat and sodium content. However, it has a strong amino acid profile – and the fearmongering surrounding bacon is slowly being trumped by studies showing that intake of saturated fat is not associated with diabetes or cardiovascular disease. Souza, et. al. in 2015 found that saturated fat intake was not linked to mortality due to heart disease or incidences of heart disease, ischemic stroke, or diabetes.  In 2010, Siri-Tarino, et. al. had similar results with their meta-analysis; there was no significant association between saturated fat intake and the risk for heart disease. 
For diabetics, bacon is a good choice because it has almost zero carbohydrates (the actual amount is 2.1 grams per 100 grams of bacon) and is a great source of protein, which is the building block of our cells and tissues. In fact, eating a lot of bacon won’t raise your post-prandial blood glucose levels by much, if at all, making it an excellent breakfast choice. Pasture-raised bacon will be higher in the vitamins, minerals and EFAs your body needs. 
A good breakfast steak is another great option of diabetics – for the same reason bacon is. Steak, or any cut of meat, is the best source for dietary protein to help rebuild our cells and tissues. In some ways, it is better than bacon in terms of nutritional content because it has no carbohydrates and has minimal sodium as well. Steak is also a good source of potassium, approximately 300mg per 100 grams of beef steak – roughly the same as a banana. Protein is definitely the way to go if you want to skip carbohydrates in the morning. 
5. Greek Yogurt With Nuts
Yogurt is a crowd favorite when talking about healthier food alternatives. Not only is it a great snack, but it can also be a great breakfast choice for people with diabetes. Added nuts will add extra nutrients. One factor to consider when choosing yogurt is that historically, yogurt and other fermented foods have been thought to help reduce the risk for chronic disease, including diabetes. The microorganisms found in these types of food, typically called probiotics, improve gut health and reduce inflammation and oxidative stress, both contributors to chronic disease. 
In 2017, Salas-Salvado, et. al., found that intake of yogurt was associated with a decreased risk for type 2 diabetes. These results were reflected in 13 observational studies, with the most recent showing a 14 percent risk reduction among people who ate yogurt versus people who did not eat yogurt at all. The probiotics in yogurt could potentially regulate glucose metabolism and decrease blood sugar levels in the body, in both healthy and older individuals with high risk for cardiac health problems. 
The 5 Worst Breakfasts For Diabetics
1. Oatmeal (?)
While oats are generally seen as a healthy food, they do contain significant levels of carbohydrates (66 grams per 100 grams of oatmeal), which get turned into glucose, spiking your blood sugar. This is seen as “good enough” by Ken Berry MD, however we actually think that oatmeal is a better alternative for people with diabetes than white bread, pancakes, and other cereals. 
Various studies have shown the benefits of including oatmeal in your diet if you are diabetic: In July 2020, a prospective study by Hu, et. al. found that eating oatmeal and whole grain food in general over a 10-year period was able to reduce the risk for type 2 diabetes.  A similar study by Delgado, et. al. in August 2018 focused on short-term effects of eating oatmeal, specifically on its effects on insulin resistance and glucose metabolism. After two days of dietary adjustment, the researchers concluded that oatmeal was able to reduce the required insulin doses of the participants, while maintained adequate control of their blood sugar. A follow up done four weeks later also revealed lower HbA1c levels, another good marker for better glycemic control. 
There is one further danger of perceiving oatmeal as a healthy breakfast: The tendency to add unhealthy choices like sugar, syrup, or fruit to your meal in order to make it taste better. This adds even more carbohydrates to your intake, causing an even higher post-prandial blood sugar level. So if you’re going to eat oatmeal, just stick to plain oats and avoid the syrup.
While a banana may have 350mg of potassium, it has a high 22 grams per 100 grams of carbohydrate. Compare this to avocados which have less carbohydrates per 100 grams, only 9 grams, compared to a banana’s 23 grams. While bananas have a pretty low glycemic index value (around 51), the high-carb content makes it way short of ideal. 
3. English Muffin
If there was a food item to avoid as a diabetic, it would be any bread or pastry – English muffins included! You might think they’re a healthier alternative to plain white sandwich bread, but you would be wrong. A hundred grams of English muffin actually contain a huge 46 grams of carbohydrates – carbs that your body turns into glucose, which spikes blood sugar and fructose, which puts fat in your liver. On top of that, English muffins are very often eaten with jam or conserves, which contain a high proportion of table sugar! A very bad combination for people with diabetes. 
You might think that muesli is one of those “automatically healthy foods”, with pristine alpine slopes in every spoonful, but hold it right there. Muesli’s glycemic index can range from low to high, depending on the ingredients. Muesli sometimes has much added sugar, depending on the brand. For example, the first one on the USDA FoodData list, Safeways Signature Select, has 26.3g of sugars per 100 grams! It should be fairly obvious why this “health food” would be a disaster for diabetics (and those hoping to avoid becoming diabetic)… It’s a carb fest! The dried fruit in muesli is often sweetened as well, as part of their preservation process (and to “improve” the palatability of muesli), adding unnecessary sugar intake to your diet. 
5. “Boxed Cereal” With Skim Milk
Speaking of cereals, let’s look at boxed cereals in general. Not only is boxed cereal typically very high in carbohydrates (looking at the USDA list, we found one with an astonishing 86g of carbs per 100 grams of cereal), it also typically contains a large quantity of sugar (or a variety of it). Ken Berry MD regards boxed cereal with skimmed milk as the absolute “worst of the worst”. 
This has some backing in science: In 2019, a study Xu, et. al actually found a positive association between the intake of cereal and type 2 diabetes among people 80 years old and younger, meaning people who ate cereal for breakfast were found more likely to develop diabetes than people who didn’t. 
Beyond contributing to your daily caloric intake, cereal has nothing much to add to your diet, which is why they are typically advertised as being fortified with vitamins and minerals to make them seem like a healthier breakfast choice. It typically contains ultra-processed grains, Basically, you’re paying for a box of empty calories and table sugar – a very unhealthy choice for diabetics.  It gets worst when you combine this with the lactose in milk, which breaks down into glucose, fructose and galactose, which all spike blood sugar and encourage the storage of fat in the liver.
Dr. Berry ends the video with an interesting thought – why not skip breakfast altogether? Skipping breakfast helps you keep your blood sugar low and encourages normalized insulin levels.
The 5 Best & Worst Breakfasts for Diabetics Graphic © healthpowerboost.com. Egg Illustration: Pixabay (PD)
 US Department of Health and Human Services. National Diabetes Statistics Report 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
 Johns Hopkins Medicine. The Digestive Process: What Is the Role of Your Pancreas in Digestion? https://www.hopkinsmedicine.org/health/conditions-and-diseases/the-digestive-process-what-is-the-role-of-your-pancreas-in-digestion
 Mayo Clinic. Diabetes treatment: Using insulin to manage blood sugar. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-treatment/art-20044084
 Mayo Clinic. Diabetes. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
 Geiker, N., et. al. (2018) Egg consumption, cardiovascular diseases and type 2 diabetes. https://pubmed.ncbi.nlm.nih.gov/28952608/
 Richard, C., et. Al. (2017). Impact of Egg Consumption on Cardiovascular Risk Factors in Individuals with Type 2 Diabetes and at Risk for Developing Diabetes: A Systematic Review of Randomized Nutritional Intervention Studies. https://pubmed.ncbi.nlm.nih.gov/28359773/
 Mozaffarian, D. (2017). Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity – A Comprehensive Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814348/
 Abd Elkader, A., et. al. (2021). Phytogenic compounds from avocado (Persea americana L.) extracts; antioxidant activity, amylase inhibitory activity, therapeutic potential of type 2 diabetes. https://www.sciencedirect.com/science/article/pii/S1319562X21009979
 Ezejiofor, A., et. al. (2013). Hypoglycaemic and tissue-protective effects of the aqueous extract of persea americana seeds on alloxan-induced albino rats. https://pubmed.ncbi.nlm.nih.gov/24643349/
 Souza, R., et. al. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. https://pubmed.ncbi.nlm.nih.gov/26268692/
 Siri-Tarino, P., et. al. (2010). Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. https://pubmed.ncbi.nlm.nih.gov/20071648/
 Food Data Central (US Department of Agriculture). Pork, cured, bacon, cooked, restaurant. https://fdc.nal.usda.gov/fdc-app.html#/food-details/749420/nutrients
 Food Data Central (US Department of Agriculture). Beef, short loin, t-bone steak, bone-in, separable lean only, trimmed to 1/8″ fat, choice, cooked, grilled. https://fdc.nal.usda.gov/fdc-app.html#/food-details/746763/nutrients
 Kok, C. & Hutkins, R. (2018). Yogurt and other fermented foods as sources of health-promoting bacteria. https://pubmed.ncbi.nlm.nih.gov/30452699/
 Salas-Salvado, J. (2017). Yogurt and Diabetes: Overview of Recent Observational Studies. https://pubmed.ncbi.nlm.nih.gov/28615384/
 Food Data Central (US Department of Agriculture). Oatmeal. https://fdc.nal.usda.gov/fdc-app.html#/food-details/1995469/nutrients
 Hu, Y., et. al. (2020). Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies. https://pubmed.ncbi.nlm.nih.gov/32641435/
 Delgado, G., et. al. (2018). Dietary Intervention with Oatmeal in Patients with uncontrolled Type 2 Diabetes Mellitus – A Crossover Study. https://pubmed.ncbi.nlm.nih.gov/30157531/
 Food Data Central (US Department of Agriculture). Banana. https://fdc.nal.usda.gov/fdc-app.html#/food-details/1105314/nutrients
 Food Data Central (US Department of Agriculture). English muffin. https://fdc.nal.usda.gov/fdc-app.html#/food-details/2164374/nutrients
 The University of Sidney. Muesli. https://glycemicindex.com/2021/04/muesli/
 Food Data Central (US Department of Agriculture). Cereal. https://fdc.nal.usda.gov/fdc-app.html#/food-details/1628852/nutrients
 Xu, X., et. al. (2019). Can regular long-term breakfast cereals consumption benefits lower cardiovascular diseases and diabetes risk? A longitudinal population-based study. https://pubmed.ncbi.nlm.nih.gov/31378560/
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