What's for Breakfast? It Matters With Diabetes

Breakfast is often touted as the most important meal of the day. If you have diabetes and prefer cereal for your morning meal, choosing a hot cereal like Cream of Wheat, especially when eaten with protein and fat, may help stabilize your blood sugar levels.

When it comes to choosing your breakfast with diabetes in mind, "hot cereals are preferred over cold cereals because cold cereals tend to raise blood sugars more than hot cereals, like Cream of Wheat," explains Leigh Tracy, RD, CDE, a dietitian and certified diabetes educator at the Center for Endocrinology at Mercy Medical Center in Baltimore.

Still, she adds, it's important to add protein and some fat when eating hot cereals to help slow down the rise of blood sugar. A small study, published online in April 2019 in the ​American Journal of Clinical Nutrition​, found that when participants ate a high-fat, low-carb breakfast of an omelet, they did not have the after-breakfast blood sugar spike experienced when they ate oatmeal and fruit for breakfast.

"If people really want to eat cold cereal," Tracy adds, "I suggest they switch from using milk to using unsweetened milk alternatives like unsweetened almond milk, which has little to no carbohydrates."

Breakfast also may play a role in diabetes prevention. A review of six studies, published in the ​Journal of Nutrition​ in January 2019, found that if you consume a healthy breakfast, you may lower your risk for developing type 2 diabetes altogether. The more days (up to five) that individuals skipped breakfast, the higher their risk for developing type 2 diabetes, independent of their body mass index.

The study also noted that skipping breakfast may be associated with other unhealthy habits that raise diabetes risk, such as lack of exercise or smoking, among others.

​Read more:​ Cereal Can Be a Healthy Breakfast — as Long as You Choose the Right Box

Though protein, fat and carbs all directly affect your blood sugar, carbohydrates can spike your levels faster and higher than the others, according to the Centers for Disease Control and Prevention. Hence, people with diabetes often count carbs via what's known as the glycemic index (GI) — a scale that ranks foods from 0 to 100 based on how quickly or slowly the carbs they contain affect your blood sugar, with 100 being the most dramatic effect a food can have on blood sugar.

Cream of Wheat has a moderate GI score (56 to 69), according to Harvard Health Publishing, "which is one of the reasons why I suggest people add foods with protein and some fat to the meal to help lower the GI," says Tracy. "Since protein and fat help to slow down the digestion of food, adding it to meals and snacks is a good idea."

As healthy alternatives, rolled or steel-cut oatmeal, oat bran and muesli are lower on the GI than Cream of Wheat and considered low GI items (55 or less), according to the National Library of Medicine.

If you have diabetes, the best breakfast choices, says Tracy, are high-fiber cereals with 5 grams or more per serving of fiber. Mayo Clinic explains that fiber slows the absorption of sugar, which can help improve your blood sugar levels. The federal government's Dietary Guidelines for Americans sets a goal of consuming a minimum of 14 grams of fiber per 1,000 calories, noting that most people don't consume that much.

To add more fiber to your diet, consider selecting cereals that have "fiber," "whole grain" or "bran" in their name, or add unprocessed wheat bran to your bowl of cereal to pump up the fiber content, suggests the Mayo Clinic. The nutrition information label on Original Cream of Wheat indicates that it has 1 gram of fiber per serving, but Whole Grain Cream of Wheat has 5 grams of fiber per serving, according to the Cream of Wheat manufacturer, B&G Foods.

Tracy suggests that if you have questions about the best breakfast choices, ask a registered dietitian or certified diabetes educator for suggestions.

​Read more:​ 11 Protein-Packed Breakfasts to Power You Through the Morning