Bath Breakfast Project (BBP) - Examining the Role of Extended Daily Fasting in Human Energy Balance and Associated Health Outcomes: study protocol for a randomised controlled trial [ISRCTN31521726].

James A Betts, Dylan Thompson, Judith D Richardson, Enhad A Chowdhury, Matthew Jeans, Geoffrey D Holman, Kostas Tsintzas

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Abstract

Background: Current guidance regarding the role of daily breakfast in human health is largely grounded in cross-sectional observations. However, the causal nature of these relationships has not been fully explored and what limited information is emerging from controlled laboratorybased experiments appears inconsistent with much existing data. Further progress in our understanding therefore requires a direct examination of how daily breakfast impacts human health under free-living conditions.

Methods/Design: The Bath Breakfast Project (BBP) is a randomised controlled trial comparing the effects of daily breakfast consumption relative to extended fasting on energy balance and human health. Approximately 70 men and women will undergo extensive laboratory-based assessments of their acute metabolic responses under fasted and post-prandial conditions, to include: resting metabolic rate, substrate oxidation, dietaryinduced thermogenesis and systemic concentrations of key metabolites/hormones. Physiological and psychological indices of appetite will also be monitored both over the first few hours of the day (i.e. whether fed or fasted) and also following a standardised test lunch used to assess voluntary energy intake under controlled conditions. Baseline measurements of participants’ anthropometric characteristics (e.g. DEXA) will be recorded prior to intervention, along with an oral glucose tolerance test and acquisition of adipose tissue samples to determine expression of key genes and estimates of tissue-specific insulin action. Participants will then be randomly assigned either to a group prescribed an energy intake of ≥3000 kJ before 1100 each day or a group to extend their overnight fast by abstaining from ingestion of energy-providing nutrients until 1200 each day, with all laboratory-based measurements followed-up 6 weeks later. Freeliving assessments of energy intake (via direct weighed food diaries) and energy expenditure (via combined heart-rate/accelerometry) will be made during the first and last week of intervention, with continuous glucose monitors worn both to document chronic glycaemic responses to the intervention and to verify compliance.

Trial registration: Current Controlled Trials ISRCTN31521726.

LanguageEnglish
Article number172
JournalTrials
Volume12
DOIs
StatusPublished - Jul 2011

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Breakfast
Baths
Fasting
Randomized Controlled Trials
Energy Intake
Outcome Assessment (Health Care)
Health
Accelerometry
Diet Records
Basal Metabolism
Lunch
Social Conditions
Appetite
Glucose Tolerance Test
Energy Metabolism
Compliance
Meals
Adipose Tissue
Eating
Heart Rate

Cite this

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title = "Bath Breakfast Project (BBP) - Examining the Role of Extended Daily Fasting in Human Energy Balance and Associated Health Outcomes: study protocol for a randomised controlled trial [ISRCTN31521726].",
abstract = "Background: Current guidance regarding the role of daily breakfast in human health is largely grounded in cross-sectional observations. However, the causal nature of these relationships has not been fully explored and what limited information is emerging from controlled laboratorybased experiments appears inconsistent with much existing data. Further progress in our understanding therefore requires a direct examination of how daily breakfast impacts human health under free-living conditions. Methods/Design: The Bath Breakfast Project (BBP) is a randomised controlled trial comparing the effects of daily breakfast consumption relative to extended fasting on energy balance and human health. Approximately 70 men and women will undergo extensive laboratory-based assessments of their acute metabolic responses under fasted and post-prandial conditions, to include: resting metabolic rate, substrate oxidation, dietaryinduced thermogenesis and systemic concentrations of key metabolites/hormones. Physiological and psychological indices of appetite will also be monitored both over the first few hours of the day (i.e. whether fed or fasted) and also following a standardised test lunch used to assess voluntary energy intake under controlled conditions. Baseline measurements of participants’ anthropometric characteristics (e.g. DEXA) will be recorded prior to intervention, along with an oral glucose tolerance test and acquisition of adipose tissue samples to determine expression of key genes and estimates of tissue-specific insulin action. Participants will then be randomly assigned either to a group prescribed an energy intake of ≥3000 kJ before 1100 each day or a group to extend their overnight fast by abstaining from ingestion of energy-providing nutrients until 1200 each day, with all laboratory-based measurements followed-up 6 weeks later. Freeliving assessments of energy intake (via direct weighed food diaries) and energy expenditure (via combined heart-rate/accelerometry) will be made during the first and last week of intervention, with continuous glucose monitors worn both to document chronic glycaemic responses to the intervention and to verify compliance. Trial registration: Current Controlled Trials ISRCTN31521726.",
author = "Betts, {James A} and Dylan Thompson and Richardson, {Judith D} and Chowdhury, {Enhad A} and Matthew Jeans and Holman, {Geoffrey D} and Kostas Tsintzas",
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T1 - Bath Breakfast Project (BBP) - Examining the Role of Extended Daily Fasting in Human Energy Balance and Associated Health Outcomes: study protocol for a randomised controlled trial [ISRCTN31521726].

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AU - Thompson,Dylan

AU - Richardson,Judith D

AU - Chowdhury,Enhad A

AU - Jeans,Matthew

AU - Holman,Geoffrey D

AU - Tsintzas,Kostas

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