Was there a particular reason that breakfast was the meal you chose to focus on for this study?
Dr Sarah Berry For the PREDICT study we had two components. One was a tightly controlled clinic day, where people were attending our clinic in the UK at St Thomas’ Hospital, or the clinic in the USA at Massachusetts General Hospital in Boston. And we gave them what we call a ‘metabolic challenge meal’ – a standardised, high-fat, high-carb meal for breakfast, in the form of a muffin and a milkshake. Then we gave them a standardised lunch to really stress their systems so we could start to differentiate people’s responses.
Then they entered a two-week at-home phase where they were fitted with various wearable technology, such as a continuous glucose monitor. During the at-home phase we provided them with standardised breakfasts with different macronutrient compositions for the whole two weeks. They differed each day in terms of the fat, protein, carbohydrate and fibre content. By giving it to them as a breakfast, it meant that everyone came to them standardised, as they’d all fasted overnight. We asked them to avoid exercise, because we know exercise can modulate your glycaemic response. Then, after three hours, they were allowed to eat freely, whichever meals they wanted, and we call this ad libitum. This way we could also look in a very real-life context, as well as in this tightly controlled context.
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