In the past, people with diabetes were put on very restrictive calorie-controlled diets that were divided into six small meals. However, we now know there is no one-size that fits all and six meals daily does not always result in improved outcomes.
“This study shows that, in obese insulin-treated type 2 diabetes patients, a diet with three meals per day, consisting of a big breakfast, average lunch and small dinner, had many rapid and positive effects compared to the traditional diet with six small meals evenly distributed throughout the day: better weight loss, less hunger and better diabetes control while using less insulin,” said lead study author Daniela Jakubowicz, M.D., professor of medicine at Tel Aviv University, in a press release.
“The hour of the day—when you eat and how frequently you eat—is more important than what you eat and how many calories you eat,” she noted. “Our body metabolism changes throughout the day. A slice of bread consumed at breakfast leads to a lower glucose response and is less fattening than an identical slice of bread consumed in the evening.”
The study participants consisted of 11 women and 18 men who were obese with type 2 diabetes. They were all beingtreated with insulin and averaged 69 years of age. The patients were put on two different weight loss diets for three months. However, the calories were the same on both diets. Group one ate three meals: a large breakfast, a medium-sized lunch, and a small dinner. The second group ate the traditional diet for diabetes and weight loss: six small meals evenly spaced throughout the day, including three snacks.
The overall glucose levels and glucose spikes of participants were measured during the first two weeks on the diet, and at the end of the study by continuous glucose monitoring. Insulin dosage was adjusted as needed.
At three months, group one lost 11 pounds while the second group eating the traditional diabetes diet gained 3 pounds. Fasting glucose levels decreased 54 mg/dl (from 161 to 107) in group one, and they required significantly less insulin. Fasting glucose levels in the second group only decreased 23 mg/dl (from 164 to 141), and they needed more insulin. Moreover, carbohydrate craving and hunger decreased significantly in group one but increased in the second group.
Importantly, even before there was significant weight loss, participants in group one had a substantial reduction of blood glucose. This finding suggests that even before weight loss, a change in the meal timing itself has a quick beneficial effect on glucose balance that is further improved by weight loss.
“A diet with adequate meal timing and frequency has a pivotal role in glucose control and weight loss,” Jakubowicz observed.
Bottom line. What you choose to eat, how much you eat, and when you eat are all important in weight loss and keeping your blood glucose level in the range that your healthcare team recommends. So, go ahead, eat breakfast like a king, lunch like a queen and dinner like a pauper.
Constance Brown-Riggs, is a registered dietitian, certified diabetes educator, national speaker and author of the Diabetes Guide to Enjoying Foods of the World, a convenient guide to help people with diabetes enjoy all the flavors of the world while still following a healthy meal plan. Follow Constance on social media @eatingsoulfully