Diabetics: 2 vs. 6 Meals a Day

Fresh groceries in a paper bag with weight scale
Are you a type 2 diabetic struggling to eat six daily meals? Research shows that two large meals of breakfast and lunch are better than six small meals with the same number of total calories in a day for diabetics. Two larger meals actually help control weight and blood sugar for those with type 2 diabetes. The research was conducted by Dr. Hana Kahleov√° and colleagues of the Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic and was published in the journal of the European Association for the Study of Diabetes, Diabetologia.

A total of 54 patients that were between 30-70 years of age being treated with oral diabetes drugs were assessed for this study. Their BMI was between 27-50 and their HbA1c (glycated hemoglobin) was between 6 to 11.8%. The patients were divided into two groups of 27, and each group was asked to follow one of two calorie restricted diet regimens for 12 weeks before moving on to the other program for another 12 weeks. Both diets contained 500 less calories than the recommended daily amount. The difference is that one of the diets contained two meals (B2) whereas the other one contained six meals (A6) a day. In the cross-over trial, the B2 group’s two meals were only breakfast and lunch. Both diets were composed of equal macronutrient and caloric content. Using a variety of mathematical modelling and techniques, insulin sensitivity, pancreatic beta cell function (the cells that produce insulin), and liver fat content were measured.

What the researchers found was that bodyweight was reduced in both regimens. However, a bit more weight (3.7 kg or 8.2 pounds) was lost in the B2 group than the A6 group (2.3 kg or 5.1 pounds). Liver fat content also decreased more in the B2 group. Similarly, fasting plasma glucose and C-peptide levels also decreased to a greater extent in the B2 regime, but increased in the A6 group. Moreover, oral glucose insulin sensitivity increased for both diets, but more for the B2 group. No adverse events were found in either of the regimes.

What did the authors conclude? Eating only breakfast and lunch such as those in the B2 group is better than the same caloric restriction split into six meals as seen in the A6 diet. Participants who ate only two daily large meals reduced their bodyweight, fat content in their livers, fasting blood glucose, C-peptide and glucagon, and increased their insulin sensitivity more than those who ate six small meals per day. They add that therapy strategies should focus on the frequency and timing in addition to the energy and macronutrient content of food. Further larger, long-term research is essential before they are able to offer recommendations of meal frequency.

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