Keeping blood sugar levels from rising too high after meals is one of the key goals for people who have diabetes. Now, a small new study from researchers at Weill Cornell Medical College suggests that, for obese people who have Type 2 diabetes, the order in which they eat their food may be an important tool to this end.
Earlier studies have shown that consuming whey protein prior to a meal or altering the balance of carbohydrate, fat, and protein in a meal can reduce after-meal blood sugar levels. To determine what impact the order in which food is eaten at a meal has on after-meal blood sugar, researchers recruited 11 obese people with Type 2 diabetes who were being treated with the oral medicine metformin.
On two separate days a week apart, the participants were given a typical Western meal consisting of vegetables, protein, carbohydrates, and fat in the form of chicken breast, steamed broccoli with butter, lettuce-and-tomato salad with low-fat dressing, ciabatta bread, and orange juice. Blood sugar and insulin levels were checked in the morning prior to eating and again at 30, 60, and 120 minutes after the meal.
For the first meal, the subjects were told to eat the carbohydrates first, followed by the protein, vegetables, and fat 15 minutes later. The following week, they were instructed to eat the protein, vegetables, and fat first, followed by the carbohydrates 15 minutes later.
The researchers found that, when carbohydrates were eaten last, the participants’ blood sugar levels were significantly lower at the 30-, 60-, and 120-minute after-meal checks (29%, 37%, and 17%, respectively), and insulin levels were substantially lower as well, compared to when the carbohydrates were eaten first.
“Based on this finding, instead of saying ‘don’t eat that’ to their patients,’ clinicians might instead say ‘eat this before that,” said lead study investigator Louis Aronne, MD. “While we need to do some follow-up work, based on this finding, patients with Type 2 might be able to make a simple change to lower their blood sugar throughout the day, decrease how much insulin they need to take, and potentially have a long-lasting, positive impact on their health.”
Limitations of the study include its small size and a follow-up period of only 120 minutes after each meal to analyze blood sugar and insulin levels. Future studies that involve a longer follow-up to determine the full impact of food order on blood sugar levels are necessary, the authors note.
For more information about the research, read the article “Food Order Has Significant Impact on Glucose and Insulin Levels” or see the study’s abstract in the journal Diabetes Care. And to learn more about preventing after-meal blood sugar spikes, see the article “Strike the Spike II,” by 2014 Diabetes Educator of the Year Gary Scheiner.