Two Meals Beat Six for Diabetes Patients

Diabetes patients may better control weight and blood sugar eating two big meals instead of six small ones

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Some diabetes patients believe eating five or six small meals a day helps control weight and boost metabolism. More evidence, however, is challenging the benefits of this meal plan.

Eating more, smaller meals throughout the day has been seen as a way to stimulate the metabolism, which is the physical and chemical processes in the body that convert or use energy.

While some studies have suggested that eating smaller meals may lead to modest health improvements, new research has shown that eating two large meals a day — breakfast and lunch — may be better for managing weight and blood sugar than consuming six smaller meals for patients with diabetes.

"Exercise regularly to boost your metabolism."

Hana Kahleová, MD, with the Diabetes Centre, Institute for Clinical and Experimental Medicine in Prague, Czech Republic, and colleagues evaluated 29 men and 25 women with diabetes, ranging in age from 30 to 70.

These participants were asked to follow one of two dietary regimens. Each eating plan had 500 fewer calories per day than the recommended amount. Over the course of 12 weeks, one group of 27 ate six small meals spread throughout the day, while the other ate only a large breakfast and a large lunch.

The calorie-restricting diets produced weight loss in both groups, but the two-meal-a-day patients lost more — an average of 8 pounds versus 5 pounds in the other group.

While liver fat content dropped in both groups, the two-meal patients had a 0.04 percent decrease compared to a 0.03 percent decrease for the six-meal eaters. Fat buildup in the liver inhibits the organ's ability to help regulate blood sugar in the body.

The two-meal participants also experienced greater decreases in fasting plasma glucose and C-peptide (an indicator of insulin production). In patients with type 2 diabetes, C-peptide levels may be high as the pancreas works harder to produce more insulin to overcome insulin resistance (when the body does not use insulin effectively). Insulin is hormone made by cells in the pancreas that helps glucose enter the body's cells so it can be used for energy.

Fasting plasma glucagon, which is a hormone that causes the liver to release glucose (blood sugar) into the bloodstream, decreased on the two-meal schedule, but increased on the multi-meal plan. Oral glucose insulin sensitivity (the body’s ability to use insulin) rose in both groups, but more in for the two-meal patients.

Dr. Kahleová told dailyRx News, "Our results support the ancient proverb: Eat breakfast like a king, lunch like a prince and dinner like a pauper."

Because there were no differences in caloric intake, nutrition or energy expenditure between the two groups, Dr. Kahleová theorized that eating meals later in the day may influence weight loss.

“A potential mechanism explaining this [weight loss] difference is that food intake timing can influence the circadian system [physical, mental and behavioral changes that follow a roughly 24-hour cycle],” said Dr. Kahleová in an interview with dailyRx News.

This study was published in May in Diabetologia, the journal of the European Association for the Study of Diabetes. This study was supported by the Ministry of Health, Prague, Czech Republic and by the Grant Agency of Charles University.

Review Date: 
May 15, 2014
Last Updated:
May 19, 2014