Eating 5-6 small meals/snacks instead of 2-3 large meals

[Lamont D]

If I said to you, I have done the eating every three hours diet as advised by my endocrinologist when first diagnosed.
I will tell you, that, first and foremost, it doesn't work, and is unsustainable because trying to find different ways to eat every day is a nightmare, and if you are still carbing, you will be in permanent spike or a high rollercoaster ride of blood glucose. You might find yourself obsessing about food.
If you have diabetes, you have carb intolerance, how much depends on your glucose levels and health.
I have total carb intolerance, so I get really ill when I come out of keto. Very low carb is effective in so many ways. And I have no doubt in my experience that the majority of people would benefit greatly by going on a very low carb program, designed for you, designed by you, your tastes, availability, affordability and more.
I also use intermittent fasting, I don't eat at all till mid afternoon, then in a four or five hour window, I have a couple of smallish meals. No food after seven pm. The reason is because I want to be in normal BG levels by bed time, I don't want to go hypo overnight.

Low carb food is great, not only do I have carb intolerance, I have had lactose intolerance (dairy) since very young. So I have had to adapt to eating what is healthy for me.
So called healthy food, such as porridge, wholemeal, brown pasta, brown rice and more, which was part of my recommended dietary regime from doctors, was actually killing me.
And if I hadn't , I wouldn't be advising you to go low carb

 

[Deleted member 567281]

I think those numbers might fall within the "normal" range - in that they predict an HbA1c in normal range . There's a calculator on the main website here.

It is of course possible for any of us to miss a high point, but the other thing is that a lower but longer rise can be problematic too. It's entirely normal for BGs to rise after eating - the real issue is how quickly they return to normal levels, because that shows how efficient your insulin is being at taking the glucose out of your blood.

So - I would expect if I was eating something flour-based to see a very rapid rise from around 5(ish) to maybe 8 after an hour and 11 or 12 after two, but dropping only slowly and maybe still at 6.5 or more the following morning. My system is good at making glucose out of flour and putting it into my blood, but rubbish at getting it out of my blood and into my cells.

"lower but longer rise can be problematic too" that's what I was wondering about! I'm reading Glucose Revolution at the moment (and following the author, a young woman, on Instagram). It's all about balancing BG to avoid spikes and flatten the curve. She's not even advocating low carb eating, just talking about the importance of the order you eat carbs/protein/fat/fibre. I haven't got too far into it, but I'm hoping it might answer that question.

Interesting info about your BG levels! I guess we all react differently and we just have to find what works best for us.

 

[Deleted member 567281]

Could you take a meter in your pocket.? I know you are supposed to wash hands before testing but in my experience as long as you wash them after eating it's usually not that critical.

I think you really need to know whether you are actually having hypos. (Reactive hypoglycemia is a thing and one of its possible causes is the carbs but other triggers are exercise and there are other causes for hypos as well). Also, I think you say in another thread that you haven't had an hba1c done yet?

A lot of the T2s here go very low carb because they need to in order to keep their levels down, and some do it because they find it easier to go very low rather than moderately low. Everyone makes their own choices to suit their own metabolism.

At the moment you don't really know whether you are prediabetic or whether you are having true hypos. Both those questions are very important.

That's true, I haven't got my levels tested yet. I've got a date for the end of Feb. When I mentioned my hypos to the GP, she didn't seem very concerned. I know it's reactive - it only ever happens 2+ hours after meals on my way home from work, which is a long walk. I'm also premenopausal, which could very well be a factor. Eating a small banana before I set off seems to help.

As for checking my levels in public - I don't think I can do that! It would be too awkward! Plus, when it happens I'm really shaky and I'm not sure I would manage. Luckily, it hasn't happened since I started my banana fix!

 

[Deleted member 567281]

Hi @Susan369 your profile says you are prediabetic, how high is your HbA1c?
Do you have any symptoms of diabetes, like thirsty, tingling feet, blurring vision?
If not you might only need small adjustments to what you eat.
There is a huge range on how many carbs T2 diabetics can tolerate,
so 150 g could be just fine for some where as for others, 20 g is the maximum.
You need to measure the impact of food.
As long as your BG numbers are around around 5 (possibly 6) before eating
and spikes 2 h after eating are less than 2 and don't continue to rise
you could be ok as you are never in the diabetic range.
It is normal that BG levels rise after eating.
I honestly think well-intentioned advice to go very low carb might be misplaced at this stage.
@Susan369 needs to find out for herself which part of her diet she can tolerate
and what is causing spikes.

Regarding your question on snacking. In my view there is no evidence
why eating often is better than eating up to 3 times a day and plenty to the contrary.
Basically snacking leads to more snacking and more total calories,
which could lead to gaining weight or too much carbs which could lead to diabetes.
Read the book Diabetes Code by Jason Fung if you want to know more.
In my experience stopping snacking was one of the low-hanging fruits
after my diagnosis. I was surprised how quickly I got used to it.
Consider switching to breakfast, lunch and dinner.
For intermittent fasting you can skip any of these.

When eating a whole meal one needs to make sure that
there is adequate fat and protein as fat is much more satiating,
than carbs, which will make you hungry again after two hours.
Compare eating an omelette with eating cornflakes for breakfast
if you want to do the experiment yourself

I haven't had my levels checked yet - currently waiting for my appointment. I had to choose something in my profile and that was the closest I could get. I guess a more accurate description would be "I suspect I might be prediabetic" I changed my diet and lifestyle over a year ago now - cut out added sugars and simple carbs - although I did fall off the wagon over Christmas, but not badly.

When I say I'm "snacking" - what I mean is that I'm distributing the same food intake over several smaller meals as I can't seem to eat too much in one go - also I'm a very slow eater. I don't actually eat more this way and it's mostly healthy, wholefood stuff.

 

[Deleted member 567281]

Just to answer my own question, I've found some information that is supported by clinical evidence. At the same time, I realise there could be other studies claiming the exact opposite. I think we'll just have to decide for ourselves and do what we think is best - the same thing will not work for everyone as our circumstances are different. In any case, I find this information quite reassuring:

"Spreading your meals and snacks throughout the day may help you avoid both high and low blood sugar levels (62Trusted Source).

Snacking between meals may also reduce your risk of type 2 diabetes (63Trusted Source).

In fact, several studies suggest that having smaller, more frequent meals throughout the day could improve insulin sensitivity and lower blood sugar levels (62Trusted Source, 64Trusted Source).

In addition, eating smaller meals and healthy snacks throughout the day may lower glycated hemoglobin (HbA1c) readings, indicating improvements in blood sugar levels over the previous 3 months (62Trusted Source).

14 Natural Strategies to Lower Blood Sugar Levels

From dietary adjustments to medicinal foods, here's what you need to know to manage blood sugar levels in a natural way.

www.healthline.com

 

[HSSS]

i think a lot of these are based on avoiding pigging out on rubbish at meal times because you’re hungry having not eaten satiating foods. its important to read the details of these claims and consider any limitations of the study. So many blog/articles give sweeping statements with little actual evidence.

The results and conclusions of 62 say “Increased eating frequency was associated with larger increases in HbA1c”. It’s also worth noting it’s mostly type 1 youths. The rest of the paper, including the bits you quote as discussion not evidence, show a myriad of conflicting opinions and results. Source 64 is also a study of type 1 who are typically not insulin resistant. In type 1 in particular hypo avoidance is an important consideration thus potentially higher overall levels are acceptable.

As ever what those meals consist of makes as much if not more difference than how frequent they are. There’s no reference to the content of the meals. Also a constant but high ish level is not as good as a Low ish level that varies a bit in Type 2.

I suspect you will continue frequent meals as that is what obviously is desirable and convenient for you. All I’d say is test as much as you can* and possibly spend a few weeks doing one method and a few doing fewer but more filing meals and compare your results before settling on a long term plan.

*why can’t you test on the way home when you get these funny turns. It’s guesswork without data. Find a quieter spot, turn your back on people for a little privacy etc. It only takes a minute or so. Most passers by wouldn’t even notice let alone care What’s more important, your health or a little awkwardness the first few times? Or a libre for a few weeks could solve that issue if you can stretch to funding one.

 

[pixie1]

I had a look at the link, If the advice is followed, I would imagine that it would be the best way of eating towards developing T2 diabetes.
I would recommend that you test when you feel as if you are having a hypo, you won't know until you test. Other wise its a guessing game.

 

[Deleted member 567281]

i think a lot of these are based on avoiding pigging out on rubbish at meal times because you’re hungry having not eaten satiating foods. its important to read the details of these claims and consider any limitations of the study. So many blog/articles give sweeping statements with little actual evidence.

The results and conclusions of 62 say “Increased eating frequency was associated with larger increases in HbA1c”. It’s also worth noting it’s mostly type 1 youths. The rest of the paper, including the bits you quote as discussion not evidence, show a myriad of conflicting opinions and results. Source 64 is also a study of type 1 who are typically not insulin resistant. In type 1 in particular hypo avoidance is an important consideration thus potentially higher overall levels are acceptable.

As ever what those meals consist of makes as much if not more difference than how frequent they are. There’s no reference to the content of the meals. Also a constant but high ish level is not as good as a Low ish level that varies a bit in Type 2.

I suspect you will continue frequent meals as that is what obviously is desirable and convenient for you. All I’d say is test as much as you can* and possibly spend a few weeks doing one method and a few doing fewer but more filing meals and compare your results before settling on a long term plan.

*why can’t you test on the way home when you get these funny turns. It’s guesswork without data. Find a quieter spot, turn your back on people for a little privacy etc. It only takes a minute or so. Most passers by wouldn’t even notice let alone care What’s more important, your health or a little awkwardness the first few times? Or a libre for a few weeks could solve that issue if you can stretch to funding one.

Thank you for your reply. It's always worth putting things into context and examining them from different perspectives. I'm definitely getting a CGM once my HbA1c is confirmed. You're right, it's total guess work otherwise. It's also possible that different people react differently as our metabolism, hormones, lifestyles and indeed diabetic conditions are so different. What is suitable for one person, may not be suitable for others.

Interestingly, yesterday I managed to fast past midday and only had two meals (plus a very small banana in between for my commute home) but my levels were higher than on the days when I had several snack-sized meals (on average 5.7 vs 5.1). The overall carb content would have been similar on both days. Yes, I realise I need more data and experiments! Yesterday was also a more stressful day, so that could be a contributing factor.

 

[Lamont D]

Just to answer my own question, I've found some information that is supported by clinical evidence. At the same time, I realise there could be other studies claiming the exact opposite. I think we'll just have to decide for ourselves and do what we think is best - the same thing will not work for everyone as our circumstances are different. In any case, I find this information quite reassuring:

"Spreading your meals and snacks throughout the day may help you avoid both high and low blood sugar levels (62Trusted Source).

Snacking between meals may also reduce your risk of type 2 diabetes (63Trusted Source).

In fact, several studies suggest that having smaller, more frequent meals throughout the day could improve insulin sensitivity and lower blood sugar levels (62Trusted Source, 64Trusted Source).

In addition, eating smaller meals and healthy snacks throughout the day may lower glycated hemoglobin (HbA1c) readings, indicating improvements in blood sugar levels over the previous 3 months (62Trusted Source).

14 Natural Strategies to Lower Blood Sugar Levels

From dietary adjustments to medicinal foods, here's what you need to know to manage blood sugar levels in a natural way.

www.healthline.com

Every one of those, is telling you to eat more!
Eating so called healthy snacks is usually really unhealthy for those susceptible to prediabetics and T2s, and including those like me, that have issues with too much insulin circulating.

 

[HSSS]

Thank you for your reply. It's always worth putting things into context and examining them from different perspectives. I'm definitely getting a CGM once my HbA1c is confirmed. You're right, it's total guess work otherwise. It's also possible that different people react differently as our metabolism, hormones, lifestyles and indeed diabetic conditions are so different. What is suitable for one person, may not be suitable for others.

Interestingly, yesterday I managed to fast past midday and only had two meals (plus a very small banana in between for my commute home) but my levels were higher than on the days when I had several snack-sized meals (on average 5.7 vs 5.1). The overall carb content would have been similar on both days. Yes, I realise I need more data and experiments! Yesterday was also a more stressful day, so that could be a contributing factor.

The cgm sounds ideal. It takes more than one day to build a picture and establish what is good and what are other factors (stress is probably the 2nd biggest factor for most of us). Also bear in mind which carbs can matter. Some of us react more significantly to certain types of carbs that we’d expect based on carb count alone. Eg some really spike on grains but not so much on potatoes and rice or vice versa. Legumes are a frequent tricky to predict item too. I’m guessing the way our personal microbiome breaks down and accesses the fibre and glucose in each item. So pay attention to that when monitoring too. Add a food diary to the figures to get the most useful information to base your decisions on.

 

[Deleted member 567281]

The cgm sounds ideal. It takes more than one day to build a picture and establish what is good and what are other factors (stress is probably the 2nd biggest factor for most of us). Also bear in mind which carbs can matter. Some of us react more significantly to certain types of carbs that we’d expect based on carb count alone. Eg some really spike on grains but not so much on potatoes and rice or vice versa. Legumes are a frequent tricky to predict item too. I’m guessing the way our personal microbiome breaks down and accesses the fibre and glucose in each item. So pay attention to that when monitoring too. Add a food diary to the figures to get the most useful information to base your decisions on.

Good advice, thanks. I need start writing down exactly what I ate and when. Also, the order in which we eat carbs/fats/protein matters - as well as the ratio, obviously. Apparently, if you eat fibre dense foods first, it will take longer for the carbs to get into your blood stream. I will also experiment with apple cider vinegar as it's supposed to slow down the process.

 

[Deleted member 567281]

Every one of those, is telling you to eat more!
Eating so called healthy snacks is usually really unhealthy for those susceptible to prediabetics and T2s, and including those like me, that have issues with too much insulin circulating.

I can see why you would think that, but my rationale is that I don't actually eat more - I just spread out what I would eat in 2 meals across 4 or 5 smaller meals. I'm thinking this might flatten the glucose curve. Or maybe it won't, I don't know - I'll experiment on myself!

 

[bulkbiker]

my levels were higher than on the days when I had several snack-sized meals

Because your body was desperately trying to dump as much sugar as it could whilst it had a chance.
And then you topped up your sugar levels with a banana.

By spreading out your meals you are keeping your demand for insulin production going for a longer time which has lead to the insulin resistance you are currently demonstrating with high blood sugar levels.

If I sound a bit exasperated it's because you are almost self harming doing what you are doing.

Im afraid that all your "trusted sources" have got it wrong.

But hey what do I know. I realise you must try whatever you want.

 

[plantae]

Well the best thing to do would be eat an ultra low carb large meal.
Greater satiety .. there are no "essential carbs" so..

Edit to add.. when first starting out I aimed for under 20 g per day.

Under 20 g of carbs per day? Why?

 

[bulkbiker]

Under 20 g of carbs per day? Why?

To get into ketosis.. to burn fat for fuel.
I have been in ketosis virtually every time I have tested ever since.

 

[plantae]

To get into ketosis.. to burn fat for fuel.
I have been in ketosis virtually every time I have tested ever since.

Ah I see. I don't think that'd be safe for me but this is a general thread so whatever works I guess. And I am happy it works for you. The general consensus, though, is that the ketogenic diet is a fad unless you have epilepsy. There are very few studies that support it. Are you on it for weight loss or glucose control, and does it work?

 

[plantae]

I may as well say it. I do not believe in the keto diet. Even without high blood sugar you can develop DKA (google it). The keto diet works for you and that's great, but I think it's potentially dangerous and should not be done without medical supervision. Good on you for sticking with it though... I doubt I could eat less than 20 g of carbs a day even though I don't like them

 

[bulkbiker]

Are you on it for weight loss or glucose control, and does it work?

I put my weight loss and T2 remission down to ketogenic dieting and time restricted eating. Results are in my signature.

The general consensus, though, is that the ketogenic diet is a fad unless you have epilepsy.

I'm afraid that the "general consensus" is often completely wrong. Look at ViRTA health in the USA ... their remission results using ketogenic dieting are as good as if not better than the Newcastle diet.

https://www.virtahealth.com

 

[bulkbiker]

I think it's potentially dangerous

Maybe tell these guys then..

Ketogenic Forums

A place for discussions around ketogenic metabolism

www.ketogenicforums.com

 

[HSSS]

Ah I see. I don't think that'd be safe for me but this is a general forum so whatever works I guess. The general consensus, though, is that the ketogenic diet is a fad unless you have epilepsy. There are very few studies that support it. Are you on it for weight loss or glucose control, and does it work?

Why wouldn’t it be safe for a person? Presumably not currently for you because of your as yet uncontrolled hypos and treatment issues for 3c. But there are type 1 that do very successfully use it out there. It’s much more frequently used as a successful and supported by science tool for type 2. Different conditions different approaches

Dipping in and out of ketosis has been the norm for much of human existence. It challenges the low fat mantra (which has even less evidence for it’s fundamental principles) of the last 50 yrs and that causes waves and ruffles feathers when you rock the status quo.

Not sure why you think there’s few studies supporting it. It’s probably true there aren’t a huge number of studies overall, rather than them mostly being against it as you suggest. Supporting it for what?