It’s not just what you eat, but the order in which you eat it, according to new research.
The study, conducted at Weill Cornell Medical College, found that people with obesity and type 2 diabetes could ensure lower post-meal insulin and blood glucose levels by eating protein and vegetables before carbohydrates.
“We’re always looking for ways to help people with diabetes lower their blood sugar,” said senior author Dr. Louis Aronne, the Sanford I. Weill Professor of Metabolic Research and a professor of clinical medicine at Weill Cornell Medical College.
“We rely on medicine, but diet is an important part of this process, too. Unfortunately, we’ve found that it’s difficult to get people to change their eating habits.
“Carbohydrates raise blood sugar, but if you tell someone not to eat them – or to drastically cut back – it’s hard for them to comply. This study points to an easier way that patients might lower their blood sugar and insulin levels.”
The researchers recruited 11 participants, all of whom had obesity or type 2 diabetes. Each patient was given the same dosage of metformin. The, each participant was instructed to follow a certain diet: twice in two weeks, each participant ate a meal of carbohydrates, protein, vegetables and fat.
The first time they ate the meal, the participants ate the carbohydrates first. They then ate the protein, vegetables and fat 15 minutes later. Blood glucose levels were then tested three times at various intervals.
The second time the participants ate the meal, the order was reversed: first, they ate the protein, vegetables and fat, then the carbohydrates fifteen minutes later. Their blood glucose levels were collected in the same way as before, at the same intervals.
Blood glucose levels were lower by around 30 per cent when the participants ate the protein, vegetables and fat first, suggesting that the order in which the food was eaten affected post-meal blood glucose levels.
Although the study has some limitations – primarily the small group of participants – it reveals that how we eat might be as important as what we eat.
It is not the first study to suggest it. In December, a study published in Cell Metabolism found that confining calorie intake to an eight to twelve hour period could reduce the risk of high cholesterol, type 2 diabetes, and obesity. Although that study had its limitations too, the findings are interesting and potentially significant.
“Based on this finding, instead of saying ‘don’t eat that’ to their patients, clinicians might instead say ‘eat this before that,'” said Dr. Arrone.
“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.”
The research was published in Diabetes Care.

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