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In patients with obesity and type 2 diabetes, high-energy breakfast promotes weight loss, improves diabetes and decreases the need for insulin. The shows that, in obese insulin-treated type 2 diabetes patients, a diet with three meals per day, consisting of a big breakfast, average lunch and small dinner, had positive effects compared to six small meals. It leads to weight control, less hunger and better diabetes control while using less insulin,” said lead study author Daniela Jakubowicz, M.D., professor of medicine at Tel Aviv University.
When you eat and how frequently you eat is more important than what you eat and how many calories. Body metabolism changes with time throughout the day. A slice of bread consumed at breakfast leads to a lower glucose response and is less fattening than bread consumed at dinner. Researchers studied women and men who had obesity and type 2 diabetes, being treated with insulin. The patients were randomly assigned to eat different weight-loss diets, which contained an equal number of daily calories, for three months.
Group one ate three meals: a large breakfast, a medium-sized lunch and a small dinner. The second group ate six small meals evenly spaced throughout the day, including three snacks. Overall glucose levels and glucose spikes were measured for 14 days at baseline, during the first two weeks on diet, and at the end of the study by continuous glucose monitoring (CGM). Glucose levels were tested every two weeks and insulin dosage was adjusted as needed.
After three months, group one lost 5 kilograms while group two gained 1.4 kg (3 lb). Fasting glucose levels decreased 54 mg/dl (from 161 to 107) in the group one but only 23 mg/dl (from 164 to 141) in the group two. Overall mean glucose levels dropped in the first 14 days by 29 mg/dl (from 167 to 138 mg/dl) and 38 mg/dl (from 167 to 129 mg/dl) after three months in the group one. Overall mean glucose levels dropped only 9 mg/dl (from 171 to 162 mg/dl) in the first 14 days and only 17 mg/dl (from 171 to 154 mg/dl) in the group two.
Mean glucose levels during sleep dropped only in the group one, by 24 mg/dl (from 131 to 107), but not in the group two. Group one needed less insulin (-20.5 units/day, from 54.7 to 34.8) while the group two needed more insulin (+2.2 units/day, from 67.8 to 70). Carbohydrate craving and hunger decreased significantly in group one but increased in group two. Group one experienced a significant reduction of overall glycemia after 14 days .Diet with adequate meal timing and frequency is essential for glucose control and weight loss.
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