Study Finds Six Small Meals a Day May Not be Optimal for Type 2 Diabetes Patients

Until very recently it was thought that people who wanted or needed to lose weight would be more successful on the snacking model, which recommends eating several small meals a day. This model has also been standard for patients with type 2 diabetes because it was thought six small meals a day would have less impact on blood sugar.

But a new study is suggesting that people with type 2 diabetes saw significant improvements in their diabetes management when they ate only breakfast and lunch than when they followed the snacking model. Conducted by a group of researchers in Prague, the study found two meals a day decreased fasting blood sugars, improved insulin sensitivity, and led to fewer hunger pains and less depression.

Numbers at a Glance

The study observed 54 patients – 20 of which were men and 25 women between the ages of 30 and 70 – who were all on prescription medication to manage their diabetes. Participants were divided into two groups of 27 and were asked to follow one of two calories restricted diets (each consisting of 500 fewer calories than the recommended daily amount) for a 12 week period. At the end of the 12 weeks they were switched to the other diet for another 12 weeks.

One diet followed the snacking model and included six small meals while the other included two large meals: breakfast, which was eaten between 6 and 10 a.m., and lunch eaten between noon and 4 p.m. Both diets had the same amount of calories and nutrients.

The Results Were Surprising

Although further studies will need to be conducted before the researchers can offer clear recommendations, the results are promising. “Eating large breakfasts and lunches may be more beneficial than the usual snacking model,” said Dr. Hana Kahleova, the study’s lead author from the Institute for Clinical and Experimental Medicine in Prague.

More Satisfaction and Improved Mood Leads to Maintained Healthy Dieting

One interesting aspect of this study was how moods improved significantly when participants ate two larger meals as opposed to six smaller ones. Fewer depressive symptoms and an overall improved quality of life make it easier for those with type 2 diabetes to stick with the appropriate diet.

Participants also reported feeling less hungry on the two-meal a day diet which flies against popular belief that several smaller meals help individuals feel fuller longer. Kahleova believes that people who eat less frequently throughout the day may actually feel fuller and more satisfied when they do eat. When people eat smaller meals they tend to feel hungrier and want more at each meal. Disinhibition, the tendency to overeat in certain situations, occurred frequently while participants were on the 6 smaller meals diet. Kahleova added that in order for people to feel fuller and more satisfied on the two-meal a day plan, they must eat 30 to 40 grams of fiber a day.

Recognizing the Emotional Component to Eating

Though much has been said about “emotional eating,” that is eating as a result of how a person is feeling emotionally (instead of eating because a person is hungry), not much research has been done on the emotional component to eating: how and when and what we eat and how that makes us feel. By looking at the effect of eating patterns on an individual’s depressive symptoms, this study has shed new light on the interplay between how we eat and how we feel.

It is critically important for people with type 2 diabetes to have an eating plan that can help them maintain a healthy weight and steady blood sugar levels long-term. “There’s no one right way or wrong way, but I think this says that we do have to pay attention to this emotional side of eating,” said Margaret Powers of the International Diabetes Center at Park Nicollet in Minneapolis. “If somebody’s eating two large meals a day and they want to eat at other times and they can’t and that’s making them miserable, that’s not the right plan.”

Powers also mentions one of the most important goals for diabetics and their nutritionists is to make sure patients can truly enjoy food. Often when someone is diagnosed with diabetes, the first thing that happens is they are given a list of things they can’t eat, and this is depressing right off the bat.

“One of the goals of nutrition therapy for diabetes is actually to maintain the enjoyment of food,” she said. “Our goal is to help a patient understand that his or herself so they can help find the best self-management plan . . . Whatever the food plan is, it should be a lifelong eating pattern.”

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