Breakfast is the most important meal of the day –– unless you have type 2 diabetes. In a new study from Linköping University in Sweden, researchers show that a single meal based on a Mediterranean diet is associated with better health outcomes than low-fat and low-carb diets split over three meals. The findings could inspire new palliative and preventative measures against the chronic condition that currently affects upwards of 26 million Americans. 

The study, which is published in the journal PLoS ONE, sought to quantify the effects of certain diets on blood glucose, blood lipids, and other hormones in diabetics. Three diets were considered: a low-fat diet, a low-carb diet, and the Mediterranean diet –– a meal plan that emphasizes whole grains, legumes, fish, herbs, and nuts. Notably, while the former diets were split over three meals, the latter pooled the day’s caloric content into a single lunch taken with red wine. 

"We found that the low-carbohydrate diet increased blood glucose levels much less than the low-fat diet but that levels of triglycerides tended to be high compared to the low-fat diet," the researchers wrote. "It is very interesting that the Mediterranean diet, without breakfast and with a massive lunch with wine, did not induce higher blood glucose levels than the low-fat diet lunch, despite such a large single meal."

The results were derived from a randomized cross-over trial in which 21 patients diagnosed with type 2 diabetes tried all three diets in varying orders. During each test day, the researchers collected six separate blood samples from each subject. 

According to co-author Fredrik Nyström, the study’s methodology recalls the original version of the much-praised diet. "[The outcome of the study] suggests that it is favorable to have a large meal instead of several smaller meals when you have diabetes, and it is surprising how often one today refers to the usefulness of the so-called Mediterranean diet but forgets that it also traditionally meant the absence of a breakfast,” he explained. “Our results give reason to reconsider both nutritional composition and meal arrangements for patients with diabetes.”

The current research effort dovetails with a number of previous studies illuminating the diverse health benefits associated with the Mediterranean diet. This year, the meal plan has been linked to improvements in cognitive abilities as well as longer lifespans among the obese. According to the Mayo Clinic, the diet relies on fruit, vegetables, beans, legumes, and nuts as the foundation of every meal. In addition, the diet emphasizes:

  • Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
  • Replacing butter with healthy fats, such as olive oil
  • Using herbs and spices instead of salt to flavor foods
  • Limiting red meat to no more than a few times a month
  • Eating fish and poultry at least twice a week

Source: Hanna Fernemark, Christine Jaredsson, Bekim Bunjaku, Ulf Rosenqvist, Fredrik H. Nystrom, Hans Guldbrand. A Randomized Cross-Over Trial of the Postprandial Effects of Three Different Diets in Patients with Type 2 Diabetes. PLoS ONE, 2013