For people with type 2 diabetes, watching what they eat is essential to keeping their weight in check and controlling their blood sugar levels. A study led by Dr. Hana Kahleová from the Diabetes Centre, Institute for Clinical and Experimental Medicine in Prague, has revealed that eating two large meals for breakfast and lunch instead of six small meals scattered throughout the day is a diabetic's best option for controlling weight and blood sugar levels.

"Eating only breakfast and lunch reduced body weight, liver fat content, fasting plasma glucose, C-peptide and glucagon, and increased OGIS, more than the same caloric restriction split into six meals,” the authors said in a statement. “These results suggest that, for type 2 diabetic patients on a calorie-restricted diet, eating larger breakfasts and lunches may be more beneficial than six smaller meals during the day."

Kahleová and her colleagues recruited 29 male and 25 female diabetes patients between the ages of 30 and 70 whose body mass indexes ranged from 27 to 50 kg/m2. Individuals participating in the study were receiving oral diabetes medication and reported HbA1c of six to 11.8 percent. All 54 participants were split into two groups of 27 and asked to engage in one eating program for 12 weeks before switching to a second eating program for another 12 weeks. Throughout the first 12-week eating program, participants were given six small meals, and during the second they were given two large meals for breakfast and lunch. Both eating programs consisted of the same level of macronutrients and calorie content.

At the end of each 12-week period, researchers used diabetes testing techniques and mathematical modeling to check each patient’s liver fat content, insulin sensitivity, and the function of cells that produced insulin. The body weight of the group that ate two large meals decreased by 8.1 lbs. at the end of the 12 weeks compared to 5 lbs. for the group that ate six small meals. Liver fat content, fasting plasma glucose, and C-peptide levels also decreased more so for patients who were given two large meals instead of six small meals. Levels of the hormone that converts glycogen back to glucose decreased when the patient was given two large meals, whereas it increased in patients who were given six small meals.

“Novel therapeutic strategies should incorporate not only the energy and macronutrient content but also the frequency and timing of food. Further larger scale, long-term studies are essential before offering recommendations in terms of meal frequency," the authors concluded.

Source: Belinova L, Malinska H, Kahleova H, et al. Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study. Diabetologia. 2014.