Two Meals a Day are Better than Six for Patients with Type 2 Diabetes
6/11/2012 12:00:00 PM
6/11/2012 2:00:00 PM
, LENKA BELINOVA, MARTIN HILL, TEREZIE PELIKANOVA,
Caloric restriction is crucial in the treatment of type 2 diabetes (T2D) typically (but not necessarily) apportioned into five or six small meals during the day. The aim of our study was to compare the effect of six vs. two meals a day with the same caloric restriction on body weight and HbA1c in subjects with T2D.
In a randomized, crossover study, we assigned 54 patients with T2D to follow two regimens of a hypocaloric diet (-500 kcal/day), each for 12 weeks: six meals a day (A), and two meals a day (B). The diet in both regimens had the same macronutrient and energy content. We measured weight, HbA1c, fasting glycemia, plasma C-peptide, immunoreactove insulin and lipids. For statistical analysis, 2x2 crossover ANOVA was used.
Body weight decreased in both regimens (p<0.001), more in B (-2.3; 95% CI -2.7 to -2.0 kg in A vs. -3.7; 95% CI -4.1 to -3.4 kg in B; p<0.001). Fasting glycemia decreased in both regimens (p<0.001), more in B (-0.47; 95% CI -0.57 to -0.36 mmol/L in A vs. -0.78; 95% CI -0.89 to -0.68 mmol/L in B; p=0.004). Fasting C-peptide decreased in both regimens (p<0.001), more in B (-0.05; 95% CI -0.09 to -0.01 nmol/L in A vs. -0.14; 95% CI -0.18 to -0.1 nmol/L in B; p=0.05). Hb1Ac decreased in both regimens (p<0.001); the trend toward greater decrease in B was not significant (-0.23; 95% CI -0.27 to -0.19 % in A vs. -0.25; 95% CI -0.29 to -0.20 % in B; p=0.08). Plasma immunoreactive insulin, triglycerides and LDL-cholesterol decreased comparably in both regimens. No significant change in total or HDL-cholesterol was observed in either regimen.
Two meals a day reduced body weight, fasting glycemia and plasma C-peptide more than a diet with the same caloric restriction divided in six more frequent meals in patients with T2D. HbA1c and plasma lipids improved comparably in both regimens. Our data suggest that it may be more beneficial to apportion a diet into fewer larger meals than into smaller ones during the day for patients with T2D.
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