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Diabetes: 2 large meals better than 6 small

WebMD UK Health News
Medically Reviewed by Dr Farah Ahmed

16th May 2014 – New research suggests two large meals, breakfast and lunch, are better than six small meals with the same amount of calories, for controlling weight and blood sugar in people with type 2 diabetes.

The results of the study, conducted in Prague in the Czech Republic, have been published in Diabetologia, the journal of the European Association for the Study of Diabetes.

Small study

The study assessed 54 patients, 29 men and 25 women, treated with tablets for diabetes. The patients were aged between 30 and 70 years old and were divided into two groups of 27. They were asked to follow one of two restricted calorie diets for 12 weeks. Then, after completing one diet, they moved to the other, again for 12 weeks.

Each diet contained 500 calories fewer than the recommended daily amount. One diet included six small meals: breakfast, lunch and dinner, and three smaller snacks in between. The other included two large meals: breakfast eaten between 6am and 10am, and lunch between 12pm and 4pm.

Both diets had the same nutrient and calorie content.


The researchers found that body weight decreased in both diets but there was a greater reduction in weight when consuming two large meala, losing 3.7kg (8.2 pounds) compared to 2.3kg (5 pounds) with six small meals.

In both diets, liver fat content decreased, slightly more in the two large meal diet than for the six small meal diet.

Levels of fasting plasma glucose and C-peptide, a protein involved in insulin synthesis, decreased in both diets, again more for the two large meal diet.

Fasting plasma glucagon, the hormone that converts glycogen back to glucose, decreased with the two large meal diet, but it increased for the six small meals diet. Oral glucose insulin sensitivity (OGIS) increased in both diets, more for the two large meal diet.

No adverse events were recorded for either diet.


The authors, led by Dr Hana Kahleová from the Diabetes Centre at the Institute for Clinical and Experimental Medicine in Prague, acknowledge that their data contradicts a widely held opinion that eating more frequently is healthier than eating less frequent larger meals. They say: "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."

In a statement, Dr Richard Elliott, research communications officer at Diabetes UK says: "This study adds to evidence that shows eating fewer, larger meals a day could help people with type 2 diabetes manage their condition more effectively than eating smaller meals more frequently.

"However, larger studies over longer periods of time will be needed to back up these findings before we would make changes to the dietary advice given to people with type 2 diabetes. What we do know is that eating a healthy balanced diet, taking regular physical activity and maintaining a healthy weight, together with taking any medication prescribed by your doctor, is vital for effective management of type 2 diabetes.”

Reviewed on May 16, 2014

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