The impact of food order on postprandial glycaemic excursions in prediabetes.
Level 2 - randomized trial
Individual randomized crossover trial
PubMed 30101510 · doi:10.1111/dom.13503
What was done
Fifteen participants with prediabetes consumed the same meal on 3 separate days in random order: carbohydrate first, followed 10 minutes later by protein and vegetables (CF); protein and vegetables first, followed 10 minutes later by carbohydrate (PVF); or vegetables first followed by protein and carbohydrate (VF). Blood was sampled for glucose and insulin measurements at 0, 30, 60, 90, 120, 150, and 180 minutes.
What was found
Incremental glucose peaks were attenuated by >40% in both the PVF and VF conditions compared with CF. The incremental area under the curve for glucose was 38.8% lower following the PVF meal order compared with CF. Postprandial insulin excursions were significantly lower in the VF meal condition compared with CF. The CF meal pattern showed marked glycemic variability, whereas glucose levels were stable in the PVF and VF conditions.
Why it matters
Sequencing meal components so that protein or vegetables are eaten prior to carbohydrates is a simple, zero-cost behavioral approach to blunt acute postprandial glucose spikes in prediabetes.
Limits
The study had a very small sample size of 15 participants. It evaluated only acute postprandial responses over 180 minutes following a single meal type, leaving long-term adherence, glycemic markers such as HbA1c, and clinical outcomes unmeasured.
Cited by
- supports Eating vegetables at the beginning of a meal creates a fiber mesh in the intestine that slows glucose absorption and reduces postprandial glucose spikes.