Effects of meal sequence intervention on blood glucose response in healthy adults: a systematic review.
Level 1 - systematic review of randomized trials
Systematic review of randomized and controlled intervention trials
PubMed 41837403 · doi:10.7762/cnr.2025.0027
What was done
A systematic review of literature published between January 2015 and March 2025 across PubMed, Cochrane Library, Web of Science, KoreaMed, and RISS evaluating the effect of meal sequence on postprandial glycemic responses in healthy adults. From 2,442 identified records, 6 studies met inclusion criteria: one randomized controlled trial, four randomized crossover trials, and one repeated-measures study, encompassing 107 total participants aged 20 to 36.7 years.
What was found
Most included studies reported that eating vegetables, fruits, or protein-rich foods prior to carbohydrate-rich foods reduced postprandial blood glucose responses and glucose incremental area under the curve (iAUC) compared to mixed meals or carbohydrate-first meals. No quantitative effect sizes, mean differences, or confidence intervals were provided in the abstract.
Why it matters
Food sequencing offers an accessible, non-pharmacological behavioral strategy to blunt acute postprandial glucose spikes in healthy individuals without requiring changes to overall caloric intake or meal composition.
Limits
The abstract reports no numerical effect sizes or statistical variance metrics. The total evidence base is very small (6 studies, 107 total participants) and restricted to young adults (aged 20–36.7 years), limiting generalizability. Studies measured only acute postprandial responses; long-term metabolic outcomes and real-world dietary adherence were not evaluated.