Does the sequence of food affect blood glucose levels?

This study examined whether meal sequence affects blood glucose levels in individuals with type 2 diabetes. The authors concluded that meal sequence affects blood glucose levels after a meal and nutritional therapy may be important in managing type 2 diabetes.

Postprandial blood glucose levels are the levels of sugar in the blood after a meal. High postprandial blood glucose levels can occur in patients with type 2 diabetes (T2D). High blood glucose over time can result in damage to small blood vessels, leading to further complications. Therefore, it is necessary to reduce postprandial high blood glucose.

Glucagon-like peptide-1 (GLP-1) is a hormone that stimulates the release of insulin (hormone needed to break down glucose). There are currently drugs available to mimic the effects of GLP-1, however, it is not clear whether certain foods are capable of increasing GLP-1. It is believed that protein and fats, particularly fish oils, may increase GLP-1 secretion. It is possible that the sequence of a meal, such as by ingesting meat or fish (sources of protein) before rice (source of carbohydrate), may stimulate GLP-1 and reduce postpradial blood glucose.

This study aimed to determine whether ingesting meat or fish before rice leads to a reduction in postprandial blood glucose.

This study included 22 participants. 12 participants had T2D and 10 participants were healthy volunteers. Both the T2D participants and healthy participants altered their morning meal over three days. Participants ate rice 15 minutes before fish one morning and fish 15 minutes before rice on another morning. On the third morning, all participants ate meat 15 minutes before rice.

Blood levels of glucose, insulin and GLP-1 were measured. The rate of stomach emptying was also measured.

In comparison to eating rice first, the change and variation in blood glucose over time was lower when T2D participants ate fish or meat before rice.

GLP-1 levels were higher when T2D participants ate fish or meat first rather than rice. Participants had a greater increase in GLP-1 levels when meat was eaten first. The gastric emptying rate was lower after eating fish or meat first compared to rice first.

This study concluded that meal sequence is important in controlling postprandial blood glucose levels.

Participants ingested the second food 15 minutes after the first food. It is not known whether extending this interval may result in a greater reduction in blood glucose levels. In addition, this study did not include an additional meal of rice before meat.

Consult your physician regarding the possibility of altering your food intake to reduce postprandial blood glucose.