“Food order” the next frontier of medical nutrition to treat diabetes, research demonstrates

27 Feb 2023 --- Researchers have found that the order of eating vegetables, protein or fat – along with eating them slowly – can improve postprandial blood glucose trajectory and decrease insulin secretion in people with or without Type 2 diabetes mellitus (T2DM).

The team of Japanese researchers recruited 18 healthy women from Kyoto Women’s University in Japan for an interventional study to test their hypothesis, with results showing that the speed and order with which vegetables, protein and fat are consumed can significantly impact postprandial blood glucose and the development of T2DM.

Globally, 537 million people are estimated to have diabetes and the number is predicted to increase to 783 million by 2045, with 90% of them estimated to be T2DM. Diabetes is the gateway to many other disorders and conditions, including renal failure, new onset blindness and lower-extremity amputation in the US.

Food order mattersThe average Japanese person needs to eat the recommended 350 g of vegetables.
While people’s diets have been pivotal in managing and preventing T2DM, several difficulties remain, including one being more effective than another at weight loss, people changing their diets and others stopping dieting altogether.

The study published in Nutrients sought to explore whether fast eating habits lead to an increased risk of diabetes and obesity. A within-participants cross-over design was conducted in which identical meals were consumed at three different eating speeds.

The test meal (tomato, broccoli, fried fish and boiled white rice) for this study was consumed by 18 young, healthy women to assess the influence on postprandial blood glucose, insulin, triglyceride and free fatty acid levels.

The breakfast meal consisted of 671 kcal and was consumed at a fast speed (10 minutes), slow speed (20 minutes) with vegetables first and slow speed (20 minutes) with carbohydrates first for three consecutive days. 

There was no significant difference between fast and slow eating on postprandial blood glucose and insulin levels as long as vegetables were consumed first. However, postprandial blood glucose at 30 minutes was significantly lower in slow eating with vegetables first than that of fast eating with the same food order.

The results suggest that food ordered with vegetables first and carbohydrates last improves postprandial blood glucose and insulin concentrations even if the meal was consumed faster.

Overall, the study shows that adjusting the order at which foods are consumed can be an “efficient and cost-effective” way to promote weight management in obese and healthy individuals to prevent T2DM.

Eating patterns under the microscope  A diet containing whole grains, fiber and fish have the potential to reduce premature death rish factors, research indicates.   
Various other evidence-based studies have suggested that a diet rich in vegetables and low GI grains is the substantial dietary pattern predicting low risk of T2DM, obesity and cardiovascular diseases. 

Thus far, research has shown that the most effective diets include the Mediterranean diet, a low-calorie diet, a low-carbohydrate, low-glycemic-index diet, a vegetarian diet and an intermittent fasting diet.

In Japan, “food order” is widely recognized as an innovative medical nutrition therapy for individuals with T2DM and significantly affects acute and chronic glycemic control.

The average amount of vegetables consumed in Japan is less than the 350 g recommended by the Ministry of Health, Labor and Welfare. About 70% of US citizens do not eat the amount of vegetables recommended by the US Department of Agriculture and 25% do not eat vegetables at all. 

Economic shortcomings, lack of knowledge and access to fresh produce are a few reasons cited for the low consumption of fresh vegetables and food. 

According to the researchers writing in nutrients, the food order and eating speed in the present study are easier to maintain in real life than other methods of medical nutrition therapy for T2DM. 

The specific role types of diets have in maintaining overall bodily health continue to be a key focus for nutritionists. Another recent study from the German Diabetes Center in Düsseldorf revealed a strong association between the addition of whole grains, fiber, fish and n-3 polyunsaturated fatty acids as having the potential to reduce all premature death risk factors in adults with T2DM.

Elsewhere, researchers have demonstrated that adults with prediabetes who take vitamin D supplements are 15% less likely to develop diabetes, according to a recent review of three clinical trials published in the Annals of Internal Medicine. 

By Inga de Jong