Eating certainly affects glucose control. But does the timing of your food intake really matter, as long as you take your medications when you’re supposed to?
What about European cultures who favor a larger midday meal? What time of the day should you eat for optimal glycemic control?
Certainly, regularly scheduled meals and snacks are best for glycemic control. This is a long well-known principle. Standard of care recommendations are three meals, 4-5 hours apart, same or similar times of the day every day.
Setting your meal times and medication times on a regular schedule will result in improved glucose control throughout the day, and over time, evidenced by improved HbA1c values and improved insulin sensitivity.
A sample daily meal schedule would be: 7:00 a.m. – 8:00 a.m. breakfast + 12:00 p.m. – 1:00 p.m. lunch + 5:00 p.m. – 6:00 p.m. dinner.
Regular recommendations are 60 grams of carbohydrate at each of these meals, but that should be individualized by working with a Registered Dietitian (RD) or Certified Diabetes Educator (CDE). Individuals on long-acting insulin will need a bedtime snack including 15-30 grams of carbohydrate to avoid nighttime hypoglycemia. This can be tricky for people working a night shift, or other lifestyle issues affecting a ‘typical’ schedule. Again, work with an RD or CDE to determine what can work for you.
Hunger & Satiety
Eating on a regular schedule, with small frequent mini-meals keeps you satisfied. Skipping meals in order to lose weight eventually ends up with overeating at the next meal.
Eating the traditional three larger meals each day may lead to hungry spells in between. Hunger scores were significantly improved in human subjects fed a larger morning meal compare to those fed a larger evening meal. An important key is mindfulness of satiety feelings. Paying attention to whether or not you are truly hungry or satisfied can regulate how much you eat. Eating slower and more mindfully would benefit anyone with difficulty controlling their food intake at a meal.
Just like glycemic control, energy levels stabilize and regulate with regular meal times. Your circadian rhythm for sleep is similar to that of food and glucose needs, and subsequent energy levels. Especially in diabetes, energy levels are linked to regular eating times because the glucose needs are more specialized.
More recent research confirms the age-old belief that timing of food affect weight status. Eating late at night contributes to weight gain, eventual obesity and adiposity.
Feeding animal and human subjects at the “wrong” times (i.e.; in the dark) results in higher deposition of fat tissue for storage. Meal timing throughout light hours has been proven to influence not only obesity, but weight loss therapy. If a larger meal is consumed during the light hours, the Mediterranean cultural norm of a larger mid-day meal is associated with healthier weight status than a larger evening meal. This held true independent of overall caloric intake. Late eaters lose less weight than earlier eaters, regardless of total calories ingested.
It is long known that sleep patterns follow a circadian rhythm, with sleep occurring most naturally during the dark hours. Newer research shows that our organ systems have a natural daily rhythm – including stomach, intestines, pancreas, liver, and even adipose/fat tissue. There is also a synchronization of the organ systems with each other, fully dependent on food intake. For example: the mouth produces salivary amylase in response to food intake. In turn, the stomach works in gastric emptying, the pancreas releases insulin, the intestines absorb nutrients, and the liver releases bile. All things work together like a functional machine. Keeping food intake on a regular schedule enables these organ systems to function at an optimal level.
Other Hormone Regulation
Leptin is a hormone produced by adipocytes (fat cells) involved in the control of hunger. Research has shown that regular daytime eating patterns help regulate the release of leptin, resulting in reduced hunger scores and cravings. Gherlin, a hormone produced by the gastrointestinal tract, also plays a significant role in appetite regulation. Gherlin levels are stabilized with regular daytime eating. Hormonal stabilizing, resulting in appetite stabilizing, results in reducing of food intake and proven changes in overall weight and weight-related measurements (body mass index, abdominal circumference, body fat percentage).
- American Diabetes Association (ADA) – http://www.diabetes.org/living-with-diabetes/recently-diagnosed/where-do-i-begin/choosing-what-to-eat.html
- National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) – https://www.niddk.nih.gov/health-information/diabetes/diabetes-diet-eating
- American Journal of Clinical Nutrition – 2005; 81: 16-24, H.R. Farshchi et al.
- Physiology and Behavior – 2014; 10.116, M. Garaulet & P. Gómez-Abellán.
- Advances in Nutrition – 2015 Mar; 6(2): 214–223, S. Soferet al.