Two Large Meals a Day for Diabetes

David Mendosa Health Guide
  • Until now, some experts on health have recommended that we eat several small meals a day to help us lose weight. It also seemed logical that eating smaller meals would have less of an impact on the blood sugar of those of us with diabetes.


    But a new study demonstrated that some people with type 2 diabetes who ate only breakfast and lunch lost more weight than when they ate six smaller meals a day. In this randomized crossover study they also had bigger decreases in fasting blood sugar, bigger improvement in insulin sensitivity, and bigger improvements in other markers of better diabetes management.

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    Researchers in the Czech Republic worked with 54 people with diabetes for 24 weeks to have them eat the same number of calories spread over either two or six meals a day. The people in the study followed diets of eating six small meals a day or two large daily meals for 12 weeks. Then they switched to the other diet plan for 12 more weeks.


    In the two-meal group they ate breakfast between 6 a.m. and 10 a.m. followed by lunch between noon and 4 p.m. When they switched diet plans they could eat six times a day whenever they wanted.


    Each diet had 500 fewer calories than normal. When they ate the two bigger meals, they averaged a weight loss of 3 pounds more and lost 1 1/2 inches more from their waist size than when they ate six smaller meals of equal total calories.


    “Eating only breakfast and lunch reduced body weight, liver fat content, fasting plasma glucose, C-peptide and glucagon, and increased oral glucose insulin sensitivity more than the same caloric restriction split into six meals,” says Hana Kahleova, MD, PhD. She is the study’s lead author and a researcher at the Diabetes Centre of the Institute for Clinical and Experimental Medicine in Prague. The journal of the European Association for the Study of Diabetes, Diabetologia, published this research May 20 online in advance of print. 


    “The patients were really afraid they would get hungry in the evening,” says Dr. Kahleova. “But feelings of hunger were lower as the patients ate until they were satisfied. When they ate six times a day the meals were not leaving them feeling satisfied. It was quite surprising.”


    Dr. Kahleova calls the two-meal diet “intermittent fasting.” Skipping dinner and therefore fasting for the 14 to 22 hours without food in this study might deserve that label. But last year when I recommended skipping dinner for weight loss I wrote that “Sometimes I tell myself that skipping dinner is intermittent fasting. But that would be an exaggeration.”


    I recommended it then only for weight loss. In fact I skipped dinner last night because I ate too much the day before. I know that it works for weight loss, and the finding of this new study that shows it also works for reducing our blood sugar level is an unexpected bonus.


    We may not even have to skip dinner entirely to get some of the weight loss and blood sugar control benefits that the people in this study achieved. A very small dinner might well offer some of the benefits that Dr. Kahleova found in her study. 


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    “Our results support the ancient proverb: Eat breakfast like a king, lunch like a prince, and dinner like a pauper,” she says. Her study sure gives this old adage new life.

Published On: May 27, 2014