Recipe for Weight Loss, Glucose Control Lies in Meal Sizeby Amy Hendel, P.A. Health Writer
You may have heard the adage, “Eat breakfast like a king, lunch like a prince, and dinner like a beggar.” I’ve been a believer in this approach for some of my clients if weight loss or weight maintenance is the goal. I also frame the feminized version, “Eat breakfast like a queen, lunch like a princess, and dinner like a pauper.” The original saying has been around for quite some time, but is there any evidence to back it up? A 2018 study suggests that not only what you eat, but how much you eat and when may have significant effects on weight loss and blood glucose control.
People with both obesity and uncontrolled type 2 diabetes often require high doses of insulin therapy daily which can lead to further weight gain and the need for even more insulin – a somewhat vicious cycle. The goal of the study was to find a daily feeding program that would optimize weight loss and glucose control in this subset of patients.
Comparing two common diets
The three-month study enlisted a group of 29 people with uncontrolled type 2 diabetes and randomly divided them into two groups – the Bdiet group and the 6Mdiet group. The Bdiet group ate three meals a day with a specific quantity allotted to the meals. Breakfast was the large meal of the day, lunch was medium size, and dinner was the smallest meal. In comparison, the 6Mdiet group ate six small meals (three meals and three snacks) spaced out during the day. The second diet outline is based on recent thoughts by some experts in the world of nutrition that frequent feedings keep blood sugar better stabilized and eating every couple of hours helps to limit overeating.
Each person used continuous glucose monitoring to supply frequent blood sugar measurements and the researchers also tested blood sugar levels in a lab every two weeks during the three month study. Researchers were focused on overall weight loss and insulin use changes, as well as hunger scores and craving scores.
The Bdiet group lost significant weight compared to the 6Mdiet group (with average losses of 5 kg versus 1.4 kg).
BMI decreased on average by 1.9 in the Bdiet group, but increased by 0.1 in the 6Mdiet group.
HbA1c decreased by 1.2 in the Bdiet group vs 0.2 in the 6Mdiet group.
Glycemic (blood sugar) levels decreased on average by 38 mg/dl (from 167 to 129 mg/dl) in the Bdiet group, but only on average by 17 mg/dl in the 6Mdiet group (171 to 154 mg/dl).
The Bdiet group reduced daily of insulin intake by approximately 20.5 units compared to the 6Mdiet group that needed an increase of 2.2 units daily.
Hunger scores and craving scores decreased in the Bdiet group, while they increased in the 6Mdiet group. Specifically, carbohydrate/starch cravings decreased in the Bdiet group and increased in the 6Mdiet group.
Given that these people were all struggling with serious weight issues and a more serious form of type 2 diabetes, finding a feeding approach that could help them to lose weight, improve blood glucose levels, reduce the need for insulin, reduce cravings and hunger especially for “sugar-based foods” was accomplished by a more strict three meal a day program that had the bulk of eating occurring in the morning and the lightest meal at the end of the day.
Other possible benefits of a high energy breakfast diet
It’s also fair to say that this approach of eating the most energy dense meal for breakfast might also work for individuals who are simply trying to shed excess pounds or struggling with food cravings. Given that highly processed refined carbohydrates seem to be one significant culprit driving the obesity epidemic in the U.S., a diet plan that helps to lower cravings for this specific food group would be extremely helpful.
Though this was a small study, I discuss this type of eating in my book, The 4 Habits of Healthy Families, emphasizing that meals should be comprised of energy dense, high fiber foods that help to provide nourishment while helping one to feel full, with the bulk of calories earlier in the day as one possible approach. If you're interested in trying a Bdiet approach, here are a few meal plan suggestions:
1 egg and 2 egg whites scrambled with sautéed vegetables, side salad with ¼ of an avocado, 1 piece of whole grain toast, 1 serving of fruit, coffee with milk
Whole grain English muffin split in half with part skim mozzarella cheese and tomato slices, mixed green salad topped with sunflower seeds, serving of fruit and coffee with milk
Serving of Greek yogurt layered with berries, nuts and whole grain cereal plus one hard-boiled egg, ½ of a whole grain pita, herbal tea plus milk (or coffee)
Half a turkey sandwich made with roast turkey, tomato slices and mustard, salad topped with slivered nuts, ½ cup berries, and club soda
Grilled fish (4 ounces), grilled vegetables, ½ cup quinoa, small cup of melon and water
Grilled tofu and vegetables, small side of brown rice, small orange and club soda
“Light” dinner choices:
Bowl of bean soup, serving of whole grain crackers and one piece of fruit plus herbal tea
½ of a melon with a scoop of cottage cheese and light sprinkle of berries and sunflower seeds and herbal tea
One piece of whole grain toast with a serving of nut butter, one serving of fruit and a cup of milk (skim, soy or nut milk)