Slimming goes better with two large meals a day than with six smaller meals researchers at the Institute for Clinical and Experimental Medicine in Prague discovered. According to the Czechs, who used plump and fat subjects with type-2 diabetes, losing weight by eating two large meals a day is healthier too.
The researchers gave 54 subjects aged between 30 and 70 six small meals per day for three months, and for another three months they gave them two large meals a day. The two meals a day were a heavy breakfast and an equally heavy lunch.
The composition of the diet was the same in both periods: 55 percent of the energy came from carbohydrates, 20 percent from protein and the rest came from fats. The subjects were given about five hundred kcals fewer than they burned.
All subjects exercised about the same.
Faster weight loss
The subjects lost weight during both periods. But the amount lost and the decrease in waist measurement were both greater during the period in which the subjects ate two meals a day.
During the period that the subjects ate six meals a day their waist circumference decreased by 1 cm; during the period that they only ate twice a day the decrease was 5 cm.
The subjects lost a couple of dozen percent more kilograms when they only ate twice a day [in the figure below:
During the period that the subjects ate twice a day the amount of fat in their liver [HFC] went down more than it did during the period when they ate six times a day. In addition, when they ate fewer meals they had less glucose and C-peptide [a marker for insulin production] in their blood in the early morning. This is an indication of an improved insulin and glucose balance.
“These results suggest that eating two larger meals a day (breakfast and lunch) may be more beneficial for patients with type 2 diabetes than six smaller meals during the day”, the Czechs write. “Novel therapeutic strategies should incorporate not only the energy and macronutrient content but also the frequency and timing of food. Further larger scale, long-term studies are essential before offering recommendations in terms of meal frequency.”
Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study.
The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function.
In a randomised, open, crossover, single-centre study (conducted in Prague, Czech Republic), we assigned 54 patients with type 2 diabetes treated with oral hypoglycaemic agents, both men and women, age 30-70 years, BMI 27-50 kg/m(2) and HbA1c 6-11.8% (42-105 mmol/mol), to follow two regimens of a hypoenergetic diet, A6 and B2, each for 12 weeks. Randomisation and allocation to trial groups (n?=?27 and n?=?27) were carried out by a central computer system. Individual calculations of energy requirements for both regimens were based on the formula: (resting energy expenditure?×?1.5)?-?2,092 kJ. The diet in both regimens had the same macronutrient and energy content. HFC was measured by proton magnetic resonance spectroscopy. Insulin sensitivity was measured by isoglycaemic-hyperinsulinaemic clamp and calculated by mathematical modelling as oral glucose insulin sensitivity (OGIS). Beta cell function was assessed during standard meal tests by C-peptide deconvolution and was quantified with a mathematical model. For statistical analysis, 2?×?2 crossover ANOVA was used.
The intention-to-treat analysis included all participants (n?=?54). Body weight decreased in both regimens (p?< ?0.001), more for B2 (-2.3 kg; 95% CI -2.7, -2.0 kg for A6 vs -3.7 kg; 95% CI -4.1, -3.4 kg for B2; p?0.001). HFC decreased in response to both regimens (p?0.001), more for B2 (-0.03%; 95% CI -0.033%, -0.027% for A6 vs -0.04%; 95% CI -0.041%, -0.035% for B2; p?=?0.009). Fasting plasma glucose and C-peptide levels decreased in both regimens (p?0.001), more for B2 (p?=?0.004 and p?=?0.04, respectively). Fasting plasma glucagon decreased with the B2 regimen (p?0.001), whereas it increased (p?=?0.04) for the A6 regimen (p?0.001). OGIS increased in both regimens (p?0.01), more for B2 (p?=?0.01). No adverse events were observed for either regimen.
Eating only breakfast and lunch reduced body weight, HFC, fasting plasma glucose, C-peptide and glucagon, and increased OGIS, more than the same caloric restriction split into six meals. These results suggest that, for type 2 diabetic patients on a hypoenergetic diet, eating larger breakfasts and lunches may be more beneficial than six smaller meals during the day. Trial registration ClinicalTrials.gov number, NCT01277471, completed. Funding Grant NT/11238-4 from Ministry of Health, Prague, Czech Republic and the Agency of Charles University - GAUK No 702312.
PMID: 24838678 [PubMed - in process] PMCID: PMC4079942