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Eating protein and vegetables before carbohydrates leads to lower post-meal glucose and insulin levels in obese patients with type 2 diabetes

1 July 2015

Emerging research, recently published through the American Diabetes Association, has revealed a potentially new approach to nutrition for patients with type 2 diabetes. Existing evidence strongly correlates carbohydrate consumption to increased glycaemic response, however limited data is currently available on the effects of food order on postprandial glycaemia in type 2 diabetic patients. Consequently one study aimed to pursue the effects of food order, modelled on a typical Western meal (incorporating vegetables, protein and carbohydrate) on postmeal glucose levels in type 2 diabetic patients, and investigate how comparable the findings were to typical pharmaceutical interventions. 

The pilot study tested 11 type 2 diabetic subjects (6 female, 5 male). Patients were required to fast overnight (12-h) prior to the consumption of an isocaloric meal of identical composition; scheduled on two separate days, one week apart. Blood was sampled for analysis at baseline (before ingestion) and at 30, 60 and 120 minutes after consumption. On the first visit food order was carbohydrate followed by protein and vegetables 15 minutes later; this was reversed one week later during the second visit. 

The results established that food order, and carbohydrate ingestion during a meal had a significant impact on postmeal glucose levels. It was observed that postmeal glucose levels decreased by 28.6%, 36.7% and 16.8% at 30, 60 and 120 minutes respectively when carbohydrate was consumed after vegetables and protein. It was suggested that these finding were comparable to pharmacological interventions and that altering macronutrient order could improve insulin sensitivity in diabetic patients. 

While more research is required to assess the long term implications and underlying mechanics, the data published is promising and could potentially have long-lasting, positive effects on the health and wellbeing of diabetic patients.

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