If you’re feeling lost in a flurry of diabetes literature trying to do ‘the right thing’ only to be contradicted later, this study may just spin your head in a new direction.

By its intensive nature, diabetes holds the power to make us question consuming one of the very things that keep us alive and well — food.

It becomes a measured piece of daily living through scales, portion sizes, carbohydrates and its nutritional content.

Friends, colleagues and health professionals are quick to proffer advice –— that unfortunately often conflicts with each another. Eat small meals, no carbs, some carbs, ‘a diabetic diet’, paleo, no grains, no fat, high fat, low calorie, high protein, Atkins, eat anything — but whatever you do, count carbs. It’s no wonder we feel so confused.

According to Amy Campbell, a nutritionist at Joslin Diabetes Center: “The important message is that with proper education and within the context of healthy eating, a person with diabetes can eat anything a person without diabetes eats.”

This may be true, but have seen what your colleagues at work are eating? The diet most Americans have isn’t good for anyone — diabetes or not. What is the end goal here; what is it that we’re seeking?

Back to Basics

Let’s take it back to the basics. Lose the focus on food choices, not what — but how often should we be eating?

Most of us are taught to spend our cash (carbohydrate allotments) wisely — don’t blow it Vegas style in one meal.

Eating is fun, but it’s all about energy. If we take in too much and too often we see the slippery slope of disease and its side effects creeping in.

So what’s the ‘right way’ to do it? It depends what ‘expert’ you ask.


It turns out researchers are looking for the golden answer as well. Kahleova et al performed a focused study on the effects of six small meals versus two larger meals per day. The research study can be read in full at Diabetologia.

Their unique study analyzed data on body weight, hepatic (liver) fat content , insulin resistance and beta cell functioning. They felt their diet suggestions were not only sustainable as a long term way of eating, but also allowed for an improved fasting time with meals eaten only at breakfast and lunch. True, but what about night time hunger and the social implications that go along with abstaining from food after lunch?

Their study included 52 participants diagnosed with type 2 diabetes that were taking diabetes medications by mouth. Participants were between 30-70 years of age; with hemoglobin A1c results between 6-11.8, and BMI’s between 27-50.
Study participants were involved in their assigned dietary regime for 12 weeks — either six small meals or two large meals per day.


Body weight decreased in both groups — more significantly for the two-meals/ day group.
Hepatic fat content decreased in both groups — more significantly for the two-meals/ day group.
Fasting blood sugar and C-Peptide levels decreased in both groups — more significantly in the two-meals/ day group.
Fasting glucagon levels decreased in the two-meals/ day group; it increased in the six-meals/ day group.
• Insulin Sensitivity increased in both groups — more significantly for the two-meals/ day group.

Two versus six small meals

Going against our train of thought, the clear winner was a diet that included two meals per day. This study suggests that taking the same caloric intake and dividing it between six meals per day was a measurable loser, proving their hypothesis correct.

So now what?

You may be tempted to figure this all out on your own, but it isn’t a recommended project to shoulder. Changes in diet are usually reflected by changes in medications which must be initiated with a medical practitioner. It’s important to have honest conversations with your health care provider prior to making lifestyle changes that may impact your blood sugar levels.

These researchers would like to see more long-term studies based on their observances prior to recommending changes in the diabetic diet –— even in the face of their study results.

So, keep enjoying dinner — for now.

To learn more about diabetes and nutrition:

Snacking on Nuts - Your Ticket to Health
Should People with Diabetes Eat Fruit?
8 Taboo Foods with Health Benefits