By Dr. Viktoriya Zabigaylo, ND
Eating balanced meals is known to be an important factor for blood sugar control and ensuring that we get an adequate amount of nutrients. This means having enough protein, fat, and fiber with each meal. Recent research suggests that we should also consider the order in which we eat a meal, as it can also impact blood sugar regulation.
In one study, meals consisting of vegetables, fish and white rice were eaten by healthy young women, but in different orders. If the vegetables were eaten first, insulin and glucose spikes after the meal were much lower than if the white rice was eaten first. Another study showed that eating a ciabatta bun before a meal resulted in blood glucose spiking 40% higher compared to when the ciabatta was eaten at the end of the meal. This suggests that eating carbohydrates on an empty stomach has a much greater influence on blood sugar compared to saving them for last.
The speed of eating a meal was also tested – 10 minutes (fast) versus 20 minutes (slow). While vegetables were still eaten first in both groups, the slow eating group showed much lower blood glucose spikes 30 minutes after completing the meal. However, beyond one hour after the meal there was no significant difference between the two eating speeds. Although this study shows that eating speed may not impact blood sugar regulation as much, other studies have shown a correlation between people with fast eating habits and a higher risk of diabetes and obesity. Also, slower eating may benefit certain populations that have delayed insulin secretion such as people of Japanese, East Asian, and European descent.
These studies imply that it is important to have a balanced meal, but save the carbs for the end. This is one of the reasons why a 3-course meal starts with a salad or vegetables first. They contain high amounts of fiber which slows the digestion and absorption of carbs and improves insulin secretion. Bitter greens like arugula, kale, rapini, and radicchio can also help stimulate digestion just prior to eating a meal. Apple cider vinegar taken before meals or as a component in salad dressings can further help with glycemic control and improving insulin sensitivity.
Adding these dietary modifications can be helpful for managing high blood sugar and insulin resistance, such as in pre-diabetes, diabetes and PCOS.
References
Hadi, A., Pourmasoumi, M., Najafgholizadeh, A., Clark, C. C., & Esmaillzadeh, A. (2021). The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complementary Medicine and Therapies, 21(1), 179.
Iehara, R., Imai, S., Kajiyama, S., Yamamoto, M., Miyawaki, T., Matsumoto, S., … & Fukui, M. (2022). Vegetable juice preload ameliorates postprandial blood glucose concentration in healthy women: A randomized cross-over trial.
Imai S, Kajiyama S, Kitta K, et al. Eating vegetables first regardless of eating speed has a significant reducing effect on postprandial blood glucose and insulin in young healthy women: randomized controlled cross-over study. Nutrients. 2023;15(5):1174.
Kasuya, N., Inoue, N., Inoue, Y., Murata, I., & Kanamoto, I. (2019). Effect of vegetable juice consumption prior to eating rice on postprandial blood glucose and insulin levels. Experimental and Therapeutic Medicine, 18(5), 3817-3822.
Shishehbor, F., Mansoori, A., & Shirani, F. (2017). Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. diabetes research and clinical practice, 127, 1-9.
Shukla, A. P., Dickison, M., Coughlin, N., Karan, A., Mauer, E., Truong, W., … & Aronne, L. J. (2019). The impact of food order on postprandial glycaemic excursions in prediabetes. Diabetes, Obesity and Metabolism, 21(2), 377-381.