Metabolic effects of alterations in meal frequency in type 2 diabetes
Abstract
OBJECTIVE: The effects of altering meal frequency on measures of glucose and lipid metabolism in type 2 diabetes were examined by comparing isocaloric dietary regimens in which daily food intake was provided by three or nine meals each day. RESEARCH DESIGN AND METHODS: A total of 13 free-living men and women with type 2 diabetes or persistently impaired glucose tolerance participated in a randomized crossover study in which three- and nine-meal regimes were followed for 4-week periods. Fasting plasma lipid and lipoprotein, glucose and insulin concentrations were measured at weekly intervals and glucose, insulin, and triglyceride responses following a 75-g glucose load at weeks 2 and 4 of each diet period. Dietary intake was also recorded during these weeks. RESULTS: Nutrient intakes and all measures of carbohydrate and lipid metabolism were similar on the three- and nine-meal regimes. CONCLUSIONS: This longer-term study could not confirm the potential benefits of increased meal frequency suggested by comparable 4-week studies in type 2 diabetic individuals and acute experiments in individuals with diabetes. However, as there were no adverse effects of consuming nine meals per day, it would seem appropriate that meal frequency in those with type 2 diabetes should be left to personal choice, provided that energy balance is maintained.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Clinical trials, both short-term and long-term, with or without caloric restriction, in various populations, have produced contradictory results regarding the association of meal frequency with body weight, postprandial glycemia, insulin resistance, and overall glycemic control.
“Clinical trials, both short-term (14–28 days) [321,325,328,329,330,331,332] and long-term [323,324] with no caloric restriction in non-obese and obese women with PCO syndrome at an early or late stage IGT or overt early-stage T2DM, and long-term studies with caloric restriction in T2DM without [333] or with antidiabetic treatment [320,326], have produced contradictory results regarding the associ”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [331]
Cited by
Sorted by citations
Franz, M. J., Bantle, J. P., Beebe, C. A., Brunzell, J. D., Chiasson, J.-L., Garg, A., Holzmeister, L. A., Hoogwerf, B., Mayer-Davis, E., Mooradian, A. D., et al. (2002) · Diabetes Care · doi:10.2337/diacare.25.1.148 · Cited by 1,165 · see citing works
Breakfast Frequency and Quality in the Etiology of Adult Obesity and Chronic Diseases
Timlin, M. T., & Pereira, M. A. (2007) · Nutrition Reviews · doi:10.1301/nr.2007.jun.268-281 · Cited by 330 · see citing works
Harte, A. L., Varma, M. C., Tripathi, G., McGee, K. C., Al‐Daghri, N. M., Al-Attas, O. S., Sabico, S., O’Hare, J. P., Ceriello, A., Saravanan, P., et al. (2011) · Diabetes Care · doi:10.2337/dc11-1593 · Cited by 236 · see citing works
“Because it is acknowledged that obese and type 2 diabetic subjects tend to eat high SFA without correspondingly high levels of fruit or healthy foods, this diet would clearly affect their endotoxin and inflammatory status (28,31,32).”
BackgroundInfluentialKahleova, H., Belinova, L., Malinska, H., Oliyarnyk, O., Trnovska, J., Skop, V., Kazdova, L., Dezortova, M., Hajek, M., Tura, A., et al. (2014) · Diabetologia · doi:10.1007/s00125-014-3253-5 · Cited by 229 · see citing works
“A longer term study, comparing the effect of three and nine meals daily (each period lasting 4 weeks), in 13 patients with type 2 diabetes, did not confirm the beneficial effects of increased meal frequency [39].”
BackgroundPapakonstantinou, E., Oikonomou, C., Nychas, G., & Dimitriadis, G. D. (2022) · Nutrients · doi:10.3390/nu14040823 · Cited by 199 · see citing works
Sievenpiper, J. L., Chan, C. B., Dworatzek, P. D., Freeze, C., & Williams, S. L. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.009 · Cited by 200 · see citing works
Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency
Mekary, R. A., Giovannucci, E., Cahill, L., Willett, W. C., van Dam, R. M., & Hu, F. B. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.057521 · Cited by 180 · see citing works
“Earlier trials showed no effect on glucose metabolism in a comparison of subjects with T2D on low or high eating frequency regimes (13, 14).”
BackgroundCarbohydrate and the Regulation of Blood Glucose and Metabolism
Wolever, T. M. S. (2003) · Nutrition Reviews · doi:10.1301/nr.2003.may.s40-s48 · Cited by 151 · see citing works
Dworatzek, P. D. N., Arcudi, K., Gougeon, R., Husein, N., Sievenpiper, J. L., & Williams, S. L. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.01.019 · Cited by 149 · see citing works
Eating Frequency and Energy Regulation in Free-Living Adults Consuming Self-Selected Diets
McCrory, M. A., Howarth, N. C., Roberts, S. B., & Huang, T. T. ‐. (2010) · Journal of Nutrition · doi:10.3945/jn.109.114991 · Cited by 101 · see citing works
“(21) showed a nonsignificant increase of 14.”
Metabolic impacts of altering meal frequency and timing - Does when we eat matter
Hutchison, A. T., & Heilbronn, L. K. (2016) · Biochimie · doi:10.1016/j.biochi.2015.07.025 · Cited by 91 · see citing works
Jakubowicz, D. J., Landau, Z., Tsameret, S., Wainstein, J., Raz, I., Åhrén, B., Chapnik, N., Barnea, M., Ganz, T., Menaged, M., et al. (2019) · Diabetes Care · doi:10.2337/dc19-1142 · Cited by 78 · see citing works
The effect of feeding frequency on insulin and ghrelin responses in human subjects
Solomon, T. P. J., Chambers, E. S., Jeukendrup, A. E., Toogood, A. A., & Blannin, A. K. (2008) · British Journal Of Nutrition · doi:10.1017/s000711450896757x · Cited by 76 · see citing works
Is snacking good or bad for health: An overview
Miller, R. B., Benelam, B., Stanner, S. A., & Buttriss, J. (2013) · Nutrition Bulletin · doi:10.1111/nbu.12042 · Cited by 66 · see citing works
Should snacks be recommended in obesity treatment? a 1-year randomized clinical trial
Forslund, H. B., Klingström, S., Hagberg, H., Löndahl, M., Torgerson, J. S., & Lindroos, A. K. (2007) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602860 · Cited by 63 · see citing works
Diabetes mellitus type 2 in adults
Dedov, I. I., Shestakova, M. V., Mayorov, A. Y., Шамхалова, М. Ш., Sukhareva, O. Y., Galstyan, G. R., Tokmakova, A. Y., Nikonova, T. V., Surkova, E. V., Кононенко, И. В., et al. (2020) · Diabetes Mellitus · doi:10.14341/dm12507 · Cited by 58 · see citing works
Schwingshackl, L., Nitschke, K., Zähringer, J., Bischoff, K., Lohner, S., Torbahn, G., Schlesinger, S., Schmucker, C. M., & Meerpohl, J. J. (2020) · Advances in Nutrition · doi:10.1093/advances/nmaa056 · Cited by 44 · see citing works
“In 10 RCTs, the mean BMI of the included participants was ≥30 (23, 24, 29– 31, 36, 39, 41, 43, 44), while in 5 RCTs (23, 24, 30, 31, 41) only participants with a BMI ≥30 were included and 3 RCTs included participants with T2D or impaired glucose tolerance, respectively (28, 35, 39).”
BackgroundPapakonstantinou, E., Kontogianni, M. D., Mitrou, P., Magriplis, E., Vassiliadi, D., Nomikos, T., Lambadiari, V., Georgousopoulou, E., & Dimitriadis, G. (2018) · Diabetes & Metabolism · doi:10.1016/j.diabet.2018.03.008 · Cited by 39 · see citing works
Papakonstantinou, E., Kechribari, I., Mitrou, P., Trakakis, E., Vassiliadi, D., Georgousopoulou, E., Zampelas, A., Kontogianni, M. D., & Dimitriadis, G. (2016) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2015.225 · Cited by 34 · see citing works
Dashti, H. S., & Mogensen, K. M. (2016) · Nutrition in Clinical Practice · doi:10.1177/0884533616662995 · Cited by 27 · see citing works
Almoosawi, S., Prynne, C. J., Hardy, R., & Stephen, A. M. (2013) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2013.01.003 · Cited by 27 · see citing works
Energy and Nutrient Timing for Weight Control
McCrory, M. A., Shaw, A. C., & Lee, J. A. (2016) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2016.04.017 · Cited by 25 · see citing works
Abdollahi, S., Kazemi, A., de Souza, R. J., Clark, C. C. T., & Soltani, S. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2020.12.038 · Cited by 23 · see citing works
Improved diabetes control after prolonged fasting — the Ramadan model
Maislos, M., Abou-Rabiah, Y., Zuili, I., & Shany, S. (2001) · Practical Diabetes · doi:10.1002/pdi.166 · Cited by 19 · see citing works
Livesey, G. (2002) · British Journal of Nutrition · doi:10.1079/bjn2002730 · Cited by 20 · see citing works
Evidence for Efficacy and Effectiveness of Changes in Eating Frequency for Body Weight Management
Kant, A. K. (2014) · Advances in Nutrition · doi:10.3945/an.114.007096 · Cited by 18 · see citing works
Hauner, H. (2010) · Wiley eBooks · doi:10.1002/9781444324808.ch14 · Cited by 21 · see citing works
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2023) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-023-01532-z · Cited by 21 · see citing works
Salehi, M., Kazemi, A., & Zadeh, J. H. (2014) · PubMed Central · Cited by 13 · see citing works
Heller, T., Kloos, C., Kessler, D. S., Muller, N., Thierbach, R., Wolf, G., & Müller, U. (2014) · Diabetic Medicine · doi:10.1111/dme.12616 · Cited by 11 · see citing works
Leiva, T., Basfi-fer, K., Rojas, P., Fernando Carrasco, N., & Manuel Ruz, O. (2016) · Revista médica de Chile · doi:10.4067/s0034-98872016001000002 · Cited by 7 · see citing works
Hauner, H. (2016) · doi:10.1002/9781118924853.ch16 · Cited by 5 · see citing works
Li, C., D'Agostino, R. B., Dabelea, D., Liese, A. D., Mayer‐Davis, E. J., Pate, R. R., & Merchant, A. T. (2018) · Pediatric Diabetes · doi:10.1111/pedi.12690 · Cited by 4 · see citing works
“([32]) on the impact of eating frequency on metabolic effects among 13 adults with T2D did not confirm the A cc ep te d A rti cl e”
Schernthaner, G., & Schernthaner, G.-H. (2007) · CRC Press eBooks · doi:10.3109/9780849379581-29 · Cited by 4 · see citing works
Pafili, Z., & Dimosthenopoulos, C. (2021) · HORMONES · doi:10.1007/s42000-021-00314-1 · Cited by 4 · see citing works
Dworatzek, P. D. N., Arcudi, K., Gougeon, R., Husein, N., Sievenpiper, J. L., & Williams, S. L. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.07.048 · Cited by 2 · see citing works
Vásquez, V. S., Fernández, C. T., & Soto, C. V. (2015) · PubMed · doi:10.3305/nh.2015.31.4.8359 · Cited by 1 · see citing works
The Effect of Meal Frequency on Preprandial Resting Metabolic Rate
Goodman-Larson, A., Johnson, K., Shevlin, K., & Skemp-Arlt, K. M. (2003) · Cited by 1 · see citing works
Hunag, Y., Farid, F., & Suleiman, B. (2023) · Studies in computational intelligence · doi:10.1007/978-3-031-42112-9_11 · Cited by 1 · see citing works
Li, C. (2015) · Scholar Commons (University of South Carolina)
IMPACTO DA INGESTÃO ALIMENTAR NO CONTROLO GLICÉMICO DE DIABÉTICOS TIPO 2 NÃO-INSULINOTRATADOS
de Almeida, S. C. M. (2006)
The effect of physical activity on the insulin response to frequent meals
Holmstrup, M. E. (2011) · Syracuse University Libraries (Syracuse University)
Nutrition therapy for new diabetes patients
Szerlong, H., Daitch, L., & Stallings, J. (2011)
Sambra, V., Fernández, C. T., & Soto, C. V. (2015)
Hauner, H. (2007) · CRC Press eBooks · doi:10.3109/9780849379581-27
Shaw, A. C. (2022) · Digital Archive @ GSU · doi:10.57709/7041873
News update for readers of Practical Diabetes International
(2001) · Practical Diabetes · doi:10.1002/pdi.205
Hussain, M. I., Naveed, F., Sheikh, M., et al. (2023) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs20231772
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2024) · Figshare · doi:10.6084/m9.figshare.24564275
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2024) · Figshare · doi:10.6084/m9.figshare.26640109
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2024) · Figshare · doi:10.6084/m9.figshare.26640112
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2024) · Figshare · doi:10.6084/m9.figshare.26640121
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2023) · Figshare · doi:10.6084/m9.figshare.24564095
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2024) · Figshare · doi:10.6084/m9.figshare.26640115
Blazey, P., Habibi, A., Hassen, N., Friedman, D., Khan, K. M., & Ardern, C. L. (2024) · Figshare · doi:10.6084/m9.figshare.26640124
Approaches for Individualizing the Diabetes Eating Plan
Evert, A. B. (2026) · American Diabetes Association eBooks · doi:10.2337/9781580408493-ch03
Eating patterns and type 2 diabetes risk in men: Breakfast omission, eating frequency, and snacking
Mekary, R. A., Giovannucci, E., Willett, W. C., van Dam, R. M., & Hu, F. B. (2012) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.028209 · Cited by 325 · see citing works
“Potential reasons for the discrepant results between the old (37) and recent (34) reviews are the progressive increase in portion sizes and the decrease in snack quality over the years that led to increased energy density (defined as the energy content per gram of food eaten) (38) and increased energy intake (39).”
BackgroundMethodResult
- Authors
- Arnold, L., Mann, J. I., & Ball, M. J.
- Affiliations
- University of Otago (NZ)
- ORCID
- Mann, Jim I
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1997-11-01
- Volume
- 20
- Issue
- 11
- Pages
- 1651-1654
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2135773336
- Cited by
- 58
- References
- 0
- Citations by year
- 2026: 1 · 2024: 6 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 3 · 2016: 5 · 2015: 4 · 2014: 4 · 2013: 5 · 2012: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- meal frequency, type 2 diabetes, glucose metabolism, lipid metabolism, insulin response, glucose tolerance, isocaloric diet, fasting lipids, lipoproteins, energy balance, dietary intervention
- MeSH terms
- Aged, Blood Glucose, Creatinine, Diabetes Mellitus, Type 2, Feeding Behavior, Female, Humans, Insulin, Lipids, Male, Middle Aged, Glucose Intolerance, Cross-Over Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
