Effect of Short-Term Increase in Meal Frequency on Glucose Metabolism in Individuals with Normal Glucose Tolerance or Impaired Fasting Glucose: A Randomized Crossover Clinical Trial

Abstract

Effects of meal frequency on blood glucose levels and glucose metabolism were evaluated over 3 days in adult males with normal glucose tolerance (NGT, n = 9) or impaired fasting glucose (IFG, n = 9) in a randomized, crossover comparison study. Subjects were provided with an isocaloric diet 3 times daily (3M) or 9 times daily (9M). Blood glucose was monitored on Day 3 using a continuous glucose monitoring system, and subjects underwent a 75-g oral glucose tolerance test (OGTT) on Day 4. Daytime maximum blood glucose, glucose range, duration of glucose ≥180 mg/dL, and nighttime maximum glucose were significantly lower in the NGT/9M condition than in the NGT/3M condition. Similar findings were observed in the IFG subjects, with a lower daytime and nighttime maximum glucose and glucose range, and a significantly higher daytime minimum glucose in the 9M condition than in the 3M condition. The OGTT results did not differ significantly between NGT/3M and NGT/9M conditions. In contrast, the incremental area under the curve tended to be lower and the maximum plasma glucose concentration was significantly lower in the IFG/9M condition than in the IFG/3M condition. In IFG subjects, the 9M condition significantly improved glucose metabolism compared with the 3M condition. Higher meal frequency may increase glucagon-like peptide 1 secretion and improve insulin secretion.

Continuous Glucose Monitoring in a Healthy Population: Understanding the Post-Prandial Glycemic Response in Individuals without Diabetes Mellitus

“…The group provided with an isocaloric diet 3 times a day had higher daytime maximum blood glucose levels, a wider glucose range, greater duration of glucose levels ≥180 mg/dL, and higher night-time maximum glucose levels than those provided with an isocaloric diet 9 times a day. [70] Those receiving meals 9 times a day demonstrated significantly improved glucose metabolism than those receiving meals 3 times a day. The authors hypothesize this may be due to increased glucagon-like peptide secretion and could improve insulin secretion in those receiving more frequent meals.…”