New research suggests that two large meals (breakfast and lunch), rather than six small meals with the same total calories, are better for controlling weight and blood sugar in people with type 2 diabetes.

The researchers, asked patients being treated with oral diabetes drugs, to follow one of two regimens of a restricted calorie diet, each containing 500 calories less than the recommended daily amount.

In one programme the meals consisted of six small portions and the other 2 large meals made up of breakfast and lunch).

The participants were divided into two groups, with each doing one of the two programmes for 12 weeks and then moving on to the other programme, again for 12 weeks.

The diet in both regimens had the same macronutrient and calorie content. Liver fat content, insulin sensitivity and pancreatic beta cell function (the cells that produce insulin) were measured using a variety of techniques and mathematical modelling.

The authors say: “Eating only breakfast and lunch reduced body weight, liver fat content, fasting plasma glucose, C-peptide and glucagon, and increased OGIS, more than the same caloric restriction split into six meals. These results suggest that, for type 2 diabetic patients on a calorie-restricted diet, eating larger breakfasts and lunches may be more beneficial than six smaller meals during the day.”

They add: “Novel therapeutic strategies should incorporate not only the energy and macronutrient content but also the frequency and timing of food. Further larger scale, long-term studies are essential before offering recommendations in terms of meal frequency.”

Source: Diabetologia (the journal of the European Association for the Study of Diabetes)