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Two meals a day – does it reduce diabetes risk?

May 28, 2014

The increasing incidence of type 2 diabetes in the UK is worrying; currently three people are diagnosed with the disease every 10 minutes. Obesity is an important contributory factor and some interesting research emerged last week that suggests that fasting for part of the day could be a way forward. Dr Mark Vanderpump, Consultant Endocrinologist at The Physicians’ Clinic (TPC), reviews these latest findings.

Researchers in Prague gave one group of people a set number of calories spread over 6 small meals throughout the day. Another group had exactly the same food and calories but divided into two larger meals each day. The people eating only twice a day not only lost more weight and inches around their middles, their blood sugar showed a greater reduction overall.

Studies on diet and type 2 diabetes

Dr Mark Vanderpump, Consultant Endocrinologist at The Physicians’ Clinic (TPC) says: "Most experts agree that diet and lifestyle changes are crucial in the prevention and management of type 2 diabetes. It’s therefore surprising that so few studies have been done to investigate the impact of specific diets on diabetes risk,” says Dr Vanderpump. “This study is small but it raises some important questions.”

About type 2 diabetes

Type 2 diabetes tends to occur later in life, typically in people over 40 and, in its early stages, is a problem of insulin resistance. “This means that some insulin is still being produced by islet cells in the pancreas but the hormone doesn’t have the same effect on the body. When body cells don’t respond to insulin, they don’t take in sugar from the blood and so blood sugar can rise to dangerous levels. This makes the pancreas work harder and its function reduces further.”

It’s been estimated that when people are first diagnosed with type 2 diabetes have 10-20% of their pancreatic function. “This provides an important window of opportunity: lifestyle changes can be the only therapy a patient needs to get their blood sugar levels back within the normal range.

By reducing the amount of carbs you take in and increasing muscle activity by doing more exercise, you can reduce the demand on your pancreas quite significantly. Insulin production is maintained for longer, so you delay the need to take medication or insulin injections.”

What kind of diet is most useful in preventing or treating diabetes?

Almost every month a new diet receives publicity as being the next big advance: whatever the details of the different diets, they tend to have one common factor – they reduce the amount of calories you take in on a daily and weekly basis. Combine a diet with exercise and you start burning off more calories than you take in and you lose weight.

Dr Mark Vanderpump, new President of the British Thyroid Association

“What is less intuitive is that significant carbohydrate restriction can have an impact on the amount of fat in your pancreas in just one week. This may even reverse or at least maintain pancreas islet cell function for as long as possible.” Evidence is accumulating that periods of ‘fasting’ - either cutting down on the number of times each day that you eat, or having ‘fast days’ in each week, may have a beneficial effect on your metabolism. Overall, diets that incorporate fasting make insulin more effective again, as insulin resistance is reduced.

“This is contrary to the usual dietician advice that states the value of regular small balanced meals, including carbs. If you plan a diet that restricts carbohydrates and delivers the level of calories you need to lose weight in two meals a day, this could help if you are in the early stages of developing type 2 diabetes.

As ever, how successful the diet is depends on how well you stick to it and how long you put it into practice.” “Lifestyle change is just that – a permanent change. Going back to old habits will only lead to regaining the weight and increasing your risk of type 2 diabetes.”

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