Control blood sugar, starting with "eating" - the study found that "eating vegetables first, eating staple foods later" can significantly improve postprandial blood sugar

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Introduction: Sugar control skills "pinch" postprandial blood glucose, the study found that "eat vegetables first, then eat staple foods" can significantly improve postprandial blood sugar

Summary of research points

➤ Eating meat, fish or vegetables before eating rice can reduce the peak blood glucose of people with normal glucose tolerance by about 50%, and delay the arrival of the peak by 30 to 60 minutes;

➤ For patients with abnormal glucose tolerance, consuming protein and vegetables before carbohydrates can reduce postprandial blood glucose levels by 39%;

➤ For patients with type 2 diabetes, the benefits are more pronounced;

➤ For people with type 1 diabetes, the dietary strategy of adjusting the order of meals also works

Blood glucose is a constantly changing curve affected by many factors

The body's blood glucose levels are not static, but a constantly changing curve

Blood glucose regulation mechanisms are complex and delicate, regulated by multiple systems, multiple mechanisms, and multiple hormone levels

Figure 1 Regulation mechanism of human blood glucose

Why is it so important to manage your blood sugar after a meal? Start with the dangers of blood sugar fluctuations

In recent years, with the deepening of research, people's understanding of the harm of blood glucose fluctuations has become more and more in-depth and comprehensive

Not only diabetics, but also the blood glucose level of OGTT 2h in healthy people is also closely related

Figure 2 OGTT 2h blood glucose levels and disease risk such as CVD

A 2011 study provided more evidence that average blood glucose fluctuations (MAGE) in people with diabetes were independent of the risk factor for coronary artery disease independent of glycosylated hemoglobin (HbA1c) and had even stronger
effects than persistent hyperglycemic states.

In addition to macrovascular disease, some domestic studies have also shown that blood glucose fluctuations in patients with type 2 diabetes have a clear correlation
with microglycemia lesions.

Figure 3 MAGE is an independent risk factor for CAD

For diabetic patients with good control of blood glucose fluctuations, relevant clinical trials have confirmed that the improvement of cardiovascular outcomes is significantly better than that of poorly controlled patients, and studies have confirmed that controlling blood glucose fluctuations can bring cardiovascular benefits
to patients.

"Eat vegetables first, eat later" - reasonable adjustment of the order of meals can significantly improve postprandial blood glucose fluctuations

It is well known that the human body has different rates of digestion of different foods, which is applicable
to both healthy people and diabetics.

Studies have shown that:

➤ Eating meat, fish, or vegetables before rice can reduce the peak blood sugar of people with normal glucose tolerance by about 50%, and delay the arrival of the peak by 30 to 60 minutes
.

(Figure 4)

➤ For patients with glucose intolerance, consuming protein and vegetables before carbohydrates can reduce postprandial blood glucose levels by 39%.


(Figure 5)

➤ The benefits are more pronounced
in patients who have already been diagnosed with type 2 diabetes.

(Figure 6)

Figure 4 Effect of different types of food intake order on the peak blood glucose of patients with normal glucose tolerance

Figure 5 Effect of different types of food intake order on postprandial blood glucose in patients with glucose intolerance

Figure 6 Effect of different types of food sequences on postprandial blood glucose in patients with type 2 diabetes

For people with type 1 diabetes, the dietary strategy of adjusting the order of meals also worked
.

Clinical studies have shown that for children with type 1 diabetes, protein preload meals and mixed meals also showed significant differences in post-hematoemic blood glucose in subjects
.

As shown in the figure:

➤ Subjects who ate a mixed meal began to rise in blood sugar 30 minutes after starting to eat, and blood sugar peaked at 150 minutes after a meal and maintained until 180 minutes;

➤ Subjects who ate protein preload meals did not begin to rise blood sugar until 90 minutes after they started eating, and blood sugar peaked and maintained for 300 minutes after meals, and significantly reduced the peak
blood sugar.

Figure 7 Effect of different meals on postprandial blood glucose in children with type 1 diabetes mellitus

The mechanism behind it?

How does the order of meals affect postprandial blood glucose and blood glucose fluctuations? Based on the available evidence, it is speculated that the following factors are related:

1.
Adjusting the order of meals can delay gastric emptying;

2.
Delay the absorption of intestinal glucose;

3.
Promote the release of insulin and incretin;

4.
Inhibit the intake of insulin in the liver and reduce the rate of insulin clearance;

5.
Enhance the uptake of glucose by insulin-sensitive tissues;

6.
Reduce the production
of endogenous glucose.

brief summary

In summary, there is growing evidence that "pre-meal protein/fat intake or altering the order of meals with macronutrients" can significantly reduce postprandial blood glucose and reduce blood glucose fluctuations in people with normal glucose tolerance, abnormal glucose tolerance, and diabetes; Hypoglycemic mechanisms are associated with delaying gastric emptying, promoting glucose-stimulating insulin secretion, and reducing the clearance of glucose from the liver; Preloaded meal patterns for pre-meal intake of protein and fat or adjusting the order of meals with macronutrients have the potential to become a simple, effective, safe, and inexpensive new way
to prevent and manage diabetic postprandial hyperglycemia.