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Carbohydrate tolerance and food frequency

Published online by Cambridge University Press:  09 March 2007

David J. A. Jenkins
David J. A. Jenkins
Affiliation:
Clinical Nutrition & Risk Factor Modification Center, St Michael's Hospital, 61 Queen Street East, 6th Floor, Toronto, Ontario M5S 3E2, Canada
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Abstract

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Dietary and pharmacological approaches to slowing the rate of glucose absorption and blunting the insulin response show promise in the treatment of diabetes and hyperlipidaemia. These approaches include dietary fibre, low-glycaemic-index foods and gastrointestinal digestive enzyme inhibitors. One common feature is that they spread the nutrient load over time. A potentially simpler approach is to take more frequent smaller meals over a longer period of the day. Early studies suggested that frequent glucose and insulin administration to diabetic patients improved diabetes control. More recent acute studies of one test meal or 1 d blood metabolite profiles have identified a significant economy in insulin secretion when glucose is sipped or when meal frequency is increased in both diabetic or non-diabetic subjects. In diabetic subjects improvement in mean blood glucose levels has also been reported. However, despite the demonstration of an alteration in response over time in glucose tolerance in healthy volunteers, no longer-term improvement in glycaemic control was reported in the only study in diabetes to examine a change from three to nine meals daily over a 1- month period. The disparity between longer-term and acute studies requires further investigation. At present, although this nutritional approach holds considerable theoretical promise, specific advice is premature.

Keywords

Carbohydrate tolerance
Type
Research Article
Information
British Journal of Nutrition , Volume 77 , Issue S1 , April 1997 , pp. S71 - S81
Copyright
Copyright © The Nutrition Society 1997

References

REFERENCES

Arnold, L., Ball, M. & Mann, J. (1994). Metabolic effect of alteration in meal frequency in hypercholesterolaemic individuals. Atherosclerosis 108, 167–174.CrossRefGoogle ScholarPubMed
Arnold, L. M., Ball, M. J., Duncan, A. W. & Mann, J. (1993). Effect of isoenergetic intake of three or nine meals on plasma lipoproteins and glucose metabolism. American Journal of Clinical Nutrition 57, 446–451.CrossRefGoogle ScholarPubMed
Bellisle, F., McDevitt, R. & Prentice, A. (1997). Meal frequency and energy balance. British Journul of Nutrition 77, Suppl 1, S57–S70.CrossRefGoogle Scholar
Bertelsen, J., Christiansen, C., Thomsen, C., Poulsen, P. L., Vestergaard, S., Steinov, A., Rosmussen, L. H., Rosmussen, O. & Hermansen, K. (1993). Effect of meal frequency on blood glucose, insulin and free fatty acids in NIDDM subjects. Diabetes Care 16, 3–7.CrossRefGoogle ScholarPubMed
Blackburn, N. A., Redfern, J. S., Jarjis, H., Holgate, A. M., Hanning, I., Scarpello, J. H., Johnson, I. T & Read, N. W. (1984). The mechanism of action of guar gum in improving glucose tolerance in Man. Clinical Science 66, 329–336.CrossRefGoogle ScholarPubMed
Braaten, J. T., Wood, P. J., Scott, F. W., Riedel, K. D., Poste, L. M. & Collins, M. W. (1991) Oat gum lowers glucose and insulin after an oral glucose load. American Journal of Clinical Nutrition 53, 1425–1430.CrossRefGoogle ScholarPubMed
Bray, G. A. (1972). Lipogenesis in human adipose tissue: some effects of nibbling and gorging. Journal of Clinical Investigation 51, 537–548.CrossRefGoogle ScholarPubMed
Brown, M. S. & Goldstein, J. L. (1980). Multivalent feedback regulation of HMGCoA reductase, a control mechanism coordinating isoprenoid synthesis and cell growth. Journal of Lipid Research 21, 507–517.CrossRefGoogle Scholar
Cohn, C. (1964). Feeding patterns and some aspects of cholesterol metabolism. Federation Proceedings 23, 76–81.Google ScholarPubMed
Ducmetiere, P., Eschwege, E., Papoz, L., Richard, J. L., Claude, J. R. & Rosselin, G. (1980). Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. Diabetologia 19, 205–210.CrossRefGoogle Scholar
Edelstein, S. L., Barrett-Connor, E. L., Wingard, D. L. & Cohn, B. A. (1992). Increased meal frequency associated with decreased cholesterol concentrations; Rancho Bernado, CA 1984–1987. American Journal of Clinical Nutrition 55. 664–661.CrossRefGoogle Scholar
Ellis, A. (1934).Increased carbohydrate tolerance in diabetes following hourly administration of glucose and insulin over long periods. Quarterly Journal of Medicine 27, 137–153.Google Scholar
Fabry, P., Fodor, J., Hejl, Z., Braun, T. & Zvolankova, K. (1964). The frequency of meals; its relationship to overweight, hypercholesterolaemia, and decreased glucose tolerance. Lancet ii, 614–615.CrossRefGoogle Scholar
Facchini, F., Chen, Y. D., Hollenbeck, C. B. & Reaven, G. M. (1991). Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance and plasma uric acid concentration. Journal of the American Medical Association 266, 3008–3011.CrossRefGoogle ScholarPubMed
Flourie, B., Vidor, N., Florent, C. H. & Berrier, J. J. (1984). Effect of pectin on jejunal glucose absorption and unstirred layer thickness in normal men. Gut 25, 936–941.CrossRefGoogle Scholar
Franz, M. J., Horton, E. S., Bantle, J. P., Beebe, C. A., Brunzell, J. D., Coulston, A. M., Henry, R. R., Hogwerf, B. J. & Stacpoole, P. W. (1994). Nutrition principles for the management of diabetes and related complications. Diabetes Care 17, 490–518.CrossRefGoogle ScholarPubMed
Gatenby, S. J. (1997). Eating frequency: methodological and dietary aspects. British Journal of Nutrition 77, Suppl. 1, S7–S20.CrossRefGoogle Scholar
Gatenby, S. J.Anderson, A. O., Walker, A. D.Southon, S. & Mela, D. J. (1995). ‘Meals’ and ‘snacks’: implications for eating patterns in adults. Appetite 24, 292.Google Scholar
Gwinup, G., Byron, R. C., Roush, W., Kruger, F. & Hamwi, G. J. (1963 a) Effect of nibbling versus gorging on serum lipids in man. American Journal of Clinical Nutrition 13, 207–213.CrossRefGoogle ScholarPubMed
Gwinup, G., Byron, R. C., Roush, W., Kruger, F. & Hamwi, G. J. (1963 b). Effect of nibbling versus gorging on glucose tolerance. Lancet ii, 165–167.CrossRefGoogle ScholarPubMed
Holt, S., Heading, R. C., Carter, D. C., Prescott, L. F. & Tothill, P. (1979). Effect of gel fibre on gastric emptying and absorption of glucose and paracetamol. Lancet i, 636–639.CrossRefGoogle ScholarPubMed
Jagannathen, S. N., Connell, W. F. & Beveridge, J. M. R. (1964). Effects of gormandizing and semicontinuous eating of equicaloric amounts of formula-type high fat diets on plasma cholesterol and triglyceride levels in human volunteer subjects. American Journal of Clinical Nutrition 15, 90–93.CrossRefGoogle Scholar
Jenkins, D. J. A., Goff, D. V., Leeds, A. R., Alberti, K. G., Wolever, T. M., Gassull, M. A. & Hockaday, T. D. (1976). Unabsorbable carbohydrates and diabetes: decreased post-prandial hyperglycemia. Lancet ii, 172–174.CrossRefGoogle Scholar
Jenkins, D. J. A., Khan, A., Jenkins, A. L., Illingworth, R., Pappu, A. S., Wolever, T. M. S., Hawkins, M., Adbolell, M., Corey, P., Patten, R. & Josse, R. G. (1995). The effect of nibbling versus gorging on cardiovascular risk factors: serum uric acid and blood lipids. Metabolism 4, 549–555.CrossRefGoogle Scholar
Jenkins, D. J. A., Ocana, A., Jenkins, A. L., Wolever, T. M. S., Vuksan, V., Katzman, L., Hollands, M., Greenberg, G., Corey, P., Patten, R., Wong, G. & Josse, R. G. (1992). Metabolic advantages of spreading the nutrient load: effects of meal frequency in non-insulin-dependent diabetes. American Journal of Clinical Nutrition 55, 461–467.CrossRefGoogle ScholarPubMed
Jenkins, D. J. A., Wolever, T. M. S., Leeds, A. R., Gassall, M. A., Haismen, P., Dilawari, J., Goff, D. V., Metz, G. L. & Alberti, K. G. M. M. (1978). Dietary fibres, fibre analogues and glucose tolerance: importance of viscosity. British Medical Journal 1, 1392–1394.CrossRefGoogle ScholarPubMed
Jenkins, D. J. A., Wolever, T. M. S., Ocana, A. M., Vuksan, V., Cunnane, S. C., Jenkins, M. J. A., Wong, G. S., Singer, W., Bloom, S. R., Blendis, L. M. & Josse, R. G. (1990). Metabolic effects of reducing rate of glucose ingestion by single bolus versus continuous sipping. Diabetes 39, 775–781.CrossRefGoogle ScholarPubMed
Jenkins, D. J. A., Wolever, T. M. S., Taylor, R. H., Kannen, W., Sarson, D. & Bloom, S. R. (1983). Reply to letter by Abraira and Lawrence. American Journal of Clinical Nutrition 37, 153–154.CrossRefGoogle Scholar
Jenkins, D. J. A., Wolever, T. M. S., Vuksan, V., Brighenti, F., Cunnane, S. C., Rao, A. V., Jenkins, A. L., Buckley, G., Patten, R., Singer, W., Corey, P. & Josse, K. G. (1989). Nibbling versus gorging: metabolic advantages of increased meal frequency. New England Journal of Medicine 321, 929–934.CrossRefGoogle ScholarPubMed
Jones, P. J. H., Leitch, C. A. & Pederson, R. A. (1993). Meal frequency effects on plasma hormone concentrations and cholesterol synthesis in humans. American Journal of Clinical Nutrition 57, 868–874.CrossRefGoogle ScholarPubMed
Lakshmanan, M. R., Nepokroeff, C. M., Ness, G. L., Dugan, R. E. & Porter, J. W. (1973). Stimulation by insulin of rat liver β-hydroxy-β-methylglutaryl coenzyme A reductase and cholesterol-synthesizing activities. Biochemical and Biophysical Research Communications 50, 704–710.CrossRefGoogle Scholar
Leeds, A. L., Ralphs, D. N. L., Ebied, F., Metz, G. & Dilawari, J. P. (1981). Pectin in the dumping syndrome: reduction of symptoms and plasma volume changes. Lancet i, 1075.CrossRefGoogle ScholarPubMed
McGrath, S. A. & Gibney, M. J. (1994). The effects of altered frequency of eating on plasma lipids in free-living healthy males on normal self-selected diets. European Journal of Clinical Nutrition 48, 402–407.Google ScholarPubMed
Mann, J. (1997). Meal frequency and plasma lipids and lipoproteins. British Journal of Nutrition 77, Suppl. 1, S83–S90.CrossRefGoogle ScholarPubMed
Randle, P. J., Gasland, P. B., Hales, C. N. & Newsholme, E. A. (1963). The glucose fatty acid cycle: its role in insulin senitivity and the metabolic disturbances of diabetic mellitus. Lancet i, 785–798.CrossRefGoogle Scholar
Segura, A. G., Josse, R. G. & Wolever, T. M. S. (1995). Acute metabolic effects of increased meal frequency in type II diabetics: three vs six, nine and twelve meals. Diabetes Nutrition and Metabolism 8, 331–338.Google Scholar
Special Report Committee of the Canadian Diabetes Association (1981). Guidelines for the nutritional management of diabetes mellitus: a special report from the Canadian Diabetes Association. Journal of the Canadian Dietetic Association 42, 110–118.Google Scholar
Tai, M. M., Castillo, P. & Pi Sunyer, F. X. (1991). Meal size and frequency: effect on the thermic effect of food. American Journal of Clinical Nutrition 54, 783–787.CrossRefGoogle ScholarPubMed
Wolever, T. M. S. (1990). Metabolic effects of continuous feeding. Metabolism 39, 947–951.CrossRefGoogle ScholarPubMed
Wolever, T. M. S., Josse, R. G., Palmason, C. & Canadian Universities Multicenter Trial Group (1995). Spreading nutrient intake throughout the day associated with reduced serum cholesterol in 342 patients with type 2 diabetes. Nutrition Metabolism and Cardiovascular Diseases 5, 31–38.Google Scholar
Wood, P. J., Braaten, J. T., Scott, F. W., Riedel, D., Wolynetz, M. S. & Collins, M. W. (1994). Effect of dose and modification of viscous properties of oat gum on plasma glucose and insulin following an oral glucose load. British Journal of Nutrition 72, 731–743.CrossRefGoogle ScholarPubMed