title: Metabolic advantages of spreading the nutrient load: effects of increased meal frequency in non-insulin-dependent diabetes.
abstract: The acute effect of increasing meal frequency as a model of slow absorption was studied for 1 d in 11 patients with non-insulin-dependent diabetes. On 1 d they took 13 snacks (the nibbling diet) and on another day the same diet was taken as three meals and one snack (the three-meal diet). The nibbling diet reduced mean blood glucose, serum insulin, and C peptide concentrations over the 9.5 h of observation and 24-h urinary C peptide output by 12.7 +/- 3.7% (mean +/- SE) (P = 0.0062), 20.1 +/- 5.8% (P = 0.0108), 9.2 +/- 2.6% (P = 0.0073), and 20.37 +/- 8.12% (P = 0.039), respectively, compared with the three-meal diet. Serum triglyceride concentrations were lower by 8.5 +/- 3.2% (P = 0.037). Despite lower insulin concentrations on the nibbling diet, the concentrations of free fatty acids, 3-hydroxybutyrate, and the insulin-sensitive branched-chain amino acids responded similarly on both treatments. Metabolic benefits seen with increased meal frequency may explain the success of similar agents that prolong absorption, including fiber and enzyme inhibitors.
authors.affiliation: Department of Nutritional Sciences and Preventive Medicine, Faculty of Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: D J
authors.initials: DJ
authors.lastname: Jenkins
authors.forename: A
authors.initials: A
authors.lastname: Ocana
authors.forename: A L
authors.initials: AL
authors.lastname: Jenkins
authors.forename: T M
authors.initials: TM
authors.lastname: Wolever
authors.forename: V
authors.initials: V
authors.lastname: Vuksan
authors.forename: L
authors.initials: L
authors.lastname: Katzman
authors.forename: M
authors.initials: M
authors.lastname: Hollands
authors.forename: G
authors.initials: G
authors.lastname: Greenberg
authors.forename: P
authors.initials: P
authors.lastname: Corey
authors.forename: R
authors.initials: R
authors.lastname: Patten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000652:urine; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism*; D005215:Fasting; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009994:Osmolar Concentration; D013997:Time Factors
chemical_list: D000596:Amino Acids; D001786:Blood Glucose; D002096:C-Peptide; D006728:Hormones; D003404:Creatinine