Eat Carbs Last: Why Your Food Order Might Matter
Eating your bread at the end of a meal may help keep blood sugar levels healthy
Do you dig into the bread basket when it arrives at your restaurant table? That might be a bad idea, and not for the reasons you think.
A small new study suggests the order in which you eat your food makes a difference to your blood sugar levels (and thereby your health). Munching your carbs at the end of a meal appears to help keep those levels steady.
''What we think we are seeing is a way you could have your carbs when you have diabetes and have the enjoyment and satisfaction…but not the impact on blood sugar,” says Louis J. Aronne, MD, the Sanford I. Weill Professor of Metabolic Research and a professor of clinical medicine at Weill Cornell Medical College in New York.
Eating vegetables, then protein-containing food, then carbohydrates produced healthier blood sugar levels after a meal than the reverse that order.
Aronne and colleagues studied 11 patients who all had type 2 diabetes, were obese and were taking the oral diabetes drug metformin. They ate the same meal on two different days, a week apart. The food order at the first visit was simple carbs (ciabatta bread and orange juice), followed by protein (skinless grilled chicken breast) and vegetables (lettuce and tomato salad, low-fat Italian vinaigrette and steamed broccoli with butter). A week later, they ate the same meal in the reverse order.
The researchers wanted to see if blood sugar levels after meals, which are important for overall diabetes control, could be improved simply by changing the order in which foods were eaten. "We were looking for a method supported by research that gives a substantial effect," he says. He is always looking, he says, for simple measures that can help improve blood sugar control.
How food order makes a difference
Eating the meal with the carbohydrates last, Aronne found, ''reduced the peak blood sugar levels by 37 percent'' an hour after the meal. He terms that a significant amount. Insulin levels were reduced by nearly half. "If they ate the carbohydrates last, their body produced half as much insulin to keep the sugar in control."
Other studies have shown that eating whey protein before a meal can reduce blood sugar after a meal, Aronne says. However, he says, there is not much data on whether the order in which food is eaten can affect blood sugar.
Why does eating simple carbs last work? Aronne says eating the protein and vegetables first may prime the body to make a hormone, GLP-1 (glucagon-like peptide), which stimulates insulin production and inhibits the production of glucose.
A dietitian weighs in
The study is a good ''first step'' to assess how food choices affect blood sugar levels, says Connie Diekman, RD, MEd, director of university nutrition at Washington University in St. Louis. (Diekman was not involved in the study.) However, she says, many questions remain. Among them, she says, is the effect over time. "What about the impact from a day, not just a meal?" she asks.
Currently, she says, evidence supports the idea of eating some protein and carbs at each meal and snack to slow the blood sugar fluctuations that occur when you eat carbs alone or eat mostly simple carbs, such as juice. "I just finished seeing a young women with prediabetes and my advice to her was to focus on whole grains, vegetables and some fruits but try to consume these carbs with protein in order to achieve a more stable blood sugar level."
Related: The Solution to Smarter Snacking
A diet strategy for everyone?
Aronne's study included only people with diabetes, but other people might use this technique if their blood sugar levels are inching up, says Aronne. "We think this might be a very good approach to be part of a diabetes prevention program," he says.
About 29 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention. Another 86 million have prediabetes, with blood sugar levels higher than what is considered healthy.
Eating in this order may actually help you eat fewer carbs, Aronne says, since you may be full by the time you get to them. And that could lead to weight loss — which in turn reduces the risk of diabetes.
Aronne acknowledges the idea may seem a bit offbeat to his colleagues. "Many physicians will tell you the food all goes in the same place and [the order] doesn't matter," he says. "What we have shown is, it clearly does matter." He is continuing the research with larger numbers of people.