|August 15, 2016||0|
There’s the one about the Loch Ness Monster lurking in the cold, dark waters of the Scottish Highlands; the one about Big Foot skulking about the forests of the Pacific Northwest (and parts of Canada); and the Chupacabra, a goat-sucking monster said to live in parts of Latin America.
But perhaps the biggest myth to come along in recent years is that grazing, or eating small frequent meals throughout the day, is better for people with diabetes than eating the traditional three meals a day. After all, if you eat frequent, small meals, instead of big ones, you wouldn’t need to produce as much insulin at any one time, and your post-meal spikes would probably be much smaller. In theory, it makes sense, but does science back up the theory?
The Trouble with grazing
When it comes to controlling weight and insulin spikes, the main problem with grazing is that oftentimes, people are not hearing the entire message, but rather choosing to hear what they want: eat more. Instead of eating more frequent smaller meals, many people are simply eating more food and calories per day. This quickly leads to weight gain, which can exacerbate diabetes.
Beyond eating more, people are also making unhealthy choices when it comes to the foods they snack on. Instead of reaching for fruits and nuts, people are eating chips, baked goods, and other processed foods high on the glycemic index.
“Tell yourself, it’s not that I can’t eat that. I’m making the healthier choice not to.”
But the real problem is that eating in between meals fights our body’s ability to burn fat  and taxes our liver and pancreas. See, when we eat, no matter what it is we eat, our body releases insulin which helps carry glucose into our cells to burn as fuel. This initial energy lasts for about three hours, after which our bodies start using energy from our fat stores.
Eating more frequent meals does not allow our body to turn to our fat stores for fuel. Our liver and pancreas are under more stress because our blood sugar and fat levels remain higher throughout the day. This can also put increased stress on our blood vessels and heart. All-in-all, none of this extra stress on the body is good for anyone, particularly someone suffering from type-2 diabetes.
“Discipline is just choosing between what you want now and what you want most.”
Grazing and Glucose
A new study out of the Czech Republic has found that eating daily calories in two large meals each day may be better for controlling blood glucose levels and weight.  Animal studies have already shown reducing the frequency of meals may extend lifespan and reduce the risk of chronic diseases such as diabetes. 
To illustrate, researchers recruited 54 people to test two varying eating regimens. All participants were between the ages of 30 and 70, overweight, and on oral diabetic medications.
One group was randomly assigned to eat six small meals a day, the other group ate two large meals a day. Both meal plans consisted of the same nutrient content and roughly 1700 calories. Every day during the course of the study, various health markers, such as liver fat content and beta-cell function, were measured.
At the end of the study the researchers found that weight, liver fat content, C-peptide levels (an indicator of insulin production), and fasting plasma glucose had decreased in both groups, however to a greater extent in the group that ate the two-meal plan. 
Another interesting finding was that the levels of fasting plasma glucagon, the hormone that promotes glucose secretion by the liver, had fallen in the group eating only two large meals a day but had increased in those individuals eating six meals a day.
“One cannot think well, love well, or sleep well if one has not dined well.”
– Virginia Wolf
Is Your Diabetes All in Your Gut?
The research supporting eating fewer large meals a day instead of grazing is certainly food for thought. But beyond how many times per day you eat, it’s also important to talk about what you’re putting in your gut.
Did you know that your GI tract contains roughly six pounds of microbes? All of these form what is called your gut microbiome and each of us has a unique one, kind of like a fingerprint.  Our microbiome is affected by various things such as our genetic background, exposure to antibiotics, and of course, our diet.
Our unique mix of gut microbes is responsible for different functions throughout the body. For instance, some protect against external bacteria and support our immune system, while others are responsible for regulating intestinal hormone secretion that helps our body synthesize specific vitamins.
Recent research suggests that in addition to lifestyle and genetic predisposition, microbes may in fact play a role in the development of type 2 diabetes.  Certain microbes form toxins that, when they enter the gut, cause inflammation throughout the body, which negatively impacts liver and fat cells. As a result, insulin sensitivity and metabolism in general may be altered.
The links between an increase in obesity and diabetes and changes to our gut flora are not a coincidence. A study from the Cleveland Clinic suggests gastric bypass surgery not only has the ability to help patients lose weight, but also to help the pancreas increase insulin production by five-fold.  The surgery, it turns out, changed a hormone in the gut microbiome which triggered the pancreas to make insulin again.
At the end of the day, what do all of these studies show us? That eating 2-3 bigger meals a day is better for people with diabetes and not only helps stabilize their glucose levels, but also helps burn fat stores so they’ll lose weight. This in turn may have a positive effect on their gut microbes and help them completely turn their health around.
Now, if only we knew whether Big Foot was a grazer…
 Howarth NC, Huang TT-K, Roberts SB, et al. Eating patterns and dietary composition in relation to BMI in younger and older adults. Int J Obes 2005. 2007;31:675–684. PubMed
 Alternate-day fasting and chronic disease prevention: a review of human and animal trials, [AJCN]
[2, 4] Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomized crossover study. 9 April 2014 [Diabetologia]
 Microbiome Fingerprints – [The Scientist]
 Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. [NCBI]
 Cleveland Clinic Study Shows Bariatric Surgery Provides Long-Term Control of Type 2 Diabetes [Cleveland Clinic]