Post-prandial glucose excursions have been identified as a risk factor for cardiovascular disease (Hanefeld et al., 1999) and all-cause mortality (Balkau et al., 1998). It is therefore important to determine which nutritional therapies can reduce post-prandial glycaemia (Bantle et al., 2008). Diet regimens which are predicated on modifying the frequency of feeding occasions circumvent the limiting factors of other diet regimens, as they can be easily implemented and do not necessitate change in the type of foods consumed (Jenkins, 1997). A second meal effect, or Staub-Traugott effect, describes an improved glycaemic response to a given nutrient load following the ingestion of a clearly defined previous nutrient load and may partially explain why multiple small feeding occasions, compared to fewer larger feeding occasions, may acutely improve glucose control. There is a paucity of literature on the influence of feeding frequency on glycaemia (Betts et al., 2011) and contrasting findings in the extant literature on the occurrence of a second meal effect. In this study, the influence of feeding frequency on the glycaemic and insulinaemic responses to both an initial nutrient load and a subsequent nutrient load were examined. Five healthy humans (three males and two females) participated in this study (age 26±4 y; body mass index [BMI] 23.4±2.4 kg/m2; waist circumference 80±7 cm; mean±SD) and were each exposed to three conditions: one where seven feeding occasions (i.e., a high frequency of feeding) occurred prior to a standardised high-carbohydrate lunch-time meal (HFF trial), another where a single morning meal occurred prior to the lunch-time meal (SMM trial) and another where an extended morning fast occurred prior to the lunch-time meal (EMF trial). Peak venous plasma glucose was significantly lower (p=0.044; two-tailed t-test) in the HFF condition (6.6±0.7 mmol/l) compared to the SMM condition (7.8±0.5 mmol/l) in the pre-lunch period (Figure 1). There were no significant differences in incremental area under the curve (iAUC) for plasma glucose between the three conditions for the post-lunch period (F=0.172; p=0.727; two-way repeated measures ANOVA). There were no significant differences in iAUC for serum insulin between the three conditions for the post-lunch period (F=1.981; p=0.244; two-way repeated measures ANOVA). These results suggest that spreading a high-carbohydrate nutrient load acutely lowers peak post-prandial glucose concentrations. The inter-individual variation in the overall glycaemic response to each condition suspends the practical application of eating little and often in order to obviate any deleterious effects of the diet regimen. The second meal effect was not observed in the present study, neither following a single morning meal nor following multiple smaller feeding occasions.
Physiology 2012 (Edinburgh) (2012) Proc Physiol Soc 27, PC149
Poster Communications: Effects of feeding frequency on the metabolic responses to subsequent feeding in humans
M. Jeans1, J. D. Richardson1, E. A. Chowdhury1, D. Thompson1, J. A. Betts1
1. Department for Health, University of Bath, Bath, United Kingdom.
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Where applicable, experiments conform with Society ethical requirements.