Save the Bread for Last: Carbohydrate Timing Matters
Save the Bread for Last? New Research Suggests Meal Order Matters
Many people with type 2 diabetes focus on what they eat, but emerging research suggests that when they eat certain foods during a meal may also affect blood sugar levels. Studies from researchers at Weill Cornell Medicine found that eating vegetables and protein before carbohydrates can significantly reduce the rise in blood sugar after a meal.
In one study, adults with type 2 diabetes ate identical meals on different days but changed the order in which they consumed the foods. When participants ate vegetables and chicken first and saved bread and orange juice for the end of the meal, their blood sugar levels after eating were nearly 50% lower than when they consumed the carbohydrates first. Blood sugar levels were also about 40% lower compared to eating all the foods together as a sandwich. Researchers found that the "carbs last" approach also resulted in lower insulin requirements and higher levels of glucagon-like peptide-1 (GLP-1), a hormone that promotes fullness and helps regulate blood sugar.
These findings are important because managing blood sugar helps reduce the risk of complications associated with diabetes, including heart disease, vision loss, and nerve damage. Researchers noted that the blood sugar improvements seen with the "carbs last" method were similar to those achieved with some diabetes medications. In addition, eating protein and vegetables first may help people feel fuller and naturally consume fewer calories, which could support weight management.
This research does not mean that desserts and sugary foods become healthy simply because they are eaten at the end of a meal. Choosing nutrient-dense carbohydrates such as fruits, whole grains, beans, and vegetables remains important. However, for individuals with diabetes or prediabetes, starting meals with protein and non-starchy vegetables and saving carbohydrate-rich foods for later may be a simple strategy to help improve blood sugar control.
Practical Tips
Start meals with vegetables, salad, or broth-based soup.
Eat protein foods such as chicken, fish, eggs, tofu, or beans before carbohydrate-rich foods.
Save bread, rice, pasta, potatoes, and fruit for the end of the meal.
Continue focusing on overall healthy food choices and portion control.
The bottom line: Meal order may be another helpful tool for managing blood sugar. Eating protein and vegetables first and carbohydrates last could help reduce blood sugar spikes and support better metabolic health.
References
Shukla AP, Andono J, Touhamy SH, Casper A, Iliescu RG, Mauer E, Zhu YS, Ludwig DS, Aronne LJ. Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes.BMJ Open Diabetes Research & Care. 2017;5(1):e000440. doi:10.1136/bmjdrc-2017-000440.
Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels.Diabetes Care. 2015;38(7):e98-e99. doi:10.2337/dc15-0429.
American Diabetes Association. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report.Diabetes Care. 2019;42(5):731-754.
Evert AB, Dennison M, Gardner CD, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report.Diabetes Care. 2019;42(5):731-754.
