Researchers at Weill Cornell Medical College in New York performed a small pilot study to determine the effect of food order on post-meal blood sugar levels, using typical American foods in a nutritionally balanced meal. In the process, they may have discovered a way for people with diabetes to better control their blood sugar, and it’s as simple as eating one food after another, in the correct order.

The Research

Eleven overweight men and women who were being treated with metformin for type 2 diabetes were given the same meal on two separate days, one week apart. The meal consisted of ciabatta bread, orange juice, skinless grilled chicken breast, lettuce and tomato salad with low-fat dressing, and steamed broccoli with butter. The only difference between the two meals was that the order in which the food was eaten was reversed at the second meal.

For their first meal, the participants ate the bread and orange juice first, followed 15 minutes later by the chicken, salad, and broccoli. Blood samples were taken to determine glucose and insulin levels at 30, 60 and 120 minutes after the patients began eating, a pattern similar to how patients would measure their own blood sugar after a meal. A week later, when the order of food was reversed and the same measurements taken, there was a significant drop in both blood glucose and insulin levels as compared to the first meal.

In other words, eating the meal's vegetables or protein before consuming the carbohydrate portion of the meal resulted in a lower post-meal glucose and insulin levels.

What This Means to You

Carbohydrates play the biggest role in raising blood sugar levels, but researchers still don't have the full picture on proteins and fats, points out Marina Chaparro, MPH, RD, CDE, and a spokesperson for the Academy of Nutrition and Dietetics.

“Even though this is an early pilot study, the findings makes sense,” Chaparro says. “Future studies like this one will likely focus not only on the amount of carbs in a meal but also more on specific types of carbs and the overall composition of meals.”

Chaparro points out three important take-aways from this study for people with diabetes:

  1. Food composition matters. Combine a protein with a high–fiber carb such as oatmeal, brown rice, or whole-grain bread. This helps delay changes in blood sugar just after you eat and could also mean better sugar levels at your next meal or snack.
  2. Balance matters. Always aim for a combination of foods that won’t cause your blood sugar to spike. That means a lean protein with healthy fats like avocado and nuts, and high-fiber, non-starchy veggies like spinach and mushrooms.
  3. Food order matters. Try eating your low-carb foods (protein, fat and non-starchy vegetables) first, then eat the rest of your meal.

Marina Chaparro, RDN, CDE, MPH reviewed this article.


Chaparro, Marina, RDN, CDE, MPH. E-mail to author July 24, 2015.

Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food order has a significant impact on postprandial glucose and insulin levels. Diabetes Care. July 2015;38(7):e98-e99. doi: 10.2337/dc15-0429