B.Before the pandemic, Barbara Senich, a retiree from Chapel Hill, N.C., had been diagnosed with prediabetes, meaning her blood sugar levels put her at risk of developing Type 2 diabetes. The source of this blood sugar was sweet foods, grains, and other carbohydrates. She says she thinks about these things every 30 seconds, which leads to constant snacking.
Today, he partially reduces his appetite and blood sugar by changing his eating style. But Senich didn’t give up carbs. He changed the order he had.
Researchers have recently suggested that eating certain foods, such as non-starchy vegetables, before Carbohydrates may result in lower, healthier blood sugar compared to consuming carbohydrates first. These vegetable starters, especially consumed at breakfast, also suppress the hormones that cause hunger throughout the day.
Carbohydrates are not inherently bad. They are the main source of energy for the nervous system and provide fiber, which aids digestion and lowers cholesterol levels. Although carbohydrates are found in some unhealthy foods (like french fries), they are also abundant in healthy options that nourish the brain and muscles, such as unprocessed fruits, lentils, and beans. However, with some high-carb foods, blood sugar levels, also known as glucose, can rise above the ideal range, especially when consumed alone and in large amounts. If these spikes occur frequently over years, our cells stop responding to insulin, the hormone that normally signals cells to take up glucose for energy use. This problem, called insulin resistance, causes a buildup of sugar in the blood, a defining feature of diabetes.
Approximately 1 in 3 Americans, or 98 million people, have prediabetes, and more than 80% of them are unaware of it. Many will develop Type 2 diabetes, potentially leading to nerve damage, vision loss and shorter lives.
However, it is possible to eat your carbohydrates and maintain healthy blood sugar by changing your eating order. It’s free and “does not require superhuman willpower,” Senich says.
Why does it work?
First, when we eat vegetables, the fibers in them create a filter in the intestines. When carbohydrates arrive on the scene, the filter slows them down like sand trapping flood water, so glucose enters the bloodstream in just a trickle rather than a gush. Less insulin is needed for our cells to absorb these drips, causing less strain on the pancreas. Dr., an associate professor at Weill Cornell Medicine who conducts research on meal patterns. “The body of research strongly supports the idea that food ordering reduces post-meal glucose spikes,” says Alpana Shukla.
The strategy may provide the greatest returns in people with prediabetes and diabetes because their glucose levels are higher to begin with. However, those with normal blood sugar also benefit. In one study, when healthy people saved rice for last, their glucose levels were significantly lower than when they ate rice before meat and vegetables. More stable glucose over time can help prevent serious disease.
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Another plus for everyone is that when you eat vegetables first, you tend to eat more than when you’re filling up on carbs before eating greens. Many Americans are vitamin deficient, and on average we consume 10 to 15 grams of fiber per day, whereas our ancestors consumed about 100 grams of fiber. Changing the order “tends to favor more nutrient-dense foods,” Shukla says, “which is a good thing if you have health problems or want to prevent them.”
How to make vegetarian starters?
Aim to eat a vegetable 10 minutes before eating your carbs, but you’ll still see some benefit without any breaks before carbs, says Shukla. Noosheen Hashemi, founder and CEO of health tracking company January AI, keeps her blood sugar levels healthy by anticipating high-carb foods and bringing vegetables like broccoli, fennel, or peppers in her bag to restaurants. “I carry vegetables,” he says. (TIME owner Marc Benioff is an investor in January AI.)
It is not necessary to eat vegetables alone to reap their benefits. In people with prediabetes, combining vegetables and protein before carbohydrates results in 46% lower glucose peaks than when carbohydrates come first. According to Shukla, this combination may work slightly better than vegetables alone.
Another benefit: Feeling full for three hours after a meal; Because starters containing vegetables and protein suppress the hormone called ghrelin, which causes hunger. As a result, we can consume fewer calories. When people eat the same food in reverse order (carbs first), this ghrelin hormone rises to a much higher level within three hours.
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Eating carbs last releases another hormone, GLP-1, that slows down the rate at which your stomach sends food to the intestines, further easing the load on our insulin systems. This effect of GLP-1 is the basis for blockbuster weight loss drugs such as Ozempic, which are rapidly growing in popularity. “You can use your own GLP-1 and boost it through this intervention,” says Shukla.
Ordering food can be especially useful at breakfast. After you stop eating overnight, your mealtime glucose may be higher than at lunch or dinner, Shukla says. He recommends starting your breakfast with a vegetable omelet. Mix lots of veggies with egg protein before finishing your carb fix with a piece of multigrain toast.
“We know that ordering food throughout the day has an impact,” says Sarah Berry, associate professor of nutritional sciences at King’s College London and chief scientist at science and personalized nutrition company ZOE. Berry found that unhealthy post-lunch glucose levels are shaped in part by whether glucose spikes at breakfast, and that our personal breakfast menus are dominated by carbohydrate-heavy cereals and bagels.
For best results, imagine half your plate is covered in veggies, 25% with protein, and 25% with carbohydrates, says Shukla. But he adds that a smaller starting ingredient can also help regulate blood sugar.
“It’s not all or nothing,” says Senich, of North Carolina. She makes sure baby carrots are always available, knowing that if she has about ten carrots, it’s better than just eating carbs.
As always, it’s good to aim for unprocessed, complex and high-fiber carbohydrates.
Try a protein appetizer
Another option shown to flatten glucose spikes: a non-vegetable protein primer. Taking protein alone before carbohydrates can prevent spikes in glucose and increase satiety. Before oatmeal, Senich prefers eating unsweetened Greek yogurt or nuts, both of which are good sources of protein. An “almond appetizer” reduces postprandial glucose by 15%.
Joe Sapone, founder of a consulting firm in Atlantic Highlands, N.J., says the food sequence, along with medications, helped him lose 120 pounds. “I made it a habit to eat protein first,” he says. Fan of whey protein shakes. “I’m Italian, so food is religion,” Sapone says. “I definitely want pasta and bread.” But less hunger after shakes translates into smaller portions.
“Whey is king,” says Daniel West, a Newcastle University professor who focuses on nutrition and insulin, because it is loaded with amino acids that “prime the system” for carbohydrates. Just 15 grams of whey before a meal can increase daily glucose by 10%. Other research shows lasting benefits for 12 weeks.
West says Hashemi prefers pea protein shakes, another evidence-based option.
Relatively low-sugar fruits may also have some benefits to boot. Some studies have found that because of the high fiber in some fruits, such as strawberries, eating them before other types of carbohydrates can increase the hormone GLP-1 and help suppress appetite, compared to consuming the whole fruit last. This effect may support weight loss, but research is mixed on whether consuming fruit first helps control blood sugar levels. “It’s better to pre-load with non-starchy vegetables or protein-rich foods because they contain very little sugar or carbohydrates,” says Shukla.
Prepare for success
If you’re busy, keep veggie entrees at your fingertips. Preparation is very important. “I make sure to buy easy-to-catch vegetables at the store, like cucumbers,” says Senich. She snacks on chopped peppers while she cooks the carbs.
Sapone, who has type 2 diabetes, prepares almost a week’s worth of healthy food in advance and puts it in the refrigerator at eye level. He loads up on carrots at the beach club in case the crackers tempt him. “I’m not a very disciplined person,” he says, but he is “happy” with his food order. He’s not alone in this. D., an obesity medicine physician at Weill Cornell Medicine and co-founder of Intellihealth. “Patients swear by meal delivery to support their obesity care,” says Katherine Saunders, M.D., in part because they can still get carbohydrates. “The best diet is the one that doesn’t feel like a diet.”
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Sapone’s enthusiasm was further strengthened by his own data. He likes to use a continuous glucose monitor to keep track of how carbohydrates raise his glucose numbers and how preloads help. In addition to her weight and average blood sugar dropping, her cholesterol also dropped.
Through tech companies like January AI, people can track how meal patterns and other factors affect glucose even without using a continuous glucose monitor. When you take a photo of your meal, January’s AI algorithm predicts the meal’s after-meal impact based on demographic information like your age, body mass index, and disease status.
Food ranking is not a panacea. For obesity and diabetes, it is most effective for patients to also take medications supervised by specialists, as in the cases of Sapone and Senich. Further improvement in glucose management is achieved with good sleep, slower eating and regular exercise.
Keep in mind that most studies on vegetarian starters focus on their direct effects. More research is needed for long-term results. “We have so many tools in our toolbox,” Berry says. “Food ordering is just one of those tools.”