A new study in the Journal of Clinical Endocrinology and Metabolism finds that in individuals with diabetes, the timing and composition of certain foods may be just as important as calories and portion control.The time we eat should align with our circadian rhythm -- the biological, internal clockwork that manages our sleep-wake cycle and repeats each day. In individuals with diabetes, health outcomes could be better depending on which foods are consumed and the time of day. The study authors did not mention specific times of the day to eat, but spacing meals every 4 to 6 hours has been advised for those with diabetes. The researchers noted that in individuals with diabetes, consuming potatoes in the morning, whole grains in the afternoon, and green leafy vegetables and milk at night -- along with less processed meat in the evening -- was linked with improved long-term survival. According to Qingrao Song, M.D., of Harbin Medical University in Harbin, China, "Nutritional guidelines and intervention strategies for diabetes should integrate the optimal consumption times for foods in the future."Song and his team evaluated data from 4,642 individuals with diabetes from NHANES (National Health and Nutrition Examination Survey) to calculate their risk of dying due to heart disease. While this is just one study, other studies have indicated that processed meats such as salami, pepperoni, and sausage are linked with several types of cancer as well as heart disease. What should you advise your clients?

• Make more meals at home. They’ll have more control over the ingredients and may eat less fat, sodium, and sugar. Their health is in their hands!
• Eat most meals earlier in the day (prior to 8 PM) for better blood glucose control.
• Reduce intake of red and processed meats, regardless of mealtime. Both are linked with an increased risk of chronic diseases.
• Include more green leafy vegetables throughout the day. These are low in calories and carbs, but packed with nutrients.
• Add low-fat dairy to the eating pattern. A diet low in calcium is associated with high blood pressure. Calcium intake also reduces the risk for colon cancer.
• Swap processed grains for whole grains. Use brown rice in place of white and 100% whole wheat bread over refined bread. Fiber is powerful!
• Encourage moderate intake of starchy foods earlier in the day and include a lean protein and healthy fat source with meals. Balance, as always, is key to blood sugar control.

By Lisa Andrews, MEd, RD, LDReferences:

1. Timing Your Meals and Insulin Doses Properly Can Help Keep Your Blood Sugar Steady (webmd.com)
2. Wenbo Jiang, Qingrao Song, Jia Zhang, Yunyan Chen, Hongyan Jiang, Yujia Long, Ying Li, Tianshu Han, Hongru Sun, Wei Wei. The Association of Consumption Time for Food with Cardiovascular Disease and All-Cause Mortality Among Diabetes Patients. The Journal of Clinical Endocrinology & Metabolism, 2022 DOI: 10.1210/clinem/dgac069
3. Huang Y, Cao D, Chen Z, Chen B, Li J, Guo J, Dong Q, Liu L, Wei Q. Red and processed meat consumption and cancer outcomes: Umbrella review. Food Chem. 2021 Sep 15;356:129697
4. Henry CJ, Kaur B, Quek RYC. Chrononutrition in the management of diabetes. Nutr Diabetes. 2020 Feb 19;10(1):6
5. Villa-Etchegoyen C, Lombarte M, Matamoros N, Belizán JM, Cormick G. Mechanisms Involved in the Relationship between Low Calcium Intake and High Blood Pressure. Nutrients. 2019 May 18;11(5):1112.
6. Keum N, Liu L, Hamada T, Qian ZR, Nowak JA, Cao Y, da Silva A, Kosumi K, Song M, Nevo D, Wang M, Chan AT, Meyerhardt JA, Fuchs CS, Wu K, Ogino S, Nishihara R, Zhang X. Calcium intake and colon cancer risk subtypes by tumor molecular characteristics. Cancer Causes Control. 2019 Jun;30(6):637-649.