Vegetable-First Meal Sequence Suppresses Postprandial Glycaemic Excursions and Variability in Young Women With High-Risk Phenotype for Early-Onset Type 2 Diabetes: A 4-Arm Randomized Crossover Trial With Continuous Glucose Monitoring.

Abstract

Aims: Managing postprandial glycaemic variability is crucial for preventing metabolic diseases. Although the effects of a vegetable-first meal sequence on blood glucose levels have been well documented, there is limited research on consecutive, repeated meal sequencing for healthy young women. This study investigated the effects of 3-day repeated interventions on glycaemic profiles in this population.

Materials and methods: In this randomized crossover trial, 33 healthy Korean women consumed isocaloric test meals under four conditions: (1) VPC (vegetables-protein-carbohydrates meal sequence) with 35 min meal limit; (2) CPV (carbohydrates-protein-vegetables meal sequence) with 35 min meal limit; (3) TGR (all together without sequence) with 35 min meal limit; (4) NTL (no meal intake time limit). Glycaemic profiles and variability were examined by continuous glucose monitoring over 3 h after each meal.

Results: Compared to CPV, TGR and NTL, the VPC reduced the glucose incremental area under the curve for 0-1 h and 0-2 h and mean glucose for 0-1 h (p < 0.05). VPC also resulted in lower peak glucose and delayed time-to-peak compared to CPV (p < 0.0001). Time in range was the highest for VPC and VPC significantly reduced the mean amplitude of glycaemic excursion (MAGE) compared to all other sequences (p < 0.05).

Conclusions: VPC improves postprandial glycaemic control, demonstrating consistent benefits across different meal constraints, including unrestricted eating (NTL). Optimizing meal sequencing represents a potential strategy for managing metabolic health and preventing early-onset type 2 diabetes in young women.