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  • Original Article
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Carbohydrates, glycemic index and diabetes mellitus

Effect of meal frequency on glucose and insulin levels in women with polycystic ovary syndrome: a randomised trial

European Journal of Clinical Nutrition volume 70, pages 588–594 (2016)Cite this article

Subjects

A Corrigendum to this article was published on 04 May 2016

This article has been updated

Abstract

Background/Objectives:

The aim of the study was to compare the effect of two-meal patterns (three vs six meals per day) on glucose and insulin levels in women with polycystic ovary syndrome (PCOS).

Subjects/Methods:

In a randomised, crossover, 24-week study, 40 women with PCOS, aged 27±6 years, body mass index 27±6 kg/m2, followed a weight maintenance diet (% carbohydrates:protein:fat, 40:25:35), consumed either as a three- or a six-meal pattern, with each intervention lasting for 12 weeks. Anthropometric measurements, diet compliance and subjective hunger, satiety and desire to eat were assessed biweekly. All women underwent an oral glucose tolerance test (OGTT) with 75 g glucose for measurement of plasma glucose and insulin at the beginning and end of each intervention. HaemoglobinA1c (HbA1c), blood lipids and hepatic enzymes were measured at the beginning and end of each intervention.

Results:

Body weight remained stable throughout the study. Six meals decreased significantly fasting insulin (P=0.014) and post-OGTT insulin sensitivity (Matsuda index, P=0.039) vs three meals. After incorporation of individual changes over time, with adjustment for potential confounders, the only variable that remained significant was the Matsuda index, which was then used in multivariate analysis and general linear models. Six meals improved post-OGTT insulin sensitivity independently of age and body weight vs three meals (P=0.012). No significant differences were found between six and three meals for glucose, HbA1c, blood lipids, hepatic enzymes, subjective desire to eat and satiety.

Conclusions:

Six meals had a more favourable effect on post-OGTT insulin sensitivity in women with PCOS compared with isocaloric three meals.

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Change history

  • 04 May 2016

    This article has been corrected since Advance Online Publication and a corrigendum is also printed in this issue

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Acknowledgements

We are grateful to Vasso Fragaki, head nurse of the Diabetes Center of Attikon University Hospital, for conducting the participants’ OGTT procedure and to Maria-Assimina Gerama, clinical dietitian, for her valuable help during the conduction of the intervention. EP and MK conceptualised and designed the study; EP and IK collected the data and served as the dietitians of the team; IK conducted the biochemical analysis of blood samples; ET, DV and PM were responsible for patient screening, medical diagnosis and completed the medical examination; AZ and GD served as scientific counsellors to the project; EG conducted the statistical analysis; all authors contributed to the writing and editing of this manuscript according to their area of expertise and all authors approved it.

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Authors and Affiliations

  1. Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece

    E Papakonstantinou & A Zampelas

  2. 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Haidari, Greece

    E Papakonstantinou, E Trakakis, D Vassiliadi & G Dimitriadis

  3. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

    I Kechribari, E Georgousopoulou & M D Kontogianni

  4. Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and its Complications (H.N.D.C), Athens, Greece

    P Mitrou

  5. 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon University Hospital, Haidari, Greece

    E Trakakis

  6. Department of Nutrition and Health United Arab Emirates University, Al Ain, UAE

    A Zampelas

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Papakonstantinou, E., Kechribari, I., Mitrou, P. et al. Effect of meal frequency on glucose and insulin levels in women with polycystic ovary syndrome: a randomised trial. Eur J Clin Nutr 70, 588–594 (2016). https://doi.org/10.1038/ejcn.2015.225

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