Eating Food In A Specific Order - Does It Matter?

As the popularity of managing glucose levels continue to rise, a plethora of different ways to reduce glucose levels from spiking have amassed over the years.

From trendy fads like apple cider vinegar shots before meals to more tried and tested techniques such as going for a short walk immediately after chowing to not so sustainable and actually very short-sighted practices like avoiding high glycaemic foods altogether, the list goes on..

But there is a new kid on the block….eating foods in a specific order. 

Yes… you read that right…in a specific order.

Like starting with the burger patty and cheese first, then moving onto your chips next before wrapping up with the burger bun… crazy…right?

So is this just the latest fad that is merely adding more noise to the already complex field that is ‘balancing glucose levels’ or is there real sustenance behind this? Let’s find out…

Firstly let’s find out about what the actual recommendation is and the specific rationale behind it.

 The food order specific or ‘macro-sequencing’ approach suggests that eating our food in a particular order i.e. going from the least glycaemic (protein, veggies, fats), to the most glycaemic (carbs) is more favourable for our glucose response i.e. we have less of a ‘spike’.

So an example of this could be, salmon and asparagus first, then moving onto mash potatoes.

Managing or blunting our glucose spikes has been popularised as of late due to claims that high glucose excursions are damaging/unhealthy to the body.

Some of the claims purported by self-proclaimed ‘health-gurus’ include an increase in inflammation, increased levels of hunger, worsening of energy levels and high insulin related conditions like PCOS & more.

So, what do the studies suggest?

There’s really only 3 outcomes to discuss out of this new nutrition strategy – and they are as follows…

1.     If you’re somebody who is actively trying to manage your calorie intake i.e. you’re either trying to lose weight or you’re looking for an easy way to control your intake, then this strategy might be helpful.

 Proteins, veggies and fats are all a lot more satiating than carbs and so there is a good chance you’ll eat less overall calories simply due to feeling full quicker when eating this way.

Some might find this hard to believe, how can eating a specific part of your meal first fill you up so much to the point that you won’t finish the rest of your meal?

Well, this did happen in a study of 80 individuals. The group that was told to follow the macro-sequencing approach ended up eating on average 150kcal less per day (Shukla et al, 2023).

Whether it’s a practically sound approach to eat this way is completely up to you, but at the end of the day, when it comes to weight loss it all boils back down to the same old mantra:

Choose the method of ‘dieting’ that feels the least restrictive to you and therefore the most adherable.

2.     For type 2 diabetics, this does seem to be a compelling strategy to lower post-prandial glucose levels but with one caveat…

Because glucose levels in type 2 diabetics can frequently reach harmful levels after eating (over 11mmol/L), it is an important therapeutic target to constantly strive for.

Glucose levels reaching over 11mmol/L has been shown to cause microvasculature damage to the nerves of the eyes (which can lead to diabetic retinopathy), nerves of the kidneys (diabetic nephropathy), nerves of the periphery (diabetic neuropathy) and more.

And sure enough, this did seem to pan out in studies where going for protein and fats first did prevent large glucose levels in diabetics however…. 

When it comes to the gold standard marker for insulin sensitivity and diabetic risk, you must look at HbA1c.

That same study of 80 people over 16 weeks saw virtually no improvement in HbA1c between the macro-sequencing group and the control group indicating that this is not, independently, a useful strategy to improve insulin sensitivity and/or play a role in diabetes reversal.

 There’s no such thing as a free lunch, eh?

3.     For non-diabetics, it’s probably more hassle than it’s worth.

 Continuous glucose monitors are all the rage these days and whilst they were originally developed to make life easier for type 1 diabetics, they are now crossing over to the wellness space for non-diabetics.

The issue is that whilst the same technology is being used, the physiologies of both camps are incredibly different and the general public often lack the scientific literacy to comprehend how glucose levels pertain to our health.

Social and mainstream media continue to push the narrative that lowering glucose levels is the panacea to good health but for non-diabetics, that is very far from the truth.

Our glucose levels fluctuate for a variety of different reasons.

What you ate in your previous meal can impact how your body responds to glucose, what kind of exercise you did, how much sleep you had, what the overall quality of your diet is like etc, etc, etc.

To summarise, your glucose levels probably will be blunted if following the macro-sequencing approach, but at what cost?

Food-anxiety is on the rise with so many experts all claiming their own methods are the best way to do things and yet all contradicting each other 

The cost-benefit ratio for non-diabetics to follow a macro-sequencing approach is foolish in my opinion.

The best thing to do?

Eat your meat, veggies and carbs all together, in the right portions and in any order you like.

References

Shukla AP, Karan A, Hootman KC, Graves M, Steller I, Abel B, Giannita A, Tils J, Hayashi L, O’Connor M, et al. A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes. Nutrients. 2023; 15(20):4452. https://doi.org/10.3390/nu15204452