People with type 2 diabetes may have less depression and fewer hunger pains if they opt for a big breakfast and lunch rather than six smaller meals throughout the day, suggests a new study.

"Eating large breakfasts and lunches may be more beneficial than the usual snacking model," said Dr. Hana Kahleova, the study's lead author from the Institute for Clinical and Experimental Medicine in Prague.

"However, further larger-scale, long-term studies are needed before offering clear recommendations," she told Reuters Health in an e-mail.

The analysis used data from a previous study that compared two restricted-calorie diets in 54 people with type 2 diabetes.Each study participant spent 12 weeks eating six small meals aday, and then another 12 weeks eating a large breakfast and lunch, with no dinner.

With both diets, people reported fewer depressive symptoms and better quality of life compared to how they felt at the beginning of the study, but the improvements in mood were significantly greater when they ate larger meals twice a day.

Disinhibition, which is the tendency to overeat in certain situations, improved more on the two-meal diet. People also reported feeling less hungry when they ate just twice a day,researchers reported in the European Journal of Clinical Nutrition.
People who eat less frequently may feel fuller and more satisfied when they do eat, rather than feeling hungry all day long from eating small meals, said Kahleova, who added that people need to eat 30 to 40 grams of fiber per day to be successful.

"Eat a hearty breakfast: eat breakfast like a king, lunch as a prince and dinner as a pauper," she said. "If you feel hungry in the evening you can have a vegetable salad."

"I think it's fascinating research," said Margaret Powers of the International Diabetes Center at Park Nicollet in Minneapolis in a telephone interview.

By looking at the effect of eating patterns on patients' depressive symptoms, the new research is starting to take into account the "big emotional component to eating," said Powers,who wasn't involved with the new study but is president-elect of healthcare and education for the American Diabetes Association.

The most important thing for people with type 2 diabetes is to have a plan in terms of when they eat and how they spread out their intake of carbohydrates throughout the day, Powers said,adding that the goal is to maintain steady blood sugar levels and a healthy weight.'

"There's no one right way or wrong way, but I think this says that we do have to pay attention to this emotional side of eating," she said. "If somebody's eating two large meals a day and they want to eat at other times and they can't and that's making them miserable, that's not the right plan."

Powers said she wants to see her patients eat a healthy balance and variety of foods.

"One of the goals of nutrition therapy for diabetes is actually to maintain the enjoyment of food," she said. "Our goal is to help a patient understand that his or herself so they can help find the best self-management plan . . . Whatever the food plan is, it should be a lifelong eating pattern."