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

Eur J Clin Nutr. 2016 May;70(5):588-94. doi: 10.1038/ejcn.2015.225. Epub 2016 Feb 10.


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/m(2), 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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Glucose / analysis*
  • Cross-Over Studies
  • Fasting / blood
  • Feeding Behavior*
  • Female
  • Glucose Tolerance Test
  • Humans
  • Insulin / blood*
  • Insulin Resistance
  • Meals / physiology*
  • Polycystic Ovary Syndrome / blood
  • Polycystic Ovary Syndrome / diet therapy*
  • Time Factors
  • Young Adult


  • Blood Glucose
  • Insulin