Weight-loss surgeon Dr. Neil McDevitt unknowingly encouraged his patients to practice meal sequencing long before medical science adopted it as a term
Meal sequencing is the idea that the order in which you eat your food can affect the way the food is absorbed. Eating vegetables, protein and fat before carbohydrates can help improve blood sugar control, increase feelings of fullness and support weight loss
“It’s been a dialogue, particularly in the diabetic community, for quite some time. But it’s become far more mainstream starting in the early 2020s,” said McDevitt, who cares for patients at Novant Health General Surgery & Bariatrics in Mount Pleasant, South Carolina. “That’s when they started really looking at a lot more of the science behind it and trying to figure out, why does this work?”
Well, why does it work? McDevitt explains that the order in which you eat foods affects how the body works to process different kinds of food molecules — and a minor switch up can yield major benefits. We talked with him about the science behind meal sequencing and how it may support weight management and overall health
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Why is meal sequencing getting attention right now?
It seems to be a national phenomenon. There’s a lot of enthusiasm about medications in the field of obesity and diabetes, so we’re learning a lot more about how these hormones are affected by things that we do every day
How does meal sequencing work?
The thought is that different foods have different levels of complexity as far as our ability to digest them. Things like sugar give you a rush because as soon as you eat sugar, it’s absorbed almost immediately into your GI tract. When we eat starches, or we drink soda, the body absorbs it so rapidly that it drastically alters our blood sugar — and not in a good way, particularly if you’re diabetic. If you are diabetic and you start your meal by eating bread or rice, you’re going to see a tremendous jump in your blood sugar.
Now, when we eat things that are more complex, like proteins and fats, they take a lot more energy to break down. Your stomach tends to hold onto them as it does all the work of cooking them down into an absorbable form. This is critical because if I’m eating foods that aren’t immediately absorbed, my GI tract slows down and I’m going to feel fuller faster and stay fuller longer. Just as importantly, I’ll be able to eat a lot less food
What are some examples of meal sequencing for dinner?
You’d eat something green, like maybe a small salad, before your meal instead of bread. And then you’d eat something that is protein-based, whether it be fish or venison or a steak or scallops. I jokingly say, “If it swims, runs, crawls, or flies, then it’s a protein.” Then you’d couple that with some vegetables, and finish with something like whole-grain rice. By the time you get done with the salad, and you get done with the fish and vegetables, you probably aren’t going to have a whole lot of room for the carbohydrates.
How about meal sequencing at breakfast?
Something like Greek yogurt would provide the protein and the fats. Breakfast food doesn’t have to be “breakfast food.” It could be something like leftovers from yesterday or black beans with some salsa and sour cream. I think that we have to get away from the idea that breakfast has to be waffles or potatoes or pancakes. And if we’re leaning more toward protein and fat, some turkey sausage with eggs is a good option
How does meal sequencing match what you were advising patients to do anyway?
I was thrilled about this because it’s really central to what I consider an appropriate dietary lifestyle modification: We always push protein and produce
Protein is key to keeping up your lean muscle and metabolism.
Whenever we talk to a patient who’s trying to lose or maintain weight, our focus is protein and produce, and we ask people to either eliminate or severely minimize the starches and simple sugars
Do GLP-1 medications mimic the process that meal sequencing does naturally?
In 2020, the NIH put out a really nice summary on it. Part of the reason it works is that by eating that fiber and protein first, we actually do get a higher level of GLPs (glucagon-like peptides, a gut hormone) in our body. Those GLPs slow our stomach, and they also make us much more efficient in chewing up the sugars in our bloodstream, so it helps us with metabolizing sugars.The medications act by enhancing what our body does naturally
So can meal sequencing replace GLP-1s?
Yes, in those people who marginally need it. Unfortunately, there are so many folks out there whose obesity is so severe that this will not replace the GLPs. This is kind of a homeopathic way of attempting to achieve that benefit. So if somebody is otherwise in good health and their body mass index (BMI) is slightly elevated but not severe, and they’re just trying to lose a little bit of weight, this would be a really good strategy
What if you’re not sure about meal sequencing as a GLP-1 alternative?
If I were somebody contemplating starting a GLP-1, and I hadn’t done it yet, I would attempt this first to see if it assists in achieving those smaller portions, feeling fuller longer, and the weight loss — recognizing that being placed on a GLP-1 will accentuate anything that I’m already doing
Meal sequencing might feel odd at first to people like me, who like to “mix” foods
I’m a mixer as well, so I’m sitting here going, “I’m going to make shrimp chutney tonight, and I usually serve it on rice.” It’s going to be really interesting separating the two and seeing if it changes the culinary texture.There are great “cheats” for avoiding those starches, though. Cauliflower rice makes a great bed for that shrimp dish, and spaghetti squash goes great with a seafood
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Generally, is meal sequencing a good practice?
Yes, everybody would benefit from this. I don’t know too many people out there who aren’t trying to lose a little bit of weight — myself included
