Effects of meal sequence intervention on blood glucose response in healthy adults: a systematic review

Achieving glycemic control is essential in the prevention and management of metabolic disorders, with several dietary strategies having been proposed. Meal sequence, which is defined as the order of food consumption while maintaining the overall composition and intake, may attenuate postprandial glycemic responses. This systematic review aimed to assess the effects of meal sequences on postprandial glycemic responses in healthy adults and explore its potential as a preventive strategy for glycemic control.

Literature published between January 2015 and March 2025 in PubMed, Cochrane Library, Web of Science, KoreaMed, and RISS was searched using the keywords "healthy adult," "food order," "meal sequence," and "glucose response."

Among the 2,442 records identified, one randomized controlled trial, four randomized crossover studies, and one repeated-measures design with a total of 107 participants aged 20-36.7 years met the inclusion criteria. Most of the studies reported that consuming vegetables, fruits, or protein-rich foods before carbohydrate-rich foods reduced postprandial glucose responses and incremental area under the curve compared with mixed or carbohydrate-first meals. These effects were also noted in randomized controlled trials and randomized crossover design.

Our findings indicate that adjusting the order of food consumption can effectively mitigate acute postprandial glucose responses in healthy individuals. Further large-scale and long-term randomized controlled trials across diverse populations and standardized protocols are warranted to strengthen the evidence base.