Dear doctor;

Every day I have heavy breakfast, lunch and supper. Some people have advised me to skip one of the meals lest I get diabetes. Is that true? Please advise me. Jimmy 32

Dear Jimmy,

Usually when one eats, the food ingested reaches the stomach within 30 minutes. After that various enzymes and juices act on it assimilating what is useful for the body and preparing to expel the useless waste material. This entire process takes about 8 hours or so with variations from person to person.

Therefore one usually starts feeling hungry 8 to 10 hours after a meal. This process goes on smoothly when one takes small frequent meals i.e. breakfast, lunch and dinner. But it is disrupted if one takes a very heavy meal at one time and does not eat at other times.

A heavy meal taken one time puts a load on the gut. It is difficult to digest the big load easily causing uncomfortable bloating and discomfort. The process of assimilation of food is also disturbed hence the body failing to derive all vital nutrients.

The inner lining of the stomach contains acid which serves as a protective barrier against infections. By taking frequent meals, this acid is neutralized. With only one heavy meal, acid production is neutralized only for a short while and then its levels become high. This manifests as burning pain in the stomach or chest with nausea and or vomiting. Therefore it is advisable to take frequent meals.

Regarding diabetes, there are other risk factors like obesity, lack of physical exercise, stress, alcohol, tobacco and heredity. If one remains active physically and does not take a very high calorie diet, there is no problem with taking all meals of the day.

The quantity and quality of food to be taken depends on one’s physical build, gender and level of physical activity. In case of a positive family history of diabetes, one should be more careful and avoid very high calorie diet and becoming obese.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital