Why Your Breakfast Should Start with a Vegetable

Before the pandemic, Barbara Senich, a retiree from Chapel Hill, N.C., was diagnosed with prediabetes, meaning the sugar levels in her blood put her at risk for developing Type 2 diabetes. The source of that blood sugar was sweet foods, grains, and other carbohydrates. She says she thought about them every 30 seconds, leading to constant snacking.

Today, she’s cut her cravings and blood sugar partly by changing how she eats. But Senich didn’t ditch the carbs. She changed the order in which she has them.

Researchers have recently found that eating certain foods like non-starchy vegetables before carbs may result in lower, healthier blood sugar, compared to having carbs first. Especially at breakfast, these veggie starters also suppress hormones that cause hunger throughout the day.

Carbs aren’t inherently bad. They’re the main energy source for the nervous system and provide fiber that helps with digestion and lowering cholesterol levels. Although carbs are found in some unHealthy foods (think French fries), they’re also plentiful in wholesome options like unprocessed fruits, lentils, and beans that fuel the brain and muscles. With some high-carb foods, though, blood sugar levels, also known as glucose, can climb higher than the ideal range especially if eaten on their own and in excess. If these spikes occur often over the years, our cells stop responding to insulin, the hormone that normally signals the cells to take in glucose for energy use. This problem, called insulin resistance, causes sugar to build up in the blood—a defining feature of diabetes.

About 1 in 3 Americans, or 98 million, have prediabetes—and more than 80% aren’t aware of it. Many will develop Type 2 diabetes, resulting potentially in nerve damage, vision loss, and shorter lives.

But by changing the order in which you eat food, it’s possible to eat your carbs and have your healthy blood sugar, too. It’s free and “doesn’t require superhuman willpower,” Senich says.

Why it works

When we have veggies first, their fiber sets up a filter in the intestines. Once the carbs arrive on the scene, the filter slows them down, like sand catching floodwater, so the glucose enters the bloodstream at a mere trickle instead of a gush. Less insulin is needed for our cells to absorb these drips, putting less strain on the pancreas. “The totality of the research strongly supports the notion that food sequencing does reduce glucose spikes after a meal,” says Dr. Alpana Shukla, an associate professor of research at Weill Cornell Medicine who studies food order.

The strategy could have the biggest payoff in people with prediabetes and diabetes simply because they have higher glucose levels to begin with. But those with normal blood sugar see benefits as well. In one study, when healthy people saved rice for last, their glucose peaks were significantly lower than when they ate rice before meat and vegetables. Over time, more stable glucose could help prevent serious illnesses.

Read More: Your Diet Needs More Fermented Pickles

Another plus for everyone is that when you eat vegetables first, you tend to eat more of them, compared to filling up on carbs before having greens. Many Americans are vitamin-deficient and, on average, we get 10 to 15 grams of fiber per day, whereas our ancestors enjoyed about 100 grams. Switching up the order “tends to favor more nutrient dense foods,” Shukla says, “which is good whether you have health issues or want to prevent them.”

How to have veggie starters

Aim to eat a vegetable 10 minutes before you eat your carbs, though you’ll still see some benefit without taking any break before the carbs, Shukla says. Noosheen Hashemi, founder and CEO of the Health-tracking company January AI, keeps her blood sugar levels Healthy by bringing vegetables like broccoli, fennel, or peppers to restaurants in her purse, anticipating high-carb dishes. “I carry vegetables,” she says. (TIME’s owner, Marc Benioff, is an investor in January AI.)

It’s not necessary to eat the vegetables by themselves to get the benefits. Combining veggies and protein before carbs results in 46% lower glucose peaks, compared to carbs-first, in people with prediabetes. This combo may work slightly better than veggies alone, according to Shukla.

Another benefit: feeling full for three hours after a meal, because starters with veggies and protein suppress a hormone called ghrelin that causes hunger. We may consume fewer calories as a result. When people have the same meal in the reverse order, with carbs first, this ghrelin hormone rebounds much higher at the three-hour mark.

Read More: Why Is It So Bad to Pop a Pimple?

Eating carbs last turns up another hormone, GLP-1, that slows the rate at which your stomach sends food to the intestines, further easing the burden on our insulin systems. This effect of GLP-1 forms the basis for the blockbuster weight-loss drugs, like Ozempic, that are surging in popularity. “You can harness your own GLP-1 and boost it through this intervention,” Shukla says.

Food order may be particularly useful at breakfast. After not eating overnight, your mealtime glucose could rise higher than at lunch or dinner, Shukla says. Start breakfast with a veggie omelet, she suggests. Mix lots of vegetables with the egg protein before finishing with your carb, one piece of multigrain toast.

“We know that meal ordering across the day has an impact,” says Sarah Berry, associate professor of nutritional Sciences at King’s College London and chief scientist at the Science and personalized nutrition company ZOE. UnHealthy glucose levels after lunch are partly shaped by whether glucose spiked at breakfast, Berry has found, and carb-heavy cereals and bagels dominate our personal breakfast menus.

For the best results, visualize half your plate covered by vegetables, 25% by protein and, 25% carbs, Shukla says. But a smaller starter can help regulate blood sugar, too, she adds.

“It’s not all or nothing,” says Senich, the North Carolinian. She makes sure baby carrots are always within reach, knowing if she has about ten of them, that’s better than eating carbs only.

As always, it’s good to aim for carbs that are unprocessed, complex, and high-fiber.

Try a protein appetizer

Another option shown to flatten out glucose spikes: a protein primer without vegetables. Getting protein on its own, prior to carbs, can prevent glucose spikes and increase fullness. Before oatmeal, Senich makes sure to have sugar-free Greek yogurt or nuts, both good protein sources. An “almond apPetizer” reduces post-meal glucose by 15%.

Joe Sapone, the founder of a consulting business from Atlantic Highlands, N.J., says food sequencing has helped him lose 120 pounds, along with medications. “I’ve gotten in the habit of eating protein first,” he says. He’s a fan of whey protein shakes. “I’m Italian, so food is religion,” Sapone says. “I totally want pasta and bread.” After the shakes, though, less hunger translates into smaller portions.

“Whey is king,” says Daniel West, a Newcastle University professor focusing on nutrition and insulin, because it’s loaded with amino acids that “prime the system” for carbs. Just 15 grams of whey before a meal can improve daily glucose by 10%. Other research shows sustained benefits over 12 weeks.

Hashemi prefers pea protein shakes, another evidence-backed option, West says.

Fruit with relatively low sugar could have some benefit as a preload as well. Because of the high fiber in some whole fruits like strawberries, eating them first, before other types of carbs, may increase the GLP-1 hormone and help to suppress appetite, compared to having the whole fruit last, some studies have found. This effect could support weight loss, but research is mixed on whether consuming fruit first helps to control blood glucose levels. “Preloading with non-starchy vegetables or protein-rich foods is better because they have very little sugar or carbs,” Shukla says.

More From TIME

Prepare for success

If you’re busy, keep veggie starters at your fingertips. Preparation is key. “At the store, I make sure to buy those easy-to-grab vegetables” like cucumbers, Senich says. While cooking carbs, she snacks on chopped-up peppers.

Sapone, who has Type 2 diabetes, prepares almost a week’s worth of healthy foods ahead of time, placing them at eye-level in his refrigerator. He preloads with carrots at his beach club in case the pretzels tempt him. “I’m not a very regimented person,” he says, but he’s “happy” with food order. He’s not alone in that. “Patients swear by food order to support their obesity care,” says Dr. Katherine Saunders, an obesity medicine physician at Weill Cornell Medicine and co-founder of Intellihealth, partly because they can still have carbs. “The best diet is one that doesn’t feel like a diet.”

Read More: Why Walking Isn't Enough When It Comes to Exercise

Sapone’s enthusiasm was reinforced by his own data. He likes using a continuous glucose monitor to track how carbs on their own spike his glucose numbers, and how preloads help. In addition to dropping his weight and average blood glucose, his cholesterol is down.

Through tech companies like January AI, people can monitor how food order and other factors affect glucose even without using a continuous glucose monitor. Take a photo of your meal, and January AI’s algorithm predicts its post-meal effect based on demographics like your age, body mass index, and disease state.

Food sequencing isn’t a panacea. For obesity and diabetes, it’s most effective when patients also take medications supervised by specialists, as in Sapone’s and Senich’s cases. Further improvements in glucose management come with good sleep, slower eating and regular exercise.

And keep in mind that most studies on veggie starters focus on their immediate effects. More research is needed on long-term outcomes. “We have so many tools in the toolbox,” Berry says. “Meal ordering is just one of those tools.”