{
  "abstract": "Background/Objectives: Excess adiposity is associated with abnormal postprandial glucose responses (PPGRs), and controlled studies show that one meal can influence the PPGR of the next. Whether this carry-over occurs in everyday eating is unclear. We examined whether the timing, composition, and PPGR of the preceding meal were associated with the subsequent PPGR. Methods: This observational secondary analysis included 55 Southeast Asian adults with excess body weight and 342 within-day consecutive eating-occasion pairs recorded using a smartphone app and continuous glucose monitoring. Participant fixed-effects linear regression examined 12 preceding-meal characteristics, including intermeal interval (IMI), glycemic load, total sugar, protein, and saturated fat. The outcome was the log-transformed positive incremental area under the glucose curve ln(1 + positive 0–120 min iAUC after the subsequent meal. Each characteristic was examined separately per within-person standard deviation (SD), adjusting for current-meal characteristics, premeal glucose, and temporal factors. Confidence intervals and p values used 2000 participant-cluster bootstrap resamples; Benjamini–Hochberg q values addressed the 12 tests. Results: Higher preceding-meal protein was associated with lower iAUC (−13.9%; 95% confidence interval (CI), −23.1 to −4.2; p = 0.008; q = 0.032), whereas total sugar was associated with higher iAUC (+29.6%; 95% CI, +16.9 to +45.2; p = 0.001; q = 0.006). A 1 SD (1.9 h) longer IMI was associated with 29.1% higher iAUC (95% CI, 15.0 to 48.8; p = 0.001; q = 0.006). The saturated-fat estimate was uncertain (+14.8%; 95% CI, −0.8 to +35.2; p = 0.066; q = 0.198). Conclusions: Preceding-meal sugar, IMI and protein were associated with subsequent glucose responses. Protein was sensitive to additional macronutrient adjustment; saturated fat remained uncertain. Incomplete metabolic and dietary information limits causal interpretation.",
  "abstract_shown": true,
  "affiliations": [
    "Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 5, Centre for Translational Medicine, Block MD6, 14 Medical Drive, Singapore 117599, Singapore",
    "School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA",
    "Department of Food Science and Technology, National University of Singapore, Singapore 117542, Singapore",
    "Department of Surgery, National University Hospital, Singapore 119074, Singapore",
    "Department of Cardiology, National University Hospital, Singapore 119074, Singapore",
    "Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore",
    "Asia Longevity Medical Centre, Singapore 238859, Singapore",
    "Department of Biomedical Informatics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore",
    "Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Thu Trang La"
    },
    {
      "affs": [
        0
      ],
      "name": "Jennell Jia Ying Koh"
    },
    {
      "affs": [
        0
      ],
      "name": "Wen Wei Ang",
      "orcid": "0000-0002-1978-1543"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Xuan Ng"
    },
    {
      "affs": [
        0
      ],
      "name": "Karishma Chandramohan Amudha"
    },
    {
      "affs": [
        0
      ],
      "name": "Jessie Jun Min Lim"
    },
    {
      "affs": [
        1
      ],
      "name": "Diana-Lyn Baptiste"
    },
    {
      "affs": [
        2
      ],
      "name": "Mei Hui Liu"
    },
    {
      "affs": [
        3
      ],
      "name": "Asim Shabbir"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Roger Foo"
    },
    {
      "affs": [
        6
      ],
      "name": "Su Lin Lim",
      "orcid": "0000-0001-8478-3193"
    },
    {
      "affs": [
        3,
        7
      ],
      "name": "Kee Yuan Ngiam",
      "orcid": "0000-0001-5676-2520"
    },
    {
      "affs": [
        0,
        7,
        8
      ],
      "name": "Han Shi Jocelyn Chew",
      "orcid": "0000-0002-4209-1647"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0reragscykdr5.bib",
  "cited_by": 0,
  "doi": "10.3390/nu18213697",
  "fulltext_url": null,
  "id": "0reragscykdr5",
  "issns": [
    "2072-6643"
  ],
  "landing_url": "https://www.mdpi.com/2072-6643/18/21/3697",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-07",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/0reragscykdr5.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:21:40Z",
      "native_id": "10.3390/nu18213697",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6643/18/21/3697"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6643",
      "subfield": "nutrition"
    }
  ],
  "title": "The Second-Meal Effect Under Free-Living Conditions: A Continuous Glucose Monitoring Study of Meal History and Postprandial Glycemia",
  "title_text": "The Second-Meal Effect Under Free-Living Conditions: A Continuous Glucose Monitoring Study of Meal History and Postprandial Glycemia",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T00:21:40Z",
  "url": "https://research.draconitic.com/paper/0reragscykdr5",
  "venue": "Nutrients",
  "versions": []
}