Trial Outcomes & Findings for Effect of Whole Fruit on Glycemic Control in Adults With Type 2 Diabetes (NCT NCT03758742)

NCT ID: NCT03758742

Last Updated: 2025-06-10

Results Overview

Percentage of patients who can maintain non-diabetic levels 24-hour mean glucose without the aid of pharmacotherapy at week 12

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

34 participants

Primary outcome timeframe

Change from baseline to week 12

Results posted on

2025-06-10

Participant Flow

Participant milestones

Participant milestones
Measure
High-Fruit Diet
Whole fruit-rich diet (\~50% of calories from whole fruit) In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Overall Study
STARTED
34
Overall Study
COMPLETED
12
Overall Study
NOT COMPLETED
22

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Effect of Whole Fruit on Glycemic Control in Adults With Type 2 Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
High-Fruit Diet
n=10 Participants
Whole fruit-rich diet (\~50% of calories from whole fruit) High-Fruit Diet: Participants will consume a diet rich in whole fruit. During Phase I (Weeks 1-4; supervised controlled feeding), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In Phase II (Week 5-12; supervised controlled feeding), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable during Phases I and II. In the Follow-Up Phase (Months 4-12; free-living), participants will be instructed to continue consuming at least one-third of their diet as whole fruit and to make healthy food choices.
Age, Continuous
56 years
STANDARD_DEVIATION 8 • n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
10 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=5 Participants
Race (NIH/OMB)
White
4 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
10 participants
n=5 Participants

PRIMARY outcome

Timeframe: Change from baseline to week 12

Population: Results were analyzed per-protocol in completers who met the specified weight stability criterion

Percentage of patients who can maintain non-diabetic levels 24-hour mean glucose without the aid of pharmacotherapy at week 12

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Diabetes Remission Rate
% Who Maintained Non-Diabetic Glycemia Without Pharmacotherapy
3 Participants
Diabetes Remission Rate
% Who Weaned Off All Antihyperglycemic Medications
6 Participants

PRIMARY outcome

Timeframe: Change from baseline to Week 12

Population: Results were analyzed per-protocol in completers who met the specified weight stability criterion

% (or percentage). This quantity estimates the percentage by which all anithyperglycemic medications taken by a patient would lower HbA1c levels (i.e., percent of glycated hemoglobin molecules). Higher values indicate a higher dose and/or potency of medications.

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Medication Effect Score (MES)
-0.5 % (see definition under "Description")
Standard Error 0.5

PRIMARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: We present the results both in all participants (n=10) and those who were on stable doses of medications (n=4). The former data is presented for completeness only.

mg/dl

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Mean Glucose During a 3-hour Oral Glucose Tolerance Test (OGTT)
All n=10 participants, including those who changed their medication doses
11 mg/dl
Standard Error 9
Mean Glucose During a 3-hour Oral Glucose Tolerance Test (OGTT)
n=4 participants without medication changes
-20 mg/dl
Standard Error 12

PRIMARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: Results were analyzed per-protocol in completers who met the specified weight stability criterion

mg/dl

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Mean 24-hour Glucose Levels as Measured by Continuous Glucose Monitoring (CGM), Adjusted for Any Changes in Medication Doses Via the MES
Main Analysis
-12 mg/dl
Standard Error 7
Mean 24-hour Glucose Levels as Measured by Continuous Glucose Monitoring (CGM), Adjusted for Any Changes in Medication Doses Via the MES
Post Hoc Analysis Excluding 1 Outlier with Very Low C-peptide Levels
-18 mg/dl
Standard Error 6

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: We present the results both in all participants (n=10) and those who were on stable doses of medications (n=4). The former data is presented for completeness only.

Insulin sensitivity (dl/kg/min/μU/ml) during a 3-hour OGTT, as measured by the Oral C-Peptide Minimal Model.

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Insulin Sensitivity
All n=10 participants, including those who changed their medication doses
1.27 dl/kg/min/μU/ml
Standard Error 0.99
Insulin Sensitivity
n=4 participants without medication changes
3.03 dl/kg/min/μU/ml
Standard Error 1.61

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: We present the results both in all participants (n=10) and those who were on stable doses of medications (n=4). The former data is presented for completeness only.

Phi\_dynamic during a 3-hour OGTT, as measured by the Oral C-Peptide Minimal Model (which is a set of 5 coupled differential equations; see reference under Citations). Phi\_dynamic is a measure of beta-cell responsiveness during first-phase insulin secretion. It is a dimensionless index (arbitrary units), where higher values denote greater insulin secretion.

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Dynamic Beta-Cell Responsivity
All n=10 participants, including those who changed their medication doses
135 arbitrary units * 10^9
Standard Error 60
Dynamic Beta-Cell Responsivity
n=4 participants without medication changes
122 arbitrary units * 10^9
Standard Error 133

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: We present the results both in all participants (n=10) and those who were on stable doses of medications (n=4). The former data is presented for completeness only.

Phi\_static during a 3-hour OGTT, as measured by the Oral C-Peptide Minimal Model (which is a set of 5 coupled differential equations; see reference under Citations). Phi\_static is a measure of beta-cell responsiveness during second-phase insulin secretion. The units of measure are min\^-1, and higher values denote greater insulin secretion.

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Static Beta-Cell Responsivity
All n=10 participants, including those who changed their medication doses
-3.0 10^9/min
Standard Error 4.0
Static Beta-Cell Responsivity
n=4 participants without medication changes
0.9 10^9/min
Standard Error 10.6

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: We present the results both in all participants (n=10) and those who were on stable doses of medications (n=4). The former data is presented for completeness

mU/l

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Mean Insulin During a 3-hour OGTT
All n=10 participants, including those who changed their medication doses
-17.1 mU/l
Standard Error 4.7
Mean Insulin During a 3-hour OGTT
n=4 participants without medication changes
-38.1 mU/l
Standard Error 6.7

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints). Change from week 0 to 12 reported.

Population: We present the results both in all participants (n=10) and those who were on stable doses of medications (n=4). The former data is presented for completeness

ng/ml

Outcome measures

Outcome measures
Measure
Fruit-Rich Diet
n=10 Participants
In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Mean C-peptide During a 3-hour OGTT
All n=10 participants, including those who changed their medication doses
-0.4 ng/ml
Standard Error 0.4
Mean C-peptide During a 3-hour OGTT
n=4 participants without medication changes
-1.7 ng/ml
Standard Error 0.5

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)"

mg/dl

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

mg/dl

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

percentage

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Percentage as measured using Magnetic Resonance Spectroscopy (MRS) and 3-point M-Dixon Magnetic Resonance Imaging (MRI)

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Percentage as measured using MRS and 3-point M-Dixon MRI methods

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

mm Hg

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

beats per minute

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Time during which glucose levels are between 70 and 300 mg/dl

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Fasting total cholesterol (mg/dl), LDL cholesterol (mg/dl), HDL cholesterol (mg/dl), and triglycerides (mg/dl)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints); assessed weekly

kg

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

cm

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Visceral fat as measured using MRI (kg)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Subcutaneous abdominal fat as measured using MRI (kg)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Diversity metrics (i.e., alpha and beta diversity)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Taxonomic composition and abundances

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured on a 0-100 mm visual analog scale (VAS), using a Sweetness Taste Test

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured on a 0-100 mm visual analog scale (VAS)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Change from baseline to Weeks 4 and 12 and follow-up Months 6, 9, and 12

As estimated using a series of semi-quantitative food frequency questions from the Diet History Questionnaire

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured on five-point scales by the Food Craving Inventory-II

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured by VAS on a 0-100 mm scale

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured by a modified version of the National Cancer Institute (NCI) 2007 Food Attitudes and Behaviors Survey, which covers constructs including attitudes and beliefs, fruit and vegetable consumption, eating behaviors, and food preferences

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

Healthy days (along various dimensions) as measured by the Centers for Disease Control and Prevention's (CDC) Health-Related Qualify of Life questionnaire

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured on a 0-27 point scale by the Patient Health Questionnaire-9

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Changes from weeks 0 to 12 (primary timepoint) and weeks 0 to 4 and 4 to 12 (secondary timepoints)

As measured on a 5-point scale by the Profile of Mood States Short-Form

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 12

As measured by qualitative exit interview

Outcome measures

Outcome data not reported

Adverse Events

High-Fruit Diet

Serious events: 0 serious events
Other events: 18 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
High-Fruit Diet
n=34 participants at risk
Whole fruit-rich diet (\~50% of calories from whole fruit) High-Fruit Diet: In this supervised controlled feeding study, participants will consume a diet rich in whole fruit. During the Ramp-Up Phase (Weeks 1-4), participants will gradually increase the amount of whole fruit they consume, eventually reaching 50% of calories from whole fruit. In the Main Phase (Weeks 5-12), participants will consume a whole fruit-rich, eucaloric diet that provides 50% of calories in the form of whole fruit. The non-fruit portion of the diet will be styled as a Mediterranean Diet. Participants will be required to approximately keep their weight stable throughout the intervention.
Metabolism and nutrition disorders
Hypoglycemia
52.9%
18/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Metabolism and nutrition disorders
Hyperglycemia
44.1%
15/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Gastrointestinal disorders
Mild Stomach Pain
11.8%
4/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Nervous system disorders
Mild Tremor
8.8%
3/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Gastrointestinal disorders
Nausea
8.8%
3/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Nervous system disorders
Dizziness
8.8%
3/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
General disorders
Fatigue
5.9%
2/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Gastrointestinal disorders
Diarrhea
5.9%
2/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.
Nervous system disorders
Peripheral Sensory Neuropathy
5.9%
2/34 • Adverse events were collected at baseline (~1 week) and during Weeks 1 through 12.
Participants were queried about adverse events at each study visit.

Additional Information

Dr. Courtney M. Peterson

University of Alabama at Birmingham

Phone: 205-934-0122

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place