Liver Fat as a Dietary Target for Treating Cardiometabolic Disorders in Prediabetes and Type 2 Diabetes

NCT ID: NCT04527965

Last Updated: 2022-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-11

Study Completion Date

2022-12-20

Brief Summary

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The overall aim of this study is to investigate the long-term impact of a customized diet aimed at reducing liver fat specifically and a healthy Nordic diet on ectopic fat (liver, pancreatic and visceral) and cardiometabolic risk in individuals with prediabetes and type 2 diabetes (T2D).

Detailed Description

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Randomized controlled studies investigating the impact of replacing dietary carbohydrates with polyunsaturated fat (PUFA) on liver fat content and cardiometabolic risk in individuals with prediabetes and T2D are lacking. Also, the effects of a Healthy Nordic Diet on liver fat content and glycemic control have not be investigated. This study therefore aims to:

* Investigate the effects of the diets on liver fat content (primary aim)
* Investigate the effects of the diets on pancreatic fat, visceral fat, lean tissue, glycemic and lipid control
* Investigate the effects of the diets on plasma markers of de novo lipogenesis (DNL) and desaturation (i.e. stearoyl-Coenzyme desaturase 1, SCD-1) as well as on hepatic DNL using MRI spectroscopy
* Investigate gene-diet interactions, especially if common gene variants (e.g. in PNPLA3) known to increase liver fat and dyslipidemia, may modify the dietary effects.
* Perform lipidomic analyses to identify potential mechanistic pathways that may associate with diet-induced changes in liver fat, pancreatic fat, visceral fat, insulin sensitivity, dyslipidemia or DNL

Our hypothesis is that a customized diet will effectively reduce liver fat through suppression of hepatic DNL and SCD-1 activity, and thereby improve atherogenic dyslipidemia, insulin resistance and hyperglycemia in individuals with prediabetes and T2D.

Conditions

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NAFLD Diabetes Mellitus, Type 2 PreDiabetes

Keywords

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NAFLD Diabetes Mellitus, Type 2 Prediabetes Fatty acids Diet Lipogenesis Cardiometabolic risk

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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Customized diet to reduce liver fat

Ad libitum diet high in plant-derived PUFA and lower in carbohydrates

Group Type EXPERIMENTAL

Customized diet to reduce liver fat

Intervention Type OTHER

Ad libitum diet high in plant-derived PUFA and lower in carbohydrates

Carbohydrates: 30 E% Fat: 50 E% (PUFA 10-15 E%) Protein: 20 E%

Key foods are provided

Healthy Nordic diet

Ad libitum diet, based on Nordic foods, higher in carbohydrates (high fiber/low GI) and lower in fat but rich in monounsaturated fatty acids (MUFA) and PUFA

Group Type EXPERIMENTAL

Healthy Nordic diet

Intervention Type OTHER

Ad libitum diet, based on Nordic foods, high in carbohydrates (high fiber/low GI) and lower in fat

Carbohydrates: 50-55 E% Fat: 25-30 E% (PUFA 5-7.5 E%) Protein: 20 E%

Key foods are provided

Control

Ad libitum diet in accordance with the Nordic Nutrition Recommendations

Group Type ACTIVE_COMPARATOR

Control

Intervention Type OTHER

Ad libitum diet in accordance with the Nordic Nutrition Recommendations

Key foods are provided

Interventions

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Customized diet to reduce liver fat

Ad libitum diet high in plant-derived PUFA and lower in carbohydrates

Carbohydrates: 30 E% Fat: 50 E% (PUFA 10-15 E%) Protein: 20 E%

Key foods are provided

Intervention Type OTHER

Healthy Nordic diet

Ad libitum diet, based on Nordic foods, high in carbohydrates (high fiber/low GI) and lower in fat

Carbohydrates: 50-55 E% Fat: 25-30 E% (PUFA 5-7.5 E%) Protein: 20 E%

Key foods are provided

Intervention Type OTHER

Control

Ad libitum diet in accordance with the Nordic Nutrition Recommendations

Key foods are provided

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Men and women
* 30-75 years
* BMI 25-40
* T2D (duration ≤10 years, no insulin treatment) or prediabetes (ADA definition 2019) without diagnosed cardiovascular disease (CVD) during the last 2 years (e.g. myocardial infarction, stroke or angina pectoris)

Exclusion Criteria

* BMI \>40
* Alcohol intake \>20 g/day
* Unwillingness to follow a new prescribed diet for 1 year
* Diet-induced weight loss (≥10%) the preceding 3 months of screening
* Malignant disease
* Severe kidney and liver disease
* Heart failure or other severe CVD
* claustrophobia or metal parts in the body (MRI)
Minimum Eligible Age

30 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Uppsala University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ulf Risérus, PhD

Role: PRINCIPAL_INVESTIGATOR

Uppsala University

Lars Lind, MD

Role: STUDY_DIRECTOR

Uppsala University

Locations

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Uppsala univeristy hospital

Uppsala, , Sweden

Site Status

Countries

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Sweden

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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NAFLDiet

Identifier Type: -

Identifier Source: org_study_id