Personalized Nutrition Based on the Glycemic Response: Effect of Diet and Intestinal Microbiota

NCT ID: NCT05230342

Last Updated: 2025-04-24

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-02

Study Completion Date

2025-08-30

Brief Summary

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This study will investigate whether changes in the intestinal microbiota generated through a nutritional strategy based on functional foods, modifies postprandial glycemic responses in subjects with prediabetes and obesity, which in turn will generate a personalized dietary intervention through a prediction of postprandial blood glucose levels.

Detailed Description

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The increase in postprandial blood glucose constitutes a global epidemic and an important risk factor for the development of prediabetes and type 2 diabetes (T2D). Prediabetes is characterized by alterations in blood glucose concentrations and is considered an important risk factor for the development of T2D, considering that 70% of subjects with prediabetes will eventually develop the disease. Therefore, maintaining normal blood glucose concentrations is considered a critical point to prevent and control the development of T2D, mainly through lifestyle changes. In addition, the elevated postprandial glycemic responses (PPGRs) are an independent risk factor for the development of T2D and are associated with the presence of obesity.

Dietary intake is a central determinant of blood glucose concentrations therefore to maintain these concentrations within normal values, it is important to make adequate decisions regarding food, to induce a normal PPGRs. There are several methods to control the PPGRs such as the carbohydrate count which depends on the phenotypic characteristics of the patient. Other methods aimed at estimating the PPGRs like the glycemic index, which quantifies the PPGR derived from the consumption of a single type of food already tested, having limited applicability in the evaluation of the PPGR in real life where food is a set of different types and amounts of food, which are consumed at different times of the day under different conditions of sleep, physical activity and other activities of daily life that alter glucose concentrations.

Studies have shown inter and intrapersonal differences in PPGRs after consuming the same amount of the same food. Factors that can affect interpersonal differences in PPGRs include genetics, lifestyle, and insulin sensitivity. Another factor that may be involved is the gut microbiota.

The objective of this study is to evaluate whether the changes in the intestinal microbiota generated through a nutritional strategy based on functional foods, modifies postprandial glycemic responses in subjects with prediabetes and obesity, which in turn may generate a personalized dietary intervention through a prediction of postprandial blood glucose levels by an algorithm based-diet. This nutritional strategy consists of providing a set of functional foods such as nopal, chia, soy, inulin and the isoflavone genistein, since there is evidence that these foods lower blood glucose concentrations and modify the intestinal microbiota. A clinical trial will be conducted with 100 adults with prediabetes and obesity who meet the inclusion criteria. These patients will be divided into two groups of 50 each and their glucose will be continuously monitored with a continuous glucose monitor which will be taking glucose concentrations every 15 min. The patients will have one of two treatments; placebo or nutritional strategy with functional foods. They will be determined before and after monitoring: anthropometric and biochemical parameters, food consumption, physical activity, lifestyle, metabolites in urine as well as determination of the composition of the intestinal microbiota.

Conditions

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Obesity Pre Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The groups will receive the treatment simultaneously
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
A team researcher will use Stata 12, to perform randomization with a 1:1 allocation using random block sizes of 4. Patients and researchers who will evaluate the outcomes and perform the statistical analysis will be blinded to the assigned group.

Study Groups

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Nutritional strategy based on functional foods

Participants will be provided with a nutritional strategy based on functional foods to use over the 2 week trial. These will be nopal, chía seeds, inulin, soy protein and genistein.

Group Type EXPERIMENTAL

A package containing a mix of functional foods

Intervention Type DIETARY_SUPPLEMENT

Participants will be provided with a nutritional strategy based on functional foods to use over the 2 week trial. These will be nopal, chía seeds, inulin, soy protein and genistein.

Placebo Ingredient Group

The placebo group will receive a comparable set of food items that contain an equivalent number of calories per portion but without the added functional ingredients

Group Type PLACEBO_COMPARATOR

Placebo ingredient group

Intervention Type OTHER

The control group will receive a comparable set of food items that contain an equivalent number of calories per portion but without the added functional ingredients

Interventions

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A package containing a mix of functional foods

Participants will be provided with a nutritional strategy based on functional foods to use over the 2 week trial. These will be nopal, chía seeds, inulin, soy protein and genistein.

Intervention Type DIETARY_SUPPLEMENT

Placebo ingredient group

The control group will receive a comparable set of food items that contain an equivalent number of calories per portion but without the added functional ingredients

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Male and female.
* Adults between 18 and 60 years of age.
* BMI ≥ 30 and ≤ 50 kg/m2.
* Basal blood glucose 100 - 125 mg/dl
* The signing of the informed consent.

Exclusion Criteria

* Patients with any type of diabetes.
* Patients with high blood pressure.
* Patients with acquired diseases secondarily producing obesity and diabetes.
* Patients who have suffered a cardiovascular event.
* Patients with gastrointestinal diseases.
* Weight loss \> 3 kg in the last 3 months.
* Catabolic diseases such as cancer and acquired immunodeficiency syndrome.
* Pregnancy status.
* Positive smoking.
* Drug treatment:

* Antihypertensive drugs or treatment (thiacycline, loop or potassium-sparing diuretics, angiotensin-converting enzyme inhibitor, angiotensin II receptor blockers, alpha blockers, calcium antagonists, beta blockers).
* Treatment with hypoglycemic agents (sulfonylureas, methylalanines , biguanides, incretins) or insulin and antidiabetic drugs.
* Treatment with statins, fibrates or other drugs to control dyslipidemia.
* Use of antibiotics in the three months prior to the study.
* Use of steroid drugs, chemotherapy, immunosuppressants, or radiation therapy.
* Anorexigenic or that accelerate weight loss such as orlistat.
* Supplements with any of the functional foods used in the study.
* Probiotic, prebiotic or symbiotic supplements.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

OTHER

Sponsor Role lead

Responsible Party

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Armando Tovar

Head of department of nutrition physiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Armando R Tovar, PhD

Role: PRINCIPAL_INVESTIGATOR

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran

Locations

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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Mexico City, Mexico City, Mexico

Site Status

Armando Roberto Tovar Palacio

Mexico City, , Mexico

Site Status

Countries

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Mexico

References

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Zhu J, Xing G, Shen T, Xu G, Peng Y, Rao J, Shi R. Postprandial Glucose Levels Are Better Associated with the Risk Factors for Diabetes Compared to Fasting Glucose and Glycosylated Hemoglobin (HbA1c) Levels in Elderly Prediabetics: Beneficial Effects of Polyherbal Supplements-A Randomized, Double-Blind, Placebo Controlled Trial. Evid Based Complement Alternat Med. 2019 Apr 15;2019:7923732. doi: 10.1155/2019/7923732. eCollection 2019.

Reference Type RESULT
PMID: 31118970 (View on PubMed)

Blaak EE, Antoine JM, Benton D, Bjorck I, Bozzetto L, Brouns F, Diamant M, Dye L, Hulshof T, Holst JJ, Lamport DJ, Laville M, Lawton CL, Meheust A, Nilson A, Normand S, Rivellese AA, Theis S, Torekov SS, Vinoy S. Impact of postprandial glycaemia on health and prevention of disease. Obes Rev. 2012 Oct;13(10):923-84. doi: 10.1111/j.1467-789X.2012.01011.x. Epub 2012 Jul 11.

Reference Type RESULT
PMID: 22780564 (View on PubMed)

Ceriello A. Impaired glucose tolerance and cardiovascular disease: the possible role of post-prandial hyperglycemia. Am Heart J. 2004 May;147(5):803-7. doi: 10.1016/j.ahj.2003.11.020.

Reference Type RESULT
PMID: 15131534 (View on PubMed)

Gallwitz B. Implications of postprandial glucose and weight control in people with type 2 diabetes: understanding and implementing the International Diabetes Federation guidelines. Diabetes Care. 2009 Nov;32 Suppl 2(Suppl 2):S322-5. doi: 10.2337/dc09-S331. No abstract available.

Reference Type RESULT
PMID: 19875573 (View on PubMed)

Eleazu CO. The concept of low glycemic index and glycemic load foods as panacea for type 2 diabetes mellitus; prospects, challenges and solutions. Afr Health Sci. 2016 Jun;16(2):468-79. doi: 10.4314/ahs.v16i2.15.

Reference Type RESULT
PMID: 27605962 (View on PubMed)

Vrolix R, Mensink RP. Variability of the glycemic response to single food products in healthy subjects. Contemp Clin Trials. 2010 Jan;31(1):5-11. doi: 10.1016/j.cct.2009.08.001. Epub 2009 Sep 6.

Reference Type RESULT
PMID: 19737630 (View on PubMed)

Zeevi D, Korem T, Zmora N, Israeli D, Rothschild D, Weinberger A, Ben-Yacov O, Lador D, Avnit-Sagi T, Lotan-Pompan M, Suez J, Mahdi JA, Matot E, Malka G, Kosower N, Rein M, Zilberman-Schapira G, Dohnalova L, Pevsner-Fischer M, Bikovsky R, Halpern Z, Elinav E, Segal E. Personalized Nutrition by Prediction of Glycemic Responses. Cell. 2015 Nov 19;163(5):1079-1094. doi: 10.1016/j.cell.2015.11.001.

Reference Type RESULT
PMID: 26590418 (View on PubMed)

Mendes-Soares H, Raveh-Sadka T, Azulay S, Ben-Shlomo Y, Cohen Y, Ofek T, Stevens J, Bachrach D, Kashyap P, Segal L, Nelson H. Model of personalized postprandial glycemic response to food developed for an Israeli cohort predicts responses in Midwestern American individuals. Am J Clin Nutr. 2019 Jul 1;110(1):63-75. doi: 10.1093/ajcn/nqz028.

Reference Type RESULT
PMID: 31095300 (View on PubMed)

Christensen L, Roager HM, Astrup A, Hjorth MF. Microbial enterotypes in personalized nutrition and obesity management. Am J Clin Nutr. 2018 Oct 1;108(4):645-651. doi: 10.1093/ajcn/nqy175.

Reference Type RESULT
PMID: 30239555 (View on PubMed)

Sanchez-Tapia M, Tovar AR, Torres N. Diet as Regulator of Gut Microbiota and its Role in Health and Disease. Arch Med Res. 2019 Jul;50(5):259-268. doi: 10.1016/j.arcmed.2019.09.004. Epub 2019 Oct 5.

Reference Type RESULT
PMID: 31593850 (View on PubMed)

Kolodziejczyk AA, Zheng D, Elinav E. Diet-microbiota interactions and personalized nutrition. Nat Rev Microbiol. 2019 Dec;17(12):742-753. doi: 10.1038/s41579-019-0256-8. Epub 2019 Sep 20.

Reference Type RESULT
PMID: 31541197 (View on PubMed)

Guevara-Cruz M, Flores-Lopez AG, Aguilar-Lopez M, Sanchez-Tapia M, Medina-Vera I, Diaz D, Tovar AR, Torres N. Improvement of Lipoprotein Profile and Metabolic Endotoxemia by a Lifestyle Intervention That Modifies the Gut Microbiota in Subjects With Metabolic Syndrome. J Am Heart Assoc. 2019 Sep 3;8(17):e012401. doi: 10.1161/JAHA.119.012401. Epub 2019 Aug 27.

Reference Type RESULT
PMID: 31451009 (View on PubMed)

Other Identifiers

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3312

Identifier Type: -

Identifier Source: org_study_id

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