High Fructose Diet, the Gut Microbiome, and Metabolic Health

NCT ID: NCT06329544

Last Updated: 2025-12-17

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

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-08

Study Completion Date

2028-08-31

Brief Summary

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Americans commonly consume excess amounts of dietary fructose. Added fructose has been shown to have an adverse impact on metabolic health, including increased insulin resistance and type 2 diabetes (T2D) risk. However, the mechanisms that link dietary fructose and metabolic health are poorly understood. Malabsorption or incomplete metabolism of fructose in the small intestine is common in the population. Excess fructose reaches the colon where it may change the structure and function of the gut microbiome, alter bacterial metabolites and trigger inflammatory responses impacting T2D risk. To elucidate whether commonly consumed levels of dietary fructose influence metabolic outcomes through altering the gut microbiome, the research team will randomize 30 participants to a controlled cross-over dietary intervention, in which the participants will consume 12-day isocaloric, added fructose or glucose diets (25% of total calories) separated by a 10-day controlled diet washout period.

The research team aims to:

1. Determine the relationships between high fructose consumption, the gut microbiome and metabolic risk.
2. Characterize the causal role(s) that fructose-induced alterations to the gut microbiome have on metabolic risk using a germ-free mouse model.

The research team will measure 1) microbiota community structure and function via metagenomic sequencing of stool, 2) fecal metabolites via targeted and untargeted metabolomics, 3) anthropometrics, 4) insulin resistance, serum markers of T2D risk and inflammatory cytokines, 5) fecal microbial carbohydrate oxidation capacity and 6) liver fat via MRI elastography. The research team will use novel statistical approaches, including Distributed Lag Modeling, to understand the complex relationships between diet, the microbiome, metabolites and health outcomes.

The research team will then conduct controlled dietary interventions and fecal microbiome transplantation studies in germ-free mice. Donor fecal samples from human participants in both the glucose and fructose arms of the clinical intervention will be transplanted into germ-free and colonized mice to establish a causal relationship between fructose-induced changes to the gut microbiome, liver fat and metabolic and inflammatory changes known to increase risk for T2D.

The research team aims to comprehensively assess the structural and functional changes to the gut microbiome brought about by a high fructose diet. Determining the impact of excess fructose on the microbiome will help identify novel means by which fructose contributes to metabolic disease risk. In addition to identifying strategies to improve metabolic health in adults, data from this proposal could help inform targeted approaches to mitigate future disease risk in vulnerable populations that consume high levels of fructose, such as children.

Detailed Description

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Conditions

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MASLD Type 2 Diabetes Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

The study will be a double-blinded (participants and select study personnel), randomized controlled crossover dietary intervention design.
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators
All participants undergo both treatment arms but will be blinded to the order.

Study Groups

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Glucose Dietary then Fructose Dietary

Participants that will be randomized to the 12-day isocaloric weight-maintaining high glucose diet, then will change to the12-day isocaloric weight-maintaining high fructose diet after a 10-day washout period.

Group Type EXPERIMENTAL

Fructose

Intervention Type DIETARY_SUPPLEMENT

12-day isocaloric weight-maintaining high fructose diet (25% total calories from added fructose)

glucose

Intervention Type DIETARY_SUPPLEMENT

12-day isocaloric weight-maintaining high glucose diet (25% total calories from added glucose)

Fructose Dietary then Glucose Dietary

Participants that will be randomized to the 12-day isocaloric weight-maintaining high fructose diet, then will change to the 12-day isocaloric weight-maintaining high glucose diet after a 10-day washout period.

Group Type EXPERIMENTAL

Fructose

Intervention Type DIETARY_SUPPLEMENT

12-day isocaloric weight-maintaining high fructose diet (25% total calories from added fructose)

glucose

Intervention Type DIETARY_SUPPLEMENT

12-day isocaloric weight-maintaining high glucose diet (25% total calories from added glucose)

Interventions

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Fructose

12-day isocaloric weight-maintaining high fructose diet (25% total calories from added fructose)

Intervention Type DIETARY_SUPPLEMENT

glucose

12-day isocaloric weight-maintaining high glucose diet (25% total calories from added glucose)

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Participants must be determined to be a fructose malabsorber (screening visit) via hydrogen breath test.

Exclusion Criteria

* Use of probiotic/prebiotic/synbiotic supplements
* Consumption of \> 1 sugar sweetened beverage per day
* Antibiotics within 3 months prior to enrollment or during intervention
* Vegetarian, vegan or other restrictive dietary habits
* Food allergy
* Alcohol consumption in excess of 2 drink per day


* Physician diagnosis of a major medical illness (including type 1 or type 2 diabetes) or eating disorder
* Physical, mental, or cognitive handicaps that prevent participation
* Chronic use of any medication that may affect body weight or composition, insulin resistance, or lipid profiles;
* Current smoking (more than 1 cigarette in the past week) or use of other recreational drugs; e) restrictive dietary habits;
* food allergy;
* excess alcohol consumption;
* recent use of pro-, pre- or Synbiotics of receipt of antibiotics within 3 months prior to enrollment or during the intervention;
* consumption of greater than 1 sugar sweetened beverage per day prior to enrollment
Minimum Eligible Age

25 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Metabolic Solutions Inc.

INDUSTRY

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Icahn School of Medicine at Mount Sinai

OTHER

Sponsor Role lead

Responsible Party

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Ryan Walker

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ryan Walker

Role: PRINCIPAL_INVESTIGATOR

Icahn School of Medicine at Mount Sinai

Locations

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Mount Sinai Morningside

New York, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ryan Walker, PhD

Role: CONTACT

212-824-7088

Other Identifiers

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1R01DK137968-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY-23-01572

Identifier Type: -

Identifier Source: org_study_id