60 Participants Needed

Meal Order for Abnormal Glucose Metabolism

PW
Overseen ByPatrick Wilson, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Old Dominion University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you are using insulin, you would not be eligible to participate.

What data supports the effectiveness of the carbohydrate-first and carbohydrate-last meal order treatment for abnormal glucose metabolism?

Research shows that eating protein and vegetables before carbohydrates can help lower blood sugar spikes after meals in people with prediabetes. This approach, known as carbohydrate-last meal order, has been found to improve diet quality and may help with weight loss.12345

Is changing the order of food consumption in meals safe for humans?

Research suggests that changing the order of food consumption in meals, such as eating protein and vegetables before carbohydrates, is generally safe for humans. However, consuming a low-carbohydrate meal in the evening may increase triglyceride levels, which could raise the risk of arteriosclerosis (hardening of the arteries).23567

How does the carbohydrate-first or carbohydrate-last meal treatment differ from other treatments for abnormal glucose metabolism?

This treatment is unique because it focuses on the order in which foods are consumed during a meal, specifically eating carbohydrates either first or last. This approach can influence blood sugar levels by delaying the digestion of carbohydrates and enhancing insulin release, which is different from traditional treatments that might focus on medication or overall dietary changes.26789

What is the purpose of this trial?

Consuming a carbohydrate-rich food as the final food in a meal, as compared to the first food in a meal, has been shown to reduce blood glucose levels after eating in both diabetes patients and in healthy controls. However, gaps remain in the literature in this area of research, and currently little is known about how substrate (fuel) use is impacted by altering food order. In addition, most studies to date have used a mix of meat and plant foods, while little research has focused exclusively on vegetarian foods. This randomized experiment will examine how altering the order of foods eaten in a vegetarian meal impacts blood glucose and fuel utilization at rest.

Eligibility Criteria

This trial is for individuals with conditions like abnormal glucose metabolism, diabetes, or liver metabolic disorders. It's also relevant for those interested in how food order affects blood sugar and fuel use during rest. Participants should be comfortable with consuming vegetarian meals as part of the study.

Inclusion Criteria

I do not need insulin for any health conditions.
I have never had weight loss surgery.
Free from any allergy or condition that precludes consumption of edamame, butter, and rice
See 2 more

Exclusion Criteria

Currently pregnant
Having an implanted electrical device such as a pacemaker
I use insulin for my medical condition.
See 2 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants consume meals with different food orders to assess impact on blood glucose and fuel utilization

90 minutes
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 week

Treatment Details

Interventions

  • Carbohydrate-first meal
  • Carbohydrate-last meal
Trial Overview The study investigates the effects of eating carbohydrates at different times during a meal on blood glucose levels and the body's use of fuel while resting. Participants will eat vegetarian meals with carbs either as the first or last part to see which method is better for managing blood sugar.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Carbohydrate-last mealExperimental Treatment1 Intervention
Group II: Carbohydrate-first mealExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Old Dominion University

Lead Sponsor

Trials
25
Recruited
15,500+

Findings from Research

In a 16-week study involving 45 adults with prediabetes, those who followed a carbohydrate-last food order lost an average of 3.6 lbs and showed a trend towards lower HbA1c levels, indicating potential benefits for weight management and blood sugar control.
The carbohydrate-last approach was well-received, with 94% of participants reporting high adherence and an increase in vegetable and protein intake, suggesting it is a feasible strategy to improve diet quality in individuals with prediabetes.
A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes.Shukla, AP., Karan, A., Hootman, KC., et al.[2023]
Eating carbohydrates after consuming protein or vegetables may help lower postprandial blood glucose and insulin levels, based on a systematic review of 11 studies.
The review suggests that this 'carbohydrate-last' approach could be a simple dietary modification to improve glucose management, particularly for individuals with obesity and cardiometabolic disorders.
Ordered Eating and Its Effects on Various Postprandial Health Markers: A Systematic Review.Ferguson, BK., Wilson, PB.[2023]
A study involving 309 participants with poorly controlled type 2 diabetes showed that individualized low-carbohydrate meal replacement diets significantly improved HbA1c levels, weight, and cardiometabolic risk factors after 52 weeks, particularly in those who had three meal replacements per day.
The stringent meal replacement group (three meals/day) achieved a clinically relevant HbA1c reduction of -0.81% after one year, while the moderate group (two meals/day) did not show significant differences compared to the control group, highlighting the importance of meal frequency in managing diabetes.
Individualized Meal Replacement Therapy Improves Clinically Relevant Long-Term Glycemic Control in Poorly Controlled Type 2 Diabetes Patients.Kempf, K., Rรถhling, M., Niedermeier, K., et al.[2022]

References

A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes. [2023]
Ordered Eating and Its Effects on Various Postprandial Health Markers: A Systematic Review. [2023]
Individualized Meal Replacement Therapy Improves Clinically Relevant Long-Term Glycemic Control in Poorly Controlled Type 2 Diabetes Patients. [2022]
Efficacy of a meal sequence in patients with type 2 diabetes: a systematic review and meta-analysis. [2022]
The impact of food order on postprandial glycaemic excursions in prediabetes. [2020]
Effects of Evening-Only Low-Carbohydrate Meal on Healthy Volunteers. [2021]
A Review of Recent Findings on Meal Sequence: An Attractive Dietary Approach to Prevention and Management of Type 2 Diabetes. [2021]
Changing Meal Sequence Affects Glucose Excursions in Gestational Diabetes Mellitus. [2022]
The influence of food order on postprandial glucose levels in children with type 1 diabetes. [2019]
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