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Intermittent Eating on Glucose Homeostasis in Prediabetes

Not Applicable
Recruiting
Conditions
PreDiabetes
Obesity
Interventions
Behavioral: Time-restricted eating
Registration Number
NCT05717387
Lead Sponsor
Nanfang Hospital, Southern Medical University
Brief Summary

Prediabetes is a high-risk state for diabetes development, lifestyle modification is the cornerstone of diabetes prevention. Two novel types of intermittent fasting recently have received more attention: the 5:2 diet and time-restricted eating (TRE). TRE requires individuals to eat in a specified number of hours per day (typically 4 to 10 hours) without energy intake restriction. The 5:2 diet involves 5 feast days and 2 fast days per week; participants eat ad libitum without restriction on feast days while 25% of energy needs (approximately 500-800 kcal per day) are consumed on fast day. This randomized controlled trial aimed to evaluate the effect of TRE and the 5:2 diet on glucose homeostasis and cardiometabolic risk factors in prediabetes over 6 months compared to usual health care.

Detailed Description

Prediabetes is a high-risk state for diabetes development, lifestyle modification is the cornerstone of diabetes prevention. Two novel types of intermittent fasting recently have received more attention: the 5:2 diet and time-restricted eating (TRE). TRE requires individuals to eat in a specified number of hours per day (typically 4 to 10 hours) without energy intake restriction. The 5:2 diet involves 5 feast days and 2 fast days per week; participants eat ad libitum without restriction on feast days while 25% of energy needs (approximately 500-800 kcal per day) are consumed on fast day. Preliminary evidence suggests that both TRE and the 5:2 diet have beneficial effects on glucose control in type 2 diabetes. No much is known about the effects and molecular mechanisms by TRE or the 5:2 diet improves glucose homeostasis in prediabetes. This randomized controlled trial aimed to evaluate the effect of TRE and the 5:2 diet on glucose homeostasis and cardiometabolic risk factors in prediabetes over 6 months compared to usual health care. All eligible participants will participate in an 8-week run-in phase in which they are fed the low-calorie-diet. Participants who pass the run-in phase will be randomly assigned 1:1:1 to one of the three study groups (TRE, the 5:2 diet and control groups). Participants in the TRE group will be instructed to eat during a window of 8 h/d (8 am to 4 pm) over 12 months. Participants in the 5:2 diet group will be instructed to consume 500-600 kcal/d on fast days and eat ad libitum on feast days. Participants in the control group were instructed to receive usual health care.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
87
Inclusion Criteria
  1. Men or women aged 18-75 years;
  2. Prediabetes;
  3. Body mass index (BMI)of 28.0 to 45.0 kg/m2;
Exclusion Criteria
  1. History of HIV, hepatitis B or C (self-report) or active pulmonary tuberculosis;
  2. Diagnosis of type 1 and type 2 diabetes;
  3. History of malignant tumors;
  4. Serious liver dysfunction or chronic kidney disease (AST or ALT > 3 times the upper limit of normal, or eGFR<30 ml/min/1.73 m2);
  5. History of serious cardiovascular or cerebrovascular disease (angina, myocardial infarction or stroke) in the past 6 months;
  6. History of severe gastrointestinal diseases or gastrointestinal surgery in the past 12 months;
  7. History of Cushing's syndrome, hypothyroidism, acromegaly, hypothalamic obesity;
  8. Being a smoker or having been a smoker in the 3 months prior to their screening visit;
  9. Taking medications affecting weight or energy intake/energy expenditure in the last 6 months, including weight loss medications, antipsychotic drugs or other medications as determined by the study physician;
  10. Currently participating in weight loss programs;
  11. Women who are pregnant or plan to become pregnant;
  12. Patients who cannot be followed for 24 months (due to a health situation or migration);
  13. Patients who are unwilling or unable to give informed consent.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Time-restricted eatingTime-restricted eatingParticipants in the TRE group will be instructed to eat during a window of 8 h/d (8 am to 4 pm)
Primary Outcome Measures
NameTimeMethod
Change in percent of time in range (glucose between 3.9-7.8mmol/L) over 6 months measured with continuous glucose monitoring.Baseline to months 6
Secondary Outcome Measures
NameTimeMethod
Change in body compositionBaseline and months 6

Body composition will be assessed by DEXA.

Change in bile acid levelBaseline and months 6
Change in body mass indexBaseline and months 6
Change in blood lipidsBaseline and months 6
Change in mean glucose levelsBaseline and months 6
Change in percent of time above rangeBaseline and months 6

\>7.8 mmol/L

Change in glycemic variabilityBaseline and months 6
Change in percent of time below rangeBaseline and months 6

\<3.9 mmol/L

Change in resting metabolic rateBaseline and months 6

Resting metabolic rate will be assessed by indirect calorimetry.

Change in gut microbiome compositionBaseline and months 6
Change in body weightBaseline and months 6
Change in waist circumferenceBaseline and months 6
Change in liver fatBaseline and months 6

Liver fat will be assessed by liver Fibroscan.

Change in Systolic Blood pressureBaseline and months 6
Change in HbA1cBaseline and months 6
Change in β cell functionBaseline and months 6
Change in quality of lifeBaseline and months 6

Quality of life measured by the 12-item Short-Form Health Survey Questionnaire (SF-12)

Change in visceral fatBaseline and months 6

Visceral fat will be assessed by abdominal CT scan.

Change in Diastolic Blood pressureBaseline and months 6
Change in pulse wave velocity (PWV)Baseline and months 6
Change in insulin sensitivityBaseline and months 6

Trial Locations

Locations (1)

Nanfang Hospital of Southern Medical University

🇨🇳

Guangzhou, Guangdong, China

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