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A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes

(1) Background: Prior research in individuals with overweight/obesity and prediabetes or type 2 diabetes has shown that the ingestion of protein-rich food and non-starchy vegetables before concentrated carbohydrates (a carbohydrate-last food order) led to lower postprandial glucose excursions over 1...

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Autores principales: Shukla, Alpana P., Karan, Ampadi, Hootman, Katie C., Graves, Maya, Steller, Ian, Abel, Brittany, Giannita, Ashley, Tils, Jamie, Hayashi, Lauren, O’Connor, Madlen, Casper, Anthony J., D’Angelo, Debra, Aronne, Louis J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10610476/
https://www.ncbi.nlm.nih.gov/pubmed/37892527
http://dx.doi.org/10.3390/nu15204452
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author Shukla, Alpana P.
Karan, Ampadi
Hootman, Katie C.
Graves, Maya
Steller, Ian
Abel, Brittany
Giannita, Ashley
Tils, Jamie
Hayashi, Lauren
O’Connor, Madlen
Casper, Anthony J.
D’Angelo, Debra
Aronne, Louis J.
author_facet Shukla, Alpana P.
Karan, Ampadi
Hootman, Katie C.
Graves, Maya
Steller, Ian
Abel, Brittany
Giannita, Ashley
Tils, Jamie
Hayashi, Lauren
O’Connor, Madlen
Casper, Anthony J.
D’Angelo, Debra
Aronne, Louis J.
author_sort Shukla, Alpana P.
collection PubMed
description (1) Background: Prior research in individuals with overweight/obesity and prediabetes or type 2 diabetes has shown that the ingestion of protein-rich food and non-starchy vegetables before concentrated carbohydrates (a carbohydrate-last food order) led to lower postprandial glucose excursions over 180 min, compared to eating the same foods in the reverse order. To expand upon this research, we sought to examine the feasibility and impact of carbohydrate-last food order behavioral intervention on glucose tolerance (GT), HbA1c, weight, and nutrient intake in adults with prediabetes in the real world over a 16-week span. (2) Methods: A total of 45 adults with overweight/obesity and prediabetes were randomized to receive 4-monthly standard nutritional counseling (C) or standard nutritional counseling plus carbohydrate-last food order counseling (FO) sessions (NCT# NCT03896360). (3) Results: The FO group decreased in body weight (−3.6 ± 5.7 lbs, p = 0.017), and trended toward lower HbA1c (−0.1 ± 0.2, p = 0.054). The C group weight trended lower (−2.6 ± 6.8 lbs, p = 0.102) without altering HbA1c (−0.03 ± 0.3, p = 0.605). GT was unchanged in both groups after 16 weeks. Changes in weight, HbA1c, and GT were similar between groups. Sensitivity analysis of pre-COVID participants showed significant weight loss in the FO group (−5.9 ± 5.3 lbs, p = 0.003) but not in C group (−1.0 ± 6.8 lbs, p = 0.608). After 16 weeks, the C group significantly reduced its daily intake of calories, fat, protein, and grains whereas the FO group increased its daily intake of vegetables and protein. There were 17 (94%) FO participants that reported high intervention adherence and 13 (72%) reported it was easy to eat protein/vegetables before carbohydrates. (4) Conclusions: A carbohydrate-last food order is a feasible behavioral strategy in individuals with prediabetes that improves diet quality, notably increasing protein and vegetable intake.
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spelling pubmed-106104762023-10-28 A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes Shukla, Alpana P. Karan, Ampadi Hootman, Katie C. Graves, Maya Steller, Ian Abel, Brittany Giannita, Ashley Tils, Jamie Hayashi, Lauren O’Connor, Madlen Casper, Anthony J. D’Angelo, Debra Aronne, Louis J. Nutrients Article (1) Background: Prior research in individuals with overweight/obesity and prediabetes or type 2 diabetes has shown that the ingestion of protein-rich food and non-starchy vegetables before concentrated carbohydrates (a carbohydrate-last food order) led to lower postprandial glucose excursions over 180 min, compared to eating the same foods in the reverse order. To expand upon this research, we sought to examine the feasibility and impact of carbohydrate-last food order behavioral intervention on glucose tolerance (GT), HbA1c, weight, and nutrient intake in adults with prediabetes in the real world over a 16-week span. (2) Methods: A total of 45 adults with overweight/obesity and prediabetes were randomized to receive 4-monthly standard nutritional counseling (C) or standard nutritional counseling plus carbohydrate-last food order counseling (FO) sessions (NCT# NCT03896360). (3) Results: The FO group decreased in body weight (−3.6 ± 5.7 lbs, p = 0.017), and trended toward lower HbA1c (−0.1 ± 0.2, p = 0.054). The C group weight trended lower (−2.6 ± 6.8 lbs, p = 0.102) without altering HbA1c (−0.03 ± 0.3, p = 0.605). GT was unchanged in both groups after 16 weeks. Changes in weight, HbA1c, and GT were similar between groups. Sensitivity analysis of pre-COVID participants showed significant weight loss in the FO group (−5.9 ± 5.3 lbs, p = 0.003) but not in C group (−1.0 ± 6.8 lbs, p = 0.608). After 16 weeks, the C group significantly reduced its daily intake of calories, fat, protein, and grains whereas the FO group increased its daily intake of vegetables and protein. There were 17 (94%) FO participants that reported high intervention adherence and 13 (72%) reported it was easy to eat protein/vegetables before carbohydrates. (4) Conclusions: A carbohydrate-last food order is a feasible behavioral strategy in individuals with prediabetes that improves diet quality, notably increasing protein and vegetable intake. MDPI 2023-10-20 /pmc/articles/PMC10610476/ /pubmed/37892527 http://dx.doi.org/10.3390/nu15204452 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shukla, Alpana P.
Karan, Ampadi
Hootman, Katie C.
Graves, Maya
Steller, Ian
Abel, Brittany
Giannita, Ashley
Tils, Jamie
Hayashi, Lauren
O’Connor, Madlen
Casper, Anthony J.
D’Angelo, Debra
Aronne, Louis J.
A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes
title A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes
title_full A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes
title_fullStr A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes
title_full_unstemmed A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes
title_short A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes
title_sort randomized controlled pilot study of the food order behavioral intervention in prediabetes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10610476/
https://www.ncbi.nlm.nih.gov/pubmed/37892527
http://dx.doi.org/10.3390/nu15204452
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