TY - JOUR
T1 - Personalized Postprandial Glucose Response–Targeting Diet Versus Mediterranean Diet for Glycemic Control in Prediabetes
AU - Ben-Yacov, Orly
AU - Godneva, Anastasia
AU - Rein, Michal
AU - Shilo, Smadar
AU - Kolobkov, Dmitry
AU - Koren, Netta
AU - Dolev, Noa Cohen
AU - Shmul, Tamara Travinsky
AU - Wolf, Bat Chen
AU - Kosower, Noa
AU - Sagiv, Keren
AU - Lotan-Pompan, Maya
AU - Zmora, Niv
AU - Weinberger, Adina
AU - Elinav, Eran
AU - Segal, Eran
N1 - Publisher Copyright:
© 2021 by the American Diabetes Association.
PY - 2021/9
Y1 - 2021/9
N2 - OBJECTIVE To compare the clinical effects of a personalized postprandial-targeting (PPT) diet versus a Mediterranean (MED) diet on glycemic control and metabolic health in prediabetes. RESEARCH DESIGN AND METHODS We randomly assigned adults with prediabetes (n 5 225) to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses. During the intervention, all participants were connected to continuous glucose monitoring (CGM) and self-reported dietary intake using a smartphone application. RESULTS Among 225 participants randomized (58.7% women, mean ± SD age 50 ± 7 years, BMI 31.3 ± 5.8 kg/m2, HbA1c, 5.9 ± 0.2% [41 ± 2.4 mmol/mol], fasting plasma glucose 114 ± 12 mg/dL [6.33 ± 0.67 mmol/L]), 200 (89%) completed the 6-month intervention. A total of 177 participants also contributed 12-month follow-up data. Both interventions reduced the daily time with glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c levels, but reductions were significantly greater in PPT compared with MED. The mean 6-month change in “time above 140” was 0.3 ± 0.8 h/day and 1.3 ± 1.5 h/day for MED and PPT, respectively (95% CI between-group difference 1.29 to 0.66, P < 0.001). The mean 6-month change in HbA1c was 0.08 ± 0.19% (0.9 ± 2.1 mmol/ mol) and 0.16 ± 0.24% (1.7 ± 2.6 mmol/mol) for MED and PPT, respectively (95% CI between-group difference 0.14 to 0.02, P 5 0.007). The significant between-group differences were maintained at 12-month follow-up. No significant differences were noted between the groups in a CGM-measured oral glucose tolerance test. CONCLUSIONS In this clinical trial in prediabetes, a PPT diet improved glycemic control significantly more than a MED diet as measured by daily time of glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c. These findings may have implications for dietary advice in clinical practice.
AB - OBJECTIVE To compare the clinical effects of a personalized postprandial-targeting (PPT) diet versus a Mediterranean (MED) diet on glycemic control and metabolic health in prediabetes. RESEARCH DESIGN AND METHODS We randomly assigned adults with prediabetes (n 5 225) to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses. During the intervention, all participants were connected to continuous glucose monitoring (CGM) and self-reported dietary intake using a smartphone application. RESULTS Among 225 participants randomized (58.7% women, mean ± SD age 50 ± 7 years, BMI 31.3 ± 5.8 kg/m2, HbA1c, 5.9 ± 0.2% [41 ± 2.4 mmol/mol], fasting plasma glucose 114 ± 12 mg/dL [6.33 ± 0.67 mmol/L]), 200 (89%) completed the 6-month intervention. A total of 177 participants also contributed 12-month follow-up data. Both interventions reduced the daily time with glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c levels, but reductions were significantly greater in PPT compared with MED. The mean 6-month change in “time above 140” was 0.3 ± 0.8 h/day and 1.3 ± 1.5 h/day for MED and PPT, respectively (95% CI between-group difference 1.29 to 0.66, P < 0.001). The mean 6-month change in HbA1c was 0.08 ± 0.19% (0.9 ± 2.1 mmol/ mol) and 0.16 ± 0.24% (1.7 ± 2.6 mmol/mol) for MED and PPT, respectively (95% CI between-group difference 0.14 to 0.02, P 5 0.007). The significant between-group differences were maintained at 12-month follow-up. No significant differences were noted between the groups in a CGM-measured oral glucose tolerance test. CONCLUSIONS In this clinical trial in prediabetes, a PPT diet improved glycemic control significantly more than a MED diet as measured by daily time of glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c. These findings may have implications for dietary advice in clinical practice.
UR - http://www.scopus.com/inward/record.url?scp=85115449216&partnerID=8YFLogxK
U2 - 10.2337/DC21-0162
DO - 10.2337/DC21-0162
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C2 - 34301736
AN - SCOPUS:85115449216
SN - 0149-5992
VL - 44
SP - 1980
EP - 1991
JO - Diabetes Care
JF - Diabetes Care
IS - 9
ER -
