Effects of Almonds on Insulin Sensitivity in Prediabetes
Primary Purpose
PreDiabetes
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
1.5 oz of whole, natural almonds
Low-fat, high refined starches/sugars
Sponsored by
About this trial
This is an interventional supportive care trial for PreDiabetes
Eligibility Criteria
Inclusion Criteria:
- BMI of 25.0-39.9 kg/m2
- Prediabetic: fingerstick glycated hemoglobin 5.7-6.4% (inclusive), or fasting fingerstick capillary glucose of 100-125 mg/dL (inclusive), or 2-h post-prandial glucose of 140-199 mg/dL.
- Fasting LDL-C level <200 mg/dL and fasting TG level <400 mg/dL.
- Judged to be in general good health on the basis of medical history and screening laboratory tests.
Exclusion Criteria:
- Atherosclerotic cardiovascular disease including any of the following: clinical signs of atherosclerosis: peripheral arterial disease, abdominal aortic aneurysm, carotid artery disease [symptomatic (e.g., transient ischemic attack or stroke of carotid origin) or >50% stenosis on angiography or ultrasound], history of myocardial infarction, angina, a revascularization procedure, or other forms of clinical atherosclerotic disease (e.g., renal artery disease).
- History or presence of clinically important pulmonary (including uncontrolled asthma), endocrine (including type I or type II diabetes mellitus), chronic inflammatory disease (including irritable bowel disease, lupus, rheumatoid arthritis), hepatic, renal, hematologic, immunologic, dermatologic, neurologic, psychiatric, or biliary disorders.
- Known allergy, sensitivity, or intolerance to any ingredients in the study foods.
- Uncontrolled hypertension.
- Recent history of cancer, except for non-melanoma skin cancer.
- Recent change in body weight of ± 4.5 kg (9.9 lbs).
- Recent use of any medications intended to alter the lipid profile (e.g. bile acid sequestrants, cholesterol absorption inhibitor, fibrates, niacin (drug form), omega-3-ethyl ester drugs, and/or PCSK9 inhibitors, with the exception of the stable use of statins), weight-loss drugs or programs, systemic corticosteroid drugs, unstable use of any antihypertensive medication; medications known to influence CHO metabolism (e.g. adrenergic receptor blockers, diuretics, and/or hypoglycemic medications).
- Recent use of food/supplements known to influence lipid metabolism (e.g. omega-3 fatty acid supplements (e.g., flaxseed, fish or algal oils) or fortified foods, sterol/stanol products; dietary supplements (red rice yeast supplements; garlic supplements; soy isoflavone supplements; niacin or its analogues at doses >400 mg/d, and irregular or inconsistent use of Metamucil® or viscous fiber-containing supplements.
- Recent use of antibiotics.
- Pregnant, planning to be pregnant during the study period, lactating, or is of childbearing potential and is unwilling to commit to the use of a medically approved form of contraception throughout the study period.
- Extreme dietary habits (e.g. very low CHO diet, vegan, etc.).
- Current or recent history, or strong potential, for drug or alcohol abuse.
- History of a diagnosed eating disorder. -
Sites / Locations
- MB Clinical Research
- Illinois Institute for Food Safety and Health (IFSH) at Illinois Instiute of Technology (IIT)
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Whole, natural almonds
Low-fat, high refined starches/sugars
Arm Description
1.5 oz of whole, natural almonds
Low-fat foods,high in refined starches and added sugars
Outcomes
Primary Outcome Measures
Insulin sensitivity index (SI)
SI from a short (50-min) intravenous glucose tolerance test (IVGTT) at baseline(day 0) and end of two treatment periods (day 43 of both treatment periods)
Secondary Outcome Measures
Fasting lipoprotein lipids
Fasting blood samples will be collected for measurements of lipoprotein lipids including: Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non HDL-C, TC/HDL-C ratio and triglycerides (TG) at all visits.
Apolipoprotein (Apo) B and A1, Lipoprotein subfractions and particles
Fasting blood samples will be collected for measurements of Apo B1 and A1, and lipoprotein subfractions and particles at baseline (day 0) and end of the two treatment periods (day 43)
high-sensitivity C-reactive protein (hs-CRP)
Fasting blood samples will be collected for measurement of hs-CRP at all visits.
Serum Uric acid
Fasting blood samples will be collected to measure serum Uric acid levels at the beginning and end of each treatment periods.
Interleukin-6 (IL-6)
Fasting blood samples will be collected to measure serum IL-6 levels at baseline (day 0) and the end of the two treatment periods (day 43)
Full Information
NCT ID
NCT03126981
First Posted
April 20, 2017
Last Updated
July 23, 2019
Sponsor
Midwest Center for Metabolic and Cardiovascular Research
Collaborators
Almond Board of California
1. Study Identification
Unique Protocol Identification Number
NCT03126981
Brief Title
Effects of Almonds on Insulin Sensitivity in Prediabetes
Official Title
A Randomized, Crossover Trial to Assess the Effects of Replacing Refined Carbohydrates With Almonds on Insulin Sensitivity in Men and Women With Prediabetes.
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
April 20, 2017 (Actual)
Primary Completion Date
September 26, 2018 (Actual)
Study Completion Date
September 26, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Midwest Center for Metabolic and Cardiovascular Research
Collaborators
Almond Board of California
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
The goal of this clinical trial is to evaluate the effects of consuming 1.5 oz almonds twice daily on insulin sensitivity and markers of cardiometabolic health in men and women with prediabetes.
Detailed Description
This is a randomized, controlled, two-period crossover study that includes two screening visits, and two 6-week test periods, separated by a 4-week washout. Subjects consume twice daily, 1.5 oz whole, natural almonds (Active Condition) or low-fat foods high in refined starches and added sugars, matched for energy content to the almonds (Control Condition). The assigned study products will be dispensed with instructions to consume 2 servings (Active Product) or 3 servings (Control Products) each day, starting on day 1. Subjects will be screened for prediabetes at the first screening visits. An intravenous glucose tolerance test (IVGTT) will be completed at baseline and the end of each treatment period. Fasting blood samples will be collected for lipid profile and high-sensitivity C-reactive protein (hs-CRP) measurements at all visits. Additionally, blood will be drawn for measurement of Apolipoprotein B and A1, lipoprotein particles and subfractions, Interleukin 6 (IL-6) and Uric acid at the beginning and the end of each test period. Assessments of vital signs, body weight, evaluation of inclusion and exclusion criteria, medication/supplement use, and adverse effects will be performed throughout the study. Compliance will be assessed through a daily log record, and return of unopened study product.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
PreDiabetes
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
54 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Whole, natural almonds
Arm Type
Experimental
Arm Description
1.5 oz of whole, natural almonds
Arm Title
Low-fat, high refined starches/sugars
Arm Type
Placebo Comparator
Arm Description
Low-fat foods,high in refined starches and added sugars
Intervention Type
Other
Intervention Name(s)
1.5 oz of whole, natural almonds
Intervention Description
1.5 oz of whole, natural almonds
Intervention Type
Other
Intervention Name(s)
Low-fat, high refined starches/sugars
Intervention Description
Low-fat foods, high in refined starches and added sugars
Primary Outcome Measure Information:
Title
Insulin sensitivity index (SI)
Description
SI from a short (50-min) intravenous glucose tolerance test (IVGTT) at baseline(day 0) and end of two treatment periods (day 43 of both treatment periods)
Time Frame
43 days for each treatment period.
Secondary Outcome Measure Information:
Title
Fasting lipoprotein lipids
Description
Fasting blood samples will be collected for measurements of lipoprotein lipids including: Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non HDL-C, TC/HDL-C ratio and triglycerides (TG) at all visits.
Time Frame
Up to 43 days for each treatment period.
Title
Apolipoprotein (Apo) B and A1, Lipoprotein subfractions and particles
Description
Fasting blood samples will be collected for measurements of Apo B1 and A1, and lipoprotein subfractions and particles at baseline (day 0) and end of the two treatment periods (day 43)
Time Frame
43 days for each treatment period
Title
high-sensitivity C-reactive protein (hs-CRP)
Description
Fasting blood samples will be collected for measurement of hs-CRP at all visits.
Time Frame
Up to 43 days
Title
Serum Uric acid
Description
Fasting blood samples will be collected to measure serum Uric acid levels at the beginning and end of each treatment periods.
Time Frame
43 days for each treatment period
Title
Interleukin-6 (IL-6)
Description
Fasting blood samples will be collected to measure serum IL-6 levels at baseline (day 0) and the end of the two treatment periods (day 43)
Time Frame
43 days for each treatment period
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
69 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
BMI of 25.0-39.9 kg/m2
Prediabetic: fingerstick glycated hemoglobin 5.7-6.4% (inclusive), or fasting fingerstick capillary glucose of 100-125 mg/dL (inclusive), or 2-h post-prandial glucose of 140-199 mg/dL.
Fasting LDL-C level <200 mg/dL and fasting TG level <400 mg/dL.
Judged to be in general good health on the basis of medical history and screening laboratory tests.
Exclusion Criteria:
Atherosclerotic cardiovascular disease including any of the following: clinical signs of atherosclerosis: peripheral arterial disease, abdominal aortic aneurysm, carotid artery disease [symptomatic (e.g., transient ischemic attack or stroke of carotid origin) or >50% stenosis on angiography or ultrasound], history of myocardial infarction, angina, a revascularization procedure, or other forms of clinical atherosclerotic disease (e.g., renal artery disease).
History or presence of clinically important pulmonary (including uncontrolled asthma), endocrine (including type I or type II diabetes mellitus), chronic inflammatory disease (including irritable bowel disease, lupus, rheumatoid arthritis), hepatic, renal, hematologic, immunologic, dermatologic, neurologic, psychiatric, or biliary disorders.
Known allergy, sensitivity, or intolerance to any ingredients in the study foods.
Uncontrolled hypertension.
Recent history of cancer, except for non-melanoma skin cancer.
Recent change in body weight of ± 4.5 kg (9.9 lbs).
Recent use of any medications intended to alter the lipid profile (e.g. bile acid sequestrants, cholesterol absorption inhibitor, fibrates, niacin (drug form), omega-3-ethyl ester drugs, and/or PCSK9 inhibitors, with the exception of the stable use of statins), weight-loss drugs or programs, systemic corticosteroid drugs, unstable use of any antihypertensive medication; medications known to influence CHO metabolism (e.g. adrenergic receptor blockers, diuretics, and/or hypoglycemic medications).
Recent use of food/supplements known to influence lipid metabolism (e.g. omega-3 fatty acid supplements (e.g., flaxseed, fish or algal oils) or fortified foods, sterol/stanol products; dietary supplements (red rice yeast supplements; garlic supplements; soy isoflavone supplements; niacin or its analogues at doses >400 mg/d, and irregular or inconsistent use of Metamucil® or viscous fiber-containing supplements.
Recent use of antibiotics.
Pregnant, planning to be pregnant during the study period, lactating, or is of childbearing potential and is unwilling to commit to the use of a medically approved form of contraception throughout the study period.
Extreme dietary habits (e.g. very low CHO diet, vegan, etc.).
Current or recent history, or strong potential, for drug or alcohol abuse.
History of a diagnosed eating disorder. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kevin Maki, PhD
Organizational Affiliation
MB Clinical Research and Consulting LLC
Official's Role
Study Director
Facility Information:
Facility Name
MB Clinical Research
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33487
Country
United States
Facility Name
Illinois Institute for Food Safety and Health (IFSH) at Illinois Instiute of Technology (IIT)
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60616
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
31525129
Citation
Palacios OM, Maki KC, Xiao D, Wilcox ML, Dicklin MR, Kramer M, Trivedi R, Burton-Freeman B, Edirisinghe I. Effects of Consuming Almonds on Insulin Sensitivity and Other Cardiometabolic Health Markers in Adults With Prediabetes. J Am Coll Nutr. 2020 Jul;39(5):397-406. doi: 10.1080/07315724.2019.1660929. Epub 2019 Sep 16.
Results Reference
derived
Learn more about this trial
Effects of Almonds on Insulin Sensitivity in Prediabetes
We'll reach out to this number within 24 hrs