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Trial registered on ANZCTR
Registration number
ACTRN12616000571471
Ethics application status
Approved
Date submitted
29/04/2016
Date registered
3/05/2016
Date last updated
22/01/2020
Date data sharing statement initially provided
22/01/2020
Date results provided
22/01/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of almond consumption on metabolic and liver function in overweight and obese adults with increased fasting glucose.
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Scientific title
Effect of almond consumption on metabolic and liver function in overweight and obese adults with increased fasting glucose.
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Secondary ID [1]
289055
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Nil
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Universal Trial Number (UTN)
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Trial acronym
Nil
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Impaired glucose tolerance
298493
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cardio-metabolic disease
298494
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Non-alcoholic fatty liver disease
298495
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Overweight/obesity
298601
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Condition category
Condition code
Diet and Nutrition
298579
298579
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0
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Obesity
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Metabolic and Endocrine
298580
298580
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0
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Metabolic disorders
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Metabolic and Endocrine
298672
298672
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After a 2-week nut and seed washout period participants will consume 56g almonds/day (2 servings/day) consumed alone as whole raw almonds as a morning snack (28g) and afternoon snack (28g) for a period of 8 weeks. Participants will complete an online daily checklist throughout the study to assess compliance to the intervention.
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Intervention code [1]
294554
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Prevention
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Intervention code [2]
294628
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Treatment: Other
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Intervention code [3]
294629
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Lifestyle
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Comparator / control treatment
After a 2-week nut and seed washout period participants will consume 72g commercially available isocaloric, sweet (nut/seed free) biscuits/day (2 servings/day) consumed as a morning snack (36g) and afternoon snack (36g) for a period of 8 weeks. Participants will complete an online daily checklist throughout the study to assess compliance to the intervention.
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Control group
Active
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Outcomes
Primary outcome [1]
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Dynamic glucose regulation assessed by diurnal glucose variability (GV) and postprandial hyperglycaemia (PPG) from diurnal glucose profiles with data collected using a continuous glucose monitoring device worn for 7-days.
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Assessment method [1]
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Timepoint [1]
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Primary outcome [2]
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Liver lipid composition by proton magnetic resonance spectroscopy.
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Assessment method [2]
298076
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Timepoint [2]
298076
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [1]
323108
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Serum alanine aminotransferase, (ALT), aspartate aminotransferase (AST) (composite secondary outcome) using Beckman AU480 clinical analyser
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Assessment method [1]
323108
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Timepoint [1]
323108
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [2]
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Gut microbiome and bacteria metabolism profile on faecal DNA extracts (composite secondary outcome) by paired-read sequencing using Illumina MiSeq platform
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Assessment method [2]
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Timepoint [2]
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [3]
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Gut permeability using the dual sugar intestinal permeability test
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Assessment method [3]
323111
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Timepoint [3]
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [4]
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Total body weight and composition (composite secondary outcome) by bioelectric impedance
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Assessment method [4]
323112
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Timepoint [4]
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [5]
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Traditional markers of cardiometabolic health including fasting blood glucose, serum total cholesterol, HDL-C, triglycerides and insulin using commercial assay kits
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Assessment method [5]
323113
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Timepoint [5]
323113
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [6]
323114
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Systemic inflammatory marker including serum high-sensitive C-reactive protein (hs-CRP) using Beckman Coulter AU480 Chemistry Analyzer; serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNFa) using Multiplex.
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Assessment method [6]
323114
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Timepoint [6]
323114
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [7]
323115
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Blood pressure using an automated blood pressure monitor
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Assessment method [7]
323115
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Timepoint [7]
323115
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [8]
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Abdominal fat volume using magnetic resonance imaging.
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Assessment method [8]
323329
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Timepoint [8]
323329
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Baseline (after 2 week nut and seed washout period), 8 weeks post commencement of intervention
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Secondary outcome [9]
326286
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Food and nutrient intake using a 3-day weighted food record
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Assessment method [9]
326286
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Timepoint [9]
326286
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Prior to commencing the intervention (week 1 of 2 week nut and seed washout period), 7 weeks post commencement of intervention
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Eligibility
Key inclusion criteria
1. Male or female
2. Aged 20-70 years
3. The following inclusion criteria were chosen to maximise the probability of a population with abnormal metabolic and liver function:
a. Overweight/obese (BMI: >=27 kg/m2)
b. Waist circumference: > 88 cm for females, >102 cm for males
c. Fasting plasma glucose >=5.6 mmol/L or previously diagnosed type 2 diabetes (T2D) (confirmed by evidence of previous diagnosis and not taking any diabetes medication)
4. Weight stable (i.e. no more than 3 kg weight loss/gain in the past 2 months)
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Minimum age
20
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Smoking
2. Usage of medications/supplements, health conditions (including gastrointestinal disease, kidney disease, liver disease, cardiovascular disease, type 1 diabetes and cancer) and lifestyle factors that may affect the study outcomes or participant’s health at the discretion of the overseeing research physician after review the screening questionnaire.
3. Have type 2 diabetes and currently taking oral hypoglycaemic or insulin medication or have uncontrolled diabetes (indicated by HbA1c >10%)
4. Body weight >~140 kg due to technical difficulties related to the measurement and analysis of MRI scans with participants >~140 kg
5. History of smoking during 6 month prior to the study
6. Known allergies to nuts, dairy, gluten or not willing to consume, test foods
7. History of heavy alcohol consumption (>4 standard drinks/day)
8. Women who are attempting to become pregnant, pregnant, lactating
9. Extended absences due to travel or other commitments
10. On any weight loss program, commercial or self-administered with the goal to lose weight
11. Past history of claustrophobia – to enable body composition assessments to be performed
12. Presence of any ferrous metal in the body - to enable body composition assessments to be performed.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants who are eligible will be enrolled in the project and allocated to an intervention code based on a computer generated randomization scheme. Individuals who enrol and allocate participants to interventions will be blind to intervention codes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Eligible participants will be assigned to the interventions using stratified random assignment based on sex, age and BMI. The randomization scheme will be computer generated.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
40 participants in each group completing the study will provide 80% power (alpha<0.05) to detect a statistically significant difference of 22% between treatments for diurnal glucose variability and 2% for hepatic lipid content. An additional 10 participants (5 per group) will be recruited to account for ~10% attrition during the study (total sample size = 90)
Main intervention effects will be assessed using mixed effects longitudinal models using IBM SPSS statistics for WINDOWS.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
25/07/2016
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Actual
25/07/2016
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Date of last participant enrolment
Anticipated
31/03/2017
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Actual
7/03/2017
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Date of last data collection
Anticipated
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Actual
16/05/2017
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Sample size
Target
90
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Accrual to date
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Final
95
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment postcode(s) [1]
13164
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
293436
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Commercial sector/Industry
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Name [1]
293436
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Almond Board of California
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Address [1]
293436
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1150 Ninth St., Ste. 1500, Modesto, CA95354
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Country [1]
293436
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United States of America
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Primary sponsor type
Government body
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Name
Commonwealth Scientific Industrial Research Organisation
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Address
South Australian Health and Medical Research Institute building, North Terrace, Adelaide, South Australia, 5000
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Country
Australia
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Secondary sponsor category [1]
292260
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None
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Name [1]
292260
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Address [1]
292260
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Country [1]
292260
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Other collaborator category [1]
278961
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University
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Name [1]
278961
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University of Adelaide
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Address [1]
278961
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Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia, 5000
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Country [1]
278961
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Australia
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Other collaborator category [2]
278962
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Other
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Name [2]
278962
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South Australia Health and Medical Research Institute
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Address [2]
278962
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North Terrace, Adelaide, South Australia, 5000
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Country [2]
278962
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Australia
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Other collaborator category [3]
278963
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University
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Name [3]
278963
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University of Sydney
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Address [3]
278963
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75 East Street Lidcombe, New South Wales, Australia, 2141
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Country [3]
278963
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294883
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CSIRO Health and Medical Research Human Research Ethics Committee
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Ethics committee address [1]
294883
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GPO Box 2583, Brisbane, Queensland, 4001, Australia
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Ethics committee country [1]
294883
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Australia
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Date submitted for ethics approval [1]
294883
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16/02/2016
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Approval date [1]
294883
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22/03/2016
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Ethics approval number [1]
294883
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04/2016
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Summary
Brief summary
To examine the effects of daily almond intake over a period of 8 weeks in overweight and obese individuals with increased risk of metabolic disease on a comprehensive array of novel markers of metabolic health that share complex interrelationships including: 1. Blood glucose regulation throughout the day/night 2. Liver fat concentration and composition 3. Abdominal (including visceral) fat volume 4. Liver function 5. Gut bacteria profile and functionality 7. Body weight and composition 8. Cardiovascular Disease Risk Markers 9. Systemic Inflammatory Markers The primary hypothesis is that daily almond consumption (56g – consumed as 2 between meal snacks) for 8 weeks will reduce diurnal PPG and GV and hepatic lipid content to a greater extent than an isocaloric control snack. Secondary hypotheses are that daily almond consumption (56g – consumed as 2 between meal snacks) for 8 weeks will improve measures of liver function, gut microbiome and permeability, systemic inflammation and traditional metabolic health markers (i.e. fasting insulin and glucose, HbA1c and lipids including cholesterol and triglyceride) to a greater extent than an isocaloric control snack.
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Trial website
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Trial related presentations / publications
Bowen J, Luscombe-Marsh ND, Stonehouse W, Tran C, Rogers GB, Johnson N, Thompson CH, Brinkworth GD. Effects of almond consumption on metabolic function and liver fat in overweight and obese adults with elevated fasting blood glucose: A randomised controlled trial. Clin Nutr ESPEN. 2019 Apr;30:10-18. doi: 10.1016/j.clnesp.2018.12.088. Epub 2019 Jan 11.
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Public notes
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Contacts
Principal investigator
Name
65318
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Dr Grant Brinkworth
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Address
65318
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CSIRO
Food and Nutrition, Riverside Corporate Park, 11 Julius Avenue, North Ryde NSW 2113.
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Country
65318
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Australia
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Phone
65318
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+61 2 9490 5665
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Fax
65318
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Email
65318
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[email protected]
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Contact person for public queries
Name
65319
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Jane Bowen
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Address
65319
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CSIRO
PO Box 10041, Adelaide, South Australia, 5000
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Country
65319
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Australia
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Phone
65319
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+61 8 8303 8907
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Fax
65319
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Email
65319
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[email protected]
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Contact person for scientific queries
Name
65320
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Grant Brinkworth
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Address
65320
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CSIRO
Food and Nutrition, Riverside Corporate Park, 11 Julius Avenue, North Ryde NSW 2113.
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Country
65320
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Australia
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Phone
65320
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+61 2 9490 5665
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Fax
65320
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Email
65320
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Participant permission for data availability has not been granted.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Almond consumption affects fecal microbiota composition, stool pH, and stool moisture in overweight and obese adults with elevated fasting blood glucose: A randomized controlled trial.
2021
https://dx.doi.org/10.1016/j.nutres.2020.11.005
N.B. These documents automatically identified may not have been verified by the study sponsor.
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