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Trial registered on ANZCTR
Registration number
ACTRN12622001075774
Ethics application status
Approved
Date submitted
29/07/2022
Date registered
3/08/2022
Date last updated
29/11/2022
Date data sharing statement initially provided
3/08/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Comparing the effects of almond and walnut butters on glucose and insulin levels after eating white bread, in a population at increased risk of diabetes.
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Scientific title
Comparing the acute effects of almond and walnut butter on post-prandial glucose and insulin response in a population at increased risk of diabetes: A randomised controlled cross-over trial.
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Secondary ID [1]
307677
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 diabetes
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Condition category
Condition code
Metabolic and Endocrine
324351
324351
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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
Intervention products: Nut butters (walnut and almond)
Whilst numerous studies have focused upon whole nuts, there are few studies which have examined the effects nut butters, such as almond or walnut, on postprandial glycaemic control in a population at increased risk of diabetes (>18yrs of age, waist circumference >88cm women, >102cm men)
This study is a three-arm randomised controlled cross-over study design:
Arm 1: 60g almond butter + 104g white bread (50g available carbohydrate)
Arm 2: 60g walnut butter + 104g white bread (50g available carbohydrate)
Arm 3: 104g white bread alone (control).
All eligible participants will be asked to attend three separate face to face testing visits to complete the three study arms (one arm per visit, in a randomly allocated order). All visits will be conducted by the Honours Student M. Noonan, in conjunction with the supervisors Professor Gary Williamson and Dr Margaret Murray. At each testing visit participants will have multiple finger prick blood samples taken over a 180-minute period after consuming either the control meal or intervention meals, in order to test postprandial glucose and insulin response.
Participants will be asked to fast from 9 pm the night before (>10 h fast) following a standardised dinner meal, and avoid nuts and nut-containing foods and strenuous physical activity for 24 hours before testing. They will also be asked to consume the test meals within 10 minutes.
A washout period of at least one week will occur between each testing visit.
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Intervention code [1]
324153
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Prevention
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Comparator / control treatment
The control for this study is as follows:
Arm 3: 104g white bread alone (which provides 50g available Carbohydrate).
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Control group
Active
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Outcomes
Primary outcome [1]
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Postprandial blood glucose area under the curve (AUC).
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Assessment method [1]
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Timepoint [1]
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Blood glucose will be measured at 10 and 5 minutes before commencement of eating to ascertain fasting glucose.
Postprandial measurements will be taken at: +15, +30, +45, +60, +90, +120, +150, +180 minutes after commencement of eating.
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Primary outcome [2]
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Postprandial plasma insulin area under the curve (AUC)
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Assessment method [2]
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Timepoint [2]
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A plasma sample will be collected in the fasting state, then at +30, +60, +90, +120, +150 and +180 minutes after commencing the meal , to measure plasma insulin.
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Secondary outcome [1]
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Postprandial satiety, as measured by a visual analogue hunger scale and calculated as area under the curve (AUC)
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Assessment method [1]
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Timepoint [1]
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The Hunger Scale satiety values will be collected at the following time intervals: fasting, and 60, 120 and 180 minutes after commencement of eating.
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Eligibility
Key inclusion criteria
Individuals 18 years of age and above
A waist circumference measure greater than or equal to 88cm in women and 102cm in men
Able to consume nuts AND gluten containing products (pasta and white bread) with nil adverse effects
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Minimum age
18
Years
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Maximum age
No limit
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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
Current Smokers
Individuals with an Implanted Cardiac Defibrillator (ICD)
Consuming >14 standard drinks of alcohol per week
Females who are pregnant, trying to become pregnant or breastfeeding
Individuals who have been diagnosed with Diabetes or taking Diabetes medications
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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)
Allocation not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A Latin Square randomisation method was used to randomly generate the order in which participants were allocated to receive each of the three treatment arms
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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
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
The power calculation done for this study showed that with an alpha-value of 0.05 and for 80% power, a total of seven participants were needed to show a difference between groups. This was based upon the study by Crouch and Slater (Almond “appetizer” effect on glucose tolerance (GTT) results- JABFM, Nov 2016, 29(6), 759-766) and used postprandial area under the curve data for blood glucose, comparing a control with an almond intervention.
We will report means +/- standard deviations for baseline data (e.g. demographics, nut consumption and physical activity). Data pertaining to insulin, glucose and satiety will be reported as AUC. Within subjects ANOVA and paired T-tests will be used for examining differences.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
23/05/2022
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Date of last participant enrolment
Anticipated
2/09/2022
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Actual
31/08/2022
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Date of last data collection
Anticipated
30/09/2022
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Actual
28/09/2022
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Sample size
Target
10
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Accrual to date
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Final
8
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Monash University
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Address [1]
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Department of Nutrition, Dietetics and Food. Monash Be Active Sleep Eat (BASE) facility, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash Univeristy
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Address
Department of Nutrition, Dietetics and Food. Monash Be Active Sleep Eat (BASE) facility, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
313433
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Country [1]
313433
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash University Human Research Ethics Committee (MUHREC)
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Ethics committee address [1]
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Monash University, Wellington Road, Clayton, VIC 3800.
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
311377
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29/04/2022
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Approval date [1]
311377
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03/05/2022
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Ethics approval number [1]
311377
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32274
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Summary
Brief summary
Diabetes is a progressive, chronic disease characterised by elevated blood glucose levels. Approximately two million Australians are currently at high risk of developing Type 2 Diabetes. There has been increased attention to the effects of individual food items and nutrients on the outcome of Type 2 Diabetes in recent times, including nuts. Regular nut consumption has been shown to improve glucose control and reduce the overall risk of Type 2 Diabetes. The glycaemic response varies for different carbohydrates. In addition to the level of available carbohydrate in foods, the remaining composition of a food item can also influence the glycaemic response. Almonds have been shown to decrease blood glucose levels and increase satiety after eating. Walnuts contribute numerous positive health benefits including lowering cholesterol and reducing inflammation. Both walnuts and almonds contain high amounts of polyphenols. The form in which nuts are consumed (butter vs whole nuts) may lead to differing metabolic responses. Whilst there are several acute feeding studies which have looked at the postprandial glucose and insulin responses of whole walnuts and almonds, very few have looked at almond or walnut butters, (despite widespread commercial availability of such products). The current study design hopes to provide answers to this research gap. Significant outcomes of the research may include: - Understanding the effects of almond and walnut butters on blood glucose and insulin levels - Understanding the subjective satiety measures of almond and walnut butters We hypothesise that consuming almond butter or walnut butter with white bread will lower the resulting glucose and insulin response, as compared to white bread alone.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Gary Williamson
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Address
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Nutrition, Dietetics and Food
Faculty of Medicine, Nursing and Health Sciences, Monash University
Be Active Sleep Eat Facility (BASE)
Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168
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Country
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Australia
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Phone
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+61 399056649
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Gary Williamson
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Address
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Nutrition, Dietetics and Food
Faculty of Medicine, Nursing and Health Sciences, Monash University
Be Active Sleep Eat Facility (BASE)
Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168
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Country
120887
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Australia
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Phone
120887
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+61 399056649
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Gary Williamson
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Address
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Nutrition, Dietetics and Food
Faculty of Medicine, Nursing and Health Sciences, Monash University
Be Active Sleep Eat Facility (BASE)
Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168
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Country
120888
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Australia
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Phone
120888
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+61 399056649
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Fax
120888
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Email
120888
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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
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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
No additional documents have been identified.
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