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Trial registered on ANZCTR
Registration number
ACTRN12624001305516p
Ethics application status
Submitted, not yet approved
Date submitted
3/10/2024
Date registered
28/10/2024
Date last updated
28/10/2024
Date data sharing statement initially provided
28/10/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Fact or fiction: blood glucose response to ultra-processed foods
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Scientific title
Food processing, formulation, and inherent differences in composition on acute blood glucose control in adults with type 2 diabetes: randomised crossover study
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Secondary ID [1]
313102
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None
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Universal Trial Number (UTN)
U1111-1310-9438
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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
331938
331938
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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
Dietary interventions: single meal responses to 16 different foods and three glucose standards on 19 different mornings. Each of the foods vary in food type, processing, and formulation, but all contain 25g of available carbohydrate (sugars and starch). The three glucose drink interventions are all the same exposure and also provide 25g of available carbohydrate. The average of the three glucose exposures is used as a way to account for within-person variability in how they respond day-to-day. Foods and glucose drinks are tested inline with the ISO standard for postprandial blood glucose testing. Each intervention is started in the morning with a fasted participant who has 10 minutes to consume the food and three hours sitting in a chair while their capillary blood glucose is measured. Blood glucose measurements are taken from fingers at baseline, then at 15, 30, 45, 60, 90, 120, 150, and 180 minutes. This morning process is conducted under observation. Participants are free to pursue their interests of this three hours, but are required to remain largely sedentary in a chair. The foods being tested are 1) Oranges (225g) either as whole fruit (with and without added fibre, or orange juice (with and without added fibre. 2) Legumes (200g) (cooked plain or with olive oil) or freeze dried cooked legumes (plain or with olive oil). 3) Cow milk (450g, plain or with added protein) or yoghurt made from cow milk (plain or with added protein). 4) Cooked oats (100-170g) either intact (with or without sugar) or milled (with or without sugar). The amount of oats served per morning varies, as the added sugar counts towards the 25g available carbohydrate that determines serve size. Participants will be asked to eat all interventions of that food type (i.e. the oranges), before being asked if they wish to continue to test the next food type (i.e. oats).
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Intervention code [1]
329668
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Lifestyle
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Intervention code [2]
329777
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Treatment: Other
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Comparator / control treatment
The primary comparison for each food intervention will be the average of the three glucose drink responses.
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Control group
Active
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Outcomes
Primary outcome [1]
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Postprandial blood glucose control
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Assessment method [1]
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Measured as an incremental area under the curve (iAUC) blood glucose response of each intervention food relative to the average of the three glucose drink iAUC responses.
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Timepoint [1]
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The iAUC is measured using the capillary blood glucose measurements taken over the three hours following each dietary intervention at baseline, 15, 30, 45, 60, 90, 120, 150, and 180 minutes.
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Secondary outcome [1]
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Hunger
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Assessment method [1]
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By participants self reported mark on a 10cm visual analogue scale that ranges from "i'm not hungry at all" to "i've never been more hungry".
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Timepoint [1]
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Hunger measured at baseline, 30 minutes, 60 minutes, 120 minutes, and 180 minutes following each dietary intervention and glucose drink.
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Secondary outcome [2]
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Satiety
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Assessment method [2]
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By participants self reported mark on a 10cm visual analogue scale that ranges from "not full at all" to "completely full".
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Timepoint [2]
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Satiety measured at baseline, 30 minutes, 60 minutes, 120 minutes, and 180 minutes following each dietary intervention and glucose drink.
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Eligibility
Key inclusion criteria
Participants will be adults 18-75 years diagnosed with type 2 diabetes mellitus. Antihyperglycaemic drug use is permitted, provided a medical professional has not changed dose or type in the last three months. Regular insulin use of the same dose is also permitted, but basal bolus insulin use (changing amount in response to a meal). Presence of comorbidities will not exclude participation.
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Minimum age
18
Years
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Maximum age
75
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
Current pregnancy, lactation, allergies or intolerance to the test foods, and inability or unwillingness to comply with the intervention requirements will exclude participation.
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Study design
Purpose of the study
Treatment
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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)
Central randomisation by computer, built into REDCap online portal.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Intervention order by simple randomisation per food type using a computerised sequence generation, no stratification
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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
Efficacy
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Statistical methods / analysis
Data will be analysed according to intention to treat. A mixed model, which includes a term for order, will be used to analyse the data. Results will be presented as differences (with 95% confidence intervals) between the interventions and compared with the glucose standard. Analysis will be undertaken in Stata (version 17, StataCorp, TX, USA) with the statistician blinded to the primary analysis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/11/2024
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Actual
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Date of last participant enrolment
Anticipated
1/04/2025
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Actual
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Date of last data collection
Anticipated
30/04/2025
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Actual
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Sample size
Target
12
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Otago
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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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Edgar Diabetes and Obesity Research Centre
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Address [1]
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Country [1]
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New Zealand
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Funding source category [2]
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University
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Name [2]
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Riddet Institute, Centre of Research Excellence
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Address [2]
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Country [2]
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
319855
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Country [1]
319855
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
316258
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
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https://ethics.health.govt.nz/about/southern-health-and-disability-ethics-committee/
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Ethics committee country [1]
316258
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New Zealand
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Date submitted for ethics approval [1]
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02/10/2024
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Approval date [1]
316258
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Ethics approval number [1]
316258
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Summary
Brief summary
The purpose of this study is to test the acute response to different foods that vary in their level of processing or formulation. Our main outcomes is the acute glycaemic response to each of these foods, as it is one cardiometabolic indicator of health for adults diagnosed with T2 diabetes. With these tests we will see if food processing, formulation, or both processing and formulation influence acute blood glucose control in a predictable manner that might enable better nutrition communication about what people with type 2 diabetes should eat. We hypothesise that the different processing techniques and different added ingredients will change the blood glucose response to each food but not in a consistent manner that allows use of simplified nutrition messages such as 'food processing worsens blood glucose response' or 'food formulation worsens blood glucose response'.
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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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Dr Andrew Reynolds
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Address
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Department of Medicine, University of Otago, PO Box 56, Dunedin Otago 9010.
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Country
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New Zealand
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Phone
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+64279565826
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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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Andrew Reynolds
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Address
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Department of Medicine, University of Otago, PO Box 56, Dunedin Otago 9010.
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Country
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New Zealand
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Phone
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+64279565826
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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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Andrew Reynolds
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Address
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Department of Medicine, University of Otago, PO Box 56, Dunedin Otago 9010.
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Country
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New Zealand
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Phone
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+64279565826
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Fax
137312
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Email
137312
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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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