Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.
Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, United States; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.
Am J Clin Nutr. 2023 Aug;118(2):443-451. doi: 10.1016/j.ajcnut.2023.05.026. Epub 2023 May 24.
Recent studies have demonstrated considerable interindividual variability in postprandial glucose response (PPGR) to the same foods, suggesting the need for more precise methods for predicting and controlling PPGR. In the Personal Nutrition Project, the investigators tested a precision nutrition algorithm for predicting an individual's PPGR.
This study aimed to compare changes in glycemic variability (GV) and HbA1c in 2 calorie-restricted weight loss diets in adults with prediabetes or moderately controlled type 2 diabetes (T2D), which were tertiary outcomes of the Personal Diet Study.
The Personal Diet Study was a randomized clinical trial to compare a 1-size-fits-all low-fat diet (hereafter, standardized) with a personalized diet (hereafter, personalized). Both groups received behavioral weight loss counseling and were instructed to self-monitor diets using a smartphone application. The personalized arm received personalized feedback through the application to reduce their PPGR. Continuous glucose monitoring (CGM) data were collected at baseline, 3 mo and 6 mo. Changes in mean amplitude of glycemic excursions (MAGEs) and HbA1c at 6 mo were assessed. We performed an intention-to-treat analysis using linear mixed regressions.
We included 156 participants [66.5% women, 55.7% White, 24.1% Black, mean age 59.1 y (standard deviation (SD) = 10.7 y)] in these analyses (standardized = 75, personalized = 81). MAGE decreased by 0.83 mg/dL per month for standardized (95% CI: 0.21, 1.46 mg/dL; P = 0.009) and 0.79 mg/dL per month for personalized (95% CI: 0.19, 1.39 mg/dL; P = 0.010) diet, with no between-group differences (P = 0.92). Trends were similar for HbA1c values.
Personalized diet did not result in an increased reduction in GV or HbA1c in patients with prediabetes and moderately controlled T2D, compared with a standardized diet. Additional subgroup analyses may help to identify patients who are more likely to benefit from this personalized intervention. This trial was registered at clinicaltrials.gov as NCT03336411.
最近的研究表明，对于相同的食物，个体餐后血糖反应（PPGR）存在显著的个体间差异，这表明需要更精确的方法来预测和控制 PPGR。在个人营养计划研究中，研究人员测试了一种用于预测个体 PPGR 的精准营养算法。
本研究旨在比较两种热量限制减肥饮食在糖尿病前期或中度控制的 2 型糖尿病（T2D）成年人中对血糖变异性（GV）和糖化血红蛋白（HbA1c）的影响，这是个人饮食研究的次要结果。
个人饮食研究是一项比较 1 种大小适合所有人的低脂饮食（以下简称标准化）和个性化饮食（以下简称个性化）的随机临床试验。两组均接受行为减肥咨询，并被指示使用智能手机应用程序自行监测饮食。个性化组通过应用程序收到个性化反馈，以降低其 PPGR。在基线、3 个月和 6 个月时收集连续血糖监测（CGM）数据。评估 6 个月时 MAGE 和 HbA1c 的变化。我们使用线性混合回归进行意向治疗分析。
我们对 156 名参与者（66.5%女性，55.7%为白人，24.1%为黑人，平均年龄 59.1 岁[标准差（SD）=10.7 岁]）进行了这些分析（标准化=75，个性化=81）。标准化饮食组 MAGE 每月降低 0.83mg/dL（95%CI：0.21,1.46mg/dL；P=0.009），个性化饮食组 MAGE 每月降低 0.79mg/dL（95%CI：0.19,1.39mg/dL；P=0.010），组间无差异（P=0.92）。HbA1c 值也有类似的趋势。
与标准化饮食相比，个性化饮食并未导致糖尿病前期和中度控制的 T2D 患者 GV 或 HbA1c 降低幅度增加。进一步的亚组分析可能有助于确定更有可能从这种个性化干预中受益的患者。本试验在 clinicaltrials.gov 注册为 NCT03336411。
