Orly Ben-Yacov1,2, Anastasia Godneva1,2, Michal Rein1,2,3, Smadar Shilo1,2,4, Dmitry Kolobkov1,2, Netta Koren1,2, Noa Cohen Dolev1,2, Tamara Travinsky Shmul1,2, Bat Chen Wolf1,2, Noa Kosower1,2, Keren Sagiv1,2, Maya Lotan-Pompan1,2, Niv Zmora5,6,7, Adina Weinberger1,2, Eran Elinav8, Eran Segal9,2. 1. Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel. 2. Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel. 3. School of Public Health, University of Haifa, Haifa, Israel. 4. Pediatric Diabetes Unit, Ruth Rappaport Children's Hospital, Rambam Healthcare Campus, Haifa, Israel. 5. Immunology Department, Weizmann Institute of Science, Rehovot, Israel. 6. Digestive Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 7. Internal Medicine Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 8. Immunology Department, Weizmann Institute of Science, Rehovot, Israel eran.elinav@weizmann.ac.il eran.segal@weizmann.ac.il. 9. Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel eran.elinav@weizmann.ac.il eran.segal@weizmann.ac.il.
Abstract
OBJECTIVE: To compare the clinical effects of a personalized postprandial-targeting (PPT) diet versus a Mediterranean (MED) diet on glycemic control and metabolic health in prediabetes. RESEARCH DESIGN AND METHODS: We randomly assigned adults with prediabetes (n = 225) to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses. During the intervention, all participants were connected to continuous glucose monitoring (CGM) and self-reported dietary intake using a smartphone application. RESULTS: Among 225 participants randomized (58.7% women, mean ± SD age 50 ± 7 years, BMI 31.3 ± 5.8 kg/m2, HbA1c, 5.9 ± 0.2% [41 ± 2.4 mmol/mol], fasting plasma glucose 114 ± 12 mg/dL [6.33 ± 0.67 mmol/L]), 200 (89%) completed the 6-month intervention. A total of 177 participants also contributed 12-month follow-up data. Both interventions reduced the daily time with glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c levels, but reductions were significantly greater in PPT compared with MED. The mean 6-month change in "time above 140" was -0.3 ± 0.8 h/day and -1.3 ± 1.5 h/day for MED and PPT, respectively (95% CI between-group difference -1.29 to -0.66, P < 0.001). The mean 6-month change in HbA1c was -0.08 ± 0.19% (-0.9 ± 2.1 mmol/mol) and -0.16 ± 0.24% (-1.7 ± 2.6 mmol/mol) for MED and PPT, respectively (95% CI between-group difference -0.14 to -0.02, P = 0.007). The significant between-group differences were maintained at 12-month follow-up. No significant differences were noted between the groups in a CGM-measured oral glucose tolerance test. CONCLUSIONS: In this clinical trial in prediabetes, a PPT diet improved glycemic control significantly more than a MED diet as measured by daily time of glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c. These findings may have implications for dietary advice in clinical practice.
OBJECTIVE: To compare the clinical effects of a personalized postprandial-targeting (PPT) diet versus a Mediterranean (MED) diet on glycemic control and metabolic health in prediabetes. RESEARCH DESIGN AND METHODS: We randomly assigned adults with prediabetes (n = 225) to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses. During the intervention, all participants were connected to continuous glucose monitoring (CGM) and self-reported dietary intake using a smartphone application. RESULTS: Among 225 participants randomized (58.7% women, mean ± SD age 50 ± 7 years, BMI 31.3 ± 5.8 kg/m2, HbA1c, 5.9 ± 0.2% [41 ± 2.4 mmol/mol], fasting plasma glucose 114 ± 12 mg/dL [6.33 ± 0.67 mmol/L]), 200 (89%) completed the 6-month intervention. A total of 177 participants also contributed 12-month follow-up data. Both interventions reduced the daily time with glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c levels, but reductions were significantly greater in PPT compared with MED. The mean 6-month change in "time above 140" was -0.3 ± 0.8 h/day and -1.3 ± 1.5 h/day for MED and PPT, respectively (95% CI between-group difference -1.29 to -0.66, P < 0.001). The mean 6-month change in HbA1c was -0.08 ± 0.19% (-0.9 ± 2.1 mmol/mol) and -0.16 ± 0.24% (-1.7 ± 2.6 mmol/mol) for MED and PPT, respectively (95% CI between-group difference -0.14 to -0.02, P = 0.007). The significant between-group differences were maintained at 12-month follow-up. No significant differences were noted between the groups in a CGM-measured oral glucose tolerance test. CONCLUSIONS: In this clinical trial in prediabetes, a PPT diet improved glycemic control significantly more than a MED diet as measured by daily time of glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c. These findings may have implications for dietary advice in clinical practice.
Authors: Collin J Popp; Lu Hu; Anna Y Kharmats; Margaret Curran; Lauren Berube; Chan Wang; Mary Lou Pompeii; Paige Illiano; David E St-Jules; Meredith Mottern; Huilin Li; Natasha Williams; Antoinette Schoenthaler; Eran Segal; Anastasia Godneva; Diana Thomas; Michael Bergman; Ann Marie Schmidt; Mary Ann Sevick Journal: JAMA Netw Open Date: 2022-09-01
Authors: Sean M Gibbons; Thomas Gurry; Johanna W Lampe; Anirikh Chakrabarti; Veerle Dam; Amandine Everard; Almudena Goas; Gabriele Gross; Michiel Kleerebezem; Jonathan Lane; Johanna Maukonen; Ana Lucia Barretto Penna; Bruno Pot; Ana M Valdes; Gemma Walton; Adrienne Weiss; Yoghatama Cindya Zanzer; Naomi V Venlet; Michela Miani Journal: Adv Nutr Date: 2022-10-02 Impact factor: 11.567