Effect of Meal Composition and Timing Modification on Glucose Metabolism, Body Temperature and Sleep

Purpose

The purpose of our study is to understand the impact of different meal timing alterations on blood sugars, metabolism, microbiome and sleep physiology in people with prediabetes and diabetes; and to study the temperature/heart rate response to different meals in different people.

Conditions

  • PreDiabetes
  • Type 2 Diabetes
  • Healthy

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Be 18 years of age or older; - Not be pregnant, if female; - Be generally healthy (with no apparent symptoms at the time of enrollment) - Patients with prediabetes or diet- controlled or type 2 diabetes or controlled with metformin, will also be allowed to participate. - Be willing to provide written informed consent for all study procedures.

Exclusion Criteria

  • major organ disease - pregnant/lactating - diabetes medications except for metformin - malabsorptive disorders like celiac sprue - heavy alcohol use - use of weight loss medications or specific diets - weight change >2 Kg in the last month - history of bariatric surgery - Any medical condition that physicians believe would interfere with study participation or evaluation of results - Mental incapacity and/or cognitive impairment on the part of the patient that would preclude adequate understanding of, or cooperation with, the study protocol.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
N/A
Intervention Model
Sequential Assignment
Primary Purpose
Basic Science
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Intervention
Participants will undergo a baseline phase for 20 days, where they will follow their regular dietary intake, physical activity, and sleep. They will be wearing a CGM and an activity monitor and for a couple of nights, they will use a sleep monitor. That will be followed by 4 interventional phases where they will be asked to limit their daily eating to 10 hours or less (Time Restricted Eating, TRE), with the eating window and the caloric distribution will be shifted during each of the next 3 phases, each phase lasting 20 days. The last phase will last 8 days and participants will be asked to consume provided meals with a determined amount of protein, carbohydrates, and fat. Their body temperature will be measured using a continuous temperature device and a heart rate monitor to capture dynamic rage of the sympathetic response during and after the meal consumption (thermotyping).
  • Behavioral: Time Restrictive Eating- late
    Eating window will be 10 hours or less, starting 3 hours after waking up. Same monitoring as Baseline phase.
  • Behavioral: Time Restrictive Eating- early
    Eating window will be 10 hours or less, starting 30 min after waking up. Same monitoring as Baseline phase.
  • Behavioral: Time Restrictive Eating- early with early caloric intake
    Same as TRE-early, but concentrating caloric intake early in the eating window Same monitoring as Baseline phase.
  • Other: Macronutrient-controlled meals
    Meals with a determined amount of protein, carbohydrates, and fat.

Recruiting Locations

Stanford University
Stanford 5398563, California 5332921 94304
Contact:
Caroline Bejikian

More Details

Status
Recruiting
Sponsor
Stanford University

Study Contact

Alessandra Celli, MS
(650) 725-8491
alessandra.celli@stanford.edu

Detailed Description

Pilot data points to an effect of the time between waking up and first meal is important in blood glucose management through the rest of the day. The investigators are interested in understanding the effect of caloric distribution through the day, specifically consuming more later in the day versus earlier in the day. The investigators want to test the hypothesis that consolidating the meals during a shorter span in the day (time restricted eating) can ameliorate blood sugars and sleep parameters in the studied population. The researchers would also like to compare dynamic range of meal-induced sympathetic responses (e.g. temperature and heart rate changes) between different metabolic health conditions (e.g. insulin sensitive vs insulin resistant vs diabetes) while controlling for dietary intake. Previous research studies suggest that people with different metabolic health conditions would have different meal-induced sympathetic responses. Based on this, the primary goal of the study is to characterize metabolic health based on non-invasive wearable sensor data that measure these responses.