Individual Postprandial Glycemic Responses to Diet in N-of-1 Trials: Westlake N-of-1 Trials for Macronutrient Intake (WE-MACNUTR)

Abstract

ObjectivesWe aimed to use a novel ‘N-of-1’ study design to investigate the individual variability in postprandial glycemic response when eating diets with different macronutrient distributions among healthy adults. MethodsThirty apparently healthy young Chinese adults aged between 22 and 34 years were enrolled. Each participant was provided with high-fat, low-carbohydrate (HF-LC) and low-fat, high-carbohydrate (LF-HC) diets for six days wearing the continuous glucose monitor systems, respectively, in a randomized sequence, interspersed by a six-day wash-out period. Three cycles were conducted. The primary outcomes were the differences of maximum postprandial glucose (MPG), mean amplitude of glycemic excursions (MAGE), and area under the curve (AUC24) between intervention periods of LF-HC and HF-LC diets. A Bayesian model was used to determine responders with the posterior probability of any one of the three outcomes reaching a clinically meaningful difference. ResultsTwo participants abandoned at an early stage of the intervention, and the remaining 28 participants were included in the analysis set. The LF-HC diet, compared with the HF-LC diet, induced a higher MPG (n = 7) or MAGE (n = 5, with 3 overlapping with MPG) response among 9 individuals, who were identified as high-carb responders. On the other hand, the HF-LC diet, compared with the LF-HC diet, induced a higher MPG (n = 3) or MAGE (n = 4, with 1 overlapping with MPG) response among 6 individuals, who were identified as high-fat responders. ConclusionsThe present study supports N-of-1 trials’ feasibility for defining personalized nutritional advice modulating postprandial hyperglycemia and potentially preventing cardiometabolic diseases. Funding SourcesNational Natural Science Foundation of China.