A legume-enriched diet improves metabolic health in prediabetes mediated through gut microbiome: a randomized controlled trial
Xiaorong Wu, Alvin Surya Tjahyo, Vera Sergeyevna Brok Volchanskaya, Long Hui Wong, Xianning Lai, Yi Ning Yong, Farhana Osman, Shia Lyn Tay, Priya Govindharajulu, Shalini Ponnalagu, Rachel Tso, Hwee Sze Teo, Kaijie Khoo, Huan Fan, Chew Chan Goh, Clara Poh Lian Yap, Melvin Khee‐Shing Leow, Christiani Jeyakumar Henry, Sumanto Haldar, Kevin Lim
Abstract
Healthy dietary patterns rich in legumes can improve metabolic health, although their additional benefits in conjunction with calorie restriction have not been well-established. We investigated effects of a calorie-restricted, legume-enriched, multicomponent intervention diet compared with a calorie-restricted control diet in 127 Chinese prediabetes participants, living in Singapore. The study was a 16-week, single-blind, parallel-design, randomized controlled trial (n = 63 intervention group (IG), n = 64 control group (CG); mean ± SD age 62.2 ± 6.3 years, BMI 23.8 ± 2.6 kg/m2). Primary outcomes were markers of glycemia and all measurements were taken at 2 or 4-weekly intervals. At the end of 16 weeks, both groups had significantly lower BMI (q(Time) = 1.92 ×10-42, β = -0.02) compared with baseline, with minimal difference between groups. The IG had significantly greater reductions in LDL cholesterol (q(Treatment×Time) = 0.01, β = -0.16), total cholesterol (q(Treatment×Time) = 0.02, β = -0.3) and HbA1c (q(Treatment×Time) = 0.04, β = -0.004) compared with CG, alongside increases in fiber degrading species in IG, mediated through metabolites such as bile acids and amino acids. A legume-enriched, multicomponent intervention diet can improve metabolic health in a prediabetes population, in addition to benefits obtained from calorie restriction alone, partially mediated through changes in gut microbial composition and function. Trial registration: Clinical Trials NCT04745702. Prediabetics have an increased risk of type 2 diabetes. In this parallel-design, randomized controlled trial, the authors show improvements in metabolic health in a prediabetes population consuming a legume-rich diet, which are mediated through favorable changes in gut microbiome.