1. Introduction
obesity, glucose tolerance, prediabetes, weight loss, diabetes
OBESITY, TYPE 2 DIABETES, PREDIABETES, DIABETES
(1) Background: Prior research in individuals with overweight/obesity and prediabetes or type 2 diabetes has shown that the ingestion of protein-rich food and non-starchy vegetables before concentrated carbohydrates (a carbohydrate-last food order) led to lower postprandial glucose excursions over 180 min, compared to eating the same foods in the reverse order. To expand upon this research, we sought to examine the feasibility and impact of carbohydrate-last food order behavioral intervention on glucose tolerance (GT), HbA1c, weight, and nutrient intake in adults with prediabetes in the real world over a 16-week span. (2) Methods: A total of 45 adults with overweight/obesity and prediabetes were randomized to receive 4-monthly standard nutritional counseling (C) or standard nutritional counseling plus carbohydrate-last food order counseling (FO) sessions (NCT# NCT03896360). (3) Results: The FO group decreased in body weight (−3.6 ± 5.7 lbs, Parallel with increasing rates of obesity, the prevalence of prediabetes in the US has grown to 38% of the adult population [Data from multiple intensive lifestyle intervention studies directed toward diet modification, increased physical activity, and weight loss in diverse patient populations have shown a 40–70% relative risk reduction in developing diabetes compared with standard care [This prospective pilot study expands what is known from previous research on nutrient order and tests the feasibility and metabolic effects of this behavioral intervention in the real world. A 16-week carbohydrate-last food order behavioral intervention was implemented in adults with prediabetes to assess its feasibility and impact on glucose tolerance (GT), HbA1c, weight, and nutrient intake. We postulated that a carbohydrate-last food order was a feasible behavioral strategy in individuals with prediabetes and that the addition of food order counseling to standard nutritional counseling would improve glucose tolerance, HbA1c, and nutrient intake, while reducing body weight.