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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12619000246189
Ethics application status
Approved
Date submitted
5/02/2019
Date registered
19/02/2019
Date last updated
15/06/2025
Date data sharing statement initially provided
19/02/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The effects of Mediterranean diet with or without intermittent fasting in Type 2 Diabetes in a Greek cohort (the MedDietFast trial)
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Scientific title
The effects of Mediterranean diet with or without intermittent fasting in Type 2 Diabetes in a Greek cohort (the MedDietFast randomised controlled trial)
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Secondary ID [1]
297184
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 diabetes
311227
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Condition category
Condition code
Metabolic and Endocrine
309854
309854
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1
Intensive personalised dietary counseling based on a Mediterranean diet [low in saturated fat [<7% of total energy intake (TEI)] and high in fiber (>40g/day)], consumed ad libitum and delivered by a nutritionist with minimum 5 years' experience.
The duration of the intervention will be 6 months. Participants will have phone or video appointments with a nutritionist biweekly for 12 weeks and monthly thereafter to facilitate compliance.
Appointments will last between 45 to 60 minutes depending on clients needs and compliance with the intervention.
Adherence to the Mediterranean dietary pattern will be assessed from 7 consecutive days (including 2 weekend days) of daily weighed food records for every 14-day period.
Arm 2
Intensive personalised dietary counseling based on a Mediterranean diet [low in saturated fat (<7% of TEI) and high in fiber (>40g/day)], consumed ad libitum accompanied by time restricted feeding (12h fasting every day).
The intervention will be delivered by a nutritionist with minimum 5 years' experience.
The duration of the intervention will be 6 months. Participants will have phone or video appointments with a nutritionist biweekly for 12 weeks and monthly thereafter to facilitate compliance.
Appointments will last between 45 to 60 minutes depending on clients' needs and compliance with the intervention.
Adherence to the Mediterranean dietary pattern will be assessed from 7 consecutive days (including 2 weekend days) of daily weighed food records for every 14-day period.
The same intervention will apply in a cohort in Greece, where all appointments will be online.
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Intervention code [1]
313447
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Treatment: Other
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Comparator / control treatment
Participants randomised to the control group will receive intensive dietary counselling based on the Australian Dietary Guidelines for healthy eating fortnightly for 12 weeks and monthly thereafter. During these telephone appointments, the nutritionist will reinforce dietary counselling, behavioural change and address any potential challenges and issues that the participant is facing in adhering to the diets. Consultations will last between 45 to 60 minutes depending on clients needs and compliance with the intervention.
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Control group
Active
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Outcomes
Primary outcome [1]
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Changes in HbA1c assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [1]
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Timepoint [1]
318810
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Timepoint: Baseline, 3 months (primary timepoint) and 6 months after intervention commencement
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Secondary outcome [1]
366124
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Changes in fasting plasma glucose assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [1]
366124
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Timepoint [1]
366124
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Secondary outcome [2]
366125
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Changes in plasma insulin concentrations assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [2]
366125
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Timepoint [2]
366125
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Secondary outcome [3]
366126
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Changes in LDL cholesterol assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [3]
366126
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Timepoint [3]
366126
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Secondary outcome [4]
366127
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Changes in systolic and diastolic blood pressure assessed using automated sphygmomanometry
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Assessment method [4]
366127
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Timepoint [4]
366127
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Timepoint: Baseline, and at 6 weeks, 3 months and 6 months after intervention commencement
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Secondary outcome [5]
366128
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Changes in CRP assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [5]
366128
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Timepoint [5]
366128
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Secondary outcome [6]
366129
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Medication changes assessed using a medication record at each visit, asking specifically if there were any changes to the medications or the dose taken.
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Assessment method [6]
366129
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Timepoint [6]
366129
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Medication changes were assessed at baseline, 3 months, and 6 months. This change was made prior to enrolment commencement.
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Secondary outcome [7]
366578
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Changes in HDL cholesterol assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [7]
366578
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Timepoint [7]
366578
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Secondary outcome [8]
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Changes in triglycerides assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [8]
366579
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Timepoint [8]
366579
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Secondary outcome [9]
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Changes in total cholesterol assessed by using serum essay analysis performed in a qualified laboratory.
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Assessment method [9]
366735
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Timepoint [9]
366735
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Timepoint: Baseline, and at 3 and 6 months after intervention commencement
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Eligibility
Key inclusion criteria
1. Informed consent
2. Diagnosed with Type 2 Diabetes [HbA1c greater than or equal to 6.5% (48 mmol/mol); or a fasting plasma glucose level greater than or equal to126 mg/dl (7.0 mmol/l) or; 2-hour post-challenge (oral glucose tolerance test) plasma glucose level greater than or equal to 200 mg/dl (11.1 mmol/l) and/or taking oral glycaemic medications]
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Minimum age
20
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Participants aged 20 – 75 years
2. Body mass index greater than 20 kg/m2
3. Unwillingness or inability to comply to the dietary intervention
4. Type 1 diabetes or taking insulin
5. Unstable diabetic control or changes in diabetes medication in the last 3 months prior the initiation of the trial.
6. Mediterranean Diet Adherence Score (MEDAS) greater than or equal to 9 [41]
7. Shift working
8. Eating duration greater than or equal to 12 h during the previous year and or regularly skip meals for dieting
9. Proteinuria (urinary albumin to creatinine ratio >30 mg/mmol) and impaired renal function eGFR<60
10. Malignancy in the past 2 years (other than nonmelanoma) and currently receiving active treatment
11. Active and uncontrolled liver, respiratory, gastrointestinal, cardiovascular disease, mental illness, endocrinopathy (other than stable treated thyroid disease) or inflammatory diseases (e.g. rheumatoid arthritis, Crohn’s disease, colostomy, malabsorption)
12. History of/or current eating disorder
13. Food allergies, or food aversions that prevent participants consuming key Mediterranean foods
14. Pregnant and/or currently breastfeeding
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A sample size of n=96 patients (32 patients per group, for the three groups in the study) will be sufficient to detect a standardized effect size (eta squared) difference of 10% on the examined cases, with 80% power and a 5% significance level. Considering the possibility of 20% dropouts, an additional sample needs to be included. The sample size, therefore will need to be N=n/(1-0.2)=120 patients (40 patients per group).
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Participant recruitment difficulties
Other reasons/comments
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Other reasons
Due to participant recruitment challenges, we decided to conduct a feasibility study and pause recruitment after this initial phase. Further recruitment may be undertaken in the future as part of a fully powered trial.
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Date of first participant enrolment
Anticipated
25/07/2022
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Actual
12/08/2022
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Date of last participant enrolment
Anticipated
30/06/2023
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Actual
18/08/2023
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Date of last data collection
Anticipated
29/12/2023
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Actual
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Sample size
Target
120
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Accrual to date
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Final
53
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Recruitment outside Australia
Country [1]
21225
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Greece
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State/province [1]
21225
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Nationwide recruitment
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Funding & Sponsors
Funding source category [1]
301758
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Self funded/Unfunded
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Name [1]
301758
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N/A
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Address [1]
301758
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N/A
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Country [1]
301758
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Primary sponsor type
University
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Name
RMIT University
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Address
RMIT University, PO Box 71, Bundoora, Victoria 3083, Australia
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Country
Australia
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Secondary sponsor category [1]
301501
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None
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Name [1]
301501
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Address [1]
301501
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Country [1]
301501
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302481
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RMIT University Human Research Ethics Commitee
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Ethics committee address [1]
302481
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Research Integrity Governance and Systems RMIT University GPO Box 2476 MELBOURNE VIC 3001
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Ethics committee country [1]
302481
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Australia
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Date submitted for ethics approval [1]
302481
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14/05/2021
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Approval date [1]
302481
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29/06/2021
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Ethics approval number [1]
302481
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2021-24430-14772
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Ethics committee name [2]
311029
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RMIT University Human Research Ethics Commitee
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Ethics committee address [2]
311029
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Research Integrity Governance and Systems RMIT University GPO Box 2476 MELBOURNE VIC 3001
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Ethics committee country [2]
311029
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Australia
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Date submitted for ethics approval [2]
311029
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05/05/2022
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Approval date [2]
311029
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Ethics approval number [2]
311029
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N/A
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Ethics committee name [3]
311293
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RMIT University Human Research Ethics Committee
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Ethics committee address [3]
311293
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Research Integrity Governance and Systems RMIT University GPO Box 2476 MELBOURNE VIC 3001
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Ethics committee country [3]
311293
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Australia
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Date submitted for ethics approval [3]
311293
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22/06/2022
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Approval date [3]
311293
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Ethics approval number [3]
311293
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Summary
Brief summary
Main Goal & Objectives of the study The objective of the present trial is associated with dietary interventions in the management of Type 2 Diabetes. The focus will be oriented towards the efficacy of the Mediterranean diet (MD) in the management of type 2 diabetes. The research hypothesis is whether a Mediterranean dietary pattern with or without intermittent fasting may better control diabetes, as compared with a conventional diet based on the current recommendations for patients with Type 2 diabetes. The objectives of the project are as follows; a. the superiority or non-inferiority of a MD accompanied by intermittent fasting vs. a MD and a conventional diet against Type 2 diabetes markers, b. the feasibility/sustainability of an intermittent fasting protocol, with moderate intensity, or standard healthy dietary patterns (i.e. Mediterranean, conventional diet) in patients with Type 2 Diabetes, c. the “clear” effect of “intermittent fasting” on diabetes markers, d. the design of an alternative dietary intervention for the management of diabetes mellitus, e. the reveal of more robust evidence regarding the effect of Mediterranean diet in the management of Type 2 diabetes and. A major challenge for nutrition behavioral clinical trials is to suggest a dietary plan being not only in accordance with the recent literature tendency and showing promising results during the trials’ setting, but, most importantly, feasible to be adopted by the individuals in their daily life. The aim of the trial is to provide a feasible and sustainable guide to healthy eating, because it includes dietary guidelines based on the Mediterranean diet, combined with an innovative promising dietary protocol (Mediterranean diet accompanied by time restricted feeding), which can easily be adopted. Intervention: The three arms of the clinical trial will be as follows; a. control group, b. low saturated fat (<7% of TEI), high fiber (>40g/day) MD (Intervention I) and c.MD accompanied by time restricted feeding (TRF) (Intervention II). The active trial duration will be 6 months with follow-up in 6 weeks, 3 months and 6 months since baseline. We decided to add a Greek cohort as this will give information on the effectiveness and adherence of a Mediterranean diet in a Mediterranean population compared to a non-Mediterranean population.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Catherine Itsiopoulos
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Address
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RMIT University / Bundoora / Victoria 3083
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Country
90294
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Australia
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Phone
90294
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+61 03 9925 7395
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Fax
90294
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Email
90294
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[email protected]
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Contact person for public queries
Name
90295
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Catherine Itsiopoulos
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Address
90295
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RMIT University / Bundoora / Victoria 3083
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Country
90295
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Australia
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Phone
90295
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+61 3 9925 7395
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Fax
90295
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Email
90295
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[email protected]
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Contact person for scientific queries
Name
90296
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Catherine Itsiopoulos
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Address
90296
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RMIT University / Bundoora / Victoria 3083
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Country
90296
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Australia
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Phone
90296
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+61 3 99257395
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Fax
90296
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Email
90296
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
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Case-by-case basis at the discretion of Primary Sponsor
Conditions for requesting access:
•
-
What individual participant data might be shared?
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All of the individual participant data collected during the trial, after de-identification
What types of analyses could be done with individual participant data?
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Only to achieve the aims in the approved proposal, including meta-analyses
When can requests for individual participant data be made (start and end dates)?
From:
Immediately following publication, no end date
To:
-
Where can requests to access individual participant data be made, or data be obtained directly?
•
Access subject to approvals by Principal Investigator
Are there extra considerations when requesting access to individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Type
Citation
Link
Email
Other Details
Attachment
Study protocol
Study-related document.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF