A low-glucose eating pattern is associated with improvements in glycemic variability among women at risk for postmenopausal breast cancer: an exploratory analysis

Michelle R Jospe; Yue Liao; Erin D Giles; Barry I Hudson; Joyce M Slingerland; Susan M Schembre

doi:10.3389/fnut.2024.1301427

A low-glucose eating pattern is associated with improvements in glycemic variability among women at risk for postmenopausal breast cancer: an exploratory analysis

Front Nutr. 2024 Apr 10:11:1301427. doi: 10.3389/fnut.2024.1301427. eCollection 2024.

Authors

Michelle R Jospe¹, Yue Liao², Erin D Giles³, Barry I Hudson¹, Joyce M Slingerland¹, Susan M Schembre¹

Affiliations

¹ Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States.
² Department of Kinesiology at the College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States.
³ School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.

Abstract

Background: High glycemic variability (GV) is a biomarker of cancer risk, even in the absence of diabetes. The emerging concept of chrononutrition suggests that modifying meal timing can favorably impact metabolic risk factors linked to diet-related chronic disease, including breast cancer. Here, we examined the potential of eating when glucose levels are near personalized fasting thresholds (low-glucose eating, LGE), a novel form of timed-eating, to reduce GV in women without diabetes, who are at risk for postmenopausal breast cancer.

Methods: In this exploratory analysis of our 16-week weight loss randomized controlled trial, we included 17 non-Hispanic, white, postmenopausal women (average age = 60.7 ± 5.8 years, BMI = 34.5 ± 6.1 kg/m², HbA1c = 5.7 ± 0.3%). Participants were those who, as part of the parent study, provided 3-7 days of blinded, continuous glucose monitoring data and image-assisted, timestamped food records at weeks 0 and 16. Pearson's correlation and multivariate regression were used to assess associations between LGE and GV, controlling for concurrent weight changes.

Results: Increases in LGE were associated with multiple unfavorable measures of GV including reductions in CGM glucose mean, CONGA, LI, J-Index, HBGI, ADDR, and time spent in a severe GV pattern (r = -0.81 to -0.49; ps < 0.044) and with increases in favorable measures of GV including M-value and LBGI (r = 0.59, 0.62; ps < 0.013). These associations remained significant after adjusting for weight changes.

Conclusion: Low-glucose eating is associated with improvements in glycemic variability, independent of concurrent weight reductions, suggesting it may be beneficial for GV-related disease prevention. Further research in a larger, more diverse sample with poor metabolic health is warranted.Clinical trial registration: ClinicalTrials.gov, NCT03546972.

Keywords: blood glucose self-monitoring; continuous glucose monitoring; food intake regulation; glucose-guided eating; glycemic control.

Associated data

ClinicalTrials.gov/NCT03546972

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported in part by National Cancer Institute (R21CA215415) (SS). This work was also supported by the University of Texas MD Anderson Cancer, Center Duncan Family Institute for Cancer Prevention and Risk Assessment; the University of Texas MD Anderson Cancer Center, Center for Energy Balance in Cancer Prevention and Survivorship; and the University of Texas MD Anderson Cancer, Center Research-Related Patient Care Charges Fund (P30CA016672).