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CompletedNCT04820322Updated Jan 22, 2025Results posted

Comparison of the Postprandial Glycemic and Insulinemic Response After a Fibersym Containing Cookie With a Control

An interventional study of Fibersym and Control cookie in Postprandial Hyperglycemia, sponsored by MGP Ingredients, Inc.. Completed at 1 site in Canada. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-01-22.

Sponsored by MGP Ingredients, Inc. · Not applicable, Interventional, and Other

From the registry’s dates

  • Registered 2 years 5 months after the study started (first participant enrolled Aug 2018, registered Feb 2021).
Phase
Not applicable
Study type
Interventional
Enrollment
16
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Fibersym® is a RS4-type resistant modified wheat starch in which over 85% of the total starch is resistant starch as measured by AOAC method 991.43. It is meant to be consumed on a regular basis and doses up to 33g/day can be tolerated. The effect of a Fibersym-containing meal on postprandial glucose and insulin levels when compared to a control meal, where both meals contain the same amount of available carbohydrate, is not known. This study therefore investigated the acute effect of a Fibersym cookie and a control cookie matched for available carbohydrate after a 3-day habituation period.

Read the detailed description

The study used a double-blind, randomized, cross-over design.

Visit 1: Participants willing to be considered were invited to come to the research centre to have the study procedures explained to them and be given a copy of the consent form which they may either sign then, take away to sign at a later date, or decline to participate. Participants were encouraged to ask any questions they may have and not to sign the consent form until all of their questions have been answered to their satisfaction. Those who consented to participate came to the research centre for a pre-selection visit when subject eligibility will be determined. A number of parameters were assessed including blood pressure, weight, height, BMI, and brief medical history.

Visit 2-3: Each eligible subject received one of the treatments at visit 2 and the other at visit 3. The order of the 2 treatments was randomized using an online randomization calculator. The interval between visits was no less than 6 days and no more than 4 weeks. Prior to each visit there was a 3-day pre-feeding period during which subjects consumed either 108.9g Control Cookies (approx. 3.5 cookies) per day or 136.2 g of Fibersym Cookies (approx. 4 cookies) per day (delivering 29 g fiber from Fibersym/day) according to the randomized order. Cookies were consumed with each main meal (breakfast, lunch and dinner).

Subjects were provided with a calorie appropriate, standard frozen dinner to be consumed on the evening before each visit. On the day of each visit, participants came to GI Labs in the morning after a 10-12 h overnight fast (except for water). Two (2) fasting fingerprick blood samples were collected at -5 min and 0 min. Each sample consisted of 2 vials, one for glucose analysis and one for insulin analysis (4-8 drops of blood each). Questionnaires to record satiety and GI symptoms were administered. Participants were then a 40g available carbohydrate protion of the same type of cookie (Control or Fibersym) they had been consuming over the past 3 days containing together with 250 ml of water and instructed to consume them over 15 minutes. Additional blood samples were collected 15, 30, 45, 60, 90 and 120 min after the start of the test meal. Satiety questionnaires were administered at the same time intervals. GI symptom questionnaires were filled out at 2 h in addition to fasting.

Test Foods:

The sugar snap cookie formula (Control) was obtained from the American Institute of Baking (AIB) International (Manhattan, KS). Fibersym RW (Appendix 1) was added as an extra portion to the Control Cookie recipe, amounts were adjusted so that both the control and Fibersym cookie portions contained the same amount of available carbohydrate (ingredients are listed in appendix 1). Both cookies were baked at the facilities of AIB. The macronutrient composition of baked cookies was determined by an independent laboratory and the final weights of the cookies fed were adjusted accordingly.

To maintain blinding, the cookies were re-packaged by a GI Labs staff member not involved in the clinical trial. Product label displayed the subject number, subject initials, product ID, ingredients statement, GIL repacked date, expiration date, researcher name and telephone number, investigational use statement, and allergy warnings (if needed). Study Product Intake Logs were completed upon dispensation of study product to each subject. After the data had been entered, checked for errors and the database locked, the code was broken.

Participants were asked to maintain stable dietary and activity habits throughout their participation and to refrain from drinking alcohol and from unusual levels of food intake or physical activity for 24 h before each test. Subjects were asked to complete a 3- day record of supplement consumption and whether they consumed the standard evening meal, in addition to a 3-day symptom diary before each test visit. If any subject was not feeling well or had not complied with the preceding experimental conditions, the test was not carried out and was rescheduled for another day.

02

Conditions studied

  • Postprandial Hyperglycemia

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03

In context

Hyperglycemia

699 studies on the registry are indexed under Hyperglycemia; 105 are open to participants now.

This study's enrollment of 16 is below the median of 46 across 521 interventional studies indexed under Hyperglycemia.

Browse Hyperglycemia studies →

Lead sponsor

This is the only study on the registry with MGP Ingredients, Inc. as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Male or non-pregnant females, 18-75 years of age, inclusive
  • Body mass index (BMI) between 18.5 and 35 kg/m² inclusive at screening.
  • Systolic blood pressure \<130 mm Hg; Diastolic blood pressure \<90 mm Hg.
  • Willing to maintain habitual diet, physical activity pattern, and body weight throughout the trial.
  • Willing to abstain from strenuous exercise, or consume alcoholic drinks 24 hours before study days.
  • Absence of health conditions that would prevent fulfillment of study requirements as judged by the Investigator on the basis of medical history.
  • Understanding the study procedures and willing to provide informed consent to participate in the study and authorization to release relevant protected health information to the study Investigator.
  • Female subjects; willing to use a contraceptive method to avoid pregnancy during the study period.

Exclusion criteria

Exclusion Criteria:

  • Failure to meet any one of the inclusion criteria
  • Smokers
  • Known history of diabetes, gastrointestinal, liver, kidney, or cardiovascular (including, but not limited to, atherosclerotic disease, history of myocardial infarction, peripheral arterial disease, stroke), and pulmonary disease
  • Use of medications known to influence carbohydrate metabolism, including, but not limited to adrenergic blockers, diuretics, thiazolidinediones, metformin and systemic corticosteroids within 4 weeks of the screening visit, or with any condition which might, in the opinion of Dr. Wolever, the president of GI Testing, either: 1) make participation dangerous to the subject or to others, or 2) affect the results.
  • Use of antibiotics within 4 weeks of start of study
  • Major trauma or surgical event within 3 months of screening.
  • Unwillingness or inability to comply with the experimental procedures and to follow GI Labs safety guidelines.
  • Known intolerance, sensitivity or allergy to any ingredients in the study products.
  • Extreme dietary habits, as judged by the Investigator (i.e. Atkins diet, very high protein diets, etc.)
  • Change in body weight of >3.5 kg within 4 weeks of the screening visit.
  • History of cancer in the prior two years, except for non-melanoma skin cancer.
  • Exposure to any non-registered drug product within 30 d prior to screening.
  • Pregnancy or breastfeeding
  • Any history of an eating disorder (e.g., anorexia nervosa, bulimia nervosa, binge eating) diagnosed by a health professional
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
16 participants (actual)

Study arms

  • Placebo comparator
    control cookie

    a sugarsnap cookie baked specifically for this trial

    Other: Control cookie

  • Active comparator
    Fibersym cookie

    a sugarsnap cookie baked using the same methodology for the control cookie but with the resistants starch RS4, Fibersym, added

    Other: Fibersym

Interventions

  • OtherFibersym

    RS4-type resistant modified wheat starch

  • OtherControl cookie

    control cookie

06

What researchers measure

Primary outcomes

  1. 2-hour Postprandial Glucose Incremental Area Under the Curve (IAUC)

    2-hour postprandial glucose incremental area under the curve (IAUC), calculated from blood samples taken 5 min prior to meal, 0, 15, 30, 45, 60, 90 and 120 min after the start of the test meal.

    Time frame: 2 hours

Secondary outcomes

  1. 2-hour Postprandial Insulin Incremental Area Under the Curve (IAUC)

    2-hour postprandial insulin incremental area under the curve (IAUC) calculated from blood samples taken 5 min prior to meal, 0, 15, 30, 45, 60, 90 and 120 min after the start of the test meal.

    Time frame: 2 hours

  2. Abdominal Bloating

    The occurrence of abdominal bloating (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

    Time frame: 4 days

  3. Belching

    The occurrence of belching (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

    Time frame: 4 days

  4. Nausea

    The occurrence of nausea (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

    Time frame: 4 days

  5. Diarrhea

    The occurrence of diarrhea (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

    Time frame: 4 days

  6. Flatulence

    The occurrence of flatulence (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

    Time frame: 4 days

  7. Satiety Scores

    Satiety is the mean of 4 measures, hunger (H), fullness (F), desire to eat (D) and prospective consumption (how much do you think you can eat) (P) each measured using visual analogue scales (VAS) at intervals over the postprandial period. A VAS is a 100mm line anchored at the right end with phrase indicating a high in tensity of the feeling (eg. as hungry as I have ever felt) and at the left other end with a phrase indicating a low intensity of feeling (eg. not hungry at all). For each measure the minimum score is 0 and the maximum score is 100, as measured in mm from the left end. Higher scores mean more hungry, less full, more desire to eat and high prospective consumption (can eat a large amount). The mean score is calculated as (H - F + D + P)/4.

    Time frame: 2 hours

07

Results

Posted Jan 22, 2025

Participant flow

Participant flow — Overall Study
MilestoneExperimental: Control Cookie, Then Fibersym CookieFibersym Cookie First
Started106
Completed96
Not completed10
Withdrew: Adverse event10

Outcome measures

Primary2-hour Postprandial Glucose Incremental Area Under the Curve (IAUC)

2-hour postprandial glucose incremental area under the curve (IAUC), calculated from blood samples taken 5 min prior to meal, 0, 15, 30, 45, 60, 90 and 120 min after the start of the test meal.

Time frame:
2 hours
Reported as:
Mean · mmol*min/L
2-hour Postprandial Glucose Incremental Area Under the Curve (IAUC)
mmol*min/LControl CookieFibersym Cookie
2-hour Postprandial Glucose Incremental Area Under the Curve (IAUC)124 ± 16106 ± 16
Statistical analysis
  • Control Cookie vs Fibersym Cookie · t-test, 2 sided · p = 0.087
Secondary2-hour Postprandial Insulin Incremental Area Under the Curve (IAUC)

2-hour postprandial insulin incremental area under the curve (IAUC) calculated from blood samples taken 5 min prior to meal, 0, 15, 30, 45, 60, 90 and 120 min after the start of the test meal.

Time frame:
2 hours
Reported as:
Mean · pmol*h/L
2-hour Postprandial Insulin Incremental Area Under the Curve (IAUC)
pmol*h/LControl CookieFibersym Cookie
2-hour Postprandial Insulin Incremental Area Under the Curve (IAUC)245 ± 24189 ± 21
Statistical analysis
  • Control Cookie vs Fibersym Cookie · t-test, 2 sided · p = 0.020
SecondaryAbdominal Bloating

The occurrence of abdominal bloating (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

Time frame:
4 days
Reported as:
Count of participants · Participants
Abdominal Bloating
ParticipantsControl CookieFibersym Cookie
Abdominal Bloating88
Statistical analysis
  • Control Cookie vs Fibersym Cookie · Fisher Exact · p = 1.00
SecondaryBelching

The occurrence of belching (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

Time frame:
4 days
Reported as:
Count of participants · Participants
Belching
ParticipantsControl CookieFibersym Cookie
Belching910
Statistical analysis
  • Control Cookie vs Fibersym Cookie · Fisher Exact · p = 0.70
SecondaryNausea

The occurrence of nausea (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

Time frame:
4 days
Reported as:
Count of participants · Participants
Nausea
ParticipantsControl CookieFibersym Cookie
Nausea89
Statistical analysis
  • Control Cookie vs Fibersym Cookie · Fisher Exact · p = 0.71
SecondaryDiarrhea

The occurrence of diarrhea (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

Time frame:
4 days
Reported as:
Count of participants · Participants
Diarrhea
ParticipantsControl CookieFibersym Cookie
Diarrhea67
Statistical analysis
  • Control Cookie vs Fibersym Cookie · Fisher Exact · p = 0.71
SecondaryFlatulence

The occurrence of flatulence (none, mild, moderate or severe) daily before breakfast during the three days of each pre-feeding period and before consuming the test meal on day 4.

Time frame:
4 days
Reported as:
Count of participants · Participants
Flatulence
ParticipantsControl CookieFibersym Cookie
Flatulence1112
Statistical analysis
  • Control Cookie vs Fibersym Cookie · Fisher Exact · p = 0.67
SecondarySatiety Scores

Satiety is the mean of 4 measures, hunger (H), fullness (F), desire to eat (D) and prospective consumption (how much do you think you can eat) (P) each measured using visual analogue scales (VAS) at intervals over the postprandial period. A VAS is a 100mm line anchored at the right end with phrase indicating a high in tensity of the feeling (eg. as hungry as I have ever felt) and at the left other end with a phrase indicating a low intensity of feeling (eg. not hungry at all). For each measure the minimum score is 0 and the maximum score is 100, as measured in mm from the left end. Higher scores mean more hungry, less full, more desire to eat and high prospective consumption (can eat a large amount). The mean score is calculated as (H - F + D + P)/4.

Time frame:
2 hours
Reported as:
Mean · mm
Satiety Scores
mmControl CookieFibersym Cookie
Satiety Scores79 ± 970 ± 8
Statistical analysis
  • Control Cookie vs Fibersym Cookie · t-test, 2 sided · p = 0.11
Post-hoc0-90min Incremental Area Under the Glucose Curve

Incremental area under the curve from 0 to 90 min calculated from blood samples taken 5 min prior to meal, 0, 15, 30, 45, 60 and 90 min after the start of the test meal.

Time frame:
90 min
Reported as:
Mean · mmol*min/L
0-90min Incremental Area Under the Glucose Curve
mmol*min/LControl CookieFibersym Cookie
0-90min Incremental Area Under the Glucose Curve108 ± 1387 ± 12
Statistical analysis
  • Control Cookie vs Fibersym Cookie · t-test, 2 sided · p = 0.023
Post-hoc0-90min Incremental Area Under the Insulin Curve

Incremental area under the curve from 0 to 90 min calculated from blood samples taken 5 min prior to meal, 0, 15, 30, 45, 60 and 90 min after the start of the test meal.

Time frame:
90 min
Reported as:
Mean · pmol*h/L
0-90min Incremental Area Under the Insulin Curve
pmol*h/LControl CookieFibersym Cookie
0-90min Incremental Area Under the Insulin Curve216 ± 21162 ± 18
Statistical analysis
  • Control Cookie vs Fibersym Cookie · t-test, 2 sided · p = 0.014
Post-hocGlucose Peak Rise

Difference between fasting and maximum glucose concentration during the test

Time frame:
2 hours
Reported as:
Mean · mmol/L
Glucose Peak Rise
mmol/LControl CookieFibersym Cookie
Glucose Peak Rise2.20 ± 0.241.72 ± 0.23
Statistical analysis
  • Control Cookie vs Fibersym Cookie · t-test, 2 sided · p = 0.040

Adverse events

Collected over 1 month. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Control Cookie0/16 (0%)0/16 (0%)1/16 (6.3%)
Fibersym Cookie0/15 (0%)0/15 (0%)0/15 (0%)
Most frequent other events
Most frequent other events
EventControl CookieFibersym Cookie
InfectionRespiratory, thoracic and mediastinal disorders1/160/15

Baseline characteristics

15 completed the cross-over study successfully and all were included in the analysis

Age, Continuous
Age, Continuous(years)Control Cookie First Followed by Fibersym CookieFibersym Cookie First Followed by Control CookieTotal
Mean33 ± 1229 ± 831 ± 11
Sex: Female, Male
Sex: Female, Male(Participants)Control Cookie First Followed by Fibersym CookieFibersym Cookie First Followed by Control CookieTotal
Female6410
Male426
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Control Cookie First Followed by Fibersym CookieFibersym Cookie First Followed by Control CookieTotal
American Indian or Alaska Native000
Asian437
Native Hawaiian or Other Pacific Islander000
Black or African American000
White639
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)Control Cookie First Followed by Fibersym CookieFibersym Cookie First Followed by Control CookieTotal
Canada10616
08

Study locations

1 site
  • Glycemic Index Laboratories, Inc
    Toronto, Ontario M5C 2N8, Canada
09

References and documents

Publications

  • Wolever TMS, Maningat CC, Seib PA, Campbell JE, Jenkins AL. Cross-linked phosphorylated RS4 wheat starch reduces glucose and insulin responses after 3 days of pre-feeding in healthy adults: an acute, double-blind, randomized controlled clinical trial. Int J Food Sci Nutr. 2023 Sep;74(5):621-629. doi: 10.1080/09637486.2023.2236809. Epub 2023 Jul 20. PubMed 37475127 ↗

Study documents

  • Protocol and statistical analysis plan · Aug 7, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 22, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04820322
Lead sponsor
MGP Ingredients, Inc.
Collaborators
Glycemic Index Laboratories, Inc
Responsible party
Dr. Thomas M. Wolever (President, Glycemic Index Laboratories, Inc) — Principal investigator
First posted
Mar 29, 2021
Start date
Aug 24, 2018
Primary completion
Oct 19, 2018
Completion
Oct 19, 2018
Results posted
Jan 22, 2025
Last update
Jan 22, 2025

Study contacts

Thomas MS Wolever, MD
principal investigator · Glycemic Index Laboratories, Inc

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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