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Healthy DietNCT03407053

Effect of Ultra Processed Versus Unprocessed Diets on Energy Intake

A study testing Ultra-processed diet and Unprocessed diet in people with Healthy Diet, run by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: Eating too much processed food is believed to lead to obesity. But the effect of processed food on energy intake has not been carefully studied. Researchers want to study people s diets for 4 weeks and do specialized tests of the effects. Participants will get two diets. Read more about this study

Who is it for?
Ages 18 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Healthy Diet
What is being tested?
Ultra-processed diet and Unprocessed diet
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
1 Mar 2018to 26 Feb 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Adults age 18-50 years, male and female
  • Weight stable (< +/- 5 % over past 6 months)
  • 4. Body mass index (BMI) greater than or equal to 18 kg/m^2
  • 5. Willing to cease their habitual caffeine intake during the study, beginning one week prior to inpatient admission
  • 6. Written informed consent
  • 7. Willing to eat the food provided in the study
  • 8. Able to complete daily bouts of stationary cycling at a moderate rate and intensity with a heart rate (HR) equal to or greater than 0.3x(220-age-HR(rest))+HR(rest) but not exceeding 0.4x(220-age-HR(rest))+HR(rest) and no signs of arrhythmia

Who cannot join

  • Evidence of metabolic or cardiovascular disease, or disease that may influence metabolism (e.g. cancer, diabetes, thyroid disease)
  • Taking any prescription medication or other drug that may influence metabolism (e.g. diet/weight-loss medication, asthma medication, blood pressure medication, psychiatric medications, corticosteroids, or other medications at the discretion of the PI and/or study team)
  • Hematocrit < 34% (women only)
  • Hematocrit < 40% (men only)
  • Pregnancy, lactation (women only)
  • Participating in a regular exercise program (> 2h/week of vigorous activity)
Show all 14Show fewer
  • Caffeine consumption > 300 mg/day
  • Regular use of alcohol (> 2 drinks per day), tobacco (smoking or chewing) amphetamines, cocaine, heroin, or marijuana over past 6 months
  • Eating disorders or psychological conditions, such as (but not limited to) claustrophobia, clinical depression, bi-polar disorders, that would be incompatible with safe and successful participation in this study, as determined by investigators.
  • --Past or present history of claustrophobia since part of the protocol will involve being confined to a small room for whole-body indirect calorimetry and being in an MRI scanner for liver fat measures
  • Implants, devices, or foreign objects implanted in the body that interfere with the Magnetic Resonance procedures
  • Volunteers with strict dietary concerns (e.g. vegetarian or kosher diet, food allergies)
  • Volunteers unwilling or unable to give informed consent
  • Non-English speakers due to unavailability of required questionnaires in other languages.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • National Institutes of Health Clinical Center

    Bethesda, Maryland, 20892

Other trials in United States

About this study

Background:

Eating too much processed food is believed to lead to obesity. But the effect of processed food on energy intake has not been carefully studied. Researchers want to study people s diets for 4 weeks and do specialized tests of the effects. Participants will get two diets. They will have the same calories and nutrients, but one diet will be unprocessed food and the other will be ultra-processed.

Read more

Objective:

To better understand how processed and unprocessed foods affect daily food consumption and how the body handles blood sugar.

Eligibility:

Healthy adults ages 18-50 who have stable weight and can exercise

Design:

Participants will not eat for 12 hours. Then they will be screened with:

  • Medical history
  • Physical exam
  • Heart and blood tests
  • Resting energy expenditure test (REE). A hood will collect air exhaled while lying down for 30-40 minutes.
  • Psychiatric questions
  • Questions about mood, eating, sleep, and socioeconomic status
  • 20-minute stationary biking

Female participants will have a urine pregnancy test.

Participants will stay in the clinic for 4 weeks. For 2 weeks they will get a processed diet. For the other 2 weeks they will get an unprocessed diet. Participants cannot use the study period to gain or lose weight.

Participants will have:

  • Meals and snacks provided
  • Daily exercise
  • Blood, urine, and saliva tests
  • To drink a special water and a very sweet liquid
  • REE
  • Scans and X-rays
  • To wear activity monitors and a device to measure blood sugar
  • Several 24-hour periods in a room that measures oxygen and carbon dioxide
  • Repeats of screening questions
  • Questions about hunger and meals
  • Sleep monitoring
  • Taste tests
Read the detailed description

Overconsumption of foods that result from extensive industrial processing is believed to contribute to the development of obesity. Ultra-processed foods now represent most of the calories consumed in America and their contribution to overall diet has increased in parallel with the rise in the prevalence of obesity over the past several decades. While such correlations are suggestive, the effect of industrial processing per se, independent of dietary macronutrient composition, on ad libitum energy intake has not been carefully investigated. Therefore, we will conduct feeding studies in adult men and women to investigate the differences in ad libitum energy intake resulting from consuming test diets for a pair of 2-week periods in a randomized, crossover design during a single 4-week period. The test diets presented to participants will be matched for calories, macronutrient composition, sugar, fiber, and sodium, but one diet will be composed of ultra-processed foods whereas the other diet will be unprocessed foods.

Conditions
Healthy Diet
Being tested
Ultra-processed diet, Unprocessed diet
Keywords
Calories, Food Intake, Glucose, Body Composition, Body Weight Regulation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ultra-processed dietDietary supplement

    Consuming ultra-processed diet over a 2-week period

  • Unprocessed dietDietary supplement

    Consuming unprocessed diet over a 2-week period

Study groups in NCT03407053
Study groupRoleWhat they receive
Ultra-processed diet then unprocessed dietActive comparatorParticipants assigned to this arm will consume ultra-processed diet for two weeks followed by unprocessed diet for two weeks
Receives: Dietary Supplement: Ultra-processed diet; Dietary Supplement: Unprocessed diet
Unprocessed diet then ultra-processed dietActive comparatorParticipants assigned to this arm will consume unprocessed diet for two weeks followed by ultra-processed diet for two weeks
Receives: Dietary Supplement: Ultra-processed diet; Dietary Supplement: Unprocessed diet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ad Libitum Energy Intake

    Ad libitum energy intake averaged over 14 days for each diet, measured in kilocalories (kcal) per day.

    Measured: 14 days

Secondary outcomes (2)
  1. Change in Body Weight

    Change in body weight from baseline to day 14 for each diet, measured in kilograms (kg)

    Measured: Baseline and day 14

  2. Change in Fat Mass

    Change in body fat mass from baseline to day 14 for each diet, measured in kilograms (kg). Body fat mass was measured using Dual-energy X-ray absorptiometry (DXA) measurements.

    Measured: Baseline and day 14

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jan 2018
  2. Study start1 Mar 2018
  3. Primary completion26 Feb 2020
  4. Study completion26 Feb 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03407053
Sponsor's protocol ID
180044
Other IDs
18-DK-0044
Status last verified
28 Jan 2021
First submitted
20 Jan 2018
Last updated
29 Jun 2021
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, Chung ST, Costa E, Courville A, Darcey V, Fletcher LA, Forde CG, Gharib AM, Guo J, Howard R, Joseph PV, McGehee S, Ouwerkerk R, Raisinger K, Rozga I, Stagliano M, Walter M, Walter PJ, Yang S, Zhou M. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019 Jul 2;30(1):67-77.e3. doi: 10.1016/j.cmet.2019.05.008. Epub 2019 May 16.

    PubMed 31105044
  • Brunstrom JM, Schatzker M, Rogers PJ, Courville AB, Hall KD, Flynn AN. Consuming an unprocessed diet reduces energy intake: a post-hoc analysis of a randomized controlled trial reveals a role for human nutritional intelligence. Am J Clin Nutr. 2026 Mar;123(3):101183. doi: 10.1016/j.ajcnut.2025.101183. Epub 2025 Dec 29.

    PubMed 41475551
  • Abar L, Steele EM, Lee SK, Kahle L, Moore SC, Watts E, O'Connell CP, Matthews CE, Herrick KA, Hall KD, O'Connor LE, Freedman ND, Sinha R, Hong HG, Loftfield E. Identification and validation of poly-metabolite scores for diets high in ultra-processed food: An observational study and post-hoc randomized controlled crossover-feeding trial. PLoS Med. 2025 May 20;22(5):e1004560. doi: 10.1371/journal.pmed.1004560. eCollection 2025 May.

    PubMed 40392756
  • Hengist A, Ong JA, McNeel K, Guo J, Hall KD. Imprecision nutrition? Intraindividual variability of glucose responses to duplicate presented meals in adults without diabetes. Am J Clin Nutr. 2025 Jan;121(1):74-82. doi: 10.1016/j.ajcnut.2024.10.007. Epub 2024 Dec 2.

    PubMed 39755436
  • Sciarrillo CM, Guo J, Hengist A, Darcey VL, Hall KD. Diet order significantly affects energy balance for diets varying in macronutrients but not ultraprocessing in crossover studies without a washout period. Am J Clin Nutr. 2024 Oct;120(4):953-963. doi: 10.1016/j.ajcnut.2024.08.013. Epub 2024 Aug 18.

    PubMed 39163976
  • Sciarrillo CM, Guo J, Hengist A, Darcey VL, Hall KD. Diet order affects energy balance in randomized crossover feeding studies that vary in macronutrients but not ultra-processing. medRxiv [Preprint]. 2023 Oct 4:2023.10.03.23296501. doi: 10.1101/2023.10.03.23296501.

    PubMed 37986904
  • O'Connor LE, Hall KD, Herrick KA, Reedy J, Chung ST, Stagliano M, Courville AB, Sinha R, Freedman ND, Hong HG, Albert PS, Loftfield E. Metabolomic Profiling of an Ultraprocessed Dietary Pattern in a Domiciled Randomized Controlled Crossover Feeding Trial. J Nutr. 2023 Aug;153(8):2181-2192. doi: 10.1016/j.tjnut.2023.06.003. Epub 2023 Jun 3.

    PubMed 37276937
  • Jaime-Lara RB, Franks AT, Agarwal K, Nawal N, Courville AB, Guo J, Yang S, Brooks BE, Roy A, Taylor K, Darcey VL, LeCheminant JD, Chung S, Forde CG, Hall KD, Joseph PV. No significant salt or sweet taste preference or sensitivity differences following ad libitum consumption of ultra-processed and unprocessed diets: a randomized controlled pilot study. Chem Senses. 2023 Jan 1;48:bjad007. doi: 10.1093/chemse/bjad007.

    PubMed 36897799
  • Howard R, Guo J, Hall KD. Imprecision nutrition? Different simultaneous continuous glucose monitors provide discordant meal rankings for incremental postprandial glucose in subjects without diabetes. Am J Clin Nutr. 2020 Oct 1;112(4):1114-1119. doi: 10.1093/ajcn/nqaa198.

    PubMed 32766882

Questions about this trial

What is this clinical trial studying?

A study testing Ultra-processed diet and Unprocessed diet in people with Healthy Diet, run by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Jun 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ad Libitum Energy Intake (time frame: 14 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03407053, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2021.

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