protocolSection identificationModule nctId: NCT06365385, orgStudyIdInfo id: FOODSEQ-MARS, briefTitle: Postprandial Metabolic and Appetite Responses to Different Food Intake Sequences in Athletes, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2024-04, primaryCompletionDateStruct date: 2024-09, completionDateStruct date: 2024-10, studyFirstPostDateStruct date: 2024-04-15, lastUpdatePostDateStruct date: 2024-04-15, sponsorCollaboratorsModule leadSponsor name: Universidade do Porto, class: OTHER, collaborators name: Federação Portuguesa de Futebol, collaborators name: Fundação para a Ciência e a Tecnologia, descriptionModule briefSummary: Emerging evidence suggests that following a 'carbohydrate-last meal pattern', wherein foods rich in protein, fat, fiber, and/or polyphenols are consumed before sources of simple carbohydrate (CHO) in a meal, results in reduced postprandial glycaemic responses than the reverse food order or a co-ingestion pattern. This effect has been observed across the spectrum of glucose tolerance, from patients with diabetes to individuals with normal glucose tolerance (Kuwata et al., 2016; Nishino et al., 2018; Lu et al., 2019; Sun et al., 2020). Furthermore, reduced glucose excursions have been linked to decreased subsequent hunger and energy intake (Lu et al., 2019; Wyatt et al., 2021).However, to date, no studies on food intake sequence have targeted athletes, despite their increased CHO demands (Thomas et al., 2016) which could expose them to repeated episodes of hyperglycaemia and high glycaemic variability, known to increase the risk of adverse cardiovascular outcomes and all-cause mortality (Loader et al., 2015; Cavero-Redondo et al., 2017; Faerch et al., 2018). Additionally, athletes often face pressure to meet body composition standards and may benefit from strategies that enhance satiety and craving control. Finally, there is reason to believe that better glycaemic control could lead to improved performance, given that enhancements in endurance activities have been observed with a low-glycemic-index diet compared to a high-glycemic-index diet (Heung-Sang Wong et al., 2017).Therefore, this randomised crossover trial is part of a wider project which seeks to explore the impact of food intake sequence on metabolic health and performance in athletes. Specifically, this trial aims to investigate the acute, postprandial metabolic and appetite responses to consuming an identical meal in two intake sequences (CHO-last versus CHO-first) in athletes, while in the resting state., conditionsModule conditions: Healthy, conditions: Nutrition, Healthy, conditions: Postprandial Hyperglycemia, conditions: Hunger, conditions: Craving, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: RANDOMIZED, interventionModel: CROSSOVER, interventionModelDescription: This study is a randomised controlled trial with a counterbalanced crossover design. Block randomisation will be performed by an external researcher, and allocation concealment will be ensured through the use of sequentially numbered, opaque, sealed envelopes., primaryPurpose: BASIC_SCIENCE, maskingInfo masking: SINGLE, maskingDescription: This is a non-blind trial, since both participants and the investigator delivering the test-meal will be able to see the ingredients and the order in which they are consumed. However, outcome assessors will be blinded to the intervention sequence., whoMasked: OUTCOMES_ASSESSOR, enrollmentInfo count: 15, type: ESTIMATED, armsInterventionsModule interventions name: Carbohydrate-last meal pattern, interventions name: Carbohydrate-first meal pattern, outcomesModule primaryOutcomes measure: Postprandial blood glucose concentrations, secondaryOutcomes measure: Postprandial subjective appetite ratings, secondaryOutcomes measure: Prospective ad libitum energy intake, secondaryOutcomes measure: Prospective ad libitum nutritional intake, secondaryOutcomes measure: Postprandial serum insulin concentrations, secondaryOutcomes measure: Postprandial plasma total GLP-1 concentrations, secondaryOutcomes measure: Postprandial plasma total GIP concentrations, secondaryOutcomes measure: Postprandial serum total ghrelin concentrations, secondaryOutcomes measure: Postprandial plasma total PYY concentrations, secondaryOutcomes measure: Postprandial serum triglyceride concentrations, secondaryOutcomes measure: Postprandial serum NEFA concentrations, eligibilityModule sex: MALE, minimumAge: 18 Years, maximumAge: 64 Years, stdAges: ADULT, contactsLocationsModule, hasResults: False