Poi for Mama: a Pilot to Improve Maternal Microbiome and Gestational Diabetes Risk

NCT07446205 — Not applicable, Recruiting, 50 participants, University of Hawaii

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RegistryNCT07446205
StatusRecruiting
PhaseNot applicable
Study typeInterventional; na, single group, masking: none, prevention
Enrollment50 (Estimated)
SponsorUniversity of Hawaii (Other)
ConditionsGestational Diabetes Mellitus (GDM), Pregnancy
InterventionsFermented Poi (Other)
Datesstart 2026-06-12, primary completion 2027-01-31 (estimated), completion 2027-01-31 (estimated), first posted 2026-03-03, last updated 2026-07-02
Locations3 sites in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Gestational Diabetes Mellitus (GDM) All trials for Pregnancy All trials of Fermented Poi

-Summary

This investigator-initiated, non-randomized pilot study evaluates the effect of daily consumption of fermented poi on the maternal microbiome and gestational diabetes risk during pregnancy. Fifty pregnant participants between approximately 12 and 24 weeks of gestation will receive one pound of poi daily for four weeks, accompanied by culturally tailored nutrition education delivered via secure text messaging. Changes in vaginal, oral, and rectal microbiome composition, diet quality, gestational diabetes diagnosis, and pregnancy-related outcomes will be assessed and compared with matched controls derived from an existing cohort. This study aims to inform the feasibility and design of a larger culturally grounded dietary intervention for gestational diabetes prevention.

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+Detailed description

This investigator-initiated, non-randomized pilot study evaluates whether daily consumption of fermented poi during pregnancy can improve maternal microbiome composition and reduce risk factors related to gestational diabetes mellitus (GDM). The intervention will be implemented during the second trimester. After a brief dietary washout period (avoiding poi and other fermented foods/beverages as specified in the protocol), eligible participants will receive fermented poi from a single source meeting food safety standards and will be instructed to consume one pound per day for 28 consecutive days. Participants will also receive culturally tailored nutrition education delivered via secure text messaging throughout the intervention period.

Participants will complete study assessments at enrollment, baseline, mid-point, end of intervention, long term follow-up in third trimester. Maternal microbiome outcomes will be assessed using self-collected vaginal swabs (with optional self-collection of oral and rectal swabs, if applicable). Samples will be labeled with a study identification code and returned to the study team using approved procedures. Study staff will collect anthropometrics and blood pressure at scheduled visits. Participants will complete questionnaires related to pregnancy characteristics, psychosocial and cultural factors, and intervention acceptability and feasibility. Dietary intake will also be assessed using a mobile food record and questionnaire-based measures during the study period. With participant authorization, information on GDM diagnosis and labor and delivery outcomes will be obtained from the participant's health care provider.

Study outcomes will be compared with matched controls derived from an existing cohort with similar characteristics and no or low poi consumption. Findings from this pilot study will inform feasibility, procedures, and effect-size estimates to support the design of a larger culturally grounded dietary intervention for GDM prevention.

+Arms and interventions

ArmTypeInterventionsDescription
Poi InterventionExperimentalOther: Fermented PoiDaily consumption of fermented poi for 4 weeks during the second trimester.
  • Fermented Poi (Other): Participants consume one pound of fermented poi daily for 28 days.

+Outcome measures

Primary outcomes

  • Maternal microbial composition at the end of the intervention [Baseline and 4 weeks]: Assessment of changes in maternal microbial composition, including the relative abundance of beneficial species such as Lactobacilli crispatus, by the end of the 4-week poi intervention.

Secondary outcomes

  • Maternal microbial composition and its association with the bacterial taxonomic profile of fermented poi [4 weeks]: Identification of whether maternal microbial composition is associated with the bacterial taxonomic profile of the fermented poi provided during the study.

Other outcomes

  • Diet quality score (Food Frequency Questionnaire) [Baseline and 4 weeks]: Change in diet quality score as measured by the Food Frequency Questionnaire, comparing participants who completed the poi intervention with matched controls.
  • Gestational weight gain [Baseline and 4 weeks]: Change in maternal weight (kg) from baseline to post-intervention, comparing participants who received the poi intervention with matched controls
  • Blood pressure [Baseline and 4 weeks]: Change in systolic and diastolic blood pressure (mmHg) from baseline to post-intervention, comparing participants who received the poi intervention with matched controls
  • Gestational diabetes mellitus (GDM) diagnosis [By post-intervention (no later than 27 weeks gestation)]: Proportion of participants with a Gestational diabetes mellitus (GDM) diagnosis (yes/no) by post-intervention, comparing participants who received the poi intervention with matched controls
  • Acceptability score (Theoretical Framework of Acceptability [TFA] questionnaire) [4 weeks]: Acceptability score as measured by the Theoretical Framework of Acceptability (TFA) questionnaire (e.g., mean score), assessed at post-intervention.

+Eligibility

Sex: Female, ages: 18 Years to any

Inclusion Criteria:

* Be at least 10 weeks into their pregnancy
* have no pre-existing health conditions
* Be able to read and write in English
* be at least18 years of age
* Own a smartphone
* Live on the windward side of O'ahu
* Be able to complete study activities

Exclusion Criteria:

* Less than 10 weeks pregnant or already in third trimester
* Have pre-existing health conditions
* Not able to read and write in English
* Under 18 years of age
* Do not own a smartphone
* Do not live on the windward side of O'ahu
* Unable to complete study activities

+Locations (3)

FacilityCityCountryStatus
University of Hawai'i Cancer CenterHonolulu, HawaiiUnited StatesRecruiting
Hawaii Pacific HealthHonolulu, HawaiiUnited StatesRecruiting
Waimanalo Health CenterWaimanalo, HawaiiUnited StatesRecruiting

+Publications

  • Brown AC, Shovic A, Ibrahim SA, Holck P, Huang A. A non-dairy probiotic's (poi) influence on changing the gastrointestinal tract's microflora environment. Altern Ther Health Med. 2005 Jan-Feb;11(1):58-64. PMID 15712767
  • Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial. Biomed Pharmacother. 2021 Sep;141:111915. doi: 10.1016/j.biopha.2021.111915. Epub 2021 Jul 10. PMID 34328109
  • Baiao DDS, de Freitas CS, Gomes LP, da Silva D, Correa ACNTF, Pereira PR, Aguila EMD, Paschoalin VMF. Polyphenols from Root, Tubercles and Grains Cropped in Brazil: Chemical and Nutritional Characterization and Their Effects on Human Health and Diseases. Nutrients. 2017 Sep 20;9(9):1044. doi: 10.3390/nu9091044. PMID 28930173
  • Lagisetty PA, Priyadarshini S, Terrell S, Hamati M, Landgraf J, Chopra V, Heisler M. Culturally Targeted Strategies for Diabetes Prevention in Minority Population. Diabetes Educ. 2017 Feb;43(1):54-77. doi: 10.1177/0145721716683811. PMID 28118127
  • Jenkins DJ, Woolston BM, Hood-Pishchany MI, Pelayo P, Konopaski AN, Quinn Peters M, France MT, Ravel J, Mitchell CM, Rakoff-Nahoum S, Whidbey C, Balskus EP. Bacterial amylases enable glycogen degradation by the vaginal microbiome. Nat Microbiol. 2023 Sep;8(9):1641-1652. doi: 10.1038/s41564-023-01447-2. Epub 2023 Aug 10. PMID 37563289
  • Dias S, Pheiffer C, Adam S. The Maternal Microbiome and Gestational Diabetes Mellitus: Cause and Effect. Microorganisms. 2023 Aug 31;11(9):2217. doi: 10.3390/microorganisms11092217. PMID 37764061
  • Cho JJ, Yamakawa RA, Hollyer J. Hawaiian Kalo, Past and Future. Sustain Agric Univ Hawaii Manoa CTAHR. Published online 2007.
  • Miller DE. Glycemic Index of Taro Corm and Poi. M.S. University of Hawai'i at Manoa; 2002. Accessed February 25, 2025. https://www.proquest.com/docview/2572554294/abstract/AEE2EEA85A341C8PQ
  • Kawamura MY, Mau MK, Soon R, Yamasato K. A Scoping Review on Gestational Diabetes in Hawai'i: A "Window of Opportunity" to Address Intergenerational Risk for Type 2 Diabetes Mellitus. Hawaii J Health Soc Welf. 2022 Mar;81(3):58-70. PMID 35261986
  • Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press (US); 2009. Available from http://www.ncbi.nlm.nih.gov/books/NBK32813/ PMID 20669500
  • Slouha E, Gates KM, Al-Geizi H, Baah E, Clunes LA, Kollias TF. The Relationship Between Gestational Diabetes and the Risk of Cancer: A Systematic Review. Cureus. 2024 Jan 31;16(1):e53328. doi: 10.7759/cureus.53328. eCollection 2024 Jan. PMID 38435884
  • Kramer CK, Campbell S, Retnakaran R. Gestational diabetes and the risk of cardiovascular disease in women: a systematic review and meta-analysis. Diabetologia. 2019 Jun;62(6):905-914. doi: 10.1007/s00125-019-4840-2. Epub 2019 Mar 7. PMID 30843102
  • Auvinen AM, Luiro K, Jokelainen J, Jarvela I, Knip M, Auvinen J, Tapanainen JS. Type 1 and type 2 diabetes after gestational diabetes: a 23 year cohort study. Diabetologia. 2020 Oct;63(10):2123-2128. doi: 10.1007/s00125-020-05215-3. Epub 2020 Jul 29. PMID 32725280
  • Ikoh Rph CL, Tang Tinong R. The Incidence and Management of Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus. Cureus. 2023 Aug 31;15(8):e44468. doi: 10.7759/cureus.44468. eCollection 2023 Aug. PMID 37664380
  • Sonne DP, Hemmingsen B. Comment on American Diabetes Association. Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(Suppl. 1):S1-S135. Diabetes Care. 2017 Jul;40(7):e92-e93. doi: 10.2337/dc17-0299. No abstract available. PMID 28637892
  • American Diabetes Association Professional Practice Committee. 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S111-S125. doi: 10.2337/dc24-S006. PMID 38078586
  • Calvo MJ, Parra H, Santeliz R, Bautista J, Luzardo E, Villasmil N, Martinez MS, Chacin M, Cano C, Checa-Ros A, D'Marco L, Bermudez V, De Sanctis JB. The Placental Role in Gestational Diabetes Mellitus: A Molecular Perspective. touchREV Endocrinol. 2024 Apr;20(1):10-18. doi: 10.17925/EE.2024.20.1.5. Epub 2024 Mar 14. PMID 38812661

+Investigators