Lauren Thomas Berube

Clinical Assistant Professor of Public Health Nutrition

Professional overview

Lauren Berube, PhD, MS, RDN, is a nutrition and behavioral scientist. With clinical training as a dietitian, she has expertise in medical nutrition therapy and dietary assessment. Her research identifies predictors and outcomes of prenatal, postpartum, and childhood health behaviors, with a focus on understanding how dietary patterns contribute to cardiometabolic health outcomes. She uses technology and personalized approaches to engage clinical populations in self-management and lifestyle behavior change. She has worked on several clinical trials and implementation studies related to maternal and child health, including a primary healthcare-based child obesity prevention intervention beginning in pregnancy, a mobile health intervention for management of gestational diabetes in Nepal, and an observational study that used continuous glucose monitoring to measure the glycemic profiles of individuals with gestational diabetes. During her postdoctoral training, she was engaged in clinical trials that utilized behavioral methods and technology to deliver personalized nutrition interventions for adults with prediabetes and type 2 diabetes.  

Prior to joining GPH, she worked as an Associate Research Scientist at the Institute for Excellence in Health Equity at New York University Grossman School of Medicine, where she managed a maternal health community implementation project delivered digitally by community health workers using culturally responsive text messaging and video links.

Dr. Berube received her PhD from New York University and completed postdoctoral training at New York University Grossman School of Medicine.

Education

BS, Biology, Roanoke College

MS, Food Science and Technology, Cornell University

PhD, Nutrition and Dietetics, New York University

Postdoctoral Fellow, Population Health Science Scholars Program, New York University

Honors and awards

Ruth L. Kirschstein Institutional National Research Service Award, National Institute of Health (2021202220232024)

Outstanding Dissertation Award Nominee, New York University (2019)

Research and Travel Grant, New York University (2018)

Steinhardt Graduate Scholarship, New York University (201320142015)

Gary Wesley Leonard Memorial Award in Biology, Roanoke College (2010)

Publications

Publications

A randomized clinical trial comparing low-fat with precision nutrition–based diets for weight loss : impact on glycemic variability and HbA1c

Kharmats, A. Y., Popp, C., Hu, L., Berube, L. T., Curran, M., Wang, C., Pompeii, M. L., Li, H., Bergman, M., St-Jules, D. E., Segal, E., Schoenthaler, A., Williams, N., Schmidt, A. M., Barua, S., & Sevick, M. A. (n.d.).

Publication year

2023

Journal title

American Journal of Clinical Nutrition

Volume

118

Issue

2

Page(s)

443-451

10.1016/j.ajcnut.2023.05.026

Abstract

Abstract

Background: Recent studies have demonstrated considerable interindividual variability in postprandial glucose response (PPGR) to the same foods, suggesting the need for more precise methods for predicting and controlling PPGR. In the Personal Nutrition Project, the investigators tested a precision nutrition algorithm for predicting an individual's PPGR. Objective: This study aimed to compare changes in glycemic variability (GV) and HbA1c in 2 calorie-restricted weight loss diets in adults with prediabetes or moderately controlled type 2 diabetes (T2D), which were tertiary outcomes of the Personal Diet Study. Methods: The Personal Diet Study was a randomized clinical trial to compare a 1-size-fits-all low-fat diet (hereafter, standardized) with a personalized diet (hereafter, personalized). Both groups received behavioral weight loss counseling and were instructed to self-monitor diets using a smartphone application. The personalized arm received personalized feedback through the application to reduce their PPGR. Continuous glucose monitoring (CGM) data were collected at baseline, 3 mo and 6 mo. Changes in mean amplitude of glycemic excursions (MAGEs) and HbA1c at 6 mo were assessed. We performed an intention-to-treat analysis using linear mixed regressions. Results: We included 156 participants [66.5% women, 55.7% White, 24.1% Black, mean age 59.1 y (standard deviation (SD) = 10.7 y)] in these analyses (standardized = 75, personalized = 81). MAGE decreased by 0.83 mg/dL per month for standardized (95% CI: 0.21, 1.46 mg/dL; P = 0.009) and 0.79 mg/dL per month for personalized (95% CI: 0.19, 1.39 mg/dL; P = 0.010) diet, with no between-group differences (P = 0.92). Trends were similar for HbA1c values. Conclusions: Personalized diet did not result in an increased reduction in GV or HbA1c in patients with prediabetes and moderately controlled T2D, compared with a standardized diet. Additional subgroup analyses may help to identify patients who are more likely to benefit from this personalized intervention. This trial was registered at clinicaltrials.gov as NCT03336411.

Development and Testing of a Mobile App for Management of Gestational Diabetes in Nepal : Protocol for a User-Centered Design Study and Exploratory Randomized Controlled Trial

Berube, L. T., Shrestha, A., Shrestha, A., Daneault, J. F., Shakya, P. R., Dhimal, M., Shrestha, R., & Rawal, S. (n.d.).

Publication year

2024

Journal title

JMIR Research Protocols

Volume

13

10.2196/59423

Abstract

Abstract

Background: The prevalence of gestational diabetes mellitus (GDM) is increasing, particularly in low- and middle-income countries (LMICs) like Nepal. GDM self-management, including intensive dietary and lifestyle modifications and blood glucose monitoring, is critical to maintain glycemic control and prevent adverse outcomes. However, in resource-limited settings, several barriers hinder optimal self-management. Mobile health (mHealth) technology holds promise as a strategy to augment GDM treatment by promoting healthy behaviors and supporting self-management, but this approach has not yet been tested in any LMIC. Objective: This report describes the protocol to develop a culturally tailored mHealth app that supports self-management and treatment of GDM (GDM–Dhulikhel Hospital [GDM-DH] app, phase 1) and test its usability and preliminary efficacy (phase 2) among patients with GDM in a periurban hospital setting in Nepal. Methods: The study will be conducted at Dhulikhel Hospital in Dhulikhel, Nepal. In the development phase (phase 1), a prototype of the GDM-DH app will be developed based on expert reviews and a user-centered design approach. To understand facilitators and barriers to GDM self-management and to gather feedback on the prototype, focus groups and in-depth interviews will be conducted with patients with GDM (n=12), health care providers (n=5), and family members (n=3), with plans to recruit further if saturation is not achieved. Feedback will be used to build a minimum viable product, which will undergo user testing with 18 patients with GDM using a think-aloud protocol. The final GDM-DH app will be developed based on user feedback and following an iterative product design and user testing process. In the randomized controlled trial phase (phase 2), newly diagnosed patients with GDM (n=120) will be recruited and randomized to either standard care alone or standard care plus the GDM-DH app from 24-30 weeks gestation until delivery. In this proof-of-concept trial, feasibility outcomes will be app usage, self-monitoring adherence, and app usability and acceptability. Exploratory treatment outcomes will be maternal glycemic control at 6 weeks post partum, birth weight, and rates of labor induction and cesarean delivery. Qualitative data obtained from phase 1 will be analyzed using thematic analysis. In phase 2, independent 2-tailed t tests or chi-square analyses will examine differences in outcomes between the 2 treatment conditions. Results: As of July 2024, we have completed phase 1. Phase 2 is underway. The first participant was enrolled in October 2021, with 99 participants enrolled as of July 2024. We anticipate completing recruitment by December 2024 and disseminating findings by December 2025. Conclusions: App-based lifestyle interventions for GDM management are not common in LMICs, where GDM prevalence is rapidly increasing. This proof-of-concept trial will provide valuable insights into the potential of leveraging mHealth app–based platforms for GDM self-management in LMICs.

Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study : study protocol for a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes

Berube, L. T., Popp, C. J., Curran, M., Hu, L., Pompeii, M. L., Barua, S., Bernstein, E., Salcedo, V., Li, H., St-Jules, D. E., Segal, E., Bergman, M., Williams, N. J., & Sevick, M. A. (n.d.).

Publication year

2024

Journal title

Trials

Volume

25

Issue

1

10.1186/s13063-024-08337-w

Abstract

Abstract

Background: The Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study is a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes (T2D). The study aims to test the efficacy of a personalized behavioral approach for dietary management of moderately controlled T2D, versus a standardized behavioral intervention that uses one-size-fits-all dietary recommendations, versus a usual care control (UCC). The primary outcome will compare the impact of each intervention on the mean amplitude of glycemic excursions (MAGE). Methods: Eligible participants are between 21 and 80 years of age diagnosed with moderately controlled T2D (HbA1c: 6.0 to 8.0%) and managed on lifestyle alone or lifestyle plus metformin. Participants must be willing and able to attend virtual counseling sessions and log meals into a dietary tracking smartphone application (DayTwo), and wear a continuous glucose monitor (CGM) for up to 12 days. Participants are randomized with equal allocation (n = 255, n = 85 per arm) to one of three arms: (1) Personalized, (2) Standardized, or (3) UCC. Measurements occur at 0 (baseline), 3, and 6 months. All participants receive isocaloric energy and macronutrient targets to meet Mediterranean diet guidelines, in addition to 14 intervention contacts over 6 months (4 weekly then 10 biweekly) to cover diabetes self-management education. The first 4 UCC intervention contacts are delivered via synchronous videoconferences followed by educational video links. Participants in Standardized receive the same educational content as those in the UCC arm, following the same schedule. However, all intervention contacts are conducted via synchronous videoconferences, paired with Social Cognitive Theory (SCT)-based behavioral counseling, plus dietary self-monitoring of planned meals using a mobile app that provides real-time feedback on calories and macronutrients. Participants in the Personalized arm receive all elements of the Standardized intervention, in addition to real-time feedback on predicted post-prandial glycemic response (PPGR) to meals and snacks logged into the mobile app. Discussion: The DiaTeleMed Study aims to address an important gap in the current landscape of precision nutrition by determining the contributions of behavioral counseling and personalized nutrition recommendations on glycemic control in individuals with T2D. The fully remote methodology of the study allows for scalability and innovative delivery of personalized dietary recommendations at a population level. Trial registration: ClinicalTrials.gov NCT05046886. Registered on September 16, 2021.

Effect of a Personalized Diet to Reduce Postprandial Glycemic Response vs a Low-fat Diet on Weight Loss in Adults with Abnormal Glucose Metabolism and Obesity : A Randomized Clinical Trial

Popp, C. J., Hu, L., Kharmats, A. Y., Curran, M., Berube, L. T., Wang, C., Pompeii, M. L., Illiano, P., St-Jules, D. E., Mottern, M., Li, H., Williams, N., Schoenthaler, A., Segal, E., Godneva, A., Thomas, D., Bergman, M., Schmidt, A. M., & Sevick, M. A. (n.d.).

Publication year

2022

Journal title

JAMA network open

Volume

5

Issue

9

Page(s)

E2233760

10.1001/jamanetworkopen.2022.33760

Abstract

Abstract

Importance: Interindividual variability in postprandial glycemic response (PPGR) to the same foods may explain why low glycemic index or load and low-carbohydrate diet interventions have mixed weight loss outcomes. A precision nutrition approach that estimates personalized PPGR to specific foods may be more efficacious for weight loss. Objective: To compare a standardized low-fat vs a personalized diet regarding percentage of weight loss in adults with abnormal glucose metabolism and obesity. Design, Setting, and Participants: The Personal Diet Study was a single-center, population-based, 6-month randomized clinical trial with measurements at baseline (0 months) and 3 and 6 months conducted from February 12, 2018, to October 28, 2021. A total of 269 adults aged 18 to 80 years with a body mass index (calculated as weight in kilograms divided by height in meters squared) ranging from 27 to 50 and a hemoglobin A1clevel ranging from 5.7% to 8.0% were recruited. Individuals were excluded if receiving medications other than metformin or with evidence of kidney disease, assessed as an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2using the Chronic Kidney Disease Epidemiology Collaboration equation, to avoid recruiting patients with advanced type 2 diabetes. Interventions: Participants were randomized to either a low-fat diet (

Self-reported olfactory dysfunction and diet quality : Findings from the 2011–2014 national health and nutrition examination survey (nhanes)

Rawal, S., Duffy, V. B., Berube, L. T., Hayes, J. E., Kant, A. K., Li, C. M., Graubard, B. I., & Hoffman, H. J. (n.d.).

Publication year

2021

Journal title

Nutrients

Volume

13

Issue

12

10.3390/nu13124561

Abstract

Abstract

We identified associations between self-reported olfactory dysfunction (OD) and dietary attributes in participants aged ≥40 years (n = 6,356) from the nationally representative 2011–2014 National Health and Nutrition Examination Survey (NHANES). The chemosensory questionnaire and 24-hour dietary recalls were administered by trained interviewers. OD was defined as self-report of either smell problems in the last year, worse smell relative to age 25, or perceiving phantom odors. Dietary outcomes included Healthy Eating Index 2015 score (HEI) with adequacy and moderation components (higher scores indicated higher diet quality), dietary diversity, energy density, and intake of major food groups. Survey-weighted linear regression models estimated OD– diet associations, adjusting for socio-demographic, lifestyle, and clinical factors. Adjusted mean difference (95% CI) between those with versus without OD, showed that adults with OD had significantly lower HEI moderation score (−0.67 (−1.22, −0.11)) and diets higher in energy density (0.06 (0.00, 0.11)), and percent energy from saturated fat (0.47 (0.12, 0.81)), total fat (0.96 (0.22, 1.70)), and added sugar (1.00 (0.33, 1.66)). Age and sex-stratified analyses showed that younger females (40–64 years) primarily accounted for the associations with diet quality and total/saturated fat intake. These findings inform dietary screening and recommendations for adults who report OD, including those experiencing transient or persistent smell loss with COVID-19.

Weight loss is associated with improved daytime time in range in adults with prediabetes and non-insulin-treated type 2 diabetes undergoing dietary intervention

Barua, S., Upadhyay, D., Berube, L. T., Popp, C. J., Curran, M., Pompeii, M. L., Hu, L., Aleman, J. O., Bergman, M., & Sevick, M. A. (n.d.).

Publication year

2025

Journal title

Diabetic Medicine

10.1111/dme.70052

Abstract

Abstract

Aims: To characterize changes in continuous glucose monitoring (CGM)-derived time in tight range (TIR) measures in individuals with prediabetes or non-insulin-treated type 2 diabetes undergoing dietary weight loss intervention and to quantify the association between weight loss and TIR improvement. Methods: Data from the Personal Diet Study, a 6-month behavioural weight loss intervention in adults with prediabetes or non-insulin-treated type 2 diabetes [HbA1c ≤ 8.0% (64 mmol/mol), managed with diet alone or with metformin], was analysed. Participants wore a CGM for a maximum of 2 weeks at baseline and 6 months. Changes in overall, daytime (06:00 h–23:59 h) and overnight (00:00 h–05:59 h) time in 54–140 mg/dL or 3.0–7.8 mmol/L (TIR54–140), 70–140 mg/dL or 3.9–7.8 mmol/L (TIR70–140) and >140 mg/dL or >7.8 mmol/L (TAR>140) were analysed. The association between weight change and TIR change adjusted for demographic and clinical covariates was computed using linear regression. Results: Baseline and 6 months CGM data from 76 participants (63 ± 8 years, 62% female, 64% White, BMI 33 ± 5 kg/m2, HbA1c 5.8 ± 0.6%) were analysed. Overall TIR54–140 increased (3.3% [0.3, 6.3]%; p = 0.03), with improvement in daytime (3.8% [0.9, 6.8]%; p = 0.01) but not overnight TIR54–140 (2.0% [−2.2, 6.1]%; p = 0.36). In adjusted analysis, every 5% points of weight loss was associated with a 3.2% points increase in overall TIR54–140 (p = 0.016), driven by a 3.5% points increase in daytime TIR54–140 (p = 0.006). Similar associations were found for TAR>140 but not TIR70–140. There were no associations between weight loss and change in any overnight TIR measure. Conclusion: Weight loss was associated with improved daytime TIR54–140 and TAR>140 in individuals with prediabetes and non-insulin-treated type 2 diabetes undergoing dietary intervention. The daytime time in tight range measures can complement traditional markers like HbA1c, offering a more comprehensive view of glycaemic variations during dietary weight loss programmes for individuals with prediabetes and type 2 diabetes not on insulin.