Effects of a High Protein Diet on Clinical Outcomes in Heart Failure
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Purpose
This research project was designed to study the role of dietary modifications in heart failure (HF) patients that suffer from type 2 diabetes mellitus and obesity. Specifically, the purpose of this study is to determine whether or not heart failure patients participating in a 3-month intensive lifestyle modification program of either a high protein (30 % of total calories from protein) group will have a significant improvement in weight reduction, quality of life and clinical outcomes compared to a standardized protein (15% of total calories from protein) group.
| Condition | Intervention |
|---|---|
|
Heart Failure Diabetes Mellitus |
Procedure: 12-week supervised weight loss intervention |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | Examining the Effects of a High Protein Diet on Adiposity and Cardiac Structure in Patients With Heart Failure, Obesity, and Diabetes Mellitus |
- Change from Baseline in adiposity (and body composition; i.e., % body fat)) [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
- Change from Baseline in lipid profiles (while controlling for statin drug dosage) [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
- Change from Baseline in glycemic control and insulin resistance [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
- Change from Baseline in peripheral blood circulation (as measured using peripheral arterial tonometry and plasma nitroxide measurement) [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
- Change from Baseline in levels of quality of life [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
- Change in Cardiac Structure [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
- Change in Cardiac Function [ Time Frame: 3 months and 15 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 90 |
| Study Start Date: | December 2009 |
| Estimated Study Completion Date: | July 2013 |
| Estimated Primary Completion Date: | May 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: High Protein Group
12-week supervised weight loss program consisting of a HP diet defined as 30% of energy from protein, 40% from carbohydrates and 30% from fat
|
Procedure: 12-week supervised weight loss intervention
Patients in the 2 study arms will participate in an intensive 12-week supervised weight loss intervention and will be seen by the same dietician at regular intervals: baseline, 2 weeks, 4 weeks, 8 weeks, and 12 weeks. Participants will receive personalized nutrition counseling and support during each of these visits. Participants will be randomized to either the HP or SP diet and assigned to receive one of two standard structured energy-restricted meal plans (1200, 1500 Kcal/day) based on the computed calorie deficit
Other Names:
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Active Comparator: Standard Protein Group
12-week supervised weight loss program consisting of a SP diet defined as 15% of energy from protein, 55% from carbohydrates and 30% from fat
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Procedure: 12-week supervised weight loss intervention
Patients in the 2 study arms will participate in an intensive 12-week supervised weight loss intervention and will be seen by the same dietician at regular intervals: baseline, 2 weeks, 4 weeks, 8 weeks, and 12 weeks. Participants will receive personalized nutrition counseling and support during each of these visits. Participants will be randomized to either the HP or SP diet and assigned to receive one of two standard structured energy-restricted meal plans (1200, 1500 Kcal/day) based on the computed calorie deficit
Other Names:
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Detailed Description:
Clinical management of heart failure (HF) related to obesity and diet recommendations currently lacks a strong scientific basis, and clinicians are divided in their approach to diet recommendations for this patient population. It has been shown that in extremely obese HF patients, weight reduction improves cardiac structure and function as well as functional status and symptomatology. Evidence on the impact of voluntary weight loss on improvement in survival in obese HF patients, however, is limited.
The purpose of this study is to determine whether or not heart failure patients participating in a 3-month intensive lifestyle modification program of either a high protein (30% of total calories from protein) group will have a significant improvement in weight reduction, quality of life and clinical outcomes compared to a standardized protein (15% of total calories from protein) group.
In addition to dietary interventions, participants in both groups with be given an exercise prescription and encouraged to exercise for 20-30 minutes at least 3-5 times each week as tolerated. They will also continue to receive usual medical care, advice and other support for their condition from their cardiologist or medical physician. Both sets of participants will utilize self-monitoring tools to assist with diet compliance and behavior change. These self-monitoring tools are mandatory and will be collected and analyzed. At each visit, subjects will also be asked to will also be asked to have their weight and waist circumference measured and, at select visits, they will provide a 24 hour recall to assess fullness with the overall diet. Subjects will be given a 3-day food (3DFR) record at baseline, which will be returned at the the 2-week, 4- week and 8-week visits, and will also complete the 3DFR at three months.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- obese (BMI > 27 kg/m2);
- history of type 2 DM or documented impaired fasting glucose (IFG) according to fasting plasma glucose levels of 100-125 mg/dl or meeting 3 out of 4 criteria or Metabolic Syndrome ( as defined by the International Diabetes Federation 2011
- evaluation of HF and optimization of medical therapy; and
- ischemic or idiopathic HF etiology.
Exclusion Criteria:
- age ≤18 years old;
- history of clinically significant illness including acute myocardial infarction or sustained ventricular arrhythmia in the prior 3 months or current liver, respiratory, and/or gastrointestinal disease and malignancy;
- pregnancy or lactation;
- serum creatinine level > 1.5 mg/dl;*
- currently participating in a supervised weight loss program;
- physician refusal to permit patient participation in the study; and
- weight loss of >6% in the last 6 months
- gout or history of gout
Contacts and Locations| Contact: Lorraine S. Evangelista, PhD,RN,FAAN | 949-824-1771 | evangell@hs.uci.edu |
| Contact: Marjan Motie, Ph.D. | 949-824-8707 | mmotie@hs.uci.edu |
| United States, California | |
| University of California Medical Center | Recruiting |
| Orange, California, United States, 92868 | |
| Contact: Evangelista evangell@hs.uci.edu | |
| Contact: Motie mmotie@hs.uci.edu | |
| Principal Investigator: Lorraine S Evangelista, PhD,RN,FAAN | |
| Principal Investigator: | Lorraine S Evangelista, PhD,RN,FAAN | University of California, Irvine |
More Information
No publications provided
| Responsible Party: | University of California, Irvine |
| ClinicalTrials.gov Identifier: | NCT01423266 History of Changes |
| Other Study ID Numbers: | 1 R01 HL093466-01 |
| Study First Received: | August 15, 2011 |
| Last Updated: | February 6, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, Irvine:
|
High Protein Diet in heart failure obesity and heart failure Weight management in Heart failure heart failure, diabetes and obesity |
Additional relevant MeSH terms:
|
Diabetes Mellitus Heart Failure Glucose Metabolism Disorders Metabolic Diseases |
Endocrine System Diseases Heart Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on May 19, 2013