Anti-inflammatory Dietary Intervention in Overweight and Obese Adolescents
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Purpose
The number of overweight and obese children has increased in Ireland at a greater rate than worldwide trends. The poor eating patterns that drive adolescent obesity leads to an increase in the number of unhealthy inflammatory hormones and fats circulating in the blood which increase an adolescent's risk of developing diabetes and heart disease later in life. Dietary patterns have changed whereby key nutrients that are found in fruit, vegetables and fish, which are known to have beneficial effects and reduce risk of obesity and diabetes in later life, may need to be replaced. This project will determine whether a key anti-inflammatory nutrient supplement taken for 8 weeks will improve the metabolic profile of adolescents aged 13-18 years old. Detailed cellular analysis will determine the cellular and molecular mechanisms to provide a thorough explanation of the health effects of this intervention.
| Condition | Intervention |
|---|---|
|
Overweight Obesity |
Dietary Supplement: Supplement containing fish oil, vitamin C, alpha-tocopherol, green tea extract and lycopene Dietary Supplement: Placebo supplement |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Novel Anti-inflammatory Dietary Intervention to Improve the Metabolic Phenotype of Overweight and Obese 13-18 Year Old Adolescents - Insights Into Potential Genetic Susceptibility |
- Homeostasis model of assessment - insulin resistance [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Homeostasis model of assessment - insulin resistance (HOMA-IR) will be derived from fasting glucose and insulin concentrations [(fasting plasma glucose x fasting serum insulin)/22.5] as determined by Matthews et al., 1985
- Adiponectin [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Adiponectin, a marker of insulin sensitivity, will be determined pre- and post-intervention.
- Markers of inflammation [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Markers of inflammation such as C reactive protein, interleukin (IL) - 6, IL-1β, tumour necrosis factor alpha, intra-cellular adhesion molecule-1, vascular cell adhesion molecule-1, retinol binding protein 4, fibrinogen, white blood cells and related inflammatory markers
- Lipid Profile [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Full lipid profile and lipidomic analyses (total triacylglycerol, non-esterified fatty acids, total cholesterol, LDL cholesterol, HDL cholesterol and plasma fatty acid composition, diglycerides, cholesterol esters and sphingomyelins,) and related lipid markers
- Inflammatory genetic variants [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Inflammatory genetic variants such as complement component 3, lymphotoxin- α, IL-6, IL-1β, TNF-α, adiponectin polymorphisms and related variants that link to the inflammatory phenotype
- Functional molecular analysis (ex-vivo) [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Functional molecular analysis will be conducted to determine which insulin sensitising pathways have been modulated by the intervention
| Estimated Enrollment: | 90 |
| Study Start Date: | January 2012 |
| Estimated Study Completion Date: | October 2014 |
| Estimated Primary Completion Date: | May 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Anti-inflammatory supplement
8-weeks of daily supplementation with: 1 x fruit juice fortified with fish oil, and 4 x film-coated tablets containing vitamin C, alpha-tocopherol, green tea extract and lycopene in conjunction with a weight management programme |
Dietary Supplement: Supplement containing fish oil, vitamin C, alpha-tocopherol, green tea extract and lycopene
1 x fruit juice fortified with salmon oil containing 1000mg EPA and 1000mg DHA daily for 8 weeks AND 4 x film-coated tablets containing 561mg vitamin C, 389mg alpha-tocopherol, 416mg green tea extract and 15mg lycopene daily for 8 weeks in conjunction with a weight management programme |
|
Placebo Comparator: Placebo supplement
8 weeks of daily supplementation with: 1 x fruit juice fortified with high-oleic sunflower oil, and 4 x film-coated placebo tablets in conjunction with a weight management programme |
Dietary Supplement: Placebo supplement
1 x fruit juice fortified fortified with high oleic sunflower oil daily for 8 weeks AND 4 x film-coated placebo tablets daily for 8 weeks in conjunction with a weight management programme |
Detailed Description:
The emerging model of obesity and diabetes is characterised by sub-acute chronic inflammation and insulin resistance. Mechanistic data indicates inflamed adipose tissue with increased infiltration of immune cells that generate pro-inflammatory cytokines. With childhood obesity in Ireland increasing at a rapid pace, it is important to establish the role of a non-pharmacological dietary approach to decreasing the sub-acute chronic inflammation seen in overweight and obese children. Several foods contain nutrients that are known to have anti-inflammatory properties. Such foods including fish, fruits and vegetables are known to be deplete in the adolescent diet. The aim of this project is to investigate whether a nutritional supplement containing anti-inflammatory nutrients, n-3 polyunsaturated fatty acids (found in fish oil), vitamin C, vitamin E, and polyphenols found in green tea and tomato; will improve metabolic phenotype in 13-18 year old teenagers over an 8-week period. Further, to provide insight into the role of genetics in the development of metabolic dysregulation and response to dietary treatment.
Eligibility| Ages Eligible for Study: | 13 Years to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female
- 13-18 years
- Body mass index ≥ 91st percentile on UK growth reference charts (Cole, 1995)
- Medications/dietary supplements which do not interfere with the intervention are allowed, on condition that the participants adhere to the same regimen during the intervention, including oral contraceptives and other non-fatty acid based dietary supplements (e.g. garlic)
- Smoker or non-smoker
- Not participating in any other intervention study
Exclusion Criteria:
- Pregnancy or lactation
- Endocrine disorders such as Polycystic Ovary Syndrome
- Currently on treatment for a chronic inflammatory condition such as asthma
- Kidney or liver dysfunction
- Iron deficiency anaemia
- Prescribed anti-inflammatory medication
- Consumers of fatty acid supplements including fish oils, evening primrose oil and antioxidant vitamin (A, C, E, -carotene) supplements
- High consumers of oily fish (> 2 servings/week)
- Participants planning to start a special diet or lose weight (e.g. Slimfast, Atkins etc)
- Weight change ≥3kg within the last 3 months
- Alcohol or drug abuse (based on clinical judgement)
- Participants with an allergy to fish and/or shellfish
Contacts and Locations| Contact: Helen M Roche, BSc, MSc, PhD | +353-1-7166845 | helen.roche@ucd.ie |
| Ireland | |
| University College Dublin | Recruiting |
| Dublin, Ireland | |
| Adelaide and Meath Hospital, Incorporating the National Children's Hospital Dublin, | Recruiting |
| Dublin, Ireland | |
| Trinity Centre for Health Sciences, St, James's Hospital | Completed |
| Dublin 8, Ireland | |
| Principal Investigator: | Helen M Roche, BSc, MSc, PhD | University College Dublin |
| Principal Investigator: | Fiona Lithander, BSc, PhD | University of Dublin, Trinity College |
More Information
No publications provided
| Responsible Party: | Dr Helen M Roche, Associate Professor of Nutrigenomics, University College Dublin |
| ClinicalTrials.gov Identifier: | NCT01665742 History of Changes |
| Other Study ID Numbers: | TNS-5 |
| Study First Received: | August 12, 2012 |
| Last Updated: | September 17, 2012 |
| Health Authority: | Ireland: Research Ethics Committee |
Keywords provided by University College Dublin:
|
Obesity Chronic inflammation Anti-inflammatory dietary intervention Genetic susceptibility |
Additional relevant MeSH terms:
|
Disease Susceptibility Genetic Predisposition to Disease Obesity Overweight Disease Attributes Pathologic Processes Overnutrition Nutrition Disorders Body Weight Signs and Symptoms Anti-Inflammatory Agents Ascorbic Acid Alpha-Tocopherol Vitamin E Lycopene |
Tocopherols Tocotrienols Vitamins Therapeutic Uses Pharmacologic Actions Antioxidants Molecular Mechanisms of Pharmacological Action Protective Agents Physiological Effects of Drugs Micronutrients Growth Substances Radiation-Protective Agents Anticarcinogenic Agents Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 23, 2013