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Effects of Diet Changes on Metabolism
This study is currently recruiting participants.
Verified by National Institutes of Health Clinical Center (CC), April 2009
First Received: August 30, 2007   Last Updated: November 25, 2009   History of Changes
Sponsor: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00523627
  Purpose

This study, conducted at the NIH Clinical Research Unit at the Phoenix Indian Medical Center, will examine how the body's metabolism (energy expenditure) changes when people overeat and when they fast and how different diets (e.g., high-protein or high-fat) affect metabolism. The results may provide information about whether there are mechanisms that make some people more resistant than others to gaining weight when they eat more.

Non-smoking healthy subjects between 18 and 55 years of age who weigh no more than 350 pounds may be eligible for this study. Participants undergo the following procedures:

  • Pregnancy test for women of childbearing age.
  • Oral glucose tolerance test. For this test, an I.V. line (needle attached to a plastic tube) is inserted into a vein to allow several blood draws without repeated needle sticks. After the first blood sample is drawn, the subject drinks a cola-flavored sugar solution. Five additional blood samples are then drawn over 3 hours.
  • Blood test for DNA (genetic) studies related to obesity, diabetes and related medical problems.
  • DEXA scan. This test measures body fat. The subject lies on a table while a very small dose of X-rays is passed through the body.
  • Respiratory chamber. This test measures how many calories the body burns a day and assesses energy balance between intake and expenditure. Subjects stay in a room with two windows, equipped with a sink, toilet, television and DVD player, desk, chair, telephone and bed for 24 hours. The test is repeated five times during the first 18-day admission and 3 times during the second 13-day admission. For the first two sessions, subjects are fed a diet equal to the amount of energy their body uses. For the next 6 stays they are fed double the amount of calories their body usually uses for 5 of the stays and fast (consume nothing but water and soda without caffeine or calories) during 1 stay. The overfeeding diets may be high or low in protein, normal in protein, or high in fat. Blood tests are done on the day of each respiratory chamber session and a 24-hour urine sample is collected for one day while in the chamber.
  • Eating behavior questionnaires.
  • Psychological performance tests.

Some participants are asked to volunteer to repeat two of the chamber studies to validate the measurements. The repeat session includes only the fasting and the overfeeding with normal protein content.

All participants are followed at 6 months with blood tests, a DEXA scan, and urine tests (including pregnancy test for women). At annual visits for years 1 through 7, participants have the 6-month tests plus an oral glucose tolerance test.


Condition
Obesity
Overnutrition

Study Type: Observational
Study Design: Prospective
Official Title: Study of Short-Term Metabolic Adaptation: Prediction of Weight Change and Effects of Macronutrient Manipulations

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Estimated Enrollment: 50
Study Start Date: August 2007
Detailed Description:

Some people appear to be more resistant than others to gaining weight when they overeat, though they do not increase their physical activity. This may indicate that adaptive mechanisms exist, which lead to wasting as heat part of the excess calories taken in. Such mechanisms exist in rodents. Human studies have provided conflicting results. A pilot study on the relationship of the weight change over time with the changes in the amount of energy an individual uses over 24 hours (energy expenditure, EE) with 48-h overfeeding (OF) and fasting (F) in Pima Indian men has shown that persons with the greatest increase in EE with OF and the smallest decrease in EE with F gained the least weight over time, indicating that the ability to waste more calories when overfed may reduce weight gain. Other studies, however, have not shown such relationship. In addition, it has been proposed that unbalanced (namely low-protein) diets can help magnify these effects. The aims of this study are to test whether (a) the changes in EE in response to 24-h OF and F predict changes in weight over two years, and (b) low-protein and high-carbohydrate diets magnify the metabolic response to 24-h OF compared to normal protein and high-fat diets. 50 volunteers will be evaluated at baseline, 6 months and on a yearly basis for up to 7 years. At baseline, during two consecutive admissions 4 weeks or less apart, subjects will undergo 8 24-h sessions in a human respiratory chamber to measure EE while on a weight-maintaining diet, and then in random order F, 200% OF on a normal-protein diet, 200% OF on a low-protein diet, 200% OF on a high-carbohydrate, normal-protein diet, 200% OF on a high-carbohydrate, low-protein diet, and 200% OF on a high-fat, normal-protein diet . Body weight and composition will also be measured at each admission. Hormonal measurements to find determinants of adaptive changes in EE in response to OF and F will also be performed. This study will provide significant insights into possible mechanisms that may help people resist weight gain and obesity, as well as their determinants.

  Eligibility

Ages Eligible for Study:   18 Years to 55 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria
  • INCLUSION CRITERIA:
  • Age: 18-55 years, to exclude effects of aging on energy expenditure and weight change
  • Premenopausal
  • Weight: greater than or equal to 350 lb (maximum weight allowed on the DXA scanning tables by the manufacturer).

EXCLUSION CRITERIA:

History or clinical manifestation of:

  • Current smoking
  • Impaired glucose tolerance (IGT), type 1 and type 2 diabetes
  • Endocrine disorders, such as Cushing's disease, pituitary disorders, and hypo- and hyperthyroidism
  • Pulmonary disorders, including chronic obstructive pulmonary disease, which would limit ability to follow the protocol (investigator judgment)
  • Cardiovascular diseases, including coronary heart disease, heart failure, arrhythmias, and peripheral artery disease
  • Hypertension, as diagnosed and treated by an outside physician or by sitting blood pressure measurement, using an appropriate cuff, higher than 140/90 mmHg on two or more occasions
  • Liver disease, including cirrhosis, active hepatitis B or C, and AST or ALT greater than or equal to 3 times normal
  • Renal disease, as defined by serum creatinine concentrations greater than or equal to 1.5 mg/dl and/or proteinuria > 300 mg/day (200 microgram/min)
  • Central nervous system disease, including previous history of cerebrovascular accidents, dementia, and neurodegenerative disorders
  • Cancer requiring treatment in the past five years, except for non-melanoma skin cancers or cancers that have clearly been cured or in the opinion of the investigator carry an excellent prognosis (e.g., Stage 1 cervical cancer).
  • Infectious disease such as active tuberculosis, HIV (by self-report), chronic coccidiomycoses or other chronic infections that might influence weight.
  • Conditions not specifically mentioned above may serve as criteria for exclusion at the discretion of the investigators

Alcohol and/or drug abuse (more than 3 drinks per day and use of drugs, such as amphetamines, cocaine, heroin, or marijuana).

Pregnancy or lactation

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00523627

Contacts
Contact: Marie S. Thearle, M.D. (602) 200-5304 thearlem@mail.nih.gov

Locations
United States, Arizona
NIDDK, Phoenix Recruiting
Phoenix, Arizona, United States, 85014
Sponsors and Collaborators
  More Information

Publications:
Study ID Numbers: 999907215, 07-DK-N215
Study First Received: August 30, 2007
Last Updated: November 25, 2009
ClinicalTrials.gov Identifier: NCT00523627     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Energy Expenditure
Adaptive Thermogenesis
Low-protein Overfeeding
Fasting
Weight Gain
Energy Expenditure
Weight Gain

Additional relevant MeSH terms:
Body Weight
Signs and Symptoms
Obesity
Nutrition Disorders
Overweight
Overnutrition

ClinicalTrials.gov processed this record on February 08, 2010