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Mediterranean Diet and Protein-Sparing Modified Diet for Metabolic Syndrome in Liver Transplant Recipients

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02174783
Recruitment Status : Terminated
First Posted : June 26, 2014
Last Update Posted : March 14, 2017
Information provided by (Responsible Party):
The Cleveland Clinic

Brief Summary:
Many metabolic complications can develop after liver transplant including: diabetes, high blood pressure, obesity, heart attacks and stroke. The goal of this study is to look at the safety and effect of 2 well known and established diet regimens on the people who had a prior liver transplant and investigate whether it helps with the control of these comorbidities.

Condition or disease Intervention/treatment Phase
Liver Transplantation Metabolic Syndrome X Obesity Other: Control group Other: Mediterranean diet Other: Protein-Sparing Modified Fast (PSMF) Not Applicable

Detailed Description:
The Mediterranean diet has been shown to be effective in improving hepatic steatosis, insulin sensitivity, diabetes control and reducing cardiovascular risk in adult patients, but there is no data available for patients who underwent liver transplant. The protein-sparing modified fast (PSMF) diet has been used for years at the Cleveland Clinic to treat adult patients with obesity-related medical problems, but its safety and efficacy has not been established in liver transplant recipients.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 25 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Safety and Efficacy of Mediterranean Diet and Protein-Sparing Modified Diet on Obesity and Metabolic Syndrome in Liver Transplant Recipients: A Randomized Clinical Trial
Study Start Date : June 2014
Actual Primary Completion Date : January 2015
Actual Study Completion Date : April 2015

Arm Intervention/treatment
Active Comparator: Control group
Standard of care group
Other: Control group
Patient will be provided with basic nutrition educational materials that outline principles of a healthy diet, including: moderation, portion control, increased intakes of fruits, vegetables and whole grains and reduced intakes of saturated fat, salt and sugar. Brief education will be provided by the hepatologist without dietitian referral.

Experimental: Mediterranean diet
Mediterranean diet for 6 months
Other: Mediterranean diet
Patient will receive verbal diet instruction from the dietitian or from the hepatologist who has received instruction from the dietitian on following the Mediterranean diet.

Experimental: Protein-Sparing Modified Fast (PSMF)
PSMF for 6 months
Other: Protein-Sparing Modified Fast (PSMF)

Patient will be referred to the dietitian for an appointment to discuss the PSMF plan.

Protein needs of 1.5 grams/kilogram will be calculated based on patient's actual body weight.

Patient will receive verbal instruction from the dietitian, as well as printed materials for reference at home. Dietitian will provide a list of allowed and prohibited foods as per Cleveland Clinic's PSMF diet standards.

Primary Outcome Measures :
  1. Weight loss [ Time Frame: 6 months ]

Secondary Outcome Measures :
  1. Number of Participants with Serious and Non-Serious Adverse Events [ Time Frame: 6 months ]
    Investigate the safety of the mediterranean diet and PSMF in post liver transplant patients

  2. Change in Hb A1c compared to baseline [ Time Frame: 6 months ]
  3. Change in HDL and LDL compared to baseline [ Time Frame: 6 months ]
  4. Change in triglyceride compared to baseline [ Time Frame: 6 months ]
  5. Change in blood pressure compared to baseline [ Time Frame: 6 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Adult patients > 18 years old who had a successful liver transplant at least 1 year prior to enrollment who also have a BMI>30 with previous failed attempts at weight loss via conventional methods. In addition to one of the following:

  1. Triglyceride (TG)>150 mg/dl or specific treatment for this lipid abnormality
  2. HDL <40 mg/dl in females and <50 mg/dl in males or specific treatment of this lipid abnormality
  3. Systolic BP >130 or diastolic BP >85 mm Hg or treatment for previously diagnosed hypertension
  4. Fasting plasma glucose >100 mg/dl or previously diagnosed type 12 diabetes

Exclusion Criteria:

  • Significant behavioral issues that would interfere with compliance
  • Lack of readiness to change (pre-contemplation, contemplation or preparation stages)
  • Previous bariatric surgery
  • Pregnant or planning to become pregnant
  • History of a documented eating disorder (e.g. bulimia)
  • History of kidney stones

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02174783

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United States, Ohio
Cleveland Clinic
Cleveland, Ohio, United States, 44195
Sponsors and Collaborators
The Cleveland Clinic
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Principal Investigator: mohammed Eyad Yaseen Alsabbagh, MD The Cleveland Clinic
Study Director: Naim Alkhouri, MD The Cleveland Clinic
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Responsible Party: The Cleveland Clinic Identifier: NCT02174783    
Other Study ID Numbers: PTMS-9500
First Posted: June 26, 2014    Key Record Dates
Last Update Posted: March 14, 2017
Last Verified: July 2014
Keywords provided by The Cleveland Clinic:
Weight Loss
Diet, Mediterranean
Diet, Reducing
protein sparing modified diet
Additional relevant MeSH terms:
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Metabolic Syndrome
Pathologic Processes
Nutrition Disorders
Body Weight
Insulin Resistance
Glucose Metabolism Disorders
Metabolic Diseases