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Effect of Time-Restricted Feeding on Fat Loss and Cardiometabolic Risk Factors in Overweight Adults

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ClinicalTrials.gov Identifier: NCT03459703
Recruitment Status : Recruiting
First Posted : March 9, 2018
Last Update Posted : June 11, 2019
Sponsor:
Information provided by (Responsible Party):
Courtney M Peterson, University of Alabama at Birmingham

Brief Summary:

Time-restricted feeding (TRF) is a novel type of intermittent fasting that involves eating within a daily period of 10 hours or less, followed by fasting for at least 14 hours daily. Several studies in rodents report that TRF reduces body weight, improves blood sugar control, and reduces the risk of cardiovascular disease—even when food intake is matched to the control group or no weight loss occurs. Preliminary evidence suggests that TRF may also increase weight loss, fat loss, and reduce the risk of diabetes and cardiovascular disease in humans. This study will test whether TRF enhances fat loss and increases weight loss in adults with obesity, relative to conventional dieting alone. In addition, this study will determine whether TRF reduces risk factors for type 2 diabetes and cardiovascular disease and will measure the feasibility and acceptability of TRF.

In conjunction with the parent study described above, four ancillary studies will be conducted:

  1. Effect of weight loss on nitrogen metabolism and bacteria in the mouth. The primary endpoints for this ancillary study are plasma and salivary nitrate and nitrite, and the secondary endpoints are salivary nitrate reductase activity and salivary bacterial abundance.
  2. Effect of weight loss on several biomarkers related to kidney stones. The primary endpoint for this ancillary study is urinary oxalate, and the secondary endpoints are urinary citrate, chloride, sodium, potassium, calcium, phosphorus, uric acid, and creatinine.
  3. Effect of meal timing on blood pressure regulation and kidney function. The primary endpoints of this ancillary study include urinary aldosterone excretion, sodium, potassium, and endothelin, whereas the secondary endpoints include nitric oxide and albumin. Additional exploratory endpoints include renal injury markers (KIM-1, nephrin, and urine albumin-to-creatinine ratio), measures of reactive oxidative stress (e.g., hydrogen peroxide and TBARs), and urinary exosomes. Urine will be analyzed in 12-hour bins to determine how meal timing affects differentially affects these endpoints during the daytime and nighttime. The effects of weight loss on these endpoints may also be considered.
  4. Validation of a meal timing questionnaire to assess the distribution of food intake throughout the day.

Condition or disease Intervention/treatment Phase
Obesity Behavioral: Early Time-Restricted Feeding Behavioral: Control Schedule Behavioral: Structured Weight Loss Program Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 86 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Masking Description: Statistical analyses will be performed blinded.
Primary Purpose: Treatment
Official Title: Effect of Time-Restricted Feeding on Fat Loss and Cardiometabolic Risk Factors in Overweight Adults
Actual Study Start Date : July 12, 2018
Estimated Primary Completion Date : December 2019
Estimated Study Completion Date : December 2019

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Early Time-Restricted Feeding Behavioral: Early Time-Restricted Feeding
Eat all meals between 7 am - 3 pm for an average of ≥6 days per week.
Other Names:
  • Early TRF
  • eTRF

Behavioral: Structured Weight Loss Program
A structured weight loss program with physical activity recommendations and dietary counseling.

Active Comparator: Control Schedule Behavioral: Control Schedule
Eat all meals over a 12-hour or longer period for an average of ≥6 days per week.

Behavioral: Structured Weight Loss Program
A structured weight loss program with physical activity recommendations and dietary counseling.




Primary Outcome Measures :
  1. Fat loss and lean mass retention [ Time Frame: 14 weeks ]
    Percent of weight lost as fat, as measured by dual-energy X-ray absorptiometry (DXA). Lean mass retention will be quantified as 100% minus percent of weight lost as fat (i.e., is measured in the same units).

  2. Weight loss [ Time Frame: 14 weeks ]
    Change in body weight (kg), as measured by scale weight

  3. Absolute changes in body composition [ Time Frame: 14 weeks ]
    Changes in total fat mass, lean mass, bone mass, and regional values (kg), as measured by DXA. (This will be secondary to the assessment of fat loss and lean mass retention as specified above.)


Secondary Outcome Measures :
  1. Fasting glucose [ Time Frame: 14 weeks ]
    Fasting glucose (mg/dl)

  2. Fasting insulin [ Time Frame: 14 weeks ]
    Fasting insulin (IU/L)

  3. HbA1c [ Time Frame: 14 weeks ]
    HbA1c (%)

  4. Lipids [ Time Frame: 14 weeks ]
    Total cholesterol (mg/dl), LDL cholesterol (mg/dl), HDL cholesterol (mg/dl), and triglycerides (mg/dl)

  5. Blood pressure [ Time Frame: 14 weeks ]
    Systolic and diastolic blood pressure (mm Hg)

  6. Heart rate [ Time Frame: 14 weeks ]
    Heart rate in beats per minute

  7. Waist circumference [ Time Frame: 14 weeks ]
    Waist circumference (cm)


Other Outcome Measures:
  1. Appetite [ Time Frame: 14 weeks ]
    Hunger and fullness as measured by Likert (1-5 scale) and visual analog scales (a 0-100 scale, with 0 meaning "Not at all" and 100 meaning "Extremely")

  2. Food intake [ Time Frame: 14 weeks ]
    Energy intake and food intake in kcal/day, as measured using Remote Food Photography Method (RFPM)

  3. Macronutrient intake [ Time Frame: 14 weeks ]
    % of calories as fat, carbohydrate, and protein, as measured using RFPM

  4. Meal frequency [ Time Frame: 14 weeks ]
    Number of meals and snacks per day, as measured using RFPM

  5. Meal times [ Time Frame: 14 weeks ]
    Clock times of meals and snacks, as measured using RFPM

  6. Times of eating [ Time Frame: 14 weeks ]
    Start and stop times and mid-points of daily eating in clock time, as assessed by the daily adherence survey

  7. Duration of daily eating [ Time Frame: 14 weeks ]
    Average duration of the daily eating period (hours), as measured by the daily adherence survey

  8. Distribution of food intake across the daytime [ Time Frame: 14 weeks ]
    Distribution of calories eaten across the day in % per time period, as measured by a novel questionnaire that is being validated

  9. Breakfast and nighttime eating habits [ Time Frame: 14 weeks ]
    Presence and degree of breakfast and nighttime eating, as measured by a novel questionnaire that is being validated

  10. Adherence [ Time Frame: 14 weeks ]
    Self-reported adherence rate in days per week

  11. Reasons for non-adherence [ Time Frame: 14 weeks ]
    Reasons for non-adherence, as measured by the daily adherence survey

  12. Retention [ Time Frame: 14 weeks ]
    Attrition rate (%)

  13. Depression [ Time Frame: 14 weeks ]
    Depression as measured by the Patient Health Questionnaire-9. (Each question is scored on a 0-3 scale, where 0 means "Not at all" and 3 means "Nearly every day." Answers to each question are tallied to create a single composite score of depression from 0-27, with higher values meaning more depressive symptoms.)

  14. Mood states [ Time Frame: 14 weeks ]
    Mood states as measured by the Profile of Mood States (a 5-point scale with 1 meaning "Not at all" and 5 meaning "Extremely"). This study is particularly interested in the scores for anxiety and related moods.

  15. Chronotype [ Time Frame: 14 weeks ]
    Chronotype/mid-point of sleep (in clock time), as measured by the Munich Chronotype Questionnaire

  16. Stimulant usage [ Time Frame: 14 weeks ]
    Stimulant usage, as measured by the Munich Chronotype Questionnaire (in "servings" per time)

  17. Sleep duration [ Time Frame: 14 weeks ]
    Sleep duration, as measured by the Pittsburgh Sleep Quality Index

  18. Sleep quality [ Time Frame: 14 weeks ]
    Sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PQSI) (This study will use the Global PQSI score, which ranges from 0-21, where higher values correspond to worse sleep quality.)

  19. Eating Behaviors [ Time Frame: 14 weeks ]
    Restrained, emotional, and external eating, as measured by the Dutch Eating Behavior Questionnaire. (Individual questions are scored on a 5-point scale ranging from "Never" to "Very often," and composite scores for restrained, emotional, and external eating are tabulated, with higher numbers reflecting more of each trait.)

  20. Loneliness [ Time Frame: 14 weeks ]
    Loneliness, as measured by the UCLA Loneliness Scale (a 3-point scale with 1 meaning "hardly ever" and 3 meaning "often")

  21. Intervention satisfaction [ Time Frame: 14 weeks ]
    Intervention satisfaction and barriers and facilitators of adherence, as measured by qualitative exit interview

  22. Social life and daily habits [ Time Frame: 14 weeks ]
    Social life and daily habits, as measured by the frequency of occurrence of social activities (5- and 8-point rating scales)

  23. Physical activity [ Time Frame: 14 weeks ]
    Physical activity status, as measured by the Baecke Physical Activity questionnaire

  24. Plasma and salivary nitrate and nitrite [ Time Frame: 14 weeks ]
    Plasma and salivary nitrate and nitrite (nM)

  25. Salivary nitrate reductase activity [ Time Frame: 14 weeks ]
    Salivary nitrate reductase activity (nmol / min / colony forming unit) in tongue swab samples

  26. Salivary bacterial abundance [ Time Frame: 14 weeks ]
    Salivary bacterial abundance (colony forming units) in tongue swab samples

  27. 24-hour urinary oxalate, citrate, sodium, calcium, chloride, potassium, and creatinine [ Time Frame: 14 weeks ]
    24-hour urinary oxalate, citrate, sodium, calcium, chloride, potassium, and creatinine, as measured in mg/day

  28. 24-hour urinary phosphorus and uric acid [ Time Frame: 14 weeks ]
    24-hour urinary phosphorus and uric acid, as measured in g/day

  29. 24-hour urinary aldosterone excretion [ Time Frame: 14 weeks ]
    24-hour urinary aldosterone excretion (µg/12 hr)

  30. 12-hour urinary sodium and potassium [ Time Frame: 14 weeks ]
    12-hour urinary sodium and potassium (mmol/12 hr)

  31. 12-hour urinary endothelin [ Time Frame: 14 weeks ]
    12-hour urinary endothelin (ng/12 hr)

  32. 12-hour urinary nitric oxide [ Time Frame: 14 weeks ]
    12-hour urinary nitric oxide (mmol/12 hr)

  33. 12-hour urinary albumin [ Time Frame: 14 weeks ]
    12-hour urinary albumin (mg/12 hr)

  34. 12-hour urinary KIM-1 [ Time Frame: 14 weeks ]
    12-hour urinary KIM-1 (pg/g creatinine or pg/12 hr)

  35. 12-hour urinary nephrin [ Time Frame: 14 weeks ]
    12-hour urinary nephrin (ng/g creatinine or ng/12 hr)

  36. 12-hour albumin-to-creatinine ratio [ Time Frame: 14 weeks ]
    12-hour albumin-to-creatinine ratio

  37. 12-hour urinary reactive oxidative stress [ Time Frame: 14 weeks ]
    12-hour urinary hydrogen peroxide and TBARs (µmol/g creatinine or µmol/12 hr)

  38. Urinary exosomes [ Time Frame: 14 weeks ]
    Urinary exosomes (particles/ml)



Information from the National Library of Medicine

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Ages Eligible for Study:   25 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Are a new patient at the UAB Weight Loss Medicine Clinic
  • Aged 25-75 years old
  • BMI between 30-60 kg/m2 (inclusive)
  • Weigh less than 450 lbs
  • Wake up regularly between 4-9 am on most days.

Exclusion Criteria:

  • Diagnosed with diabetes, have an HbA1c of ≥6.5%, or are on diabetes medication
  • On weight loss medication
  • Addition of or withdrawal from a chronic medication within the past 10 weeks
  • Clinically significant laboratory abnormality (e.g., abnormal hemoglobin levels)
  • Significant gastrointestinal disease, major gastrointestinal surgery, or gallstones
  • Significant cardiovascular, renal, cardiac, liver, lung, adrenal, or nervous system disease that might compromise the participant's safety or data validity
  • Evidence of cancer (other than non-melanoma skin cancer) within the last 5 years
  • Unstable psychiatric, sleep, or circadian conditions (common conditions such as sleep apnea and depression are acceptable as long as they are stabilized and not rapidly worsening)
  • Lost or gained more than 5 lbs of weight in the past month
  • Currently perform overnight shift work more than once per week on average
  • Regularly eat within a less than 10-hour period each day
  • Regularly eat dinner before 6 pm
  • Traveled more than two time zones away in the two months prior to enrolling in the trial
  • Will travel more than one time zone away during the study
  • Pregnant or breastfeeding

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 ClinicalTrials.gov identifier (NCT number): NCT03459703


Contacts
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Contact: Courtney M Peterson, Ph.D. 205-934-0122 cpeterso@uab.edu
Contact: Humaira Jamshed, Ph.D. 205-934-5458 humairaj@uab.edu

Locations
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United States, Alabama
UAB Weight Loss Medicine Clinic Recruiting
Birmingham, Alabama, United States, 35205
Contact: David Bryan, M.A.    205-975-0269    dbryan@uab.edu   
Sponsors and Collaborators
University of Alabama at Birmingham
Investigators
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Principal Investigator: Courtney M Peterson, Ph.D. University of Alabama at Birmingham

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Responsible Party: Courtney M Peterson, Assistant Professor, University of Alabama at Birmingham
ClinicalTrials.gov Identifier: NCT03459703     History of Changes
Other Study ID Numbers: IRB-300001207
First Posted: March 9, 2018    Key Record Dates
Last Update Posted: June 11, 2019
Last Verified: June 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Overweight
Body Weight
Signs and Symptoms