UC Cohort - The Influence of Diet on Gut Microbiotas
UC Cohort - The Influence of Diet on Host Physiology and Disease Across Diverse Human Gut Microbiotas
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Chad Rypstra
- Phone Number: (507) 538-4298
- Email: rypstra.chad@mayo.edu
Study Locations
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-
Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults ≥ 18 years old
- Ability to give informed consent
- Diagnosis of ulcerative colitis
- Moderate UC disease activity defined by a Mayo Score of >6 with endoscopic score of 2
On a baseline diet characterized by:
- Fiber intake of < 15g/day
- > 18% of daily calories from protein
Exclusion Criteria:
- Prior history of gastrointestinal surgeries (except appendectomy and cholecystectomy)
- Use of tobacco products within the past 6 months (since nicotine may affect intestinal permeability)
- Use of NSAIDs or aspirin and unable or unwilling to stop taking two weeks prior to permeability test and for the duration of the study
- Use of osmotic laxatives and unable or unwilling to stop taking one week prior to permeability test and for the duration of the study
- Use of oral corticosteroids and unable or unwilling to stop use of oral corticosteroids within the previous 2 weeks and for the duration of the study
- Multiple dietary restrictions or unable/unwilling to alter dietary protein or dietary fiber.
- Unwilling to stop ingestion of alcohol and artificial sweeteners such as Splenda™ (sucralose), Nutrasweet™ (aspartame), sorbitol, xylitol, lactulose, or mannitol 2 days before and during the permeability testing days, e.g. foods to be avoided are sugarless gums or mints and diet beverages
- Unwilling to stop stenuous exercise (running >5 miles or equivalent) one week prior to the permeability tests
- Bowel preparation for colonoscopy less than one week prior to completion of the first stool kit and permeability test and flexible sigmoidoscopy and upper endoscopy
- Pregnancy or plan to become pregnant during the study time frame
- Vulnerable adult
- Known bleeding disorders or takes medications that increase risk of bleeding from mucosal biopsies
- Use of oral antibiotic(s) within the past 4 weeks (can be enrolled after 4-week washout period)
- Use of commercial probiotic formulations and unwilling to stop for the duration of the study
- Diagnosis of diabetes
- Any other disease(s), condition(s) or habits(s) that would interfere with completion of study, or in the judgment of the investigator would potentially interfere with compliance to this study or would adversely affect study outcomes
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: High Protein and Low Fiber Group
Subjects will consume a high protein and low fiber diet for 8 weeks
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Protein intake will be increased to be >40% calories from protein, and the fiber intake will remain <15gm/day.
|
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Experimental: Low Protein and High Fiber Group
Subjects will consume a low protein and high fiber diet for 8 weeks
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Increase fiber intake up to 40gms of fiber with a requirement to increase at least 15gms above baseline fiber, with 50-75% of total fiber intake from psyllium husk.
Subjects will be allowed to slowly increase fiber every two days to reach goal by end of week 1.
The total protein will be reduced to <10% total calories from protein.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Decrease in endoscopic Mayo score for ulcerative colitis inflammation
Time Frame: 8 weeks
|
Measured from unprepped, non-sedated flexible sigmoidoscopy by decrease in Mayo score with a decrease of at least 1 point on the endoscopic subscore or absolute endoscopic subscore of 0-1).
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8 weeks
|
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Clinical remission derived from patient reported outcomes
Time Frame: 8 weeks
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Defined as a Mayo score ≤2 and no sub-scores with a value greater than 1 is a secondary endpoint.
This what the patient reports for stool frequency and reporting of any blood in the stool
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8 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intestinal inflammation determined from blood and stool samples
Time Frame: 8 weeks
|
Measures C-reactive protein from blood samples and fecal calprotectin from stool samples
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8 weeks
|
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Urinary excretion of lactulose and 13C-Mannitol
Time Frame: 8 weeks
|
Small Bowel and Colonic Permeability by Urinary Excretion of Lactulose and 13C-Mannitol after Oral Ingestion of lactulose and 13C mannitol (5:1 ratio by mass).
The 0-2h urine most closely reflects small intestinal permeability and 8-24h urine reflects colonic permeability.
HPLC-tandem mass spectrometry will be used for detection of the sugars.
The results will be expressed as the ratio of percentage excretion of the ingested dose of lactulose and mannitol in urine.
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8 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Laura Raffals, MD, Mayo Clinic
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 20-012389
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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