- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03524742
Effects of an Avocado Based meDiterranean Diet on Serum Lipids for Secondary Prevention After Ischemic StrokE Trial. Study Protocol. (ADD-SPISE)
Effects of an Avocado Based meDiterranean Diet on Serum Lipids for Secondary Prevention After Ischemic StrokE Trial (ADD-SPISE). Study Protocol.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Introduction: Stroke is the second cause of death and the third of years of life lost worldwide. In Chile, stroke is the second cause of death. Ischemic stroke represents roughly 80% of all strokes. The 11 risk factors responsible for 91.8% of the population attributable risk of ischemic stroke are: Age, Blood Pressure ≥140/90mmHg, smoking, waist to hip ratio, Diabetes Mellitus, physical activity, alcohol intake, psychosocial factors, Apo-lipoproteins, Cardiac causes and noteworthy a healthy diet (35.8% of the population attributable risk). Recent global burden of disease analysis of disability adjusted life years (DALYs), showed that dietary risk have the highest DALYs in ischemic stroke among behavioral risk factors. The MediDiet is associated with a decreased risk of total mortality as well as stroke incidence and mortality. Although not part of the classical Mediterranean diet they are another nutrient-dense source of mono unsaturated fatty acids (MUFA), rich in vitamins, minerals, fiber, phytosterols and polyphenols extensively consumed in the Americas. Avocado-substituted diets significantly decrease cholesterol levels in diabetic and obese patients. Secondary stroke prevention studies with diet as an intervention are lacking and there is very little information of what patients eat before or after an ischemic stroke. Recurrent stroke represent 20% of all ischemic strokes at a population level and depending on the etiology, recurrent stroke can occur from 2 to 20% at 3 months of the initial event. Lowering Low Density Cholesterol (LDL-C) levels decreases stroke recurrence.
Goals: The aim is to determine the effect of a Mediterranean style diet based on Avocados as a source of poli unsaturated fatty acids (PUFAs) on lipid profile particularly LDL-C in patients who have had an ischemic stroke and are at high recurrence risk.
Methodology: Academic, open-label, blinded outcome assessment (prospective, randomized, open-blinded end-point [PROBE design]), clinical trial. Participants will be patients with an acute ischemic stroke admitted to Clínica Alemana de Santiago, who fulfills the eligibility criteria. Eligible patients will be randomly assigned to either diet intervention in a 1:1 ratio. The interventions will be: A) Avocado based Mediterranean diet with intake of ½ portion of a Hass avocado per day and B) Standard recommendation of low fat-high complex carbohydrate diet recommended by the National Cholesterol Education Program and the American Heart Association. The main efficacy outcome will be the level of plasma LDL cholesterol level at 3 months of the dietary intervention. Secondary outcomes will be changes in: Levels of serum lipid profile, serum inflammation markers, glycemic control, anthropomorphic measures of the metabolic syndrome, stroke recurrence, cardiovascular events, adverse events, compliance. A sample size of 100 patients per group (200 in total) was estimated to provide 80% power and 5% level of significance with 10% loss and 5% crossover to detect the same difference in LDL-C after 3 months of intervention in patients with acute stroke. The following measurements will be performed at baseline and at 3 months in all patients: Blood pressure, weight, height, waist circumference, cholesterol and triglyceride levels, glucose level, serum insulin level, Apo- lipoproteins A1 and B levels, soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1, Apo lipoproteins A and B, and interleukin-6 levels; In a random sample of participants (35%), investigators will measure the oleic acid plasma content as a measure of adherence to Avocado intake.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Veronica Olavarria, MD
- Phone Number: 1060 56222101111
- Email: volavarria@alemana.cl
Study Locations
-
-
Region Metropolitana
-
Santiago, Region Metropolitana, Chile
- Clinica Alemana de Santiago
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 45 years.
- A recent ischemic stroke (within the past month).
- 1 or more of the following cardiovascular risk factor: hypertension, type 2 diabetes mellitus, insulin resistance, dyslipidemia (elevated LDL or total cholesterol), current tobacco use, coronary heart disease, body mass index ≥25, family history of premature CVD.
- Informed consent provided.
Exclusion Criteria:
- Comorbidities that would interfere with compliance of the interventions or low likelihood of changing dietary habits (ie, oncological diseases under chemotherapy, institutionalized patients).
- Known allergy to avocados.
- Any feeding limitation that could interfere with the dietary intervention such as dysphagia.
- Mandatory use drugs for other reasons that can change lipid profile (like hormonal therapy, antiretroviral therapy, chronic steroids etc.).
- The following ischemic stroke possible etiologies without any of the above mentioned cardiovascular risk factors: arterial dissection, thrombophilia, cerebral vasoconstriction reversible syndrome, other infrequent or rare causes such as vasculitis or stroke related to autoimmune diseases.
- Any concomitant illness with life expectancy of less than 3 months or that would interfere with the outcome assessments and/or follow-up.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Avocado-Mediterranean Diet
Avocado based Mediterranean diet with intake of ½ portion of a Hass avocado per day, during 3 months.
|
Mediterranean diet including 1/2 portion of Hass avocado per day, considering a minimum 35% of calories as fat (22% MUFA fat, 6% PUFA fat, and ±10% saturated fat), 15% proteins, and a maximum of 50% carbohydrates.
|
Active Comparator: Control-Group Diet
Control-Group Diet consists of a low fat-high complex carbohydrate diet, during 3 months.
|
A low fat-high complex carbohydrate diet, during 3 months.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
LDL cholesterol level
Time Frame: 3 months
|
Low Density Lipoprotein (LDL) cholesterol level in mg/dL level at 3 months of the dietary intervention.
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Levels of total cholesterol
Time Frame: 3 months
|
Total cholesterol level in mg/dL at 3 months of dietary intervention
|
3 months
|
HDL Cholesterol level
Time Frame: 3 months
|
High Density Lipoprotein (HDL) cholesterol level in mg/dL level at 3 months of the dietary intervention.
|
3 months
|
Triglycerides level
Time Frame: 3 months
|
Triglycerides level in mg/dL level at 3 months of the dietary intervention.
|
3 months
|
Systolic blood pressure
Time Frame: 3 months
|
Mean systolic blood pressure in mmHg
|
3 months
|
Waist to hip ratio
Time Frame: 3 months
|
Measure of waist diameter in centimeters and hip diameter in centimeters to report waist to hip ratio
|
3 months
|
Body mass index
Time Frame: 3 months
|
Weight in kilograms and height in meters will be combined to report body mass index in kg/m^2
|
3 months
|
Serious adverse events
Time Frame: 3 months
|
Frequency of serious adverse events
|
3 months
|
Stroke Recurrence
Time Frame: 3 months
|
Frequency of stroke recurrence
|
3 months
|
Frequency of major cardiovascular events
Time Frame: 3 months
|
Frequency of major cardiovascular events (composed by acute myocardial infarction, stroke or vascular death).
|
3 months
|
ICAM serum level
Time Frame: 3 months
|
ICAM (intercelular adhesion molecule) in ng/mL
|
3 months
|
Interleukin-6 serum level
Time Frame: 3 months
|
Level of Interleukin-6 in ng/mL
|
3 months
|
Apolipoproteins levels A and B
Time Frame: 3 months
|
Level of Apolipoporoteins A and B in g/L
|
3 months
|
VCAM serum level
Time Frame: 3 months
|
VCAM (vascular cell adhesion molecule) in ng/mL
|
3 months
|
Determine plasma oleic acid levels in a subgroup
Time Frame: 3 months
|
Measurement of plasma oleic acid levels compared to basal in a randomized sample of 35% of group randomized to avocado based mediterranean diet
|
3 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Veronica Olavarria, MD, Clinica Alemana de Santiago
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- ADD-SPISE trial
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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