The Effect of CLA on Obesity, Lung Functions, Lipid Profile and Inflammation in Women With BMI≥25

The Effect of 12 Weeks of Conjugated Linoleic Acid on Obesity Markers, Lung Functions, Lipid Profile and Inflammation in Overweight and Obese Women: Double-blind Randomised Control Trial.

Conjugated linoleic acid or CLA, is one of the food supplements that could be found in meat, fats, and dairy products of ruminants which has been fed grass not on grains. CLA has shown anti-cancer, anti-obesity, and anti-inflammatory effects in several animal modules, but the results of the human studies were not consistent. Also, a very limited number of studies looked at the CLA effect on the respiratory system. The study will look at the effect of 12 weeks of supplementation of conjugated linoleic acid on obesity markers, lung functions, lipid profile, and inflammation in overweight and obese women in a double-blind randomized control trial.

The study looked at the inflammation using different approaches, where it looked at the expression of adhesion molecules on the proinflammatory monocytes as well as it analysed the expression of the stress proteins Heat-shock proteins (HSPA1A and HSPB1)on the PBMCs.

Study Overview

• Status: Completed
• Conditions: Inflammation; Obesity; Lipid Disorder; Lung Functions
• Intervention / Treatment: Dietary supplement: High oleic acid safflower oil capsules; Dietary supplement: Conjugated linoleic acid

Detailed Description

This is a double-blind randomized control trial with parallel design, where consented overweight and obese women from Chester city in the UK will be randomly assigned into two groups one group CLA will receive 4.5 g/day CLA mixture capsules while the other group will receive a placebo.

Participants will attend three clinics and by the end of each clinic, the participants will be asked to provide 20 ml venous blood samples for the analysis of the biological marker. Participants' anthropometric, body composition, lung functions, Leptin adiponectin, lipid profile, Adhesion molecules CD14, CD16, CD11b, and CD62L, HSPA1A, and HSPB1 will be assessed at three time points, at baseline after 6 and 12 weeks. The level of CLA in the plasma, as well as lipid profile (HDL, LDL, TC, TG), will be measured at each time point

Participants will be asked to fill three food diaries before attending each clinic. Body composition will be measured using bioelectric impedance, lung functions will be assessed using spirometers, adiponectin and leptin will be assessed using ELISA, and finally, CD11b, CD62L, HSPA1A, and HSPB1 will be analysed using flow cytometer. Plasma level of c9, t11-CLA and t10, c12-CLA will be measured using flame ionized Gas chromatography, and the lipid profile will be assessed using ALERE AFINION™ AS100 ANALYZER.

Power calculation for the RCT Sample size calculation is done using G*Power software, a total of 20 participant is required, 10 participants in each group, to get an effect size of 1.3 kg/m2 change in BMI from baseline and SD of 0.45, 0.05 margin of error, 95% power and 95% confidence interval. Considering a 150% drop out the total number will be 50, 25 in each group.

Participants' randomisation will be performed by an independent third party who is not involved in the current trial. Participants will be randomised into blocks using (www.randomization.com) which generate the randomisation plan. All the capsules will be packed in a light protective dark brown tamper-proof container. The randomised participants will be either allocated to the CLA group or the placebo group. CLA and placebo capsules will have the same shape and colour, and both the participants and researcher will be blind to the treatments.

Statistical analysis. IBM SPSS Statistic Data Editor Software (version25) will be used for the statistical analysis of this trial while the graphs will be made using GraphPad Prism version 7.

Descriptive statistics of baseline continuous data will be expressed in form of mean± standard error of the mean (SEM). Nominal data will be expressed in percentages. The parametric assumption will be checked using Shapiro-Wilk tests at a significant level p< 0.05. The differences between the baseline characteristics in CLA and the placebo group will be done using an independent t-test in parametric data or Mann Whitney U for non-parametric data, at a significant level P<0.05.

Testing the effects of CLA compared to placebo and the interaction with times (baseline, 6 weeks, and 12 weeks) will be done using Mixed Model Repeated Measures Analysis of Variance (ANOVA) at a significant level p< 0.05. The later analysis will be useing Tukey post hoc test with Bonferroni correction for all the measured parameters.

A paired t-test or Wilcoxon test will be done to detect the difference within- participants at different time points in parametric and non-parametric data, respectively, at a significant level P<0.05. Independent t-test or Mann Whitney U will be used to detect the difference between the CLA group and placebo across the different time points for normally and non-normally distributed data, respectively at a significant level P<0.05.

The difference in the change at week 6 compared to baseline, (∆ 6 weeks), and at week 12 compared to baseline (∆ 12 weeks), in CLA groups compared to placebo will be checked using t-test in case of normally distributed data or Mann Whitney-U for non-parametric data at significant level P<0.05. The difference between the categorical data will be done using the Chi-square test at a significant level p<0.05.

Obesity hypotheses

H1: There is a significant reduction in BMI in CLA supplemented group compared to the placebo group.

H0: There is no significant reduction in BMI in CLA supplemented group compared to the placebo group.

H2: There is a significant reduction in BW in the CLA supplemented group compared to the placebo group.

H0: There is no significant reduction in BW in the CLA supplemented group compared to the placebo group.

H3: There is a significant reduction in WHR in CLA supplemented group compared to the placebo group.

H0: There is no significant reduction in WHR in CLA supplemented group compared to the placebo group.

H5: There is a significant increase in LBM in CLA supplemented group compared to the placebo group.

H0: There is no significant increase in LBM in CLA supplemented group compared to the placebo group.

H6: There is a significant increase in %LBM in CLA supplemented group compared to the placebo group.

H0: There is no significant increase in %LBM in CLA supplemented group compared to the placebo group.

H8: There is a significant reduction in TBF in CLA supplemented group compared to the placebo group.

H0: There is no significant reduction in TBF in CLA supplemented group compared to the placebo group.

H9: There is a significant reduction in %BF in CLA supplemented group compared to the placebo group.

H0: There is no significant reduction in %BF in CLA supplemented group compared to the placebo group.

H10: There is a significant increase in the basal metabolic rate in the CLA supplemented group compared to the placebo group.

H0: There is no significant increase in the basal metabolic rate in the CLA supplemented group compared to the placebo group.

Lung function hypotheses Primary hypothesis H1: There is a significant increase in %PEF predicted in CLA supplemented group compared to the placebo group.

H0: There is no significant increase in %PEF predicted in CLA supplemented group compared to the placebo group.

Secondary hypotheses. H2: There is a significant increase in %FEV1 predicted in CLA supplemented group compared to the placebo group.

H0: There is no significant increase in %FEV1 predicted in CLA supplemented group compared to the placebo group.

H3: There is a significant increase in %FVC predicted in CLA supplemented group compared to the placebo group.

H0: There is no significant increase in %FVC predicted in CLA supplemented group compared to the placebo group.

H8: There is a significant increase in %FEV1/FVC predicted in CLA supplemented group compared to the placebo group.

H0: There is no significant increase in %FEV1/ FVC predicted in CLA supplemented group compared to the placebo group.

8.6.3 Adipokines hypotheses Primary hypothesis H1: There is a significant reduction in leptin in the CLA supplemented group compared to the placebo group.

H0: There is no significant reduction in leptin in the CLA supplemented group compared to the placebo group.

Secondary hypothesis. H2: There is a significant increase in adiponectin in the CLA supplemented group compared to the placebo group.

H0: There is no significant increase in adiponectin in the CLA supplemented group compared to the placebo group.

8.6.4 Inflammation hypotheses Primary hypothesis H1: there is a significant change in the expression of HSPA1A on PBMCs in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of HSPA1A on PBMCs in the CLA group compared to the placebo group.

Secondary hypotheses H2: there is a significant change in the expression of HSPA1A on lymphocytes in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of HSPA1A on lymphocytes in the CLA group compared to the placebo group.

H3: there is a significant change in the expression of HSPA1A on monocytes in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of HSPA1A on monocytes in the CLA group compared to the placebo group.

H4: there is a significant change in the expression of HSPB1on PBMCs in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of HSPB1 on PBMCs in the CLA group compared to the placebo group.

H5: there is a significant change in the expression of HSPB1 on lymphocytes in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of HSPB1 on lymphocytes in the CLA group compared to the placebo group.

H6: there is a significant change in the expression of HSPB1 on monocytes in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of HSPB1 on monocytes in the CLA group compared to the placebo group.

H7: there is a significant change in the expression of CD11b on pro-inflammatory monocytes (CD14++CD16+) in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of CD11b on pro-inflammatory monocytes (CD14++CD16+) in the CLA group compared to the placebo group.

H8: there is a significant change in the expression of CD11b on pro-inflammatory monocytes (CD14++CD16+) after 100ng/ml LPS stimulation for one hour in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of CD11b on pro-inflammatory monocytes (CD14++CD16+) in the CLA group compared to the placebo group.

H9: there is a significant change in the increase of CD11b expression on pro-inflammatory monocytes (CD14++CD16+) after LPS stimulation in the CLA group compared to the placebo group.

H0: there is no significant difference H8: there is a significant change in the increase of CD11b expression on pro-inflammatory monocytes (CD14++CD16+) after LPS stimulation in the CLA group compared to the placebo group.

H10: there is a significant change in the expression of CD62L on pro-inflammatory monocytes (CD14++CD16+) in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of CD62L CD11b on pro-inflammatory monocytes (CD14++CD16+) in the CLA group compared to the placebo group.

H11: there is a significant change in the expression of CD62L on pro-inflammatory monocytes (CD14++CD16+) after 100ng/ml LPS stimulation for one hour in the CLA group compared to the placebo group.

H0: there is no significant change in the expression of CD62L on pro-inflammatory monocytes (CD14++CD16+) in the CLA group compared to the placebo group.

H12: there is a significant change in the reduction of CD62L expression on pro-inflammatory monocytes (CD14++CD16+) after LPS stimulation in the CLA group compared to the placebo group.

H0: there is no significant change in the reduction of CD62L expression on pro-inflammatory monocytes (CD14++CD16+) after LPS stimulation in the CLA group compared to the placebo group.

Lipid profile hypotheses H1: there is a significant change in the level of LDL in the CLA group compared to the placebo group.

H0: there is no significant change in the level of LDL in the CLA group compared to the placebo group.

H2: there is a significant change in the level of HDL in the CLA group compared to the placebo group.

H0: there is no significant change in the level of HDL in the CLA group compared to the placebo group.

H3: there is a significant change in the level of TC in the CLA group compared to the placebo group.

H0: there is no significant change in the level of TC in the CLA group compared to the placebo group.

H4: there is a significant change in the level of TG in the CLA group compared to the placebo group.

H0: there is no significant change in the level of TG in the CLA group compared to the placebo group.

• Study Type: Interventional
• Enrollment (Actual): 58
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Cheshire
    • Chester, Cheshire, United Kingdom, CH2 1BR
      • University of Chester

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Able to swallow capsules
• Overweight and obese women (BMI≥25)
• Forced expiratory volume FEV1≥ 70%

Exclusion Criteria:

• Participants taking antibiotics,
• Participants taking weight loss medications
• Pregnant and breastfeeding women,
• Women with current or a history of severe lung disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: SUPPORTIVE_CARE
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: DOUBLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
PLACEBO_COMPARATOR: Placebo; 28 subject received 2 capsules 3times a day for 12 weeks Each capsule contain 1gm (High Oleic Acid Safflower oils)	Dietary supplement: High oleic acid safflower oil capsules; Other Names: HOSFO
ACTIVE_COMPARATOR: CLA group; Participants received 2 capsules3 times a day for 12 weeks Each capsule is 1 gm and it provided 0.75 gm CLA in a 50:50 mixture	Dietary supplement: Conjugated linoleic acid; CLA Mixture capsule (50:50, c9, t11-CLA: t10, c12-CLA); Other Names: CLA

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The change in body weight from baseline to 12 weeks	Body weight (Kg) will be measured using Bioelectric impedance technique (Tanita MC-780)	0, 6, 12 Weeks
The change in BMI from baseline to 12 weeks	weight and height will be combined to report BMI in kg/m^2	0, 6, 12 Weeks
The change in total body fat from baseline to 12 weeks	total body fat (Kg) will be measured using Bioelectric impedance technique (Tanita MC-780)	0, 6, 12 Weeks
The change in percentage body fat from baseline to 12 weeks	Percentage body fat will be measured using Bioelectric impedance technique (Tanita MC-780)	0, 6, 12 Weeks
The change in Lean body mass from baseline to 12 weeks	Lean body mass (Kg) will be measured using Bioelectric impedance technique (Tanita MC-780)	0, 6, 12 Weeks
The change in percentage lean body mass from baseline to 12 weeks	Percentage lean body mass will be measured using Bioelectric impedance technique (Tanita MC-780)	0, 6, 12 Weeks
The change in waist circumference from baseline to 12 weeks	Waist circumference will be measured by cm using the tab	0, 6, 12 Weeks
The change in waist to hip ratio from baseline to 12 weeks	Waist to hip ratio will be calculated by dividing the waist circumference cm over the hip circumference	0, 6, 12 Weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The change in Total Cholesterol (TC) from baseline to 12 weeks	TC mmol/l was measured by (Alere Afinion™ AS100 Analyzer)with test cartridges (Alere Afinion™ Lipid Panel).	0, 6, 12 weeks
The change in Triglycerides (TG) from baseline to 12 weeks	TG (mmol/l)was measured by (Alere Afinion™ AS100 Analyzer)with test cartridges (Alere Afinion™ Lipid Panel).	0, 6, 12 weeks
The change in Low Density Lipoprotein (LDL) from baseline to 12 weeks	LDL (mmol/l) was measured by (Alere Afinion™ AS100 Analyzer)with test cartridges (Alere Afinion™ Lipid Panel).	0, 6, 12 weeks
The change in (High Density Lipoprotein) HDL from baseline to 12 weeks	HDL (mmol/l) was measured by (Alere Afinion™ AS100 Analyzer) with test cartridges (Alere Afinion™ Lipid Panel).	0, 6, 12 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
The change in (Forced Expiratory Volume) FEV% predicted from baseline to 12 weeks	was measured using Micro loop spirometer	0, 6, 12 weeks
The change in (Forced Vital Capacity) FVC% predicted from baseline to 12 weeks	was measured using Micro loop spirometer	0, 6, 12 weeks
The change in (Peak of Flow) PEF% predicted from baseline to 12 weeks	was measured using Micro loop spirometer	0, 6, 12 weeks
The change in expression of CD11b on pro-inflammatory monocytes (CD14++CD16+) from baseline to 12 weeks	CD11b (MFI) expression was measured using Flow cytometer	0, 6, 12 weeks
The change in expression of CD62L on pro-inflammatory monocytes (CD14++CD16+) from baseline to 12 weeks	CD62L (MFI) expression was measured using Flow cytometer	0, 6, 12 weeks
The change in the plasma level of Leptin from baseline to 12 weeks	Leptin (ng/ml) was measured using commercially available ELISA	0,6,12 weeks
The change in the plasma level of Adiponectin from baseline to 12 weeks	Adiponectin (µg/ml) was measured using commercially available ELISA	0,6,12 weeks
The change in expression of HSPA1A on PBMCs from baseline to 12 weeks	HSPA1A (MFI) expression was measured using Flow cytometer	0, 6, 12weeks
The change in expression of HSPB1 on PBMCs from baseline to 12 weeks	HSPB1 (MFI) expression was measured using Flow cytometer	0, 6, 12weeks
The change in plasma level of c9,t10-CLA from baseline to 12 weeks	C9,t11-CLA (µg/ml) level will be measured using flam ionised gas chromatography	0, 6, 12 weeks
The change in plasma level of t10, c12-CLA from baseline to 12 weeks	T10, c12-CLA (µg/ml) level will be measured using flam ionised gas chromatography	0, 6, 12 weeks

Collaborators and Investigators

• Sponsor: University of Chester
• Investigators: Principal Investigator: Hanady Hamdallah, PhD, University of Chester

Study record dates

Study Major Dates

• Study Start (ACTUAL): November 11, 2016
• Primary Completion (ACTUAL): August 1, 2017
• Study Completion (ACTUAL): August 1, 2018

Study Registration Dates

• First Submitted: September 16, 2020
• First Submitted That Met QC Criteria: November 20, 2020
• First Posted (ACTUAL): November 23, 2020

Study Record Updates

• Last Update Posted (ACTUAL): November 23, 2020
• Last Update Submitted That Met QC Criteria: November 20, 2020
• Last Verified: August 1, 2020

More Information

Terms related to this study

• Keywords: Inflammation; Obesity; Adhesion molecules; Lung functions; Conjugated linoleic caid; heat shock proteins
• Additional Relevant MeSH Terms: Pathologic Processes; Metabolic Diseases; Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Inflammation; Lipid Metabolism Disorders
• Other Study ID Numbers: 1141/16/HH/CSN

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The results will be available in the thesis form and possibly publication. It will be available in the thesis form in 2022 and publication expected to be in 2021.

Drug and device information, study documents

• product manufactured in and exported from the U.S.: Yes