- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05002491
Change in Leptin as a Predictor of Satiety With High Protein Feeding (HiProLep)
Study Overview
Detailed Description
The role of leptin in regulating body fat mass in humans is incompletely understood. Although complete loss of leptin signaling results in morbid obesity, there is an inconsistent association between more subtle changes in leptin levels and changes in body composition. Administration of recombinant leptin to human volunteers also results in a variable loss of fat mass. Therapeutic high carbohydrate diets generally lead to decreased caloric intake and weight loss compared with high fat diets. The mechanism of this decrease in appetite is, however, unknown. In preliminary data, the invesigators have shown that compared to high fat feeding, isocaloric high carbohydrate feeding over 2 weeks leads to increased leptin excursion during 24 hours. In addition, this change in leptin signaling predicts subsequent reduction in daily caloric intake with ad-lib high carbohydrate feeding. It has recently been reported that an increase in dietary protein also leads to modest spontaneous weight loss in ad-lib feeding subjects. The current proposal is to therefore determine whether prolonged high protein feeding leads to a sustained increase in the integrated daily leptin level and whether this increase predicts a subsequent decrease in caloric intake in human volunteers. Eligible subjects will consume a control protein diet (15%, low protein) followed by a high protein diet (30% protein) for 2 weeks each while maintaining weight stability. At the end of each 2-week feeding phase, subjects will be admitted to the inpatient GCRC for frequent sampling for insulin and leptin levels over 24 hours. Immediately following the second CRC inpatient visit, subjects will continue to consume the high protein diet ad-libitum for another 12 weeks, during which time they will be followed for changes in their caloric intake and body weight. Because of limitations in metabolic kitchen resources, if this study were to be conducted solely at OHSU, it would require recruitment and study of two groups of subjects over sequential time periods. This results in delay of acquisition of data, completion of the study, and the potential introduction of seasonal variation as a study confounder. Therefore, a two-site study is proposed utilizing the metabolic kitchen resources of OHSU and the University of Washington GCRC's jointly. Instead of two groups of subjects being recruited and studied sequentially at one site, subjects will be recruited at both sites and studied in parallel, thus allowing the completion of the protocol in half the usual amount of time and without additional study confounders.
It is hypothesized that switching human volunteers from a 15% protein diet to an isocaloric high (30%) protein diet will cause a significant increase in the area under the diurnal plasma leptin versus time curve (AUC-leptin) and the insulin versus time curve (AUC-insulin), that these increases will be sustained over 2 weeks of isocaloric high protein feeding, and that the elevation in AUC-leptin will predict the extent to which caloric intake decreases when subjects are switched from an isocaloric to an ad libitum high protein diet.
Specific Aim 1: To determine whether an isocaloric increase in dietary protein content from 15% to 30% causes a significant increase in AUC-leptin and AUC-insulin that is sustained for two weeks.
Specific Aim 2: To determine whether the increase in AUC-leptin on a 30% protein diet predicts a subsequent decrease in ad libitum caloric intake and weight loss.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Ability to provide informed written consent
- Age between 18 and 65 years
- Willingness to consume only food prepared by the CRC for 6 weeks
- Body mass index between 22 and 28 kg/m2
- Weight stable to within 2 kg for 3 months preceding study, and at lifetime maximal weight
Exclusion Criteria:
- Diabetes mellitus
- Renal disease
- Other chronic medical or psychiatric illness
- Pregnancy or female subject unwilling to use contraception
- Use of tobacco products
- Regular intense exercise (>30 minutes of aerobics, 3x / week)
- Vegetarian or extreme dietary preferences (< 20% or > 40% fat diet, > 40% protein diet)
- Use of anabolic steroids, glucocorticoids, or lipid-lowering agents
- Alcohol consumption >2 drinks / day
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: High protein feeding
Two isocaloric feeding phases of 2 weeks followed by an ad-libitum feeding phase of 3 months
|
Normal vs high protein dietary feeding
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
24 hour levels of leptin after isocaloric and ad-libitum feeding phases
Time Frame: After each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Change in leptin levels measured every 30 minutes while consuming diet-assigned meals
|
After each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
24 hour levels of ghrelin after isocaloric and ad-libitum feeding phases
Time Frame: After each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Change in ghrelin levels measured every 30 minutes while consuming diet-assigned meals
|
After each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Body weight
Time Frame: Weekly during each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Change in body weight
|
Weekly during each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Appetite scores
Time Frame: Daily during each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Changes in self-reported visual analog scores (VAS) for hunger, fullness measured every 30 minutes while consuming diet-assigned meals
|
Daily during each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Lipid levels at each study visit
Time Frame: Daily during each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Changes in lipid levels at the end of the trial phases involving different diet-assigned meals
|
Daily during each 2 week isocaloric feeding phase (x2) and a 3 month ad-lib feeding phase
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Weigle DS, Breen PA, Matthys CC, Callahan HS, Meeuws KE, Burden VR, Purnell JQ. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr. 2005 Jul;82(1):41-8. doi: 10.1093/ajcn.82.1.41.
- Koren MS, Purnell JQ, Breen PA, Matthys CC, Callahan HS, Meeuws KE, Burden VR, Weigle DS. Changes in plasma amino Acid levels do not predict satiety and weight loss on diets with modified macronutrient composition. Ann Nutr Metab. 2007;51(2):182-7. doi: 10.1159/000103323. Epub 2007 May 30.
- Kratz M, Weigle DS, Breen PA, Meeuws KE, Burden VR, Callahan HS, Matthys CC, Purnell JQ. Exchanging carbohydrate or protein for fat improves lipid-related cardiovascular risk profile in overweight men and women when consumed ad libitum. J Investig Med. 2010 Jun;58(5):711-9. doi: 10.231/JIM.0b013e3181da4d37.
- Kremsdorf RA, Hoofnagle AN, Kratz M, Weigle DS, Callahan HS, Purnell JQ, Horgan AM, de Boer IH, Kestenbaum BR. Effects of a high-protein diet on regulation of phosphorus homeostasis. J Clin Endocrinol Metab. 2013 Mar;98(3):1207-13. doi: 10.1210/jc.2012-2910. Epub 2013 Feb 7.
- Horgan AM, Palmbach GR, Jordan JM, Callahan HS, Meeuws KE, Weigle DS, Kratz M, Purnell JQ. Self-selected meal composition alters the relationship between same-day caloric intake and appetite scores in humans during a long-term ad-libitum feeding study. Eur J Nutr. 2022 Nov 8. doi: 10.1007/s00394-022-03040-5. Online ahead of print.
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
Other Study ID Numbers
- Protocol 695
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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