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Asthma (and Dietary) Inflammation Reduction (AIR)

2. august 2016 opdateret af: David S. Ludwig, MD, PhD, Boston Children's Hospital

Effects of an Anti-Inflammatory Diet on Pulmonary Function in Pediatric Asthma

The purpose of this study is to evaluate the effects of a diet that is low in glycemic load and abundant in fiber, fruits, vegetables, legumes and omega-3 fatty acids ("anti-inflammatory diet") on pulmonary function in pediatric patients with asthma. The primary endpoint will be change in forced expiratory volume in one second in response to the diet intervention. Secondary outcomes will include additional spirometry measures, fraction of exhaled nitric oxide, and assessment of symptomatic asthma control. In addition, we will identify potential physiological mechanisms relating diet with lung function, including changes in systemic inflammation, insulin sensitivity, and intestinal microbiome composition.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Asthma, an inflammatory disease of the airway mucosa, is highly correlated with obesity and nutritional intake in multiple cross-sectional studies. Limited interventional data in adults with asthma, relying on behavioral modification, have reported that asthma control significantly improves with caloric restriction and diets enriched with antioxidants, and may improve with increasing omega-3 fatty acid content. A comprehensive diet harnessing anti-inflammatory properties of multiple foods may have synergistic effects on bronchial inflammation and pulmonary function, yet this possibility remains largely untested, especially in children.

We propose a randomized, controlled cross-over trial, with 6-week treatment arms, in pediatric patients with moderate to severe asthma. The experimental diet will focus on reducing glycemic load, and increasing fiber, fruits, vegetables, legumes and food-based omega-3 fatty acid content. The comparison diet will be each participant's habitual diet. Both diets will be isocaloric and weight maintaining, to isolate the effects of the dietary composition from the known beneficial effects of weight loss. In addition, the home delivery of prepared meals will alleviate the variable and incomplete adherence commonly observed in behavioral studies.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

14

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02115
        • Boston Children's Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

10 år til 21 år (Barn, Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age 10-21 years
  • Clinical diagnosis of moderate or severe persistent asthma
  • Currently prescribed inhaled corticosteroids for asthma with anticipated stable dosing regimen for the duration of the study
  • Admission to Boston Children's Hospital for clinical asthma exacerbation
  • Medical clearance from primary care provider
  • Willingness to comply with study diet

Exclusion Criteria:

  • Body mass index (BMI) < 3rd centile (age- and gender- adjusted normative range from Center for Disease Control)
  • Known eating disorder
  • Celiac disease
  • Any food allergy
  • Any other major illness as assessed by medical history or the following screening tests:
  • Alanine aminotransferase (ALT) > twice upper limit of normal for age
  • Creatinine > 1.0 mg/dL for age 10-18 years; > 1.2 mg/dL for females > 18 years; or > 1.4 mg/dL for males > 18 years)
  • Random glucose > 200 mg/dL
  • Hemoglobin < 11 g/dL for males age 10-18 years; < 11. g/dL for females age 10-18 years; <11.4 g/dL for males >18 years; or <10.9 g/dL for females age > 18 years
  • Use of systemic steroids for indication other than asthma

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Andet: Anti-Inflammatory Diet First
For the first 6 weeks, subjects will receive the anti-inflammatory diet. For the second 6 weeks, subjects will consume their habitual diet.
Andet: Anti-Inflammatory Diet
The anti-inflammatory diet will focus on reducing glycemic load, and increasing fiber, fruits, vegetables, legumes and food-based omega-3 fatty acid content.
Andet: Anti-Inflammatory Diet Second
For the first 6 weeks, subjects will consume their habitual diet. For the second 6 weeks, subjects will receive the anti-inflammatory diet.
Andet: Anti-Inflammatory Diet
The anti-inflammatory diet will focus on reducing glycemic load, and increasing fiber, fruits, vegetables, legumes and food-based omega-3 fatty acid content.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Forced expiratory volume in one second (FEV1)
Tidsramme: End of 6-week intervention
End of 6-week intervention

Sekundære resultatmål

Resultatmål
Tidsramme
Forced vital capacity (FVC)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Forced expiratory flow 25-75% (FEF25-75)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Fraction of exhaled nitric oxide (FeNO)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Asthma Control Questionnaire (ACQ)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Asthma Control Test (ACT)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Pediatric Asthma-Related Quality of Life Questionnaire
Tidsramme: End of 6-week intervention
End of 6-week intervention
Asthma medication use
Tidsramme: End of 6-week intervention
End of 6-week intervention
Serum inflammatory markers, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), tissue necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), plasminogen activator inhibitor-1 (PAI-1)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Asthma-related inflammatory markers, including eosinophilic cationic protein (ECP), monocyte chemoattractant protein (MCP-1)
Tidsramme: End of 6-week intervention
End of 6-week intervention
Measures of insulin sensitivity, including fasting glucose, fasting insulin and adiponectin
Tidsramme: End of 6-week intervention
End of 6-week intervention
Intestinal Microbiome Composition, including 16S sequencing and fecal short chain fatty acid levels
Tidsramme: End of 6-week intervention
End of 6-week intervention
Serologic markers of nutritional status, including vitamin D
Tidsramme: End of 6-week intervention
End of 6-week intervention

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Boston Children's Hospital

Efterforskere

  • Ledende efterforsker: David Ludwig, MD, PhD, Boston Children's Hospital
  • Studieleder: Bridget Hron, MD, Boston Children's Hospital
  • Studieleder: Cara Ebbeling, PhD, Boston Children's Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. januar 2014

Primær færdiggørelse (Faktiske)

1. maj 2016

Studieafslutning (Faktiske)

1. maj 2016

Datoer for studieregistrering

Først indsendt

22. november 2013

Først indsendt, der opfyldte QC-kriterier

22. november 2013

Først opslået (Skøn)

27. november 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

4. august 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. august 2016

Sidst verificeret

1. august 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 00006708

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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