The Role of Diet Quality in Sleep Among Women in Postmenopause (EMILE)
The Impact of Diet Quality and Gut Microbiota on Sleep Quality in Postmenopausal Women
This single-center, randomized controlled trial with parallel groups, consists of an intensive nutritional intervention based on a high-fiber Mediterranean diet (target intake: 30-35 g/day of dietary fiber), which will be compared with a control group receiving low-intensity nutritional counseling on the Mediterranean diet. The intervention will last 16 weeks, followed by an 8-month follow-up period to evaluate its impact and the sustainability of long-term effects.
Participants allocated to the intervention group will receive nutritional counseling and guidance to achieve the intervention target of a daily dietary fiber intake of 30 to 35 g. To this end, they will be provided with a personalized weekly meal plan and will undergo intensive follow-up throughout the intervention period.
Participants in the control group will receive educational materials on how to follow a Mediterranean diet; however, no specific dietary fiber intake targets will be established, and they will not receive a personalized weekly meal plan.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Eligible volunteers will be invited to participate in this 16-week parallel-group randomized controlled trial. All eligible participants will receive detailed information about the study and provide written informed consent prior to enrollment. Upon enrollment, participants will be assigned a unique identification code to maintain the confidentiality of their data throughout the study.
Participants will then attend a baseline assessment visit (T0), during which data on all study variables will be collected and a blood sample will be obtained for the assessment of cardiometabolic parameters. During this visit, participants will also receive instructions and materials for the assessment of sleep quality, including an actigraph to be worn on the non-dominant wrist for seven consecutive days, as well as materials and guidance for the collection of biological samples (urine and stool).
After seven days, participants will return to the study site to return the actigraph and biological samples. In addition, during this visit, they will be randomly assigned to either the intervention or control arm of the trial and will receive nutritional information according to their allocated group. After receiving the corresponding dietary instructions, participants will be asked to commence the intervention allocated to their study arm.
All participants will attend two main study visits: a baseline visit (T0) and a final assessment visit at week 16 (T2), during which all study outcomes will be evaluated. In addition, a sleep-monitoring visit will be conducted at week 8 (T1) to assess sleep-related parameters.
Follow-up procedures will differ according to group allocation:
- Intervention group: Participants will receive individualized telehealth nutrition counseling at weeks 4 and 12, together with telehealth follow-up visits at weeks 2, 6, 10, and 14.
- Control group: Participants will receive telehealth follow-up visits at weeks 4 and 12 and brief follow-up telephone calls at weeks 2, 6, 10, and 14, without nutrition counseling.
Throughout the intervention period, participants in both groups will be encouraged to maintain regular contact with the research team and to report any adverse events or relevant changes in their health status.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Maria Izquierdo-Pulido, PhD
- Numero di telefono: +34
- Email: maria_izquierdo@ub.edu
Backup dei contatti dello studio
- Nome: Maria Fernanda Fernanda Zerón-Rugerio, PhD
- Email: fernanda.zeron@ub.edu
Luoghi di studio
-
-
-
Barcelona, Spagna, 08041
- Centro de Investigación del Medicamento (CIM Sant Pau)
-
Contatto:
- Rosa Antonijoan-Arbós, PhD
- Numero di telefono: +34 935 53 78 55
- Email: rantonijoana@santpau.cat
-
Sub-investigatore:
- Isabella Parilli-Moser, PhD
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Postmenopausal women aged 50 to 60 years
- Having a poor subjective sleep quality (assessed using the Pittsburgh Sleep Quality Index, with scores of 5 points or higher)
- Having a BMI between 20 and 30 kg/m²
- Performing a moderate level of physical activity
- Having no recent history of weight changes greater than 2-3 kg during the previous 3 months.
Exclusion Criteria:
- Having any acute, chronic, or psychiatric illness
- Being current smoker
- Taking antibiotics
- Following a specific diet or have dietary restrictions
- Work rotating or night shifts
- Have undergone bariatric surgery or endoscopic bariatric procedures
- Being unable to provide written informed consent.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: High-Fiber Mediterranean Diet With Intensive Counseling
Participants assigned to this arm will follow a high-fiber Mediterranean diet targeting a daily dietary fiber intake of 30-35 g for 16 weeks. They will receive individualized nutritional counseling, a personalized weekly meal plan, and intensive follow-up to support adherence to the dietary recommendations. |
Consists of an intensive nutritional intervention based on a high-fiber Mediterranean diet (target intake: 30-35 g/day of dietary fiber). |
|
Comparatore attivo: Mediterranean Diet With Low-Intensity Counseling
Participants assigned to this arm will receive low-intensity nutritional guidance on following a Mediterranean diet for 16 weeks. They will be provided with educational materials on Mediterranean dietary recommendations, without specific dietary fiber intake targets or personalized weekly meal plans. |
Consists of receiving low-intensity nutritional counseling on the Mediterranean diet. |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Subjective Sleep Quality From Baseline to Week 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
The Spanish version of the Pittsburgh Sleep Quality Index (PSQI) will be used to assess subjective sleep quality. The global score is calculated by summing seven component scores, resulting in a total score ranging from 0 to 21. Higher scores indicate poorer sleep quality. |
Baseline, weeks 8 and 16.
|
|
Changes in Sleep Onset Latency From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Defined as the length of time, in min, it takes to transition from wake to sleep onset. Measured with an actigraph (ActTrust, CONDOR, Brazil) |
Baseline, weeks 8 and 16.
|
|
Changes in Sleep Efficiency From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Calculated in percentage as the ratio of total sleep time (TST) to time in bed (TIB). Sleep efficiency (percent) = (TST/TIB)*100 |
Baseline, weeks 8 and 16.
|
|
Changes in Wake After Sleep Onset (WASO) From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Measured in minutes of WASO with an actigraph (ActTrust, CONDOR, Brazil) |
Baseline, weeks 8 and 16.
|
|
Changes in Urinary 6-sulphatoxymelatonin From Baseline to Week 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Quantified using urine Melatonin-Sulfate ELISA kit |
Baseline, weeks 8 and 16.
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Daytime sleepiness From Baseline to Week 16
Lasso di tempo: Baseline and week 16.
|
The Epworth Sleepiness Scale (ESS) will be used to assess daytime sleepiness. The questionnaire consists of eight items, each scored from 0 to 3, yielding a total score ranging from 0 to 24. Higher scores indicate greater daytime sleepiness. |
Baseline and week 16.
|
|
Changes in Body Mass Index (BMI) From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Calculated as weight (kg) divided by height (in squared meters), BMI= kg/m^2 |
Baseline, weeks 8 and 16.
|
|
Changes in Body Fat From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Measured as the percentage of body fat with a body composition analyzer (Inbody 120, Korea) |
Baseline, weeks 8 and 16.
|
|
Changes in Waist Circumference From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Measured midway between the lower rib margin and the iliac crest with the subject standing and wearing only underwear, at the end of gentle expiration with an anthropometric tape (CESCORF, Brazil) |
Baseline, weeks 8 and 16.
|
|
Changes in Hip Circumference From Baseline to Weeks 8 and 16
Lasso di tempo: Baseline, weeks 8 and 16.
|
Measured at the level of the greater trochanter, at the widest portion of the buttocks with an anthropometric tape (CESCORF, Brazil) |
Baseline, weeks 8 and 16.
|
|
Changes in the composition of the gut microbiota from baseline to week 16.
Lasso di tempo: Baseline and week 16.
|
The composition and functionality of the gut microbiota will be assessed in collected samples through sequencing of the 16S rRNA gene fragment (V3-V4 region). Sequencing will be performed using the Illumina MiSeq 300 × 2 platform (Illumina Inc., San Diego, CA, USA), and sequence reads will be merged and processed using the MiSeq Run and MiSeq Reporter software packages. From this data we will estimate:
|
Baseline and week 16.
|
|
Changes in intestinal permeability from baseline to week 16.
Lasso di tempo: Baseline to week 16
|
Intestinal permeability will be evaluated by measuring two widely used biomarkers, calprotectin and zonulin, in fecal samples using ELISA kits (MyBioSource, San Diego, CA, USA). Lower concentrations of calprotectin and zonulin indicate improved intestinal barrier function and suggest reduced intestinal permeability. |
Baseline to week 16
|
|
Changes in short-chain fatty acids (SCFAs) from baseline and week 16
Lasso di tempo: Baseline and week 16.
|
SCFAs will be quantified will be quantified using a headspace gas chromatography-mass spectrometry (HS-GC-MS)-based method. Higher concentrations of short-chain fatty acids, particularly butyric acid, will be indicative of greater dietary fiber intake. |
Baseline and week 16.
|
|
Changes in Fasting Blood Glucose From Baseline to Week 16
Lasso di tempo: Baseline and week 16
|
Serum levels of Glucose (mg/dL) will be determined according to the procedures and protocols established by the Biochemical Analysis Laboratory of Sant Pau Hospital. |
Baseline and week 16
|
|
Changes in Total Cholesterol From Baseline to Week 16
Lasso di tempo: Baseline and week 16
|
Serum levels of Total cholesterol (mg/dL) will be determined according to the procedures and protocols established by the Biochemical Analysis Laboratory of Sant Pau Hospital. |
Baseline and week 16
|
|
Changes in HDL Cholesterol From Baseline to Week 16
Lasso di tempo: Baseline and week 16
|
Serum levels of High-density lipoprotein cholesterol (HDL-C) (mg/dL) will be determined according to the procedures and protocols established by the Biochemical Analysis Laboratory of Sant Pau Hospital. |
Baseline and week 16
|
|
Changes in LDL Cholesterol From Baseline to Week 16
Lasso di tempo: Baseline and week 16
|
Serum levels of Low-density lipoprotein cholesterol (LDL-C) (mg/dL) will be determined according to the procedures and protocols established by the Biochemical Analysis Laboratory of Sant Pau Hospital. |
Baseline and week 16
|
|
Changes in Triglycerides From Baseline to Week 16
Lasso di tempo: Baseline and week 16
|
Serum levels of Triglycerides (mg/dL) will be determined according to the procedures and protocols established by the Biochemical Analysis Laboratory of Sant Pau Hospital. |
Baseline and week 16
|
|
Changes in Glycated Hemoglobin (HbA1c) From Baseline to Week 16
Lasso di tempo: Baseline and week 16
|
Serum levels of Glycated hemoglobin (HbA1c) (%) will be determined according to the procedures and protocols established by the Biochemical Analysis Laboratory of Sant Pau Hospital. |
Baseline and week 16
|
|
Changes in diet quality from baseline to week 16.
Lasso di tempo: Baseline and week 16
|
Diet quality will be assessed using the Mediterranean Diet Adherence Screener, which has been validated for the Spanish population. This questionnaire evaluates dietary habits such as daily consumption of fruits and vegetables, regular intake of legumes and fish, and preference for olive oil as the main culinary fat. Each item is scored as either 0 or 1, depending on whether the response is negative (0) or affirmative (1). Based on the total score, adherence to the Mediterranean diet is classified as low (0-5 points), moderate (6-9 points), or high (≥10 points). |
Baseline and week 16
|
|
Changes in eating behavior from baseline to week 16
Lasso di tempo: Baseline and week 16.
|
This variable will be assessed using the Three-Factor Eating Questionnaire (TFEQ-R21C). This questionnaire consists of 21 items designed to evaluate the following dimensions of eating behavior:
Scores for each dimension are calculated as the mean of all items within that dimension, with higher scores indicating a greater expression of the corresponding eating behavior. |
Baseline and week 16.
|
|
Changes in neuropsychological performance from baseline to week 16
Lasso di tempo: Baseline to week 16.
|
These outcomes will be assessed using a computerized test battery administered with E-Prime 3.0 software (Psychology Software Tools, USA). Test results will be recorded automatically by the software and exported directly to the investigator's computer. The assessment battery will last approximately 45-50 minutes and will include the following tasks:
|
Baseline to week 16.
|
|
Changes in mental fatigue from baseline to week 16
Lasso di tempo: Baseline and week 16
|
Assessed using a visual analog or numeric rating scale integrated into the computerized battery. Participants will rate their perceived level of mental fatigue at the time of assessment. |
Baseline and week 16
|
|
Changes in anxiety and depression symptoms from baseline to week 16.
Lasso di tempo: Baseline and week 16.
|
The Hospital Anxiety and Depression Scale (HADS) consists of 14 items divided into two seven-item subscales assessing anxiety (HADS-A) and depression (HADS-D). Each subscale yields a score ranging from 0 to 21, with higher scores indicating greater severity of anxiety or depressive symptoms, respectively. |
Baseline and week 16.
|
|
Changes in well-being from baseline to week 16.
Lasso di tempo: Baseline to week 16.
|
The World Health Organization-Five Well-Being Index (WHO-5) will be used to assess subjective mental well-being. The questionnaire comprises five items, each scored from 0 to 5, yielding a raw total score ranging from 0 to 25. Higher scores indicate better mental well-being. |
Baseline to week 16.
|
|
Changes in health-related quality of life for menopausal women from baseline to week 16
Lasso di tempo: Baseline to week 16
|
Health-related quality of life will be assessed using the Cervantes Scale, a 31-item questionnaire specifically developed for menopausal women. The total score ranges from 0 to 155, with higher scores indicating poorer health-related quality of life. |
Baseline to week 16
|
|
Changes in food noise from baseline to week 16
Lasso di tempo: Baseline and week 16.
|
Food noise will be assessed using the Food Noise Questionnaire (FNQ), a five-item instrument measuring the frequency and intrusiveness of food-related thoughts. Each item is scored from 0 to 4, yielding a total score ranging from 0 to 20. Higher scores indicate greater food noise |
Baseline and week 16.
|
|
Changes in physical activity from baseline to week 16
Lasso di tempo: Baseline and week 16.
|
Physical activity levels will be measured in Metabolic Equivalents of Task (METs) using the short version of the International Physical Activity Questionnaire (IPAQ), validated in the Spanish population . Higher scores reflect a greater intensity of physical activity. Additionally, physical activity levels will be objectively measured using an actigraphy device (ActTrust, Condor, Brazil), as the mean value of motor activity. Higher values reflect a greater intensity of motor activity. |
Baseline and week 16.
|
|
Changes in flourishing from baseline to week 16
Lasso di tempo: Baseline and week 16.
|
Flourishing will be assessed using the eight-item Flourishing Scale. Each item is rated on a seven-point Likert scale from 1 to 7, yielding a total score ranging from 8 to 56. Higher scores indicate greater psychological flourishing. |
Baseline and week 16.
|
|
Changes in 3-day dietary intake from baseline to week 16.
Lasso di tempo: Baseline and week 16.
|
Dietary intake will be evaluated throug a 3-day image-based dietary records. Data from dietary records will be processed by a registered dietitian using PCN Pro 1.0 software to estimate the average daily energy (kcal/day) and nutrient intake. |
Baseline and week 16.
|
|
Adherence to the Dietary Intervention
Lasso di tempo: Weeks 2, 4, 6, 10, and 12.
|
Adherence to the intervention will be subjectively assessed by the dietitian using a 4-point ordinal scale:
|
Weeks 2, 4, 6, 10, and 12.
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Changes in Invisible Family Load from baseline to week 16.
Lasso di tempo: Baseline and week 16.
|
This outcome will be measured through the Invisible Family Load questionnaire to measure the:
|
Baseline and week 16.
|
|
Changes in handgrip strenght from baseline to week 16.
Lasso di tempo: Baseline to week 16.
|
Handgrip strength will be assessed using a Jamar Hydraulic Hand Dynamometer. Three maximal grip-strength measurements will be obtained from the dominant hand following a standardized protocol, and the highest value (kg) will be used for analysis. |
Baseline to week 16.
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Investigatore principale: Maria Izquierdo-Pulido, PhD, University of Barcelona
- Investigatore principale: Maria Fernanda Zeron-Rugerio, PhD, University of Barcelona
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- PID2023-147086OB-I00
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
The data collected from human participants are not available publicly for confidentiality reasons, but they will be made available by the PI, Maria Izquierdo-Pulido (maria_izquierdo@ub.edu), upon reasonable request.
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .