The Inflammatory Bowel Disease Mediterranean Diet (IBDMED) Microbiome-targeting Nutritional Education Program (IBDMED)
The Inflammatory Bowel Disease Mediterranean Diet (IBDMED) Microbiome-targeting Nutritional Education Program for CD Control and Prevention
The rising incidence of Crohn's disease (CD) and ulcerative colitis (UC), especially in the newly industrialized nations of Asia, highlights the possible role of environmental triggers such as diet and the gut microbiome in the pathogenesis of inflammatory bowel diseases (IBD). The Mediterranean diet (MED) has been previously correlated with beneficial outcomes in several chronic and immune-mediated diseases and has been linked with positive outcomes in IBD. However, consumption of high fiber foods like fruits, vegetables, whole grains, legumes and nuts may be challenging for patients with IBD without tight dietary guidance and support.
The IBDMED nutritional education program aims to improve the adherence of patients with IBD to MED. Patients are educated on how to implement and incorporate MED principles into their daily lifestyle, by providing information, tips, practical tools, cooking methods and recipes, that are available on an interactive website and application. Patients are monitored for their diet, sleep, physical activity and stress levels via fitness trackers and questionnaires developed for this study and receive feedback and personal recommendations from the study dietitians along the way.
This RCT will assess the feasibility and effects of an 8-week IBDMED nutritional and lifestyle education program vs. the nutritional standard of care in patients with newly diagnosed CD and in healthy subjects in Israel and India.
調査の概要
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前：Lihi Godny, PhD
- 電話番号：+97237525015
- メール：lihigodny@gmail.com
研究場所
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Petah Tikva、イスラエル
- 募集
- Rabin Medical Center
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コンタクト：
- Lihi Godny, PhD
- 電話番号：+97237525015
- メール：lihigodny@gmail.com
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-
-
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Hyderabad、インド
- 募集
- Asian Institute of Gastroenterology
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コンタクト：
- Rupa Banerjee, Dr
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Patients with early CD, defined as up to 12 months from diagnosis
- Inflammatory (B1) phenotype, specifically-no known fibrostenotic (B2) or internal penetrating (B3) disease. No known perianal disease (p). Any CD location will be included (L1-4)
- Patients with mild CD as measured by HBI 5-7 or CDAI 150-220 or patients with HBI<5 or CDAI<150 with at least one additional objective measure of inflammation: 1. inflammatory biomarkers: elevated CRP or fecal calprotectin at enrollment; active disease by endoscopy or VCE performed up to 12 weeks prior to enrollment; active inflammation demonstrated by imaging (CTE, MRE, IUS) performed up to 12 weeks prior to enrollment.
- Any stable concomitant CD therapy is allowed. 5-ASA (stable dose for at least 2 weeks), steroids (budesonide or any non topical corticosteroids)-stable dose for at least 2 weeks: prednisone up to 20 mg/day or budesonide up to 6 mg/day; immunomodulators (stable dose for 8 weeks) and/ or anti-TNFs at least 4 weeks after the end of induction or any optimization; anti integrins at least 4 weeks after the end of induction or any optimization; anti IL12/IL23 at least 4 weeks after the end of induction or any optimization; None of the above. For inclusion in a non-steroid group, a 2-week washout period will be required.
- TB evaluation was done in the Indian population
- For India-Hindi/Telugu speakers
- Willing and able to sign an informed consent form
- Willing and able to participate and adhere to IBDMED program
Exclusion Criteria:
- Pregnant women
- Diabetes mellitus
- Any previous gastrointestinal surgery (except appendectomy)
- Antibiotic therapy during the 4 weeks prior to enrollment. After enrollment, a non-CD short course of antibiotics will be allowed, if prescribed
- Any concomitant disease or treatment that according to the treating physician considerations interferes with patient safety or study outcomes (specifically-uncontrolled thyroid disease, renal failure)
- Undernutrition or need for enteral nutrition supplementation according to the treating dietitian
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：他の
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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他の：IBDMED-ISR
Patients with newly diagnosed CD in Israel
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The IBDMED program will be applied for 8 weeks and include education on MED diet and lifestyle components, focused on increasing and diversifying dietary fiber intake, reduction of ultra-processed food intake and promoting an active lifestyle.
This intervention is digitally supported by an interactive website application and step trackers to monitor lifestyle parameters.
Dietary counseling according to the local dietary guidelines for patients with IBD
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他の：IBDMED-IND
Patients with newly diagnosed CD in India
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The IBDMED program will be applied for 8 weeks and include education on MED diet and lifestyle components, focused on increasing and diversifying dietary fiber intake, reduction of ultra-processed food intake and promoting an active lifestyle.
This intervention is digitally supported by an interactive website application and step trackers to monitor lifestyle parameters.
Dietary counseling according to the local dietary guidelines for patients with IBD
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Composite biological score
時間枠：8 weeks
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A composite biological score comprised of changes in clinical (HBI/CDAI), inflammatory (CRP/calprotectin) and microbial (diversity, MDI) indices.
A decrease in clinical indices, inflammatory markers or MDI will be considered positive and will be scored as follows: -10%: +1 point, -20%: +2 points, -30%: +3 points; An increase in microbial diversity will be considered positive and will be scored as follows: +10%: +1 point, +20%: +2 points, +30%: +3 points.
The composite biological score ranges between 0-15 points.
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8 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Clinical and inflammatory response
時間枠：8 weeks
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Decrease in inflammatory activity: at least 30% decrease in HBI and/or CDAI and the additional inflammatory biomarker used at inclusion.
In any case where CRP or fecal calprotectin were elevated, they will be used to evaluate decreased activity.
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8 weeks
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Improvement in quality of life
時間枠：8 weeks
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Improved quality of life as assessed by the PRO2 (≥50% or ≥ 4 points)
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8 weeks
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Dietary adherance
時間枠：8 weeks
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Adherence to IBDMED in India and Israel-measured by IBDMED score.
The IBDMED adherance screener includes 11 items and ranges between 0-30.
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8 weeks
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Microbial outcomes- alpha diversity
時間枠：8 weeks
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Microbial diversity will be compared between groups and intra-individual changes will be assessed using paired analysis.
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8 weeks
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Microbial outcomes- Microbial dysbiosis index
時間枠：8 weeks
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MDI will be compared between groups and intra-individual changes will be assessed using paired analysis.
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8 weeks
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (予想される)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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