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.
연구 개요
연구 유형
등록 (예상)
단계
- 해당 없음
연락처 및 위치
연구 연락처
- 이름: Lihi Godny, PhD
- 전화번호: +97237525015
- 이메일: lihigodny@gmail.com
연구 장소
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Petah Tikva, 이스라엘
- 모병
- Rabin Medical Center
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연락하다:
- Lihi Godny, PhD
- 전화번호: +97237525015
- 이메일: lihigodny@gmail.com
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Hyderabad, 인도
- 모병
- Asian Institute of Gastroenterology
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연락하다:
- Rupa Banerjee, Dr
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
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
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 다른
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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다른: 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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다른: 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
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Composite biological score
기간: 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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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Clinical and inflammatory response
기간: 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
기간: 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
기간: 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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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Microbial outcomes- alpha diversity
기간: 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
기간: 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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공동 작업자 및 조사자
연구 기록 날짜
연구 주요 날짜
연구 시작 (예상)
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
염증성 장 질환에 대한 임상 시험
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University of Pennsylvania완전한Intrntl Classification of Diseases, 9th Revision, (ICD-9-CM) 410의 주진단 또는 이차진단 코드가 있는 환자(5번째 숫자가 2인 경우 제외)미국