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Mediterranean Diet, Weight Loss, and Cognition in Obese Older Adults

6 april 2021 bijgewerkt door: Dr. Fitzgibbon, University of Illinois at Chicago
The deleterious effects of obesity on cardiovascular disease (CVD) and metabolic risk factors (dyslipidemia, hypertension, and insulin resistance) are well-documented. Recent evidence also links obesity to cognitive decline and dementia. Dietary patterns are central to the development and maintenance of obesity and certain dietary patterns may contribute to the onset and progression of cognitive decline. With the rapid aging of the US population and the high prevalence of obesity among older adults, innovative lifestyle strategies to prevent cognitive decline among ethnically diverse obese older adults are critically needed.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Obesity is a leading cause of death and disability in the United States, affecting as many as 80 million Americans. It is well-established that obesity contributes to a number of risk factors for metabolic abnormalities and cardiovascular diseases (CVD), including hypertension, diabetes, and hyperlipidemia. In addition, there is growing evidence that obesity is associated with cognitive deficits in multiple domains, even in otherwise healthy older adults. With the rapidly aging US population and the high prevalence of obesity among older adults, innovative strategies to prevent cognitive decline in this population are needed. Dietary patterns are central to the development and maintenance of obesity and evidence suggests that dietary factors also may affect cognition. Studies have shown that adherence to a Mediterranean Diet (MedDiet) is associated with less cognitive decline and reduced risk for dementia in older adults. Weight loss through caloric restriction also has been shown to improve cognitive function in obese adults. Both the MedDiet and weight loss are thought to improve cognition in obese individuals and reduce CVD/metabolic risk through beneficial changes in systemic inflammation and oxidative stress. The identification of effective lifestyle interventions for diet/weight management to improve cognition among obese older adults is a public health priority. However, no randomized controlled trials (RCTs) have examined the effect of the MedDiet with and without caloric restriction, to promote weight loss on cognitive functioning in obese older adults. The investigators propose a three-arm RCT in which 180 obese (body mass index [BMI] ≥ 30 and < 50 kg/m²) older adults (55-80 years) will be randomized to: 1) an 8-month MedDiet Alone, without caloric restriction/weight loss (MedDiet-A); 2) an 8-month MedDiet lifestyle intervention with caloric restriction/weight loss (MedDiet-WL); or 3) an 8-month typical diet control (TDC) without caloric restriction/weight loss. The investigators will test the following hypotheses: 1) participants randomized to MedDiet-A and MedDiet-WL will achieve greater improvements in cognition compared to participants randomized to TDC; 2) participants randomized to MedDiet-WL will exhibit greater improvements in cognition compared to participants randomized to MedDiet-A; 3) participants randomized to MedDiet-A and MedDiet-WL will show greater improvements in CVD/metabolic risk factors, systemic inflammation, OxStress, and body weight/composition compared to participants in TDC; 4) participants randomized to MedDiet-WL will exhibit greater improvements in CVD/metabolic risk factors, systemic inflammation, OxStress, and body weight/composition compared to MedDiet-A; 5) improvements in CVD/metabolic risk factors, body composition, systemic inflammation, and OxStress will mediate the relationship between MedDiet and improved cognition. The investigators also will determine the extent to which changes in dietary habits, weight and cognitive functioning are maintained over a 6-month follow-up period.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

180

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • Illinois
      • Chicago, Illinois, Verenigde Staten, 60608
        • University of Illinois at Chicago

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

55 jaar tot 85 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Ja

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Men and women ≥ 55 years of age],
  • BMI 30.0-50.0 kg/m2,
  • English speaking
  • Have access to a phone
  • Plan to reside in the Chicago area for the following 14 months
  • Minimal levels of cognitive impairment as determined by the Montreal Cognitive Assessment (MoCA) < 19.

Exclusion Criteria:

  • The exclusion criteria ensure that participants can safely participate in the trial.
  • renal disease
  • autoimmune disorder
  • immunodeficiency
  • malabsorptive disorder
  • gastrointestinal and hepatic diseases
  • severe ischemic heart disease
  • severe pulmonary disease
  • bariatric surgery
  • alcohol abuse (> 50 grams/day) or illicit drug abuse
  • uncontrolled diabetes based on capillary hemoglobin A1c (HbA1c) > 9.0%
  • schizophrenia or bipolar disorder
  • cancer treatment within the past 12 months
  • weight > 450 lbs. (due to the weight limitation of the DXA scanner)
  • diagnosed sleep apnea and regularly using a cpap machine
  • currently adhering to a MedDiet, Montreal Cognitive Assessment (MoCA) < 19,(161) -
  • currently on a weight-loss diet or actively involved in a formal weight loss program (e.g., Weight Watchers.)

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Ander
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: MedDiet-WL
MedDiet-WL group, advice and exchange lists will be designed to promote a 1-2 lb. per week weight loss (approximately 30% caloric restriction or a reduction of about 600 calories per day) for an end goal of a 7% weight loss from baseline.
Gedragsmatig: MedDiet

Research subjects will be randomly assigned to one of three intervention groups.

The MedDiet-A group will learn about and how to adhere to the Mediterranean Diet. Over the course of 8 months, they will receive twenty-two classes 60-minute in length.

The MedDiet-WL group will learn about the Mediterranean Diet, how to adhere to is and engage in lifestyle choices like exercising and eating fewer calories so that they will loose weight. Over the course of 8 months they will receive 22 classes, each 90 minutes in length.

The Typical Diet Control group will be asked to maintain current eating and activity patterns over the course of the 14 month study.
Experimenteel: MedDiet-A
For the MedDiet-A group, dietary advice and corresponding exchange lists will be given within the context of promoting weight stability.
Gedragsmatig: MedDiet

Research subjects will be randomly assigned to one of three intervention groups.

The MedDiet-A group will learn about and how to adhere to the Mediterranean Diet. Over the course of 8 months, they will receive twenty-two classes 60-minute in length.

The MedDiet-WL group will learn about the Mediterranean Diet, how to adhere to is and engage in lifestyle choices like exercising and eating fewer calories so that they will loose weight. Over the course of 8 months they will receive 22 classes, each 90 minutes in length.

The Typical Diet Control group will be asked to maintain current eating and activity patterns over the course of the 14 month study.
Ander: Typical Diet Control (TDC)
Typical Diet Control (TDC) will maintain current eating and activity patterns and weight over 14 months.
Gedragsmatig: MedDiet

Research subjects will be randomly assigned to one of three intervention groups.

The MedDiet-A group will learn about and how to adhere to the Mediterranean Diet. Over the course of 8 months, they will receive twenty-two classes 60-minute in length.

The MedDiet-WL group will learn about the Mediterranean Diet, how to adhere to is and engage in lifestyle choices like exercising and eating fewer calories so that they will loose weight. Over the course of 8 months they will receive 22 classes, each 90 minutes in length.

The Typical Diet Control group will be asked to maintain current eating and activity patterns over the course of the 14 month study.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Assessing change in Attention between time periods
Tijdsspanne: 14 months
Baseline, 8-month (first intervention), and 14-month assessments will include Digit Symbol test.
14 months
Assessing change in Executive Function between time periods
Tijdsspanne: 14 months
Baseline, 8-month (first intervention), and 14-month assessments will include the Trail Making Test Part B.
14 months
Assessing change in Memory between time periods
Tijdsspanne: 14 months
Baseline, 8-month (first intervention), and 14-month assessments will include tests of memory including the delayed free recall from the Hopkins Verbal Learning Test.
14 months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

University of Illinois at Chicago

Medewerkers

National Institutes of Health (NIH)

Onderzoekers

  • Hoofdonderzoeker: Marian Fitzgibbon, PhD, UIC

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 september 2016

Primaire voltooiing (Werkelijk)

1 januari 2021

Studie voltooiing (Werkelijk)

1 april 2021

Studieregistratiedata

Eerst ingediend

17 april 2017

Eerst ingediend dat voldeed aan de QC-criteria

24 april 2017

Eerst geplaatst (Werkelijk)

26 april 2017

Updates van studierecords

Laatste update geplaatst (Werkelijk)

8 april 2021

Laatste update ingediend die voldeed aan QC-criteria

6 april 2021

Laatst geverifieerd

1 april 2021

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 2016-0258

Plan Individuele Deelnemersgegevens (IPD)

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ONBESLIST

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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