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Fermented Foods and Bowel Health in SCI
High Fermented Food Intake to Improve Gut Microbiome and Bowel Dysfunction in Individuals With SCI
The goal of this clinical trial is to learn whether consuming a high fermented food diet improves bowel function and gut health in adults with chronic spinal cord injury (SCI). The study will also evaluate the feasibility and tolerability of consuming fermented foods daily for 10 weeks. The main questions it aims to answer are:
- Does a high fermented food diet improve neurogenic bowel dysfunction symptoms and colonic transit in adults with SCI?
- Does fermented food intake change gut microbiome composition, short-chain fatty acid production, and intestinal inflammation?
Researchers will compare a high fermented food diet to a control diet to evaluate effects on bowel health and gut microbiome outcomes.
Participants will:
- Consume study foods daily for 10 weeks
- Attend 2 in-person study visits
- Collect stool samples at home and ship them overnight to the research team using provided collection kits and prepaid shipping materials
- Complete bowel health questionnaires and dietary recalls
- Undergo Sitz marker testing with abdominal X-rays to assess colonic transit
- Participate in biweekly monitoring contacts throughout the study period
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Jia Li, PhD
- Telefoonnummer: 6146889094
- E-mail: jia.li@osumc.edu
Studie Locaties
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Ohio
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Columbus, Ohio, Verenigde Staten, 43210
- Ohio State University
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Contact:
- Jia Li Li, PhD
- Telefoonnummer: 6146889094
- E-mail: jia.li@osumc.edu
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Adults aged 18-70 years
- At least 1 year post-onset of spinal cord injury, consistent with chronic spinal cord injury
- Traumatic spinal cord injury involving cervical or thoracic levels
- American Spinal Injury Association Impairment Scale classification A-D
- Medically stable, with no recent hospitalizations or acute illnesses
- Able to safely consume study foods, including fermented and control food products
Experiencing neurogenic bowel dysfunction, defined by at least one of the following:
- Three or fewer bowel movements per week
- More than 60 minutes required per bowel care routine
- Symptoms of incomplete evacuation
- Abdominal distension
- Fecal incontinence
- Established and stable bowel program, defined as a consistent individualized routine of timing, frequency, and evacuation methods that has remained unchanged for at least 4 weeks before enrollment
Exclusion Criteria:
- Antibiotic use within the past 4 weeks
- Active gastrointestinal disease, including Crohn's disease, ulcerative colitis, celiac disease, or gastrointestinal obstruction
- Current intake of probiotics or fermented foods exceeding 3 servings per day
- Pregnancy or breastfeeding
- Recent major bowel surgery within the past 12 weeks
- Unresolved fecal impaction
- Unstable bowel regimen that could interfere with accurate motility assessment
Inability to safely undergo Sitz marker testing, including any of the following:
- Inability to swallow the capsule
- Pregnancy, due to radiation exposure
- Contraindication to abdominal X-ray procedures
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Fermented Food Arm
Fermented food arm: participants randomized to the fermented foods arm will consume ≥6 servings/day of fermented foods after a graded ramp-up to minimize intolerance.
A 3-week ramp-up (weeks 1-3) will increase intake from 2 to 6 servings/day, followed by a 7-week full-intake phase (weeks 4-10).
To avoid single-food dominance and improve microbiome diversity, participants will be required to consume ≥3 categories/day (e.g., vegetables, dairy, soy, tea, brine) and rotate through all core fermented food categories and consume a variety of items across a 2-3-day period.
This will ensure all core items are consumed throughout the week.
Core food items will be delivered biweekly.
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Participants randomized to the fermented foods arm will consume ≥6 servings/day of fermented foods after a graded ramp-up to minimize intolerance.
Colonic transit time will be assessed using the Sitz marker test, a standardized radiopaque marker method for evaluating bowel motility.
Participants will swallow a capsule containing radiopaque markers, and abdominal X-rays will be obtained on day 5 to determine the number and distribution of retained markers throughout the colon.
Greater marker retention indicates slower colonic transit, whereas fewer retained markers indicate faster transit and improved bowel motility.
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Placebo-vergelijker: Control Diet Arm
Participants randomized to the control arm will receive non-fermented versions of the base foods consumed by the fermented foods arm and will be instructed to avoid fermented foods during the trial.
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Colonic transit time will be assessed using the Sitz marker test, a standardized radiopaque marker method for evaluating bowel motility.
Participants will swallow a capsule containing radiopaque markers, and abdominal X-rays will be obtained on day 5 to determine the number and distribution of retained markers throughout the colon.
Greater marker retention indicates slower colonic transit, whereas fewer retained markers indicate faster transit and improved bowel motility.
Participants randomized to the control arm will receive non-fermented versions of the base foods consumed by the fermented food arm and will be instructed to avoid fermented foods during the trial.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Fecal microbiome composition assessed by shotgun metagenomic sequencing
Tijdsspanne: Baseline, weeks 5 and 10
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Stool samples will be analyzed using shotgun metagenomic sequencing to characterize gut microbial taxonomic composition.
Outcomes may include relative abundance of bacterial taxa and alpha/beta diversity metrics.
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Baseline, weeks 5 and 10
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Gut microbiome functional potential measured by shotgun metagenomic sequencing
Tijdsspanne: Baseline, week 5, and week 10
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Shotgun metagenomic sequencing data will be used to assess microbial functional potential, including gene family, KEGG Ortholog, and metabolic pathway/module abundance.
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Baseline, week 5, and week 10
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Fecal calprotectin measured by ELISA
Tijdsspanne: Baseline, weeks 5 and 10
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Fecal calprotectin concentration will be measured in stool samples using an ELISA assay.
Results will be reported as fecal calprotectin concentration, with higher values indicating greater intestinal inflammation.
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Baseline, weeks 5 and 10
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Fecal Short Chain Fatty Acid measured by LC-MS/MS
Tijdsspanne: Baseline, weeks 5 and 10
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Concentrations of fecal short-chain fatty acids, including acetate, propionate, butyrate, and branched-chain fatty acids, will be quantified using LC-MS/MS.
Results will be reported as fecal SCFA concentrations.
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Baseline, weeks 5 and 10
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Neurogenic bowel dysfunction measured by the Neurogenic Bowel Dysfunction Score
Tijdsspanne: Baseline, weeks 5 and 10
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Neurogenic bowel dysfunction will be assessed using the Neurogenic Bowel Dysfunction Score.
Total scores range from 0 to 47, with higher scores indicating more severe bowel dysfunction.
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Baseline, weeks 5 and 10
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Colonic transit measured by the Sitz marker test
Tijdsspanne: Baseline, week 10
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Colonic transit will be assessed using the Sitz marker test.
Participants will ingest a capsule containing radiopaque markers, and abdominal X-rays will be used to quantify the number and distribution of retained markers.
Greater marker retention indicates slower colonic transit.
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Baseline, week 10
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Constipation severity measured by the Constipation Severity Instrument
Tijdsspanne: Baseline, weeks 5 and 10
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Constipation severity will be assessed using the Constipation Severity Instrument (CSI), a 16-item questionnaire with total scores ranging from 0 to 73, where higher scores indicate greater constipation severity.
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Baseline, weeks 5 and 10
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Stool consistency measured by the Bristol Stool Form Scale
Tijdsspanne: Baseline, weeks 5 and 10
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Stool consistency will be assessed using the Bristol Stool Form Scale, a 7-point scale ranging from Type 1, separate hard lumps, to Type 7, entirely liquid stool.
Types 3-4 generally reflect more normal stool form.
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Baseline, weeks 5 and 10
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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Ziekten van het centrale zenuwstelsel
- Ziekten van het zenuwstelsel
- Wonden en verwondingen
- Ziekten van het spijsverteringsstelsel
- Gastro-intestinale aandoeningen
- Trauma, zenuwstelsel
- Ziekten van het ruggenmerg
- Darmziekten
- Ruggenmergletsels
- Dieet, voedsel en voeding
- Fysiologische fenomenen
- Eten en dranken
- Gefermenteerd voedsel
Andere studie-ID-nummers
- 1519842
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD-toegangscriteria voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
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