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Think AHEAD (A Healthy Eating And Drinking) Study

27 de julho de 2015 atualizado por: David S. Ludwig, MD, PhD, Boston Children's Hospital

A 6-Month Study on Diet and Weight Loss in Overweight Adolescents

Advice to increase water consumption as part of a weight-reducing diet - typically to 8 cups (64 fl oz, ~2 L) per day ("8x8" water recommendation) - is almost ubiquitously recommended by healthcare professionals. Many believe that water promotes weight loss through numerous physiological mechanisms. However, only limited observational data and virtually no experimental data exist regarding the effects of water consumption on body weight. In this study, we propose a randomized controlled pilot study in which two groups of overweight adolescents will receive a standard weight loss regimen, either with (experimental intervention) or without (control intervention) additional advice and support to increase water consumption. We will utilize individual sessions, an innovative text messaging protocol, and motivational telephone calls to promote adherence to the interventions. The purpose of this pilot study is to evaluate feasibility and obtain preliminary efficacy data, to inform design of a future, definitive study.

It is hypothesized that increasing water consumption will improve the efficacy of a standard weight-reducing diet and will lead to decreased consumption of energy-containing beverages, decreased total energy intake, improved diet quality, improved immune status, and improved cardiovascular and diabetes risk factors. This simple behavioral intervention will be feasible and will significantly increase water consumption among participants in the experimental vs. control group.

Visão geral do estudo

Status

Rescindido

Condições

Intervenção / Tratamento

Descrição detalhada

This is a 6-month randomized controlled trial. After the initial baseline screening and assessments, 60 overweight adolescents will be randomly assigned (30 subjects per group) to a standard weight-reducing diet with the advice to consume 8 cups of water per day (experimental group) or the same standard weight-reducing diet without additional advice (control group). The interventions will consist of nutrition education and behavioral counseling by a registered dietitian, during individual sessions and telephone calls. Mobile text messaging will be used to reinforce information presented at the individual sessions and thereby foster adherence to dietary advice. Diet prescriptions will differ only in regard to the specificity of recommendations regarding water consumption and physical activity recommendations will not differ between groups. The frequency and content of text messages will be consistent between the experimental and control groups, with the exception that the experimental group will receive an additional phrase with each message to encourage the "8 x8" water recommendation.

A registered dietitian will communicate with each participant one time per month, either during an individual session or by telephone. Individual sessions will include nutrition classes, taste testing, hands-on activities, and opportunities for questions and answers. Text messages will be sent on a daily basis.

Study outcomes will be assessed at baseline and at regular intervals throughout the 6 months of the study.

ANALYSIS PLAN:

The blinding of the randomization will be broken on or after July 28, 2014 and the data will be analyzed according to the following plan. All analyses will follow the intention-to-treat principle, attributing each subject to his or her assigned diet regardless of compliance. Baseline characteristics will be compared between the diet groups using the Fisher exact test for categorical variables and t-test for continuous variables. The 6-month change from baseline in the primary and secondary outcomes will be compared between groups using a general linear model, adjusting for baseline covariates that are potentially correlated with the outcome. These include demographics, socioeconomic status, anthropometrics, physical activity, and beverage consumption. We will further test covariates for potential interaction, i.e., differential effect on outcome in the two trial arms. The null hypothesis is that the 6-month change from baseline will not differ between diet groups.

Tipo de estudo

Intervencional

Inscrição (Real)

38

Estágio

  • Não aplicável

Contactos e Locais

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Locais de estudo

    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02115
        • Children's Hospital Boston

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

12 anos a 17 anos (Filho)

Aceita Voluntários Saudáveis

Sim

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  • BMI ≥ 85th percentile for sex and age according to CDC growth charts
  • Access to a working telephone and cell phone
  • At least one parent willing and able to participate in the intervention with the subject
  • Residing in predominately one household (no more than one weekend every two weeks in a secondary household)
  • Medical clearance from a primary care provider or treating physician to rule out any major medical illness, disability, or disorder (e.g., liver disease, renal failure, cancer)

Exclusion Criteria:

  • Intake of more than 4 cups (250 mL per cup) of water per day
  • BMI ≥ 40 kg/m2
  • Currently smoking (> 1 cigarette in the past week)
  • Major surgery within the previous 6 months
  • Does not have a primary care provider
  • Physician diagnosis of a major medical illness (e.g. diabetes)
  • Previous diagnosis of an eating disorder
  • Physical, mental, or cognitive handicaps that prevent participation
  • Chronic use of medications that may affect study outcomes (e.g. stimulants or diuretics)
  • Another member of the family (first degree relative) or household participating in the study
  • A friend, classmate or coworker participating in the study with whom they have contact with one or more times per week
  • Girls who are pregnant, planning to become pregnant in the next 6 months, lactating, or within 6 months postpartum

Plano de estudo

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Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Diet + Water
Participants will be counseled to follow a standard weight-reducing diet including consumption of 1) ample vegetables, fruits, and legumes; 2) whole rather than refined grains; and 3) high-quality proteins at most meals and snacks. Moreover, we will recommend limiting intake of added fats and sugars and avoiding juices and sugar-sweetened beverages (per standard practice). Participants will also be counseled to increase their water intake to 8 cups per day, consistent with the popular "8 × 8" recommendation (eight 8-oz glasses of water).
Participants will receive personalized dietary counseling to promote behavior change
Comparador Ativo: Diet
Participants will be counseled on the same standard weight-reducing diet, as described above, with no specific advice regarding water consumption. Furthermore, no specific dietary recommendations will be provided on altering fluid/beverage intake, other than to decrease calorie-containing beverages as noted above. When participants ask for a recommendation regarding water intake, they will be advised that drinking plain water is the best way to satisfy thirst and instructed to drink when thirsty.
Participants will receive personalized dietary counseling to promote behavior change

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Prazo
Body mass index
Prazo: 6 month change
6 month change

Medidas de resultados secundários

Medida de resultado
Prazo
Body fat percentage
Prazo: 6 month change
6 month change
Body circumferences
Prazo: 6 month change
6 month change
Urine specific gravity
Prazo: Change throughout 6 months
Change throughout 6 months
Hunger, satiety, and palatability ratings
Prazo: 6 month change
6 month change
Diet quality
Prazo: 6 month change
6 month change
Satisfaction rating
Prazo: 6 months
6 months
Immune status
Prazo: 6 month change
6 month change
Cardiovascular risk factors
Prazo: 6 month change
6 month change
Diabetes risk factors
Prazo: 6 month change
6 month change

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Publicações e links úteis

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de fevereiro de 2011

Conclusão Primária (Real)

1 de junho de 2014

Conclusão do estudo (Real)

1 de junho de 2014

Datas de inscrição no estudo

Enviado pela primeira vez

5 de janeiro de 2010

Enviado pela primeira vez que atendeu aos critérios de CQ

5 de janeiro de 2010

Primeira postagem (Estimativa)

7 de janeiro de 2010

Atualizações de registro de estudo

Última Atualização Postada (Estimativa)

29 de julho de 2015

Última atualização enviada que atendeu aos critérios de controle de qualidade

27 de julho de 2015

Última verificação

1 de julho de 2015

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • X09-11-0587

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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