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A Pilot Study of Intermittent Calorie Restriction in Multiple Sclerosis

14 november 2017 uppdaterad av: Ellen M. Mowry, Johns Hopkins University
Experimental studies of the experimental autoimmune encephalomyelitis (EAE), a mouse model of multiple sclerosis, indicate that the number of calories fed to mice prevent EAE and are also associated with less severe disease in mice who do develop the disease. Currently, whether these results translate favorably in humans is unknown. This is a pilot trial of testing two caloric restriction (CR) diets versus a control diet in multiple sclerosis (MS) patients: one continuous caloric restriction (CR) diet where a small number of calories will be restricted every day or another intermittent CR diet where a caloric intake will be restricted more severely 2 days per week. Participants are randomized to one of the diets, and for the first 8 weeks, will receive standardized, prepared meals tailored to the specific diet. At the conclusion of the controlled feeding study, all participants will transition to an unblinded phase for an additional 40 weeks where they are provided with instructions to follow an intermittent CR diet.

Studieöversikt

Status

Avslutad

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

36

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Maryland
      • Baltimore, Maryland, Förenta staterna, 21287
        • Johns Hopkins University

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 50 år (Vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Aged 18-50
  • Capable of storing food safely, willing to follow diet/eat provided food, and able to receive shipments at home or work
  • Meets 2010 criteria for McDonald MS;
  • Relapse or new lesion in previous 2 years
  • Expanded disability status score (EDSS) < 6
  • Disease duration ≤15 years
  • Untreated or on stable on first-line MS therapy [injectable] for at least 6 months, with no anticipated changes in the next 10 weeks
  • Unchanged vitamin D dose or thyroid replacement dose (for those on it) with no anticipated changes or in supplement use for the next 10 weeks.
  • Non-regular smoker (average no more than 1 cigarette/day) for at least 2 months
  • Stable weight, by self report, for past 3 months (± 8 lbs)
  • Body mass index (BMI) > 23 kg/m2

Exclusion Criteria:

  • Pregnant or nursing, or unwilling to prevent pregnancy (if of childbearing to potential)

    • History of gastrointestinal disease causing malabsorption
    • History of diabetes requiring medication
    • History of stage IV/V chronic kidney disease or vascular disease
    • History of major surgery in past 3 months
    • Current use of warfarin
    • History of eating disorder
    • Currently on a special diet for MS/other diet (provided diet will be pork free)
    • Chemotherapy within the past year

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Continuous calorie restriction
Participants will be provided with a diet that includes approximately 78% of calories each day that would be needed to maintain current BMI.
Diet, standardized to the 50th percentile for macronutrients, will be provided at varied calorie levels as described.
Experimentell: Intermittent calorie restriction
Participants will be provided a diet that with a daily calorie intake required to maintain current BMI, except only 25% of this calorie intake will be provided for 2 days a week.
Diet, standardized to the 50th percentile for macronutrients, will be provided at varied calorie levels as described.
Placebo-jämförare: Control calorie intake
Participants will be assigned to consume enough calories each day required to maintain current BMI
Diet, standardized to the 50th percentile for macronutrients, will be provided at varied calorie levels as described.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Adverse events
Tidsram: 8 weeks
Adverse events will be categorized by organ system and by the blinded neurologist's assessment of the relation to the diet.
8 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Adherence to Calories Assigned
Tidsram: 8 weeks
Adherence will be assessed by comparing the total caloric intake provided to the patients through the assigned diet to the total energy intake determined by the research dieticians.
8 weeks
Adherence to Calories Assigned
Tidsram: 48 weeks
Adherence during the "advice-only" phase will be compared to adherence in each diet group during the first 8 weeks using paired t-tests, where the grouping is done naturally by subject.
48 weeks
Adverse Events
Tidsram: 48 weeks
Adverse events will be categorized by organ system and by the blinded neurologist's assessment of the relation to the diet.
48 weeks
Quality of Life Questionnaire
Tidsram: 48 weeks
"Functional Assessment in MS" results will be assessed during the study
48 weeks
NIH Patient-Reported-Outcomes Measurement Information System (PROMIS )Fatigue Questionnaire
Tidsram: 48 weeks
PROMIS Fatigue results will be assessed during the study
48 weeks
Change in metabolite ratios
Tidsram: 8 weeks
The impact of each calorie restriction diet versus control diet on the metabolomics profile will be assessed.
8 weeks
Immune cell subsets/cytokines
Tidsram: 8 weeks
The impact of each calorie restriction diet versus control diet on ratios of immune cell subsets (e.g. T-helper (TH)17, TH1, TH2, T regulatory) and related cytokines will be assessed.
8 weeks
Change in concentration of measures of metabolism
Tidsram: 8 weeks
The impact of each calorie restriction diet versus control diet on fasting glucose, insulin, leptin, ghrelin, C-reactive protein, lipids, and long-chain ceramides will be assessed.
8 weeks
Change in serum lipid concentration
Tidsram: 8 weeks
The impact of each calorie restriction diet versus control diet on fasting lipids and long-chain ceramides will be assessed.
8 weeks
Change in serum brain-derived neurotrophic factor concentration (BDNF)
Tidsram: 8 weeks
The impact of each calorie restriction diet versus control diet on fasting BDNF will be assessed.
8 weeks
Change in levels of oxidative stress biomarkers
Tidsram: 8 weeks
The impact of each calorie restriction diet versus control diet on protein carbonyls, 8-isoprostane, nitrotyrosine, and 4-hydroxynonenal adducts will be assessed.
8 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: Ellen Mowry, MD, Johns Hopkins University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 december 2015

Primärt slutförande (Faktisk)

1 juni 2017

Avslutad studie (Faktisk)

1 juni 2017

Studieregistreringsdatum

Först inskickad

28 december 2015

Först inskickad som uppfyllde QC-kriterierna

4 januari 2016

Första postat (Uppskatta)

6 januari 2016

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

17 november 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

14 november 2017

Senast verifierad

1 november 2017

Mer information

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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