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Obesity, Iron Regulation and Colorectal Cancer Risk

Primary Purpose

Colon Inflammation, Iron Malabsorption, Obesity

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
High heme iron diet
Low iron diet
Plant-based high non-heme iron diet
Sponsored by
University of Illinois at Chicago
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Colon Inflammation

Eligibility Criteria

55 Years - 70 Years (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Self-identify as Hispanic, African American, or Caucasian.
  • Meet body mass index (BMI > = 30.0 kg/m2) and C-reactive protein (CRP) criteria (> 2.0 mg/dl)
  • Post-menopausal (no menstruation in the past 12 months)
  • Weight stable (< 3% weight change in the past 3 months)
  • Non-smoker
  • No major medical problems
  • Have a working phone
  • No known allergies, intolerance, medical, secular or religious dietary restrictions

Exclusion Criteria:

  • Chronic constipation (less than three stools per week for several months)
  • History or intestinal cancer, inflammatory bowel disease, celiac disease, or malabsorptive bariatric surgery
  • Previous intestinal surgery
  • H pylori infection or taking H2 blockers (e.g., Zantac, Pepcid) /antacids (e.g., Rolaids) more than 3 times per week
  • Significant blood loss or blood donation in past 3 months
  • Active gastrointestinal bleed
  • Any surgery in the past 3 months
  • Hemochromatosis
  • Sickle cell disease
  • Hereditary polyposis
  • Rheumatoid arthritis
  • Type I or Type II diabetes
  • Smoker
  • Antibiotic use in the past 2 months
  • Excessive alcohol consumption [> 2 standard alcoholic drinks (12 ounces of beer, 5 ounces of wine, 1 shot of hard liquor) per day]
  • Aspirin use >81 mg/day OR >325 mg/every other day
  • Regularly taking probiotics, fiber supplements, Orlistat (over the counter brand name: Alli), or steroids (inhaled or oral)

Sites / Locations

  • University of Illinois at Chicago

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

High heme iron diet

Low iron diet

Plant-based high non-heme iron diet

Arm Description

Outcomes

Primary Outcome Measures

Change in colonic inflammation
Fecal calprotectin, a proxy for colon tissue inflammation, will be measured from stool an calprotectin immunoassay

Secondary Outcome Measures

Change in systemic inflammation
Circulating C-reactive protein, Interleukin-6 (IL-6) and Tumor necrosis factor-alpha (TNF-a) will be measured from serum using immunoassays.
Change in stool microbial community profile at the phylum and genus level
Stool samples to analyze the composition of the microbiota, extracted bacterial genomic DNA will be used as a template for polymerase chain reactions targeting the V4 variable regions of the 16S ribosomal ribonucleic acid gene. Amplicons generated from polymerase chain reaction will be run on the Illumina MiSeq sequencing platform to profile microbial communities at the phylum and genus level.
Change in serum hepcidin
Serum hepcidin will be measured using an immunoassay

Full Information

First Posted
May 7, 2018
Last Updated
September 25, 2019
Sponsor
University of Illinois at Chicago
Collaborators
American Cancer Society, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03548948
Brief Title
Obesity, Iron Regulation and Colorectal Cancer Risk
Official Title
Obesity, Iron Regulation and Colorectal Cancer Risk
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
July 15, 2015 (Actual)
Primary Completion Date
November 2018 (Actual)
Study Completion Date
June 30, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Illinois at Chicago
Collaborators
American Cancer Society, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Obesity is an independent risk factor for colorectal cancer (CRC) although the underlying mechanisms have not been elucidated. Dietary nutrients play a key role in both the prevention and promotion of CRC. While iron is an essential nutrient, excess iron is associated with carcinogenesis. Unlike the systemic compartment, the intestinal lumen lacks an efficient system to regulate iron. In conditions when dietary iron malabsorption and intestinal inflammation co-exist, greater luminal iron is associated with increased intestinal inflammation and a shift in the gut microbiota to more pro-inflammatory strains. However, treatments designed to reduce luminal, including diet restriction and chelation, are associated with lower intestinal inflammation and the colonization of protective gut microbes. Obesity is associated with inflammation-induced, hepcidin-mediated, iron metabolism dysfunction characterized by iron deficiency and dietary iron malabsorption. Obesity is also linked to intestinal inflammation. Currently, there is a fundamental gap in understanding how altered iron metabolism impacts CRC risk in obesity. The investigator's objective is to conduct a crossover controlled feeding trial of: 1) a "Typical American" diet with "high" heme/non-heme iron", 2) a "Typical American" diet with "low" iron, and 3) a Mediterranean diet with "high" non heme iron and examine effects on colonic and systemic inflammation and the gut microbiome.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colon Inflammation, Iron Malabsorption, Obesity, Diet Modification

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Typical American Diet with "high" heme/non-heme iron (16 mg) Typical American Diet with "low" iron (8 mg) Plant-based Diet with "high" non-heme iron (16 mg)
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
High heme iron diet
Arm Type
Other
Arm Title
Low iron diet
Arm Type
Other
Arm Title
Plant-based high non-heme iron diet
Arm Type
Other
Intervention Type
Other
Intervention Name(s)
High heme iron diet
Intervention Description
A "Typical American" diet with "high" heme/non-heme iron" (18 mg total). Diet is isocaloric and has a macronutrient composition of total fat 35%, carbohydrates 50%, protein 15% of calories and fiber 9g/1000 calories. Subjects consumes the diet for 3 weeks with a minimum 3 week washout before the next diet.
Intervention Type
Other
Intervention Name(s)
Low iron diet
Intervention Description
A "Typical American" diet with "low" heme/non-heme iron" (8 mg total). Diet is isocaloric and has a macronutrient composition of total fat 35%, carbohydrates 50%, protein 15% of calories and fiber 9g/1000 calories. Subjects consumes the diet for 3 weeks with a minimum 3 week washout before the next diet.
Intervention Type
Other
Intervention Name(s)
Plant-based high non-heme iron diet
Intervention Description
A plant-based diet with "high" non-heme iron" (18 mg total). Diet is isocaloric and has a macronutrient composition of total fat 35%, carbohydrates 50%, protein 15% of calories and fiber 9g/1000 calories. Subjects consumes the diet for 3 weeks with a minimum 3 week washout before the next diet.
Primary Outcome Measure Information:
Title
Change in colonic inflammation
Description
Fecal calprotectin, a proxy for colon tissue inflammation, will be measured from stool an calprotectin immunoassay
Time Frame
Baseline and post-diet (day 22) for each of the three 3-week diets
Secondary Outcome Measure Information:
Title
Change in systemic inflammation
Description
Circulating C-reactive protein, Interleukin-6 (IL-6) and Tumor necrosis factor-alpha (TNF-a) will be measured from serum using immunoassays.
Time Frame
Baseline and post-diet (day 22) for each of the three 3-week diets
Title
Change in stool microbial community profile at the phylum and genus level
Description
Stool samples to analyze the composition of the microbiota, extracted bacterial genomic DNA will be used as a template for polymerase chain reactions targeting the V4 variable regions of the 16S ribosomal ribonucleic acid gene. Amplicons generated from polymerase chain reaction will be run on the Illumina MiSeq sequencing platform to profile microbial communities at the phylum and genus level.
Time Frame
Baseline and post-diet (day 22) for each of the three 3-week diets
Title
Change in serum hepcidin
Description
Serum hepcidin will be measured using an immunoassay
Time Frame
Baseline and post-diet (day 22) for each of the three 3-week diets

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Self-identify as Hispanic, African American, or Caucasian. Meet body mass index (BMI > = 30.0 kg/m2) and C-reactive protein (CRP) criteria (> 2.0 mg/dl) Post-menopausal (no menstruation in the past 12 months) Weight stable (< 3% weight change in the past 3 months) Non-smoker No major medical problems Have a working phone No known allergies, intolerance, medical, secular or religious dietary restrictions Exclusion Criteria: Chronic constipation (less than three stools per week for several months) History or intestinal cancer, inflammatory bowel disease, celiac disease, or malabsorptive bariatric surgery Previous intestinal surgery H pylori infection or taking H2 blockers (e.g., Zantac, Pepcid) /antacids (e.g., Rolaids) more than 3 times per week Significant blood loss or blood donation in past 3 months Active gastrointestinal bleed Any surgery in the past 3 months Hemochromatosis Sickle cell disease Hereditary polyposis Rheumatoid arthritis Type I or Type II diabetes Smoker Antibiotic use in the past 2 months Excessive alcohol consumption [> 2 standard alcoholic drinks (12 ounces of beer, 5 ounces of wine, 1 shot of hard liquor) per day] Aspirin use >81 mg/day OR >325 mg/every other day Regularly taking probiotics, fiber supplements, Orlistat (over the counter brand name: Alli), or steroids (inhaled or oral)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lisa Tussing-Humphreys, PhD, MS, RD
Organizational Affiliation
University of Illinois at Chicago
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Illinois at Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60608
Country
United States

12. IPD Sharing Statement

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Obesity, Iron Regulation and Colorectal Cancer Risk

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