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Dietary Carbohydrate Type and Cardiovascular Disease (CVD) Risk Indicators

Primary Purpose

Dyslipidemia

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Diet
Sponsored by
Tufts University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dyslipidemia focused on measuring carbohydrate, inflammation, glucose homeostasis, gene expression

Eligibility Criteria

50 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • LDL cholesterol (>100 mg/dL)
  • > 50 years (all females postmenopausal, as defined by complete natural cessation of menses for > 12 months or a bilateral oophorectomy)
  • BMI > 25 and < 35 kg/m2
  • Normal kidney function as assessed by serum creatinine and blood urea nitrogen
  • Normal liver function as assessed by serum glutamic oxaloacetic transaminase and alkaline phosphatase
  • Normal thyroid function as assessed by serum thyroid stimulating hormone concentrations
  • Normal gastrointestinal function
  • Fasting plasma glucose concentrations < 120 mg/dL
  • Normotensive with or without medication
  • Non-smoker for at least 12 months
  • Alcohol intake of less than 7 drinks per week
  • Consistent physical activity pattern

Exclusion Criteria:

  • < 50 years old
  • BMI < 25 and > 35 kg/m2
  • LDL cholesterol <100 mg/dL
  • Abnormal fasting plasma glucose levels >120 mg/dL
  • Use of medications known to affect lipid metabolism:

    • Bile Acid Sequestrants (Cholestyramine, Colestipol, Colesevelam, etc.)
    • Cholesterol Absorption Inhibitors (Ezetimibe [Zetia])
    • Nicotinic Acid Agents (Niacin, Niacor, Slo-Niacin, etc)
    • Fibrates (Gemfibrozil [Lopid], Ciprofibrate, Fenofibrate [Tricor], etc)
    • Probucol
  • Use of anticoagulants (Coumadin, Heparin, Plavix, etc), anabolic steroids, and hydrocortisone
  • Use of hormone therapy medications containing estrogen
  • Use of fish oil / omega-3 supplements, and Metamucil (or fiber containing dietary supplements)
  • Any Aspirin, non-steroidal anti-inflammatory drugs (NSAID) or antihistamine use or therapies that cannot be discontinued by subject for 72 hours prior to blood draws and adipose tissue collection and any NSAIDS for 72 hours after the procedure for obtaining adipose tissue sample
  • Established cardiovascular disease as defined by history of myocardial infarction, stroke, heart failure, coronary artery bypass graft, stenosis >50%, angina and peripheral arterial disease
  • Uncontrolled hypertension or high blood pressure reading at the discretion of the study physician or nurse
  • Renal or kidney disease, as defined by a history of chronic kidney disease or by glomerular filtration rate of < 60 ml.min/1.73 m2 calculated from screening blood tests
  • Liver disease, as defined by a history of chronic hepatitis B or C, cholestatic or cirrhotic liver disease, nonalcoholic fatty liver disease, elevations of serum glutamic-pyruvic transaminase (SGPT) or serum glutamic oxaloacetic transaminase (SGOT) greater than 1.5 times the upper limit of normal at screening, bilirubin greater than 2 mg/dL (in the absence of benign causes of elevated bilirubin such as Gilbert's syndrome) at screening, or albumin below the lower limit of normal
  • Hypothyroidism or hyperthyroidism, defined as screening TSH outside of normal ranges (<0.4 or >4.5), unless controlled with medication for at least 6 months
  • Type I and II diabetes
  • Gastrointestinal disease
  • Lidocaine Allergy
  • Smoking within the past 12 months.
  • Alcohol intake > 7 drinks per week or unwillingness to not consume alcohol while participating in the study
  • Unwillingness to maintain body weight during participation in the study
  • Unwillingness to adhere to diet and study protocol
  • Weight gain or loss of more than 15 lb within 6 months prior to enrollment
  • Non-English speaking subjects
  • No Social Security number
  • Food allergies or aversions
  • Blood donation within the past 8 weeks

Sites / Locations

  • Jean Mayer Human Nutrition Research Center on Aging

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

Unrefined-carbohydrate

Refined-carbohydrate

Simple-carbohydrate

Arm Description

unrefined carbohydrate diet

refined carbohydrate diet

simple carbohydrate diet

Outcomes

Primary Outcome Measures

fasting plasma lipid profile

Secondary Outcome Measures

glucose
insulin
adipose tissue inflammatory markers
gut microbiome
High-sensitivity C-reactive protein(hsCRP)
Interleukin 6 (IL-6)
Monocyte Chemoattractant Protein 1 (MCP-1)
Tumor necrosis factor-alpha (TNF-alpha)
Monocyte gene expression

Full Information

First Posted
November 7, 2011
Last Updated
July 12, 2018
Sponsor
Tufts University
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1. Study Identification

Unique Protocol Identification Number
NCT01610661
Brief Title
Dietary Carbohydrate Type and Cardiovascular Disease (CVD) Risk Indicators
Official Title
Dietary Carbohydrate Type and CVD Risk Indicators
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
January 2012 (undefined)
Primary Completion Date
April 2015 (Actual)
Study Completion Date
December 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tufts University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of this study is to determine the effect of habituation to diets with different types of carbohydrate (simple-carb, refined-carb, unrefined-carb) on selected Cardiovascular Disease (CVD) risk indicators.
Detailed Description
The objective of this pilot study is to determine the relative comparability for an isocaloric exchange of (1) refined-carb for simple-carb and (2) refined-carb for unrefined-carb, on established and emerging CVD risk indicators. To achieve this goal, subjects with moderate dyslipidemia (LDL cholesterol > 100mg/dL) will consume diets enriched in 3 types of carbohydrate (simple-carb, refined-carb and unrefined-carb) according to a randomized, cross-over design.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dyslipidemia
Keywords
carbohydrate, inflammation, glucose homeostasis, gene expression

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Investigator
Allocation
Randomized
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Unrefined-carbohydrate
Arm Type
Other
Arm Description
unrefined carbohydrate diet
Arm Title
Refined-carbohydrate
Arm Type
Other
Arm Description
refined carbohydrate diet
Arm Title
Simple-carbohydrate
Arm Type
Other
Arm Description
simple carbohydrate diet
Intervention Type
Other
Intervention Name(s)
Diet
Other Intervention Name(s)
simple carb, refined carb, unrefined carb
Intervention Description
Unrefined-carbohydrate refers to foods made with 100% whole grains (wheat, rice, corn). Refined-carbohydrate refers to foods made with white flour (e.g., bread, pasta) or white rice. Simple-carbohydrate refers to foods made with sucrose (50% glucose/50% fructose) and high-fructose corn syrup.
Primary Outcome Measure Information:
Title
fasting plasma lipid profile
Time Frame
15-week period
Secondary Outcome Measure Information:
Title
glucose
Time Frame
15 week period
Title
insulin
Time Frame
15-week period
Title
adipose tissue inflammatory markers
Time Frame
15-week period
Title
gut microbiome
Time Frame
15-week period
Title
High-sensitivity C-reactive protein(hsCRP)
Time Frame
15-week period
Title
Interleukin 6 (IL-6)
Time Frame
15-week period
Title
Monocyte Chemoattractant Protein 1 (MCP-1)
Time Frame
15-week period
Title
Tumor necrosis factor-alpha (TNF-alpha)
Time Frame
15-week period
Title
Monocyte gene expression
Time Frame
15-week period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: LDL cholesterol (>100 mg/dL) > 50 years (all females postmenopausal, as defined by complete natural cessation of menses for > 12 months or a bilateral oophorectomy) BMI > 25 and < 35 kg/m2 Normal kidney function as assessed by serum creatinine and blood urea nitrogen Normal liver function as assessed by serum glutamic oxaloacetic transaminase and alkaline phosphatase Normal thyroid function as assessed by serum thyroid stimulating hormone concentrations Normal gastrointestinal function Fasting plasma glucose concentrations < 120 mg/dL Normotensive with or without medication Non-smoker for at least 12 months Alcohol intake of less than 7 drinks per week Consistent physical activity pattern Exclusion Criteria: < 50 years old BMI < 25 and > 35 kg/m2 LDL cholesterol <100 mg/dL Abnormal fasting plasma glucose levels >120 mg/dL Use of medications known to affect lipid metabolism: Bile Acid Sequestrants (Cholestyramine, Colestipol, Colesevelam, etc.) Cholesterol Absorption Inhibitors (Ezetimibe [Zetia]) Nicotinic Acid Agents (Niacin, Niacor, Slo-Niacin, etc) Fibrates (Gemfibrozil [Lopid], Ciprofibrate, Fenofibrate [Tricor], etc) Probucol Use of anticoagulants (Coumadin, Heparin, Plavix, etc), anabolic steroids, and hydrocortisone Use of hormone therapy medications containing estrogen Use of fish oil / omega-3 supplements, and Metamucil (or fiber containing dietary supplements) Any Aspirin, non-steroidal anti-inflammatory drugs (NSAID) or antihistamine use or therapies that cannot be discontinued by subject for 72 hours prior to blood draws and adipose tissue collection and any NSAIDS for 72 hours after the procedure for obtaining adipose tissue sample Established cardiovascular disease as defined by history of myocardial infarction, stroke, heart failure, coronary artery bypass graft, stenosis >50%, angina and peripheral arterial disease Uncontrolled hypertension or high blood pressure reading at the discretion of the study physician or nurse Renal or kidney disease, as defined by a history of chronic kidney disease or by glomerular filtration rate of < 60 ml.min/1.73 m2 calculated from screening blood tests Liver disease, as defined by a history of chronic hepatitis B or C, cholestatic or cirrhotic liver disease, nonalcoholic fatty liver disease, elevations of serum glutamic-pyruvic transaminase (SGPT) or serum glutamic oxaloacetic transaminase (SGOT) greater than 1.5 times the upper limit of normal at screening, bilirubin greater than 2 mg/dL (in the absence of benign causes of elevated bilirubin such as Gilbert's syndrome) at screening, or albumin below the lower limit of normal Hypothyroidism or hyperthyroidism, defined as screening TSH outside of normal ranges (<0.4 or >4.5), unless controlled with medication for at least 6 months Type I and II diabetes Gastrointestinal disease Lidocaine Allergy Smoking within the past 12 months. Alcohol intake > 7 drinks per week or unwillingness to not consume alcohol while participating in the study Unwillingness to maintain body weight during participation in the study Unwillingness to adhere to diet and study protocol Weight gain or loss of more than 15 lb within 6 months prior to enrollment Non-English speaking subjects No Social Security number Food allergies or aversions Blood donation within the past 8 weeks
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alice H. Lichtenstein, D.Sc.
Organizational Affiliation
Tufts University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jean Mayer Human Nutrition Research Center on Aging
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
32936872
Citation
Faits T, Walker ME, Rodriguez-Morato J, Meng H, Gervis JE, Galluccio JM, Lichtenstein AH, Johnson WE, Matthan NR. Exploring changes in the human gut microbiota and microbial-derived metabolites in response to diets enriched in simple, refined, or unrefined carbohydrate-containing foods: a post hoc analysis of a randomized clinical trial. Am J Clin Nutr. 2020 Dec 10;112(6):1631-1641. doi: 10.1093/ajcn/nqaa254.
Results Reference
derived
PubMed Identifier
29982704
Citation
Meng H, Matthan NR, Fried SK, Berciano S, Walker ME, Galluccio JM, Lichtenstein AH. Effect of Dietary Carbohydrate Type on Serum Cardiometabolic Risk Indicators and Adipose Tissue Inflammatory Markers. J Clin Endocrinol Metab. 2018 Sep 1;103(9):3430-3438. doi: 10.1210/jc.2018-00667.
Results Reference
derived

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Dietary Carbohydrate Type and Cardiovascular Disease (CVD) Risk Indicators

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