Trial of Two Dietary Programs on Cardiometabolic Risk Factors in Subjects With Metabolic Syndrome (HMS4)
Primary Purpose
Metabolic Syndrome, Overweight, Obesity
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
UltraMealPlus 360 (Medical food)
Low-glycemic-load diet
Sponsored by
About this trial
This is an interventional treatment trial for Metabolic Syndrome focused on measuring Metabolic syndrome, Serum lipid, Dietary intervention, Lifestyle modification, Glycemic load, Phytochemical, Hops, Acacia, Mediterranean diet, Kinase modulator
Eligibility Criteria
Inclusion Criteria:
- BMI ≥25 and <45
- LDL >100 mg/dl
- TG ≥150 and <400 mg/dl
meet 2 or more of the following 4 criteria:
- HDL <50 mg/dl
- blood pressure ≥130/85 mmHg (or diagnosed hypertension on medication)
- fasting glucose ≥100 mg/dl and <150 mg/dl
- waist circumference >35 inches
Exclusion Criteria:
Medical History and Concurrent Diseases
- Over the preceding 4 weeks, initiation or cessation of regular exercise
- Over the preceding 4 weeks, involvement in a significant diet or weight loss program such as Atkin's diet program, a very low calorie liquid program (such as Optifast, Medifast, and HMR), or any diet that has led to a weight loss of 10% of body weight over a period of 6 weeks
- Use of blood sugar lowering medications including thiazolidinedione class of oral medications including Avandia (rosiglitazone), Avandamet (metformin/rosiglitazone), Actos (pioglitazone), metformin (Glucophage, Fortamet, Riomet) or insulin over the preceding 12 weeks
- Over the preceding 4 weeks, regular use of Kaprex® or Kaprex AI® at least 3 days/week
- Over the preceding 4 weeks, regular use of NSAIDs (i.e. ibuprofen, celecoxib, etc.) at least 3 days per week
- Over the preceding 12 weeks, use of cholesterol lowering medications, either by prescription (statins, etc.) or over-the-counter (gugulipids, niacin, etc.)
- Over the preceding 12 weeks, use of oral or injectable corticosteroids, such as prednisone
- Current use of oral anticoagulants such as Coumadin or injectable anticoagulants such as Heparin or Low Molecular Weight Heparin
- Use of electronic implants such as pacemakers, defibrillators, nerve stimulators
- Allergy to one or more of the ingredients in the investigational products
- Poorly controlled hypertension (blood pressure above 155/95)
- History of significant liver or kidney disease (recent or ongoing hepatitis, cirrhosis, glomerulonephritis, dialysis treatment, etc.)
- History of serious heart disease (heart attack, angina, cardiac surgery, arrhythmia, or congestive heart failure)
- History of deep vein thrombosis or pulmonary embolus (blood clot to lungs)
- History of autoimmune diseases such as inflammatory bowel disease (Crohn's disease, and/or ulcerative colitis), multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, polymyositis, scleroderma and thyroiditis
- History of eating disorder (anorexia nervosa or bulimia) in preceding 5 years
- History of alcoholism or drug addiction in the preceding 5 years
- History of serious mental illness
- History of attempted suicide in past 10 years
- Untreated endocrine, neurological, or infectious disorder
- Diagnosis of Human Immunodeficiency Virus (HIV) or Acquired HIV (AIDS)
- Current cancer or a history of cancer (except skin cancer)
- Pregnancy or lactation
- If female of childbearing potential, unwillingness to practice a reliable method of birth control (i.e. physical sperm barriers or hormonal therapies)
- Any other sound medical, psychiatric and/or social reason as determined by the Principal Investigator (PI).
Physical and Laboratory Test Findings
- TG ≥ 400 mg/dl
- abnormal blood count (Hct < 30 or > 47%, WBC < 3,000 or > 12,000, platelets <140 or > 500)
- abnormal kidney function test(s) (BUN > 30 mg/dL or creatinine > 1.5 mg/dL) or liver function test(s) (bilirubin total > 2.0 mg/dL, ALT > 75 IU/L, AST > 75 IU/L; Alk Phos > 130 IU)
- fasting glucose >150 mg/dL, serum calcium (>10.5 mg/dL), positive pregnancy test (ß-hCG in blood)
Sites / Locations
- Mark McIntosh MD
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Low-glycemic-load diet
Low-glycemic-load diet + medical food
Arm Description
Modified Mediterranean-style low-glycemic-load diet
Modified Mediterranean-style, low-glycemic-load diet + medical food
Outcomes
Primary Outcome Measures
TG-to-HDL ratio
Secondary Outcome Measures
Components of metabolic syndrome (TG, HDL, resolution of MetS)
Glucose intolerance (fasting glucose/insulin, leptin, HbA1c, HOMA score)
CVD risk factors (cholesterol, LDL, chol/HDL, apoAI, apoB, apoAII, apoCII, apoCIII, apoE, homocysteine, RBC fatty acids, Framingham risk score)
Inflammatory cytokines (TNF-alpha, IL-6, sICAM, sVCAM, MCP1)
Body composition (weight, BMI, % body fat, % lean mass, waist-to-hip ratio, DEXA scanning)
Subjective assessment (MOS-MCS/PCS questionnaires, VAS-satiety/craving questionnaires)
Full Information
NCT ID
NCT01010841
First Posted
November 6, 2009
Last Updated
January 11, 2012
Sponsor
MetaProteomics LLC
Collaborators
University of Florida, University of Connecticut, University of California, Irvine
1. Study Identification
Unique Protocol Identification Number
NCT01010841
Brief Title
Trial of Two Dietary Programs on Cardiometabolic Risk Factors in Subjects With Metabolic Syndrome
Acronym
HMS4
Official Title
Multi-center, Randomized Intervention to Compare the Effects of 2 Dietary Programs on Cardiometabolic Risk Factors in Subjects With Metabolic Syndrome
Study Type
Interventional
2. Study Status
Record Verification Date
January 2012
Overall Recruitment Status
Completed
Study Start Date
August 2008 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
April 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MetaProteomics LLC
Collaborators
University of Florida, University of Connecticut, University of California, Irvine
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective of this study was to investigate from 3 sites (University of Connecticut, University of Florida, and University of California, Irvine) whether enhancement of a modified Mediterranean-style, low glycemic load diet (MED) with specific phytochemicals (soy protein, phytosterols, rho iso-alpha acids and proanthocyanidins; PED) could improve cardiometabolic risk factors in women with metabolic syndrome.
Detailed Description
As the worldwide dietary pattern becomes more westernized, the metabolic syndrome is reaching epidemic proportions. Lifestyle modifications including diet and exercise are recommended as first-line intervention for treating metabolic syndrome. Previously, we reported that specific phytochemical supplementation for 12 weeks (soy protein, phytosterols, rho iso-alpha acids and proanthocyanidins) increased the effectiveness of the modified Mediterranean-style low glycemic load dietary program on variables associated with metabolic syndrome and CVD in subjects with metabolic syndrome and elevated LDL cholesterol. In this study, we propose to conduct a multi-center randomized trial to confirm our previous findings.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome, Overweight, Obesity, Hypercholesterolemia
Keywords
Metabolic syndrome, Serum lipid, Dietary intervention, Lifestyle modification, Glycemic load, Phytochemical, Hops, Acacia, Mediterranean diet, Kinase modulator
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
89 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Low-glycemic-load diet
Arm Type
Active Comparator
Arm Description
Modified Mediterranean-style low-glycemic-load diet
Arm Title
Low-glycemic-load diet + medical food
Arm Type
Experimental
Arm Description
Modified Mediterranean-style, low-glycemic-load diet + medical food
Intervention Type
Dietary Supplement
Intervention Name(s)
UltraMealPlus 360 (Medical food)
Other Intervention Name(s)
UltraMealPlus 360
Intervention Description
Specific phytochemicals (soy protein, phytosterols, rho iso-alpha acids and proanthocyanidins; PED)
Intervention Type
Other
Intervention Name(s)
Low-glycemic-load diet
Intervention Description
Modified Mediterranean-style low-glycemic-load diet
Primary Outcome Measure Information:
Title
TG-to-HDL ratio
Time Frame
Baseline, 8 weeks, 12 weeks
Secondary Outcome Measure Information:
Title
Components of metabolic syndrome (TG, HDL, resolution of MetS)
Time Frame
Baseline, 8 weeks, 12 weeks
Title
Glucose intolerance (fasting glucose/insulin, leptin, HbA1c, HOMA score)
Time Frame
Baseline, 8 weeks, 12 weeks
Title
CVD risk factors (cholesterol, LDL, chol/HDL, apoAI, apoB, apoAII, apoCII, apoCIII, apoE, homocysteine, RBC fatty acids, Framingham risk score)
Time Frame
Baseline, 8 weeks, 12 weeks
Title
Inflammatory cytokines (TNF-alpha, IL-6, sICAM, sVCAM, MCP1)
Time Frame
Baseline, 8 weeks, 12 weeks
Title
Body composition (weight, BMI, % body fat, % lean mass, waist-to-hip ratio, DEXA scanning)
Time Frame
Baseline, 8 weeks, 12 weeks
Title
Subjective assessment (MOS-MCS/PCS questionnaires, VAS-satiety/craving questionnaires)
Time Frame
baseline, then every 2 weeks
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
BMI ≥25 and <45
LDL >100 mg/dl
TG ≥150 and <400 mg/dl
meet 2 or more of the following 4 criteria:
HDL <50 mg/dl
blood pressure ≥130/85 mmHg (or diagnosed hypertension on medication)
fasting glucose ≥100 mg/dl and <150 mg/dl
waist circumference >35 inches
Exclusion Criteria:
Medical History and Concurrent Diseases
Over the preceding 4 weeks, initiation or cessation of regular exercise
Over the preceding 4 weeks, involvement in a significant diet or weight loss program such as Atkin's diet program, a very low calorie liquid program (such as Optifast, Medifast, and HMR), or any diet that has led to a weight loss of 10% of body weight over a period of 6 weeks
Use of blood sugar lowering medications including thiazolidinedione class of oral medications including Avandia (rosiglitazone), Avandamet (metformin/rosiglitazone), Actos (pioglitazone), metformin (Glucophage, Fortamet, Riomet) or insulin over the preceding 12 weeks
Over the preceding 4 weeks, regular use of Kaprex® or Kaprex AI® at least 3 days/week
Over the preceding 4 weeks, regular use of NSAIDs (i.e. ibuprofen, celecoxib, etc.) at least 3 days per week
Over the preceding 12 weeks, use of cholesterol lowering medications, either by prescription (statins, etc.) or over-the-counter (gugulipids, niacin, etc.)
Over the preceding 12 weeks, use of oral or injectable corticosteroids, such as prednisone
Current use of oral anticoagulants such as Coumadin or injectable anticoagulants such as Heparin or Low Molecular Weight Heparin
Use of electronic implants such as pacemakers, defibrillators, nerve stimulators
Allergy to one or more of the ingredients in the investigational products
Poorly controlled hypertension (blood pressure above 155/95)
History of significant liver or kidney disease (recent or ongoing hepatitis, cirrhosis, glomerulonephritis, dialysis treatment, etc.)
History of serious heart disease (heart attack, angina, cardiac surgery, arrhythmia, or congestive heart failure)
History of deep vein thrombosis or pulmonary embolus (blood clot to lungs)
History of autoimmune diseases such as inflammatory bowel disease (Crohn's disease, and/or ulcerative colitis), multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, polymyositis, scleroderma and thyroiditis
History of eating disorder (anorexia nervosa or bulimia) in preceding 5 years
History of alcoholism or drug addiction in the preceding 5 years
History of serious mental illness
History of attempted suicide in past 10 years
Untreated endocrine, neurological, or infectious disorder
Diagnosis of Human Immunodeficiency Virus (HIV) or Acquired HIV (AIDS)
Current cancer or a history of cancer (except skin cancer)
Pregnancy or lactation
If female of childbearing potential, unwillingness to practice a reliable method of birth control (i.e. physical sperm barriers or hormonal therapies)
Any other sound medical, psychiatric and/or social reason as determined by the Principal Investigator (PI).
Physical and Laboratory Test Findings
TG ≥ 400 mg/dl
abnormal blood count (Hct < 30 or > 47%, WBC < 3,000 or > 12,000, platelets <140 or > 500)
abnormal kidney function test(s) (BUN > 30 mg/dL or creatinine > 1.5 mg/dL) or liver function test(s) (bilirubin total > 2.0 mg/dL, ALT > 75 IU/L, AST > 75 IU/L; Alk Phos > 130 IU)
fasting glucose >150 mg/dL, serum calcium (>10.5 mg/dL), positive pregnancy test (ß-hCG in blood)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert H Lerman, MD/PhD
Organizational Affiliation
MetaProteomics LLC
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Mark McIntosh, MD
Organizational Affiliation
University of Florida
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Maria Luz Fernandez, PhD
Organizational Affiliation
University of Connecticut
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Wadie Najm, PhD
Organizational Affiliation
University of California at Irvine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mark McIntosh MD
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32209
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
21600524
Citation
Jones JL, Fernandez ML, McIntosh MS, Najm W, Calle MC, Kalynych C, Vukich C, Barona J, Ackermann D, Kim JE, Kumar V, Lott M, Volek JS, Lerman RH. A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism. J Clin Lipidol. 2011 May-Jun;5(3):188-196. doi: 10.1016/j.jacl.2011.03.002. Epub 2011 Mar 11.
Results Reference
result
PubMed Identifier
21286407
Citation
Fernandez ML, Jones JJ, Ackerman D, Barona J, Calle M, Comperatore MV, Kim JE, Andersen C, Leite JO, Volek JS, McIntosh M, Kalynych C, Najm W, Lerman RH. Low HDL cholesterol is associated with increased atherogenic lipoproteins and insulin resistance in women classified with metabolic syndrome. Nutr Res Pract. 2010 Dec;4(6):492-8. doi: 10.4162/nrp.2010.4.6.492. Epub 2010 Dec 28.
Results Reference
result
PubMed Identifier
21481713
Citation
Ackermann D, Jones J, Barona J, Calle MC, Kim JE, LaPia B, Volek JS, McIntosh M, Kalynych C, Najm W, Lerman RH, Fernandez ML. Waist circumference is positively correlated with markers of inflammation and negatively with adiponectin in women with metabolic syndrome. Nutr Res. 2011 Mar;31(3):197-204. doi: 10.1016/j.nutres.2011.02.004.
Results Reference
result
PubMed Identifier
21775117
Citation
Barona J, Jones JJ, Kopec RE, Comperatore M, Andersen C, Schwartz SJ, Lerman RH, Fernandez ML. A Mediterranean-style low-glycemic-load diet increases plasma carotenoids and decreases LDL oxidation in women with metabolic syndrome. J Nutr Biochem. 2012 Jun;23(6):609-15. doi: 10.1016/j.jnutbio.2011.02.016. Epub 2011 Jul 19.
Results Reference
result
PubMed Identifier
21944261
Citation
Jones JL, Comperatore M, Barona J, Calle MC, Andersen C, McIntosh M, Najm W, Lerman RH, Fernandez ML. A Mediterranean-style, low-glycemic-load diet decreases atherogenic lipoproteins and reduces lipoprotein (a) and oxidized low-density lipoprotein in women with metabolic syndrome. Metabolism. 2012 Mar;61(3):366-72. doi: 10.1016/j.metabol.2011.07.013. Epub 2011 Sep 23.
Results Reference
result
PubMed Identifier
22024489
Citation
Jones JL, Park Y, Lee J, Lerman RH, Fernandez ML. A Mediterranean-style, low-glycemic-load diet reduces the expression of 3-hydroxy-3-methylglutaryl-coenzyme A reductase in mononuclear cells and plasma insulin in women with metabolic syndrome. Nutr Res. 2011 Sep;31(9):659-64. doi: 10.1016/j.nutres.2011.08.011.
Results Reference
result
Citation
Jones JL, Ackermann D, Barona J, Calle M, Andersen C, Kim JE, Volek JS, McIntosh M, Najm W, Lerman RH, Fernandez ML. A Mediterranean low-glycemic-load diet alone or in combination with a medical food improves insulin sensitivity and reduces inflammation in women with metabolic syndrome. British Journal of Medicine & Medical Research 1(4):356-370, 2011.
Results Reference
result
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Trial of Two Dietary Programs on Cardiometabolic Risk Factors in Subjects With Metabolic Syndrome
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