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Metabolic SyndromeNCT01793896

Beneficial Effects of Exercise and Healthy Diets on Muscle and Adipose Tissue

A study testing Diet Group, Exercise group and Diet + Exercise in people with Metabolic Syndrome, run by University of Chile at 1 site in Chile.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Both dietary caloric restriction (CR) and physical exercise (PE) exert beneficial effects, which retard or prevent age-related diseases and prolong life span. Subjects with the metabolic syndrome age prematurely, therefore preventive measures should be initiated early. Read more about this study

Who is it for?
Ages 25 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Metabolic Syndrome
What is being tested?
Diet Group, Exercise group and Diet + Exercise
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
83 participants
Where
1 siteChile
Study dates
Jul 2013to Oct 2016
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • CROSS SECTIONAL: male sex, age 25 -50 years, with BMI ranging from 20 to 35 kg/mt2. INTERVENTION STUDY: Overweight or obese men and women aged 25 - 50 years interested in losing weight,will

Who cannot join

  • CROSS SECTIONAL : diabetes mellitus, chronic neuromuscular or neurological deficits precluding normal physical activity, heavy smoking (> 5 cigarettes per day), alcohol intake > 30 g/day and chronic diseases such as cancer, HIV-AIDS, renal, pulmonary, cardiac or hepatic conditions.
  • INTERVENTION STUDY: weight fluctuations (> 3 k in the last 3 months), diabetes mellitus, chronic neuromuscular or neurologic diseases, heavy smoking (> 5 cigarettes per day) and alcohol intake > 30 g/day, and chronic diseases such as cancer, HIV, renal, pulmonary, cardiac or hepatic conditions.
  • -

Trial locations and contacts

1 site in 1 country.

Chile1 site
  • Institute of Nutrition & Food Technology (INTA)

    Santiago, Metropolitan Region, 7830490

Other trials in Chile

About this study

Official title: Mitochondrial Biogenesis, Reduction of Muscle Oxidative Damage and Improvement in Adipose Tissue Functional Profile, Account for the Beneficial Effects of Exercise and Healthy Diets

Both dietary caloric restriction (CR) and physical exercise (PE) exert beneficial effects, which retard or prevent age-related diseases and prolong life span. Subjects with the metabolic syndrome age prematurely, therefore preventive measures should be initiated early. The present study intends to demonstrate that physical exercise and/or Mediterranean diet, in middle aged volunteers with the metabolic syndrome, preserve adequate adipose tissue functionality and retard skeletal muscle aging (assessed by mitochondrial biogenesis and accumulation of ROS), by activating several pathways, homologous to CR. The investigators plan to study this by using two approaches: 1) A cross- sectional model, in which the expression of the mentioned metabolic mediators, indicators of muscle mitochondrial biogenesis and muscle oxidative damage will be compared between men with different body compositions, fat distribution, muscle strength and exercise capacity (VO2max). Also, in these men the investigators will assess the expression of uncoupling protein 1 (UCP1) in subcutaneous white adipose tissue (as a measure of adaptive thermogenesis), and inflammatory markers (Interleukin 1-6, Interleukin 1ß and CCL2 chemokine (C-C motif ligand 2)) in preperitoneal adipose tissue, plus inflammation and adipogenesis potential of their cultured preadipocytes. Moreover, in vitro studies will evaluate the functional effects of exposure of a cell lyne of human adipocyte cells (LS14)to factors secreted by media conditioned by the patients´ adipose tissue explants. 2) A prospective intervention in overweight/moderately obese middle aged volunteers that will be assigned to a weight-maintenance period (as a control group), and then randomly y assigned to a Mediterranean diet, exercise training or diet plus training. Before and after 3 months of intervention the investigators will obtain muscle tissue samples to study the expression of Peroxisome proliferator activated receptor (PPAR) gamma coactivator 1 alpha (PGC1), uncoupling protein 3 (UCP3), AMP activated protein kinase (AMPK), Sirtuin 1 (SIRT-1), mitochondrial DNA and oxidative damage indicators (8-oxo-7,8-dihydro-2-deoxyguanosine (oxodG), carboxymethyllysine (CML and its receptor (RAGE)). In vitro studies will evaluate the effect of circulating factors from the patients (serum) on LS14 inflammatory and adipogenic potential, at baseline and after 3 months of intervention.

Read the detailed description

METHODOLOGY:

This study will be composed of 2 parts:

I - CROSS SECTIONAL STUDY The aim of this section is to compare men with different body compositions, fat distribution and exercise capacity with respect to their muscle mitochondrial biogenesis, oxidative damage and energy flux regulator molecules, together with their adipose tissue inflammation, adipokine expression and thermogenic potential.

Inclusion criteria :

  • male sex
  • age 25 - 50 years
  • BMI from 20 - 35 kg/mt2
  • indication for surgery of an inguinal hernia

Exclusion criteria:

  • diabetes mellitus
  • chronic neuromuscular or neurological deficits precluding normal physical activity
  • heavy smoking (> 5 cigarettes per day)
  • alcohol intake > 30 g/day
  • chronic diseases such as cancer, HIV-AIDS, renal, pulmonary, cardiac or hepatic conditions.

Before the operation and after signing a written informed consent, the following assessment will be performed:

  1. Medical history including medication intake and complete physical examination.
  2. Dietary recall of habitual intake and calculation of AGEs ingestion.
  3. Regular physical activity assessment using the International Physical Activity Questionnaire
  4. Anthropometrics (height, weight, waist circumference)
  5. Fasting blood sampling for routine determinations (haemoglobin,lipoproteins, creatinine,prothrombin, TSH), AGEs concentrations (CML) free fatty acids, adiponectin and 8- Isoprostanes.
  6. Fasting and post glucose serum sampling for glucose and insulin measurements, and calculation of Homeostasis Model Assessment (HOMA-IR) and the Matsuda Index for determination of peripheral insulin sensitivity.
  7. Resting and exercise indirect calorimetry for estimation of resting energy expenditure, respiratory quotient and VO2 max.
  8. Handgrip and quadriceps muscle strength
  9. Dual X-Ray Energy Densitometry (DEXA) for estimation of body composition
  10. CT scan of abdominal region at L4 level for measurement of visceral and subcutaneous fat areas and estimation of liver fat infiltration.
  11. Ultrasound intensity analysis in thigh ultrasonography indicating muscle fat infiltration. After the initial evaluation, subjects will be classified as with or without the metabolic syndrome, according to the international guidelines guidelines, for further analysis of data.

A few days later, during the surgical procedure, a sample of muscle tissue (approximately 200 mg of internal abdominal oblique) will be obtained for measurement of:

  1. Fiber type
  2. Messenger Ribonucleic acid (mRNA) expression of PGC-1-alpha, SIRT-1, UCP-3 and AMPK
  3. Mitochondrial density by measurement of mitDNA and Cytochrome C activity
  4. Oxidative damage (8-oxodG, CML and RAGE).

During the same operation, 2 samples of adipose tissue will also be obtained, one subcutaneous (at the site of the incision) and the other preperitoneal (at the inguinal sac), for in vitro studies:

  1. UCP1 and inflammatory marker (interleukin 6, 1ß, CCL2) expression in mature adipocytes
  2. Inflammatory profile and adipogenic potential (expression of lipoprotein lipase, PPAR gamma and adiponectin) in cultured preadipocytes
  3. Adipogenic potential and inflammatory expression profile of LS14 adipose cells exposed to conditioned media from adipose tissue explants.

A small part of these adipose tissue samples will be placed in formaldehyde, fixed and stained with H.E for histologic estimation of adipocyte cell size.

II - INTERVENTION STUDY This section intends to demonstrate the effects of a low-AGEs Mediterranean diet and/or exercise, over skeletal muscle metabolic profile and adipogenic/inflammatory features of adipocytes.

Inclusion criteria:

  • Overweight or obese men and women
  • Ages 25 - 50 years
  • Interest in losing weight

Exclusion criteria:

  • weight fluctuations (> 3 k in the last 3 months)
  • diabetes mellitus
  • chronic neuromuscular or neurologic diseases
  • heavy smoking (> 5 cigarettes per day)
  • alcohol intake > 30 g/day
  • chronic diseases such as cancer, HIV, renal, pulmonary, cardiac or hepatic conditions.

Subjects will be invited to participate in a trial using a Mediterranean low-AGEs diet and/or physical exercise during 3 months. After signing a written informed consent,subjects will be allocated to one of these interventions, which will be randomly selected, and the following assessment will be performed, at baseline and after 3 months of intervention:

  1. Medical and medication intake history and complete physical examination.
  2. Dietary recall of habitual intake and calculation of AGEs ingestion.
  3. Physical activity questionnaire (IPAQ)
  4. Anthropometrics (height, weight, waist circumference)
  5. Fasting blood sampling for routine determinations (haemoglobin, lipoproteins, creatinine, prothrombin and TSH), AGEs concentrations (CML), free fatty acids, adiponectin, 8-Isoprostanes and serum for in vitro adipose tissue studies (see below).
  6. Fasting and post glucose blood sampling for glucose and insulin measurements, and calculation of HOMA-IR and the Matsuda Index for determination of peripheral insulin sensitivity.
  7. Dual X-Ray Energy Densitometry (DEXA) for estimation of body composition
  8. CT scan of abdominal region at L4 level for measurement of visceral and subcutaneous fat areas and estimation of liver fat infiltration
  9. Resting and exercise indirect calorimetry for estimation of resting energy expenditure, respiratory quotient and VO2 max.
  10. Handgrip and quadriceps muscle strength
  11. Ultrasound intensity analysis in thigh indicating muscle fat infiltration
  12. Ultrasound guided quadriceps muscle biopsy to measure mitochondrial density (mitDNA) and expression of PGC-1
Being tested
Control period, Diet Group, Exercise group, Diet + Exercise
Keywords
Metabolic syndrome, Ageing, Mitochondrial density, Oxidative damage, Inflammatory mediators, AMPK, Adipogenesis
Medical subject headings
Metabolic Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Control periodBehavioural

    Also called Before randomization

    Analysis at recruitment and after a month without any intervention

  • Diet GroupBehavioural

    Also called Mediterranean diet

    selected subjects will adopt a Mediterranean low-AGE diet. We will not include red wine in the Mediterranean diet (7 Kilocalories (KCal)/g), in order to attain more weight loss. Each subject will be instructed to reduce 500 Kcal of their estimated total daily energy requirements, so theoretically they will be able to reduce 5 - 10 % of their body weight in 3 months.

  • Exercise groupBehavioural

    The intervention will consist of 3 weekly 1 hour sessions (5 minutes of preconditioning, followed by 20 minutes cycling, brisk walking or jogging at 65-70 % maximal aerobic capacity, then 25 minutes resistance weight-lifting exercises and finally 10 minutes of stretching). Exercise intensity will be increased weekly according to the Borg Scale intensity. The exercise intervention will be supervised by physical education teachers, registering attendance at every session.

  • Diet + ExerciseBehavioural

    these patients will be incorporated to receive both Mediterranean diet plus exercise interventions

Study groups in NCT01793896
Study groupRoleWhat they receive
control periodSham comparatorcontrol period with no intervention. Comparison of parameters at entrance and one month later without any intervention
Receives: Behavioral: Control period
Diet groupExperimentalMediterranean diet prescription during 3 months
Receives: Behavioral: Diet Group
Exercise groupExperimentalSubjects will be trained 3 times a week during 3 months
Receives: Behavioral: Exercise group
Diet + ExerciseExperimentalBoth a dietary prescription plus exercise training during 3 months
Receives: Behavioral: Diet + Exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in mitochondrial density in muscle tissue

    As described in the methodology section

    Measured: 3 months

Secondary outcomes (1)
  1. Change in Oxidative damage in muscle tissue

    As described in the methodology section

    Measured: 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Feb 2013 (estimated)
  2. Study startJul 2013
  3. Primary completionOct 2016
  4. Study completionOct 2016

Why it stopped: Serious difficulties for patient recruitment to recruit patients

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
After a placebo phase with no intervention in the first 25 subjects recruited, overweight or obese patients were randomly assigned to one of 3 treatments: hypocaloric diet, high intensity interval training or both interventions simultaneously, for 3 months.
Masking
None (open label)
Enrolment
83 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01793896
Sponsor's protocol ID
Fondecyt 1130284
Other IDs
INSTITUTE OF NUTRITION 2013
Status last verified
Feb 2018
First submitted
11 Feb 2013
Last updated
14 Feb 2018
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A study testing Diet Group, Exercise group and Diet + Exercise in people with Metabolic Syndrome, run by University of Chile at 1 site in Chile.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 14 Feb 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Chile. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Serious difficulties for patient recruitment to recruit patients). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in mitochondrial density in muscle tissue (time frame: 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Feb 2018.

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