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Digestive Health and Immune FunctionNCT01902394

The Addition of Whole Grains to the Diets of Adults: A Study of Digestive Health and Natural Defenses

A study testing Whole grains and Refined grains in people with Digestive Health and Immune Function, run by Tufts University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine if substituting whole grains for refined grains in the diets of healthy adults over a period of 6 weeks alters the composition of the bacteria in the gut, and has beneficial effects on immune function, digestive health, cardiovascular health, regulation of body weight and… Read more about this study

Who is it for?
Ages 40 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Digestive Health and Immune Function
What is being tested?
Whole grains and Refined grains
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
108 participants
Where
1 siteUnited States
Study dates
Jun 2012to Sep 2014
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 40 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

None listed.

Who cannot join

  • Self reported weight change >4kg within the past 3 months.
  • Have participated in a weight loss program within the last 3-months; eligible if in weight reduction program to maintain body weight.
  • Not willing to reduce habitual daily fiber intake (including prebiotics) within 2 wk prior to enrollment to < ~7g/1000kcal/d for men, or <~8g/1000kcal/d for women if currently consuming greater amounts.
  • Not willing to stop consumption of probiotic or prebiotic supplements within 2 weeks prior to start of study if currently taking these, as well as during study participation.
  • Vegetarian diet.
  • Not willing to stop taking multivitamins, and supplements (with the exception of vitamin D and calcium), including fish oil or n-3 fatty acids and herbal supplements, for 30 days prior to or during study participation, if currently taking these.
Show all 34Show fewer
  • Regular use of laxatives, stool softeners, or anti-diarrheal medications, and medications influencing food intake and/or appetite.
  • Not willing to undergo a 3-month washout period after colonoscopy prior to enrollment, and not willing to defer colonoscopy until after study completion.
  • Eating disorder within the past 10 years.
  • Disinhibited eating behavior as indicated by a score above 12 on the Three Factor Eating Questionnaire.
  • Food allergies or aversions or other issues with foods that would preclude use of study diets, including gluten, milk, nuts, or eggs.
  • Individuals identified during screening as having barriers expected to deter compliance with dietary requirements (e.g., stated dislike of study foods, inadequate resources to store and reheat meals, inability to adhere to food pick-up schedule).
  • Alcohol consumption >2 drinks per day.
  • Not willing to abstain from alcohol consumption during the study.
  • Smoking or using nicotine containing products in the last 6 months.
  • Use of aspirin, non-steroidal anti-inflammatory medications (NSAIDs) or antihistamine prescribed by a physician or clinician, or the inability to discontinue the use of these substances for 72 hrs before first day blood draw until 48 hrs after DTH implant (i.e. after second reading).
  • Use of anabolic steroids, insulin, growth hormone or testosterone.
  • Type I or type II diabetes.
  • Uncontrolled major illnesses. (Will include if stable on drugs used to control cardiovascular, liver, and renal diseases, asthma, and dysphagia).
  • Current use of proton pump inhibitors and H2 blockers to control acid-reflux/heart burn
  • Use of medications which interfere with energy metabolism including oral glycemic agents and insulin.
  • Uncontrolled hypertension as determined by study physician or nurse.
  • Use of immunosuppressive drugs.
  • Active cancer or current cancer diagnosis (except non-melanoma skin cancer).
  • Active infection within 2 weeks of study enrollment, blood draws or skin tests; however, may participate if admission is postponed or study activity is rescheduled > 2 weeks after resolution of symptoms.
  • Any antibiotic use within the past 3 months, except topical antibiotic use.
  • History of dysphagia, malabsorptive disorders, inflammatory bowel disease or other gastrointestinal disorders such as ulcerative colitis, Crohn's disease, celiac disease , chronic diarrhea or constipation.
  • Gastric bypass or other surgery for weight loss.
  • Splenectomy or partial splenectomy.
  • Autoimmune diseases such as rheumatoid arthritis and psoriasis. Autoimmune thyroid disease that has been treated and with stable replacement doses is not an exclusion.
  • Taking warfarin or coumadin any time during the previous 6 months.
  • Current diagnosis of or treatment for psychosis (i.e. schizophrenia, etc.). Include depression if has been stable on treatment regimen for > 6 months.
  • Blindness or deafness not corrected with use of glasses and hearing aids.
  • Does not speak English; due to insufficient funds to hire a translator and to get all study materials translated into another language to allow us to recruit non-English speaking participants non-English speakers will not be eligible to participate.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • HNCRA at Tufts University

    Boston, Massachusetts, 02111

Other trials in United States

About this study

The purpose of this study is to determine if substituting whole grains for refined grains in the diets of healthy adults over a period of 6 weeks alters the composition of the bacteria in the gut, and has beneficial effects on immune function, digestive health, cardiovascular health, regulation of body weight and composition, and vitamin K status.

The investigators hypothesize that whole grain consumption over a period of 6 weeks will alter the gut microflora toward a more beneficial bacterial profile, improve the immune response while reducing oxidative stress and inflammatory markers, have favorable effects on factors influencing the regulation of body weight and composition,increase bacterial vitamin K synthesis, and beneficially effect surrogate markers of cholesterol synthesis/absorption, vitamin D concentrations, and whole genome DNA methylation patterns. In statin users it is hypothesized that, consumption of whole grains will alter statin pharmacokinetics by decreasing rate of statin absorption, resulting in more sustained plasma concentrations.

Read the detailed description

This study is a randomized parallel-arm trial using a six-week dietary intervention following a 2 week run-in period. Healthy volunteers will be randomized to two groups (n=40/group), and consume either a diet rich in whole grains or a diet rich in refined grains provided at estimated energy requirements for 6 weeks. Outcomes will be measured during the run-in period and at week 6 of the intervention. To control for variation in microbiota an additional 10 volunteers will serve as "negative controls" and not undergo any diet intervention.

Being tested
Whole grains, Refined grains
Keywords
digestive health and natural defenses

What participants receive

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

  • Whole grainsOther

    Following completion of the baseline period (a 2-week run-in phase), participants in the WG group will receive a diet providing 100% of energy requirements in a diet rich in whole grains and the RG group will be provided with 100% of energy requirements in a diet rich in refined grains but otherwise similar to the WG diet for 6 weeks.

  • Refined grainsOther

    Following completion of the baseline period (a 2-week run-in phase), participants in the WG group will receive a diet providing 100% of energy requirements in a diet rich in whole grains and the RG group will be provided with 100% of energy requirements in a diet rich in refined grains but otherwise similar to the WG diet for 6 weeks.

Study groups in NCT01902394
Study groupRoleWhat they receive
Whole grain rich dietExperimentalParticipants in the whole grain (WG) group will receive a diet providing 100% of energy requirements in a diet rich in whole grains.
Receives: Other: Whole grains
Refined grain rich dietPlacebo comparatorParticipants in the refined grain (RG) group will receive a diet providing 100% of energy requirements in a diet rich in refined grains.
Receives: Other: Refined grains
Negative controlNo interventionSubjects randomized to the negative control group will consume their own usual diet (i.e. not receive foods and beverages from the study).

What is being measured

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

  1. change in T Cell-mediated immunity

    Delayed-type hypersensitivity (DTH) and lymphocyte proliferation will be measured at baseline (week 2 of washout period) and at week-6 of the diet intervention to assess adaptive immune function, specifically T cell-mediated immunity.

    Measured: week 2 of washout diet and week 6 of diet intervention

  2. change in Lymphocyte proliferation

    Whole blood collected at baseline (week 2 of washout period) and at week-6 of the diet intervention will be investigated for the ability of lymphocytes to proliferate by quantifying the incorporation of tritium following mitogen stimulation.

    Measured: week 2 of washout diet and week 6 of diet intervention

  3. change in Natural Killer Function

    The ability of peripheral blood mononuclear cells to bind and kill leukemia cells will be measured at baseline (week 2 of washout period) and at week-6 of the diet intervention

    Measured: week 2 of washout diet and week 6 of diet intervention

  4. change in Cytokines

    Peripheral blood and stool samples will be analyzed at baseline (week 2 of washout diet) and week-6 of diet intervention for cytokines.

    Measured: week 2 of washout diet and week 6 of diet intervention

  5. change in Salivary immunoglobulin A (IgA)

    Salivary IgA will be analyzed at baseline (week 2 of washout period) and at week-6 of the diet intervention.

    Measured: week 2 of washout diet and week 6 of intervention diet

Secondary outcomes (20)
  1. change in gut microbiota composition

    Phylogenetic composition and relative abundance of bacteria in stool will be analyzed from 24-hour fresh sample collected at baseline (week 2 of washout diet) and at week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  2. change in cardiovascular health risk factors

    Consumption of the whole grain (WG) diet will be beneficial for multiple outcomes of cardiovascular health including a favorable blood lipid profile (low density lipoprotein, very low-density lipoprotein, high density lipoprotein, total cholesterol and triglycerides), and a decrease in blood pressure, and in oxidative stress status (secondary hypothesis).

    Measured: week 2 of washout diet and week 6 of intervention diet

  3. change in vitamin K status

    Fecal menaquinones concentrations; Fasting serum phylloquinone and menaquinones concentration from 72-hour stool collected at baseline (week 2 of washout diet) and at week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  4. change in body composition

    Fat and fat free mass; waist and hip circumference

    Measured: week 2 of washout diet and week 6 of intervention diet

  5. change in appetite

    Visual analog scales to assess hunger, fullness and satisfaction while on the study diet

    Measured: Weekly for 8 weeks

  6. change in fasting gut hormone concentration

    Plasma glucagon-like peptide-1 and peptide-YY will be measured from blood samples collected at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  7. change in fasting serum leptin

    Measured: week 2 of washout diet and week 6 of intervention diet

  8. change in glycemic regulation

    48 hr continuous glucose monitoring; fasting serum glucose; fasting serum insulin; HOMA-IR

    Measured: week 2 of washout diet and week 6 of intervention diet

  9. change in resting energy metabolism

    Resting energy expenditure; substrate oxidation at rest

    Measured: week 2 of washout diet and week 6 of intervention diet

  10. change in eating behaviors

    Questionnaires will be administered at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  11. change in quality of life

    Questionnaires will be administered at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  12. change in breath hydrogen and methane

    Measured: week 2 of washout diet and week 6 of intervention diet

  13. change in stool pH

    Will be measured from 72-hour stool sample collected at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  14. change in 72hr fecal weight

    Will be measured from 72-hour stool sample collected at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  15. change in stool water content

    Will be measured from 72-hour stool sample collected at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  16. change in total stool anaerobic and aerobic bacterial counts

    Will be measured from 72-hour stool sample collected at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  17. change in stool energy content

    Will be measured from 72-hour stool sample collected at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  18. change in DNA methylation

    Measured: week 2 of washout diet and week 6 of intervention diet

  19. change in concentrations of the cholesterol synthesis (squalene, desmosterol, lathosterol) and absorption (campesterol, sitosterol, cholestanol) markers

    Plasma squalene, desmosterol, lathosterol), campesterol, sitosterol, and cholestanol concentrations will be measured at baseline (week 2 of washout diet) and week 6 of intervention diet

    Measured: week 2 of washout diet and week 6 of intervention diet

  20. change in serum vitamin D

    Measured: week 2 of washout diet and week 6 of intervention diet

Timeline

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

  1. First posted18 Jul 2013 (estimated)
  2. Study startJun 2012
  3. Primary completionSep 2014
  4. Study completionSep 2014

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
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01902394
Sponsor's protocol ID
2720
Status last verified
May 2015
First submitted
4 Jun 2012
Last updated
21 May 2015
Results posted
No
Data monitoring committee
No

Publications

  • Karl JP, Meydani M, Barnett JB, Vanegas SM, Barger K, Fu X, Goldin B, Kane A, Rasmussen H, Vangay P, Knights D, Jonnalagadda SS, Saltzman E, Roberts SB, Meydani SN, Booth SL. Fecal concentrations of bacterially derived vitamin K forms are associated with gut microbiota composition but not plasma or fecal cytokine concentrations in healthy adults. Am J Clin Nutr. 2017 Oct;106(4):1052-1061. doi: 10.3945/ajcn.117.155424. Epub 2017 Aug 16.

    PubMed 28814395
  • Vanegas SM, Meydani M, Barnett JB, Goldin B, Kane A, Rasmussen H, Brown C, Vangay P, Knights D, Jonnalagadda S, Koecher K, Karl JP, Thomas M, Dolnikowski G, Li L, Saltzman E, Wu D, Meydani SN. Substituting whole grains for refined grains in a 6-wk randomized trial has a modest effect on gut microbiota and immune and inflammatory markers of healthy adults. Am J Clin Nutr. 2017 Mar;105(3):635-650. doi: 10.3945/ajcn.116.146928. Epub 2017 Feb 8.

    PubMed 28179226
  • Karl JP, Meydani M, Barnett JB, Vanegas SM, Goldin B, Kane A, Rasmussen H, Saltzman E, Vangay P, Knights D, Chen CO, Das SK, Jonnalagadda SS, Meydani SN, Roberts SB. Substituting whole grains for refined grains in a 6-wk randomized trial favorably affects energy-balance metrics in healthy men and postmenopausal women. Am J Clin Nutr. 2017 Mar;105(3):589-599. doi: 10.3945/ajcn.116.139683. Epub 2017 Feb 8.

    PubMed 28179223

Questions about this trial

What is this clinical trial studying?

A study testing Whole grains and Refined grains in people with Digestive Health and Immune Function, run by Tufts University at 1 site in United States.

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 0 inclusion and 34 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: finished, as of the sponsor's last update on 21 May 2015. 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 United States. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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 T Cell-mediated immunity (time frame: week 2 of washout diet and week 6 of diet intervention). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01902394, which also lists 3 linked publications.

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 21 May 2015.

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