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ObesityAlpha&OmegaNCT04279951

Alpha and Omega of Lifestyle Therapy

A study testing Resistance exercise and Omega-3 in people with Obesity, run by Inland Norway University of Applied Sciences at 1 site in Norway.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The study aims to investigate the effects of double-blinded, randomized placebo-controlled n3-fatty acid supplementation (1000 mg day-1) and 13 weeks of resistance training on muscle function/biology and systemic health in individuals with obesity (BMI>30) and lean individuals (BMI<30) Read more about this study

Who is it for?
Ages 30 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Obesity
What is being tested?
Resistance exercise and Omega-3
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
150 participants
Where
1 siteNorway
Study dates
2 Sep 2019to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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 30 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Untrained (less than 2 sessions of resistance exercise per month and less than 3 hours of endurance exercise per week)

Who cannot join

  • Unstable cardiovascular disease
  • Injuries affecting the ability to perform heavy resistance exercise
  • Mental illness
  • Allergy to local anesthesia
  • Smoking
  • Use of medicine or drugs containing steroids the last two months prior to inclusion

Trial locations and contacts

1 site in 1 country.

Norway1 site
  • Inland Norway University of Applied Sciences

    Lillehammer

Other trials in Norway

About this study

Official title: Alpha and Omega of Lifestyle Therapy - Resistance Training and Ingestion of n-3 Polyunsaturated Fatty Acids to Improve Health and Muscle Functions in Individuals With Obesity and Healthy Controls

The study aims to investigate the effects of double-blinded, randomized placebo-controlled n3-fatty acid supplementation (1000 mg day-1) and 13 weeks of resistance training on muscle function/biology and systemic health in individuals with obesity (BMI>30) and lean individuals (BMI<30)

Read the detailed description

Lifestyle therapy is important for treating lifestyle-related morbidities such as obesity. Such therapy often includes exercise and nutrition, and leads to improved health, functionality and quality of life. Unfortunately, obesity leads to adverse changes in the physiological milieu, including inflammation and altered nutritional status such as reduced omega-3:omega-6 ratios. Indeed, inadequate omega 3 levels are common even among lean individuals. This may negatively affect the outcome of lifestyle therapy with exercise, particularly those involving resistance training, contributing to the large heterogeneity seen in training responses. In accordance with this, many individuals (including both lean and obese subjects) fail to improve muscle biology/functions and health, including failure to increase muscle mass and strength, failure to improve glucose handling and inflammatory status. This makes general lifestyle therapy recommendations ineffective. Here, we investigate effects of double-blinded, randomized placebo-controlled n3-fatty acid supplementation (1000 mg day-1) and 13 weeks of low- and high-load resistance training on muscle growth/function/biology and health in individuals with obesity (BMI>30, n=60) and lean controls (BMI<30, n=60). Each participant will perform two different training protocols, one on each leg. The supplement period will commence 7 weeks prior to the onset of the strength training intervention to ensure adequate omega-3 biology at the onset of training. Analyses include assessment of the separate and combined effects of n3-supplementation and obesity on training responses to resistance training, measured as muscle mass, muscle strength/functionality, muscle biological traits, and systemic health variables such as hormone/inflammation/glucose biology, adipose tissue biology/mass, gut microbiome and health-related quality of life. The project will provide important insight into the feasibility of resistance training and n-3 fatty acid supplementation for treating individuals with obesity, paving the way for personalized lifestyle therapy.

The study has two defined main outcome measures, targeting the combined effects of omega-3 and strength training on i) muscle thickness of the thigh (measured using ultrasound; this main outcome measure targets the effects of the intervention on muscle growth), and ii) glucose tolerance (measured using an oral glucose test; this main outcome measure targets the effects of the intervention on improvements in health).

In our analytical approach, we will use a mixed model-approach to assess the main effects of the intervention, mainly defined as changes from before to after the resistance training intervention. Importantly, for health variables such as glucose tolerance, analyses will be performed by accounting for individual variation at baseline, as any beneficial effect can be expected to be higher/present only in individuals with a pathological/diseased starting point. Notably, for many variables, we will collect data from two additional time points (pre-supplementation and after two weeks of familiarization to training). These data will provide insight into additional perspectives, such as the effects of omega-3 intake-only on glucose tolerance, which will bring additional depth to our conclusions (these analyses are not necessarily specified in the Outcome Measures section). For other data, such as primary cultivation of skeletal muscle and muscle mitochondrial respiration, data will only be collected from a randomized subset of participants. For analyses of the effects of the intervention on obesity-related pathophysiologies and health-related quality of life, data from a group of non-intervention individuals will act as reference values (data sampled alongside the intervention). Finally, we will use regression analyses to explain individual differences in training responses, with particular emphasis on muscle hypertrophy/glucose tolerance and their mechanistic origin of nature.

2021/08: The number of anticipated participants was increased from 120 to 150 due to circumstances relating to the SARS-CoV-2 pandemic

Conditions
Obesity
Being tested
Resistance exercise, Omega-3, Placebo
Keywords
Resistance exercise, Omega 3
Medical subject headings
Obesity

What participants receive

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

  • Resistance exerciseOther

    High-load and low-load resistance exercise two times per week for 10 weeks, preceded by 3 weeks of familiarization to training (high-load training)

  • Omega-3Dietary supplement

    Also called N-3 PUFA

    1 gram of omega-3 per day for 20 weeks

  • PlaceboDietary supplement

    1 gram of sunflower oleic oil per day for 20 weeks

Study groups in NCT04279951
Study groupRoleWhat they receive
Omega 3ExperimentalIntake of 1 gram omega-3 (capsules) per day for 20 weeks + high-load and low-load resistance exercise two times per week for 10 weeks, preceded by 3 weeks of familiarization to training (high-load training)
Receives: Other: Resistance exercise; Dietary Supplement: Omega-3
PlaceboPlacebo comparatorIntake of 1 gram sunflower oleic oil (capsules) per day for 20 weeks + high-load and low-load resistance exercise two times per week for 10 weeks, preceded by 3 weeks of familiarization to training (high-load training)
Receives: Other: Resistance exercise; Dietary Supplement: Placebo
ControlNo interventionNo intervention

What is being measured

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

  1. Muscle thickness, ultrasound

    Muscle thickness of vastus lateralis and vastus intermedius measured using ultrasound

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  2. Glucose tolerance

    Glucose tolerance measured using an oral glucose tolerance test

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

Secondary outcomes (48)
  1. Lean body mass

    Lean body mass measured using whole-body DXA scan

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  2. Fat mass

    Fat mass measured using whole-body DXA scan

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  3. Visceral fat mass

    Visceral fat mass measured using whole-body DXA scan

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  4. Muscle mass, MRI

    Thigh muscle cross sectional area/volume measured using magnetic resonance imaging (MRI)

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  5. Muscle mass, immunohistochemistry

    Fibre type-specific muscle-fibre cross-sectional area measured using immunohistochemistry

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  6. Muscle mass, combined measure

    Muscle mass of the legs measured as the weighted average of data from ultrasound, MRI, immunohistochemistry and DXA measurements

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  7. Muscle fibre type composition

    Muscle fibre type composition measured using immunohistochemistry

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  8. Myonuclear number

    Fiber type-specific myonuclear number measured using immunohistochemistry

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  9. Muscle satellite cell number

    Fiber type-specific muscle satellite cell number measured using immunohistochemistry

    Measured: Changes throughout the course of the resistance training intervention (weeks 8, 10 and 20)

  10. Muscle capillarization

    Fiber type-specific muscle capillarization measured using immunohistochemistry

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  11. Fat infiltration (muscle)

    Fat infiltration in thigh muscle measured using magnetic resonance imaging (MRI)

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  12. Muscle quality

    Muscle strength measured per muscle mass of the legs

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  13. Unilateral lower body maximal strength

    The ability of muscles of the lower body to exert maximal force during dynamic movements

    Measured: Changes throughout the course of the resistance training intervention (weeks 8, 10 and 20)

  14. Unilateral lower body isokinetic muscle strength

    The ability of the knee extensors to exert maximal force during isokinetic movements

    Measured: Changes throughout the course of the resistance training intervention (weeks 8, 10 and 20)

  15. Unilateral lower body isometric muscle strength

    The ability of the knee extensors to exert maximal force during isometric actions

    Measured: Changes throughout the course of the resistance training intervention (weeks 8, 10 and 20)

  16. Peak power output during one-legged cycling

    Maximal cycling performance measured as peak power output (Watt) during an incremental one-legged cycling test

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  17. Oxygen consumption during one-legged cycling

    The ability to consume oxygen during an incremental one-legged cycling test

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  18. Unilateral lower body muscle endurance

    The ability of muscles of the lower body to perform repeated dynamic contractions at a specified submaximal load (70% of 1RM) to exhaustion

    Measured: Changes throughout the course of the resistance training intervention (weeks 8, 10 and 20)

  19. Waist circumference

    Circumference of the waist measured using measuring tape

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  20. Blood pressure at rest

    Blood pressure at rest measured using an automated upper-arm blood pressure cuff

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  21. Hemoglobin glycosylation (HbA1c)

    Long-term glucose levels measured as hemoglobin glycosylation of the metabolic syndrome such as waist circumference, blood pressure at rest, lipid profile ( hemoglobin glycosylation (HbA1c) and fasting blood glucose

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  22. Fasting blood glucose

    Fasting blood glucose measured in serum

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  23. N-3 PUFA (blood)

    Omega-3 (DHA/EPA) levels in blood

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  24. Inflammatory characteristics of peripheral blood mononuclear cell (PBMC)

    Expression of genes associated with inflammation and lipid metabolism in peripheral blood mononuclear cell measured using quantitative PCR

    Measured: Throughout the course of the intervention (weeks 0, 8 and 20)

  25. Lipid concentrations in blood

    Concentrations of various lipids and lipid metabolites such as triglycerides, LDL, HDL, ceramides, dihydroceramides, glucosylceramides, and lactosylceramides measured in serum using tageted metabolomics

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  26. Nutritent concentrations in blood

    Concentrations of nutrients (such as amino acids) and ions (such as iron and calcium) measured in serum

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  27. Hormone concentrations in blood

    Concentrations of hormones such as testosterone, growth hormone, thyroid hormones, cortisol and insulin (as well as c-peptide) measured in serum

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  28. Concentrations of inflammatory factors in blood

    Levels of inflammatory factors such as IL6, CRP and NFkB in serum

    Measured: Changes throughout the course of the intervention (weeks 0, 8 and 20)

  29. Muscle fractional synthesis rate

    Protein/RNA synthesis rate measured using heavy water (deuterium) and chromatography/spectrometry

    Measured: Week 18 to 20

  30. Gene expression in skeletal muscle (intervention)

    RNA (e.g. messenger RNA, ribosomal RNA, microRNA, long non-coding RNA) abundances in m. vastus lateralis, measured both as targeted genes and at the level of the transcriptome

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  31. Gene expression in skeletal muscle (familiarization)

    RNA (e.g. messenger RNA, ribosomal RNA, microRNA, long non-coding RNA) abundances in m. vastus lateralis, measured both as single genes and at the level of the transcriptome

    Measured: Changes from before to after familiarization to resistance exercise (week 8 to 10)

  32. Protein abundance in skeletal muscle (intervention)

    Levels of proteins and their modification status (e.g. phosphorylation) in m. vastus lateralis, measured at the level of single proteins and at the level of the proteome

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  33. Protein abundance in skeletal muscle (familiarization)

    Levels of proteins and their modification status (e.g. phosphorylation) in m. vastus lateralis, measured at the level of single proteins and at the level of the proteome

    Measured: Changes from before to after the resistance training intervention (week 8 to 10)

  34. Mitochondrial functions in muscle

    The ability of muscle mitochondria (extracted from muscle homogenate) to synthesize ATP in vitro

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  35. Gene expression in subcutaneous fat

    RNA (e.g. messenger RNA, ribosomal RNA, microRNA, long non-coding RNA) abundances in subcutaneous fat, measured as targeted genes

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  36. Satellite cell proliferation and myotube growth (in vitro)

    The ability of muscle satellite cells (extracted from muscle homogenate) to proliferate (rates of cell division), differentiate into myotubes and subsequently grow (rates of change in myotube size) in primary cultures

    Measured: Changes from before to after N3-supplementation-only (week 0 to 8)

  37. Musculoskeletal pain (Nordic Pain Questionnaire)

    Musculoskeletal pain measured using The standardized Nordic Pain Questionnaire

    Measured: Changes throughout the course of the training intervention (weeks 0, 8 and 20)

  38. Musculoskeletal pain (VAS)

    Musculoskeletal pain measured using VAS-scale (1-10)

    Measured: Changes throughout the course of the training intervention (weeks 0, 8 and 20)

  39. Gastrointestinal symptoms

    Gastrointestinal symptoms such as abdominal discomfort and pain, measured using Rome IV criteria

    Measured: Changes throughout the course of the training intervention (weeks 0, 8 and 20)

  40. Gut microbiome (feces, N3-supplementation-only)

    Relative composition of the gut microbiome measured using quantitative polymerase chain reaction

    Measured: Changes from before to after N3-supplementation-only (week 0 to 8)

  41. Gut microbiome (feces, training intervention)

    Relative composition of the gut microbiome measured using quantitative polymerase chain reaction

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  42. Fecal short-chained fatty acids (N3-supplementation-only)

    Short chained fatty acids measured in feces

    Measured: Changes from before to after N3-supplementation-only (week 0 to 8)

  43. Fecal short-chained fatty acids (training intervention)

    Short chained fatty acids measured in feces

    Measured: Changes from before to after the resistance training intervention (week 8 to 20)

  44. Arterial stiffness

    Arterial stiffness measured using pulse-wave velocity

    Measured: Throughout the course of the intervention (week 0, 8 and 20)

  45. Health-related quality of life (SF-36)

    Health-related quality of life measured using the SF-36 questionnaire

    Measured: Changes throughout the course of the intervention (week 0, 8 and 20)

  46. Health-related quality of life in overweight/obesity

    Health-related quality of life in overweight/obesity individuals measured using The impact of weight on quality of life (IWQOL) questionnaire

    Measured: Changes throughout the course of the intervention (week 0, 8 and 20)

  47. Health-related quality of life (PANAS)

    Health-related quality of life measured using the Positive and Negative Affect Schedule (PANAS) questionnaire

    Measured: Changes throughout the course of the intervention (week 0, 8 and 20)

  48. Activities of daily living

    Activities of daily living (e.g. time spent in physical activity, intensities of activities) measured using questionnaire

    Measured: Changes throughout the course of the intervention (week 0, 8 and 20)

Timeline

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

  1. First posted21 Feb 2020
  2. Study start2 Sep 2019
  3. Primary completion30 Mar 2022
  4. Study completionDec 2026 (estimated)

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
Basic science
Allocation
Randomised
Intervention model
Factorial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04279951
Sponsor's protocol ID
Trainome 2019#015
Acronym
Alpha&Omega
Status last verified
Aug 2022
First submitted
19 Jan 2020
Last updated
9 Aug 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Resistance exercise and Omega-3 in people with Obesity, run by Inland Norway University of Applied Sciences at 1 site in Norway.

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 6 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: under way, not looking for participants, as of the sponsor's last update on 9 Aug 2022. 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 Norway. 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?

This study is still under way. Results are not available in the source record yet.

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?

Muscle thickness, ultrasound (time frame: Changes from before to after the resistance training intervention (week 8 to 20)). The study lists 2 primary outcomes in all. 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 9 Aug 2022.

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