OmniHeart Trial: Macronutrients and Cardiovascular Risk

NCT ID: NCT00051350

Last Updated: 2018-10-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

164 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-05-31

Study Completion Date

2008-03-31

Brief Summary

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To compare the effects on blood pressure and plasma lipids of three different diets--a carbohydrate-rich diet, a protein-rich diet, or a diet rich in unsaturated fat.

Detailed Description

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BACKGROUND:

While there is widespread consensus that the optimal diet to reduce cardiovascular risk should be low in saturated fat, the type of macronutrient that should replace saturated fat (carbohydrate, protein or unsaturated fat) is a major, unresolved research question with substantial public health implications. The study will evaluate these three dietary approaches by studying their effects on established coronary risk factors and a selected group of emerging risk factors.

DESIGN NARRATIVE:

The study design was a randomized, three period cross-over feeding study that compared the effects on blood pressure and plasma lipids of a carbohydrate-rich diet patterned after the DASH diet (CARB) to two other diets, one rich in protein (PROTEIN) and another rich in unsaturated (UNSAT) fat, predominantly monounsaturated fat. The DASH diet has been shown to reduce blood pressure and LDL-cholesterol substantially, and is currently recommended by policy makers. During a one week run-in, all participants were fed samples of the three study diets (CARB, PROTEIN and UNSAT). Using a three period cross-over design, participants were then randomly assigned to the CARB, PROTEIN or UNSAT diet. Each feeding period lasted six weeks; a washout period of at least two weeks separated each feeding period. Throughout feeding (run-in and the three intervention periods), participants were fed sufficient calories to maintain their weight. Trial participants were 30 years of age or older, with systolic blood pressure of 120-159 mmHg or diastolic blood pressure of 90-99 mmHg. Primary outcomes variables were blood pressure and the established plasma lipid risk factors (LDL-C, HDL-C and triglycerides). Secondary outcomes include total cholesterol, apolipoproteins VLDL-apoB, VLDL-apoCIII, apolipoprotein B, non-HDL cholesterol, and lipoprotein(a).

Conditions

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Cardiovascular Diseases Heart Diseases Atherosclerosis Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Individuals were randomized to a sequence of 3 diets (CARB, UNSAT, PROTEIN)
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
Outcome assessors were unaware of diet sequence.

Study Groups

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CARB

Diet rich in carbohydrate

Group Type PLACEBO_COMPARATOR

CARB

Intervention Type OTHER

UNSAT

Diet rich in unsaturated fat

Group Type ACTIVE_COMPARATOR

CARB

Intervention Type OTHER

PROTEIN

Diet rich in protein

Group Type ACTIVE_COMPARATOR

CARB

Intervention Type OTHER

Interventions

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CARB

Intervention Type OTHER

Other Intervention Names

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UNSAT PROTEIN

Eligibility Criteria

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Inclusion Criteria

* Healthy adults
* Aged 30 years and older
* Systolic blood pressure of 120 to 159 mm Hg or a diastolic blood pressure of 80 to 99 mm Hg.

Exclusion Criteria

* Diabetes
* Active or prior Cardiovascular disease (CVD)
* LDL cholesterol greater than 220 mg/dL (\>5.70 mmol/L)
* Fasting triglycerides greater than 750 mg/dL (\>8.48 mmol/L)
* Weight more than 350 lb (\>159 kg)
* Taking medications that affect blood pressure or blood lipid levels
* Unwillingness to stop taking vitamin and mineral supplements
* Alcoholic beverage intake of more than 14 drinks per week.
Minimum Eligible Age

30 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lawrence Appel

Role: STUDY_CHAIR

Johns Hopkins University

References

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Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller ER 3rd, Conlin PR, Erlinger TP, Rosner BA, Laranjo NM, Charleston J, McCarron P, Bishop LM; OmniHeart Collaborative Research Group. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA. 2005 Nov 16;294(19):2455-64. doi: 10.1001/jama.294.19.2455.

Reference Type BACKGROUND
PMID: 16287956 (View on PubMed)

Kim H, Lichtenstein AH, Ganz P, Miller ER 3rd, Coresh J, Appel LJ, Rebholz CM. Associations of circulating proteins with lipoprotein profiles: proteomic analyses from the OmniHeart randomized trial and the Atherosclerosis Risk in Communities (ARIC) Study. Clin Proteomics. 2023 Jul 3;20(1):27. doi: 10.1186/s12014-023-09416-x.

Reference Type DERIVED
PMID: 37400771 (View on PubMed)

Belanger MJ, Wee CC, Mukamal KJ, Miller ER, Sacks FM, Appel LJ, Shmerling RH, Choi HK, Juraschek SP. Effects of dietary macronutrients on serum urate: results from the OmniHeart trial. Am J Clin Nutr. 2021 Jun 1;113(6):1593-1599. doi: 10.1093/ajcn/nqaa424.

Reference Type DERIVED
PMID: 33668058 (View on PubMed)

Zhang M, Juraschek SP, Appel LJ, Pasricha PJ, Miller ER 3rd, Mueller NT. Effects of High-Fiber Diets and Macronutrient Substitution on Bloating: Findings From the OmniHeart Trial. Clin Transl Gastroenterol. 2020 Jan;11(1):e00122. doi: 10.14309/ctg.0000000000000122.

Reference Type DERIVED
PMID: 31972610 (View on PubMed)

Mueller NT, Zhang M, Juraschek SP, Miller ER, Appel LJ. Effects of high-fiber diets enriched with carbohydrate, protein, or unsaturated fat on circulating short chain fatty acids: results from the OmniHeart randomized trial. Am J Clin Nutr. 2020 Mar 1;111(3):545-554. doi: 10.1093/ajcn/nqz322.

Reference Type DERIVED
PMID: 31927581 (View on PubMed)

Kovell LC, Yeung EH, Miller ER 3rd, Appel LJ, Christenson RH, Rebuck H, Schulman SP, Juraschek SP. Healthy diet reduces markers of cardiac injury and inflammation regardless of macronutrients: Results from the OmniHeart trial. Int J Cardiol. 2020 Jan 15;299:282-288. doi: 10.1016/j.ijcard.2019.07.102. Epub 2019 Aug 2.

Reference Type DERIVED
PMID: 31447226 (View on PubMed)

Loo RL, Zou X, Appel LJ, Nicholson JK, Holmes E. Characterization of metabolic responses to healthy diets and association with blood pressure: application to the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart), a randomized controlled study. Am J Clin Nutr. 2018 Mar 1;107(3):323-334. doi: 10.1093/ajcn/nqx072.

Reference Type DERIVED
PMID: 29506183 (View on PubMed)

Juraschek SP, Miller ER 3rd, Appel LJ, Christenson RH, Sacks FM, Selvin E. Effects of dietary carbohydrate on 1,5-anhydroglucitol in a population without diabetes: results from the OmniCarb trial. Diabet Med. 2017 Oct;34(10):1407-1413. doi: 10.1111/dme.13391. Epub 2017 Jul 9.

Reference Type DERIVED
PMID: 28574153 (View on PubMed)

Haring B, von Ballmoos MC, Appel LJ, Sacks FM. Healthy dietary interventions and lipoprotein (a) plasma levels: results from the Omni Heart Trial. PLoS One. 2014 Dec 15;9(12):e114859. doi: 10.1371/journal.pone.0114859. eCollection 2014.

Reference Type DERIVED
PMID: 25506933 (View on PubMed)

Gadgil MD, Appel LJ, Yeung E, Anderson CA, Sacks FM, Miller ER 3rd. The effects of carbohydrate, unsaturated fat, and protein intake on measures of insulin sensitivity: results from the OmniHeart trial. Diabetes Care. 2013 May;36(5):1132-7. doi: 10.2337/dc12-0869. Epub 2012 Dec 5.

Reference Type DERIVED
PMID: 23223345 (View on PubMed)

Juraschek SP, Appel LJ, Anderson CA, Miller ER 3rd. Effect of a high-protein diet on kidney function in healthy adults: results from the OmniHeart trial. Am J Kidney Dis. 2013 Apr;61(4):547-54. doi: 10.1053/j.ajkd.2012.10.017. Epub 2012 Dec 4.

Reference Type DERIVED
PMID: 23219108 (View on PubMed)

Furtado JD, Campos H, Sumner AE, Appel LJ, Carey VJ, Sacks FM. Dietary interventions that lower lipoproteins containing apolipoprotein C-III are more effective in whites than in blacks: results of the OmniHeart trial. Am J Clin Nutr. 2010 Oct;92(4):714-22. doi: 10.3945/ajcn.2009.28532. Epub 2010 Sep 8.

Reference Type DERIVED
PMID: 20826623 (View on PubMed)

Other Identifiers

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R01HL067098

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NA_00069360

Identifier Type: -

Identifier Source: org_study_id

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