Plant-Based, American Heart Assoc. or Mediterranean Diets In 9-18 yo With BMI >95%, Cholesterol >169 and Their Parents

NCT ID: NCT02857543

Last Updated: 2021-11-15

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2021-10-25

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this research is to investigate the effects of a PB no- added-fat and the AHA and MED in obese (BMI \>95%) children ages 9-18 with hypercholesterolemia (\>169 mg/dl) and a parent or guardian. Eligible patients will be identified by utilizing the Pediatric Obesity Registry. When possible, in-person discussions or phone calls with their primary or tertiary care physicians will introduce eligible patients and their parents to the study. All eligible patients and parents will receive letters describing the study and requesting their participation. Subjects can choose not to participate in the study, and their health care will not be affected in any way. Subjects not participating will be asked if they are willing to answer a brief questionnaire about why they chose not to participate. The proposed study will be carried out for a total of 52 weeks. The investigators expect to recruit a total of 180 participants (30 children and 30 parents/guardians in each of the three groups). Each child and parent/guardian pair will be randomly assigned to either PB no-added-fat, AHA or MED.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background: There is a need to have effective lifestyle modifications that target the growing group of obese children with dyslipidemia. The beneficial health effects of plant-based (PB) diets in adults are known. Studies have suggested that a low-fat vegan diet (no animal products) may promote weight loss, lower body mass index (BMI), and improve lipoprotein profiles and insulin sensitivity and possibly prevent cardiovascular disease (CVD).1-5 Those who follow a vegetarian diet(no animal products except for dairy and/or eggs) typically have lower cholesterol levels and a lower risk for heart disease than non-vegetarians.6-8 Additionally, vegetarian diets have been shown to not only prevent but reverse heart disease in adults.9-11 The three major diets emphasized in the 2015 United States Dietary Guidelines are a Plant-based Diet (PB), and the American Heart Association-like Diet (AHA) and Mediterranean Diet (MED).(11) Similar to the PB, the AHA diet encourage fruits, vegetables, whole grains, and low sodium intake but permits non-whole grains, low-fat dairy, selected plant oils, and lean meat and fish in moderation. The MED, is similar to AHA with more emphasis on fish and extra virgin olive oil and/or nuts).

Study Aims: The primary aim of this study is to determine whether a PB and/or AHA and/or MED diets significantly change anthropometric measurements and/or biomarkers of CVD risk after a 4 and 52-week intervention in obese children with hypercholesterolemia ages 9-18 years and one of their parents. The investigators also aim to prospectively determine for the first time in children and adults if there are significant outcome differences between the three diets highlighted in the 2015 U.S. Dietary Guidelines.

Protocol Summary The purpose of this research is to investigate the effects of a PB no- added-fat and the AHA and MED in obese (BMI \>95%) children ages 9-18 with hypercholesterolemia (\>169 mg/dl) and a parent or guardian. Eligible patients will be identified by utilizing the Pediatric Obesity Registry. When possible, in-person discussions or phone calls with their primary or tertiary care physicians will introduce eligible patients and their parents to the study. All eligible patients and parents will receive letters describing the study and requesting their participation. Subjects can choose not to participate in the study, and their health care will not be affected in any way. Subjects not participating will be asked if they are willing to answer a brief questionnaire about why they chose not to participate. The proposed study will be carried out for a total of 52 weeks. The investigators expect to recruit a total of 180 participants (30 children and 30 parents/guardians in each of the three groups). Each child and parent/guardian pair will be randomly assigned to either PB no-added-fat, AHA or MED.

Procedures of the study:

Eligible patients and parent/guardian pairs who are interested in participating in the study will have an initial phone call with the study team to answer any questions regarding the study. Informed consent, or assent for children under age 18, will then be obtained by study team investigators face-to-face with the parent/guardian and child pairs prior to the start of the study at a mutually convenient time and place at Cleveland Clinic Regional and Main Campus sites. Patient and parent/guardian pairs will be randomized to one of the three diets at the first study visit.

Throughout the 52 week diet study, participants will be asked to attend group sessions held on Saturdays during weeks 0, 1, 2, 3, 4, and 52 to learn about their assigned diets and receive support for their efforts. There will Saturday support sessions during weeks 6, 10, 16, 24, 34, and 46 and support phone calls every 2 weeks.

The participants will also provide 24 hour dietary recalls of 2 weekdays and 1 weekend day on three time points: before the first study visit, between weeks 2 and 4, and then between weeks 48 and 52.

Participants will have fasting blood tests to assess biomarkers of cardiovascular risk and anthropometric measurements will be performed weeks 0, 4, and 52. Stool and urine specimens will be obtained for possible future testing for microbiome, genomic data and markers of cardiovascular risk at weeks 0, 4, and 52.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Obesity Hypercholesterolemia Cardiovascular Disease

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

plant-based diet

Plant-based diet with as few added oils and fats as possible

Group Type ACTIVE_COMPARATOR

Plant-Based Diet

Intervention Type OTHER

American Heart Association

Diet encourages fruits, vegetables, whole grains, and low sodium intake but permits non-whole grains, low-fat dairy, selected plant oils, and lean meat and fish in moderation.

Group Type ACTIVE_COMPARATOR

American Heart Association Diet

Intervention Type OTHER

Mediterranean

Diet encourages fruits, vegetables, whole grains, and low sodium intake but permits non-whole grains, low-fat dairy, selected plant oils, with more emphasis on fish and extra virgin olive oil and/or nuts.

Group Type ACTIVE_COMPARATOR

Mediterranean Diet

Intervention Type OTHER

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Plant-Based Diet

Intervention Type OTHER

American Heart Association Diet

Intervention Type OTHER

Mediterranean Diet

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* children ages 9-18
* obese (BMI \>95%)
* hypercholesterolemia (\>169 mg/dl)

Exclusion Criteria

* pregnant women
Minimum Eligible Age

9 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

The Cleveland Clinic

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

michael macknin

Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine of CWRU, Cleveland Clinic

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83. doi: 10.2337/dc06-0606.

Reference Type BACKGROUND
PMID: 16873779 (View on PubMed)

Barnard ND, Scialli AR, Turner-McGrievy G, Lanou AJ, Glass J. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med. 2005 Sep;118(9):991-7. doi: 10.1016/j.amjmed.2005.03.039.

Reference Type BACKGROUND
PMID: 16164885 (View on PubMed)

Ferdowsian HR, Barnard ND. Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009 Oct 1;104(7):947-56. doi: 10.1016/j.amjcard.2009.05.032.

Reference Type BACKGROUND
PMID: 19766762 (View on PubMed)

Mishra S, Xu J, Agarwal U, Gonzales J, Levin S, Barnard ND. A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr. 2013 Jul;67(7):718-24. doi: 10.1038/ejcn.2013.92. Epub 2013 May 22.

Reference Type BACKGROUND
PMID: 23695207 (View on PubMed)

Turner-McGrievy GM, Barnard ND, Scialli AR. A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. Obesity (Silver Spring). 2007 Sep;15(9):2276-81. doi: 10.1038/oby.2007.270.

Reference Type BACKGROUND
PMID: 17890496 (View on PubMed)

Fraser GE. Vegetarian diets: what do we know of their effects on common chronic diseases? Am J Clin Nutr. 2009 May;89(5):1607S-1612S. doi: 10.3945/ajcn.2009.26736K. Epub 2009 Mar 25.

Reference Type BACKGROUND
PMID: 19321569 (View on PubMed)

Hu FB. Plant-based foods and prevention of cardiovascular disease: an overview. Am J Clin Nutr. 2003 Sep;78(3 Suppl):544S-551S. doi: 10.1093/ajcn/78.3.544S.

Reference Type BACKGROUND
PMID: 12936948 (View on PubMed)

Tuso PJ, Ismail MH, Ha BP, Bartolotto C. Nutritional update for physicians: plant-based diets. Perm J. 2013 Spring;17(2):61-6. doi: 10.7812/TPP/12-085.

Reference Type BACKGROUND
PMID: 23704846 (View on PubMed)

Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014 Jul;63(7):356-364b.

Reference Type BACKGROUND
PMID: 25198208 (View on PubMed)

Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, Merritt TA, Sparler S, Armstrong WT, Ports TA, Kirkeeide RL, Hogeboom C, Brand RJ. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001-7. doi: 10.1001/jama.280.23.2001.

Reference Type BACKGROUND
PMID: 9863851 (View on PubMed)

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/

Reference Type BACKGROUND

Macknin M, Kong T, Weier A, Worley S, Tang AS, Alkhouri N, Golubic M. Plant-based, no-added-fat or American Heart Association diets: impact on cardiovascular risk in obese children with hypercholesterolemia and their parents. J Pediatr. 2015 Apr;166(4):953-9.e1-3. doi: 10.1016/j.jpeds.2014.12.058. Epub 2015 Feb 12.

Reference Type BACKGROUND
PMID: 25684089 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

16-745

Identifier Type: -

Identifier Source: org_study_id