Evaluation of an Anti-inflammatory Diet in Autoimmune and Metabolic Diseases

NCT ID: NCT05766657

Last Updated: 2025-01-23

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 39 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-12-23
• Study Completion Date: 2023-11-24

Brief Summary

The overall objective of the study is to provide personalized nutritional advice based on the gut microbiota profile of children with type 1 diabetes (T1D) or obesity.

Specifically, the primary objective of NUTRI-DIET is to validate a dietary model aimed at restoring bacterial species and/or anti-inflammatory metabolites in order to prevent extra-intestinal diseases characterized by dysbiosis, such as T1D and obesity.

The primary endpoints of the study will be to monitor the glycemic control indices, i.e., blood glucose (mean of glycemic values, percentage of time-in-range value (TIR), which will be displayed by glycemic sensor) and glycated hemoglobin for diabetic children and Body mass index (BMI) z-score according to World Health Organization (WHO) recommendations (WHO BMI-for-age boys; WHO BMI-for-age girls) for obese children.

The secondary objective of the study is to characterize the microbiota profile of the study patients and to test the algorithm under development built from the integration of diet and and gut microbiota composition data that were obtained during the previous observational study NUTRI-T1D.

Detailed Description

Randomized, multicenter, 2-arm, parallel-group, single-blind controlled clinical trial (1:1 allocation ratio) with 1 group of patients with obesity (N=20) or type 1 (n=20) treated with standard obesity treatment diet or usual diet (diabetic children) and 1 group (N=20 for obesity and (N=20 for type 1 diabetes) treated with the same diets to which nutritional advice derived from microbiota analysis (NUTRI-DIET) will be added.

The study will last 12 months with an intervention phase (personalized diet) lasting 3 months.

The research includes an enrollment phase that may extend up to 9 months depending on the number of patients enrolled. The enrollment phase will be considered finished once a total of 80 patients (i.e., 40 pediatric patients with type 1 diabetes and 40 obese pediatric patients) are enrolled. During the patient enrollment phase, relevant clinical information (biological samples as faeces, urines and blood and questionnaires on diet habits, physical activity and stress) will be collected concurrently. Tests will be performed once enrollment is completed on samples from all patients collected at the time of enrollment (microbiota analysis on stool, metabolome analysis on stool and urine, serological gut barrier markers analysis on serum). Obese and/or diabetic children will be randomized to the intervention or control group. Randomization will be done according to age (≤12: >12), gender and pathology (diabetes or obesity).

Conditions

Type1 Diabetes; Obesity

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Intervention group

Children with obesity or T1D will be randomized into this group. An individualized dietary approach will be used in this group of children.

Group Type: EXPERIMENTAL

Microbiome-targeted diet

Intervention Type: DIETARY_SUPPLEMENT

The gut microbiota (on stool) and metabolic profile (on stool and urine) will be analyzed at time 0, and the dietary plan will contain specific directions aimed at restoring a proper metagenomic and metabolomic profile of the microbiota.

Control Group

children assigned to the control group will receive generic advice based on European dietary guidelines for obesity or follow their usual diet in the case of children with T1D.

Group Type: PLACEBO_COMPARATOR

Usual care diet

Intervention Type: DIETARY_SUPPLEMENT

Subjects on the control group will receive general dietetic advice for Obesity or T1D

Interventions

Microbiome-targeted diet

The gut microbiota (on stool) and metabolic profile (on stool and urine) will be analyzed at time 0, and the dietary plan will contain specific directions aimed at restoring a proper metagenomic and metabolomic profile of the microbiota.

Intervention Type: DIETARY_SUPPLEMENT

Usual care diet

Subjects on the control group will receive general dietetic advice for Obesity or T1D

Intervention Type: DIETARY_SUPPLEMENT

Eligibility Criteria

Inclusion Criteria

1. Eligible for participation will be children diagnosed with obesity (BMI > 95th percentile) and type 1 diabetes aged 8-18 years

2. Signature of informed consent

Exclusion Criteria

1. Children with any acute or chronic disease (cancer, infection, other), gastrointestinal disease, cardiovascular disease, chronic kidney disease, parathyroid disease, diseases requiring regular phlebotomies, and other chronic diseases that could affect the results of the present study

2. Taking medications other than insulin, including hypolipidemic and antihypertensive drugs

3. Use of medications that could affect the results of the study, including systemic glucocorticoids and antibiotics (in the three months prior to the study)

4. Recent weight loss or weight gain (> 3 kg), (in the 3 months preceding the study)

5. Blood transfusion in the last 3 months prior to blood sampling

6. Use of dietary supplements, including multivitamins, fish oil capsules, minerals and trace elements (three months prior to and throughout the study period)

7. Inability (physically or psychologically) to comply with the procedures required by the protocol

8. Children with specific eating disorders, which may hinder the research results

• Minimum Eligible Age: 8 Years
• Maximum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

IRCCS San Raffaele

OTHER

Sponsor Role: lead

Responsible Party

Marika Falcone

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Pediatric Unit

Milan, Milano, Italy

Autoimmune Pathogenesis Unit

Milan, Milan, Italy

Countries

Italy

Other Identifiers

NUTRI-DIET

Identifier Type: -

Identifier Source: org_study_id