Impact of Diet on the Microbiome-Immune-Brain Axis in Parkinson's Disease

NCT ID: NCT06463769

Last Updated: 2024-07-05

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-31

Study Completion Date

2028-07-31

Brief Summary

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Habitual adherence to a predominantly plant-based diet, rich in low-processed food (LPF) has been associated with a reduced risk for development and slower progression of Parkinson's Disease (PD). This could be due to neuroprotective effects by modulation of the gut microbiota and decreased neuronal and metabolic inflammation. So far, the effect of a predominantly plant-based LPF-diet on the microbiome-immune-brain axis in patients with PD remains unknown. In addition, the influence of dietetic measures on the gut microbiome is variable and may depend on (long-term) adherence as well as on PD-specific factors and lifestyle.

The investigators hypothesize that compared to an average German diet, the predominantly plant-based New Nordic LPF-diet, as a culturally adapted diet, which is rich in fermentable fiber and phytochemicals, will have beneficial effects on the gut microbiome of patients with PD by increasing the abundance of short-chain fatty acid (SCFA)-producing bacteria (primary outcome) and will improve gut motility, metabolic resilience, and inflammation (secondary outcomes). Furthermore, the investigators postulate that a patient-centered dietary intervention program, including a multifaceted patient education and supported by a web-application, will lead to high adherence as a key determinant of long-term changes in the gut microbiome. This dietary intervention will be accepted by patients as a low-threshold treatment that balances personal benefits, therapeutic barriers and ethical concerns of early risk disclosure in PD.

Detailed Description

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In a pilot-intervention study, our project will:

* develop a practical, low-threshold diet intervention for patients with prodromal and clinical PD. Adherence will be promoted (i) by a patient-oriented approach, (ii) by implementation of the predominantly plant-based New Nordic LPF-diet that is scientifically-based, culturally adapted, sustainable and culinary and (iii) by an innovative web-application.
* investigate the acute effects of the predominantly plant-based New Nordic LPF -diet on the microbiome (abundance of SCFA-producing bacteria), gastrointestinal motility, inflammation as well as metabolic and Parkinson-specific clinical outcomes in individuals with prodromal and clinical PD.
* investigate potential determinants of long-term changes in the gut microbiome (e.g. dietary adherence, gastrointestinal motility, meal timing and frequency), and factors associated with a high adherence (e.g. acceptance of diet as therapeutic intervention in the prodromal phase, health-related quality of life).

The patient-centered intervention program will be tailored to individual needs and preferences of individuals with prodromal and clinical PD. It will be designed to impart knowledge (e.g. on sustainability and health effects) and food literacy (e.g. food merchandize and culinary skills) in group meetings and culinary medicine workshops. Recipe suggestions and shopping guides will consider individual abilities and needs and a web-application is used for information, increasing self-efficacy, motivation, and monitoring. To ensure an easy integration of the diet into everyday life, partners will be included in the program, if applicable. Moreover, cultural preferences as well as financial resources will be considered. Regular feedback using statistics on nutrient intake and overall progress will be implemented to encourage adherence.

Conditions

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Parkinson Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Arm 1: Patients with prodromal PD receiving nutritional intervention Arm 2: Patients with clinical PD receiving nutritional intervention Arm 3: Patients with clinical PD receiving standard of care (control)
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Patients with prodromal PD on New Nordic LPF-diet (intervention)

Patients with prodromal PD will take part in an 8-week patient-centered intervention program on a predominantly plant-based New Nordic LPF-Diet.

Group Type EXPERIMENTAL

8 week predominantly plant-based New Nordic LPF-diet program

Intervention Type BEHAVIORAL

An 8-week patient-centered dietary intervention program will be implemented to maintain a predominantly plant-based New Nordic LPF-Diet.

maintenance of the predominantly plant-based New Nordic LPF-diet

Intervention Type BEHAVIORAL

Follow-up of long-term adherence to the diet at one and six months after completion of the intervention program.

Patients with clinical PD on New Nordic LPF-diet (intervention)

Patients with clinical PD will take part in an 8-week patient-centered intervention program on a predominantly plant-based New Nordic LPF-Diet. Patients with clinical PD will be randomized to intervention or control group.

Group Type EXPERIMENTAL

8 week predominantly plant-based New Nordic LPF-diet program

Intervention Type BEHAVIORAL

An 8-week patient-centered dietary intervention program will be implemented to maintain a predominantly plant-based New Nordic LPF-Diet.

maintenance of the predominantly plant-based New Nordic LPF-diet

Intervention Type BEHAVIORAL

Follow-up of long-term adherence to the diet at one and six months after completion of the intervention program.

Patients with clinical PD receiving standard of care (control)

Patients with clinical PD will receive standard of care information on a healthy diet and serve as control. Patients with clinical PD will be randomized to intervention or control group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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8 week predominantly plant-based New Nordic LPF-diet program

An 8-week patient-centered dietary intervention program will be implemented to maintain a predominantly plant-based New Nordic LPF-Diet.

Intervention Type BEHAVIORAL

maintenance of the predominantly plant-based New Nordic LPF-diet

Follow-up of long-term adherence to the diet at one and six months after completion of the intervention program.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* patients with probable prodromal PD (according to predefined criteria)
* patients with clinical PD with slight to moderate disease severity (Hoehn \& Yahr 1-2.5)
* habitual Western Diet (≥30% of energy intake from ultra-processed food)

Exclusion Criteria

* current adherence to a plant-based diet
* food allergies or intolerances
* significant diseases of the gastrointestinal system (e.g. celiac disease) or central nervous system, diabetes mellitus
* underweight (BMI \<18.5 kg/m2)
* active smoking
* expected changes in medication or antibiotic treatment during the intervention
Minimum Eligible Age

50 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital Schleswig-Holstein

OTHER

Sponsor Role collaborator

University of Kiel

OTHER

Sponsor Role lead

Responsible Party

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Prof. Dr. Dr. Anja Bosy-Westphal

Head of the Department of Human Nutrition, Kiel University

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anja Bosy-Westphal, PhD, MD

Role: PRINCIPAL_INVESTIGATOR

Kiel University

Eva Schäffer, MD

Role: PRINCIPAL_INVESTIGATOR

Kiel University, University Hospital Schleswig-Holstein

Locations

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Institute of Human Nutrition

Kiel, , Germany

Site Status

Kiel University, University Hospital Schleswig-Holstein

Kiel, , Germany

Site Status

Countries

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Germany

Central Contacts

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Anja Bosy-Westphal, PhD, MD

Role: CONTACT

+494318805674

Eva Schäffer, MD

Role: CONTACT

+49431 500 23800

Facility Contacts

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Eva Schäffer, MD

Role: primary

+49431 500 23800

References

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Aho VTE, Houser MC, Pereira PAB, Chang J, Rudi K, Paulin L, Hertzberg V, Auvinen P, Tansey MG, Scheperjans F. Relationships of gut microbiota, short-chain fatty acids, inflammation, and the gut barrier in Parkinson's disease. Mol Neurodegener. 2021 Feb 8;16(1):6. doi: 10.1186/s13024-021-00427-6.

Reference Type BACKGROUND
PMID: 33557896 (View on PubMed)

Solch RJ, Aigbogun JO, Voyiadjis AG, Talkington GM, Darensbourg RM, O'Connell S, Pickett KM, Perez SR, Maraganore DM. Mediterranean diet adherence, gut microbiota, and Alzheimer's or Parkinson's disease risk: A systematic review. J Neurol Sci. 2022 Mar 15;434:120166. doi: 10.1016/j.jns.2022.120166. Epub 2022 Jan 26.

Reference Type BACKGROUND
PMID: 35144237 (View on PubMed)

Maraki MI, Yannakoulia M, Stamelou M, Stefanis L, Xiromerisiou G, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Anastasiou CA, Simopoulou E, Scarmeas N. Mediterranean diet adherence is related to reduced probability of prodromal Parkinson's disease. Mov Disord. 2019 Jan;34(1):48-57. doi: 10.1002/mds.27489. Epub 2018 Oct 10.

Reference Type BACKGROUND
PMID: 30306634 (View on PubMed)

Other Identifiers

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CRC1697-C04

Identifier Type: -

Identifier Source: org_study_id

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