Effect of Consuming n-3 PUFAs Rich Foods on Triglyceride Concentration and Lipoprotein Composition

NCT ID: NCT07004777

Last Updated: 2026-02-05

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

RECRUITING

Clinical Phase

NA

Total Enrollment

375 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-02-01

Study Completion Date

2027-06-30

Brief Summary

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Hypertriglyceridemia is one of the most prevalent lipid profile disorders and is linked to a large proportion of mortality in Mexico and around the world. Various international treatment guidelines for hypertriglyceridemia have suggested the consumption of foods rich in n-3 polyunsaturated fatty acids or their intake through supplementation as a complement to lifestyle changes. However, adherence to the consumption of foods and supplements containing these fatty acids is often limited due to lack of acceptance or unaffordability. For this reason the objective of the study is to evaluate the effect and adherence to the consumption of foods rich in n-3 polyunsaturated fatty acids (PUFA) (pumpkin and chia seeds and salmon) and n-3 PUFA supplement during four weeks of a follow up dietary intervention determined by triglyceride concentration and lipoprotein composition in people with hypertriglyceridemia.

The study is divided into two phases. In the first, participants' diets will be standardized, providing them with dietary recommendations for four weeks.

Participants who maintain triglyceride levels \>200 mg/dL despite the recommendations will be invited to a second phase: a randomized controlled clinical trial consisting of a dietary intervention with a four-week follow-up.

Participants will be randomized into three treatment groups: 1) isocaloric diet and Eicosapentaenoic acid (EPA) + Docosahexaenoic acid (DHA) supplementation; 2) isocaloric diet including salmon; 3) isocaloric diet including chia and pumpkin seeds. The effect of the dietary intervention will be assessed by determining lipid composition and lipoprotein analysis, while adherence to n-3 PUFA consumption will be measured by serum fatty acid profile analysis.

Detailed Description

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The study is divided into two phases. The first phase is a prospective study with a 4-week follow-up to standardize the participants' diet. The second phase is a randomized controlled clinical trial consisting of a dietary intervention with a four-week follow-up.

Phase 1

Participants' diets will be standardized using dietary recommendations based on guidelines. Individuals who agree to participate will be required to sign an informed consent form. At baseline and at the end of this phase, participants will undergo a medical history questionaire, anthropometric assessments (weight, height, and waist circumference), body composition analysis (body fat percentage, skeletal muscle mass percentage, and lean muscle mass percentage), blood pressure measurement, and cardiometabolic risk score evaluation. Additionally, blood samples will be collected to determine serum concentrations of glucose, lipid profile parameters (total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides) as well as for the isolation of monocytes to determine mitochondrial function. It will be recommended to the participants to continue with the dietary recommendations until transitioning to the clinical trial, where those whose triglyceride concentrations remain \>200 mg/dL will be invited to participate.

Phase 2

Participants with hypertriglyceridemia will be randomly assigned to three groups, each of which will be prescribed an isocaloric diet including a food or supplement rich in n-3 PUFA:

* An isocaloric diet and EPA+DHA supplement
* An isocaloric diet including salmon
* An isocaloric diet including chia seeds

Resting energy expenditure wil be measured by indirect calorimetry to determine energy requirement of each participant. Distribution of micronutrients of the dietary intervention will be as follow: 50% carbohydrates, 20% protein, and 30% lipids .

This dietary intervention will last 4 weeks. To promote adherence, participants will be given foods or supplements rich in n-3 PUFA.

The same assessments conducted in the previous phase will be repeated at the start and at the end of the 4 week-follow-up period of the intervention. Additionally, other parameters will be evaluated, including insulin levels; inflammatory markers ; endothelial markers and intercellular adhesion molecule-1, cardiometabolic risk markers ; oxidative stress markers; liver function tests ; and pulse wave velocity. Lipid composition and lipoprotein analysis will also be determined to evaluate the effect. As well as the concentration of serum fatty acid profile analysis to evaluate the adherence to PUFA-n3.

In both phases, dietary intake and the adherence to dietary treatment will be monitored using 24-hour dietary recalls, which will be conducted during all visits, as well as through phone calls 2 times per week and text messages.

Conditions

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Hypertriglyceridemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The groups will receive the treatment simultaneously.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The person who will perform the biochemical determinations and the statistical analysis will be blinded from the intervention group by assigning each patient.

Study Groups

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Salmon diet

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

Group Type EXPERIMENTAL

Isocaloric diet including salmon

Intervention Type OTHER

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

This dietary intervention consists of a four-week follow-up period and incorporates the intake of salmon.

Chia and pumpkin seeds diet

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

Group Type EXPERIMENTAL

Isocaloric diet including chia and pumpkin seeds

Intervention Type OTHER

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

This dietary intervention consists of a four-week follow-up period and incorporates the intake of pumpkin and chia seeds.

Diet plus fish oil

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

Group Type ACTIVE_COMPARATOR

Isocaloric diet plus fish oil

Intervention Type DIETARY_SUPPLEMENT

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

This dietary intervention consists of a four-week follow-up period and incorporates EPA + DHA supplement (fish oil) to the diet.

Interventions

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Isocaloric diet including chia and pumpkin seeds

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

This dietary intervention consists of a four-week follow-up period and incorporates the intake of pumpkin and chia seeds.

Intervention Type OTHER

Isocaloric diet plus fish oil

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

This dietary intervention consists of a four-week follow-up period and incorporates EPA + DHA supplement (fish oil) to the diet.

Intervention Type DIETARY_SUPPLEMENT

Isocaloric diet including salmon

Diet based on participant-specific energy expenditure. With the following macronutrient distribution: 50% carbohydrates, protein 20% and 30% fats.

This dietary intervention consists of a four-week follow-up period and incorporates the intake of salmon.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Phase 1

* Signing of the informed consent form
* Both sexes.
* Adults over 18 years of age.
* BMI \>18.5 kg/m2.
* Triglycerides between 200 and 500 mg/dL.
* Total cholesterol less than 240 mg/dL

Phase 2

* Both sexes
* Adults over 18 years of age.
* BMI \>18.5 kg/m2
* Individuals whose triglyceride concentration is greater than 200 mg/dL and less than 500 mg/dL after dietary treatment (dietary recommendations based on the National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATPIII) guidelines).

Exclusion Criteria

* Any type of diabetes.
* kidney disease diagnosed by a physician.
* Acquired diseases that secondarily cause obesity and diabetes.
* Patients who have suffered a cardiovascular event.
* Weight loss \>3 kg in the last 3 months.
* Catabolic diseases such as cancer and acquired immunodeficiency syndrome.
* Pregnancy.
* Treatment with any medication:
* Treatment with antihypertensive drugs (tricyclic, loop, or potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, alpha-blockers, calcium channel blockers, beta-blockers).
* Treatment with hypoglycemic agents (sulfonylureas, biguanides, incretins) or - insulin and antidiabetics.
* Treatment with statins, fibrates, or other drugs to control dyslipidemia.
* Use of steroid medications, chemotherapy, immunosuppressants, or radiation therapy.
* Anorectic agents or those that accelerate weight loss.
* Treatment with any medication that influences inflammation (corticosteroids, nonsteroidal anti-inflammatory drugs, colchicine, interleukin-1 inhibitors) or triglyceride metabolism (metformin, glitazones, SGLT2 inhibitors, fibrates, statins, cholesterol ester transporter protein (CETP) inhibitors, pancreatic lipase inhibitors).
* Anticoagulants and antiplatelets (warfarin, aspirin, clopidogrel).
* People with a smoking cessation index (SCI) greater than 21.
* People with a tobacco Index greater than 21.
* Consumption of large amounts of alcohol (14 drinks for women or 21 drinks for men in a typical week).
* Consumption of any recreational psychoactive substance.
* Allergy or intolerance to any food listed in the proposed pantry.
* Unwillingness to consume any of the foods listed in the proposed pantry.
* Previous n-3 PUFA supplementation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

OTHER

Sponsor Role lead

Responsible Party

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Martha Guevara Cruz

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Martha Guevara

Role: STUDY_DIRECTOR

INCMNSZ

Locations

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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Mexico City, Mexico City, Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Martha Guevara, MD, PhD

Role: CONTACT

+52 55 5487 0900 ext. 2802

Armando Tovar, PhD

Role: CONTACT

+52 55 5487 0900 ext. 2802

Facility Contacts

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Martha Guevara-Cruz, MD, PhD

Role: primary

+525554870900 ext. 2802

Armando Tovar, PhD

Role: backup

+525554870900 ext. 2801

References

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Ly R, MacIntyre BC, Philips SM, McGlory C, Mutch DM, Britz-McKibbin P. Lipidomic studies reveal two specific circulating phosphatidylcholines as surrogate biomarkers of the omega-3 index. J Lipid Res. 2023 Nov;64(11):100445. doi: 10.1016/j.jlr.2023.100445. Epub 2023 Sep 18.

Reference Type BACKGROUND
PMID: 37730162 (View on PubMed)

Ottestad I, Hassani S, Borge GI, Kohler A, Vogt G, Hyotylainen T, Oresic M, Bronner KW, Holven KB, Ulven SM, Myhrstad MC. Fish oil supplementation alters the plasma lipidomic profile and increases long-chain PUFAs of phospholipids and triglycerides in healthy subjects. PLoS One. 2012;7(8):e42550. doi: 10.1371/journal.pone.0042550. Epub 2012 Aug 28.

Reference Type BACKGROUND
PMID: 22952598 (View on PubMed)

Erkkila AT, Manninen S, Fredrikson L, Bhalke M, Holopainen M, Ruuth M, Lankinen M, Kakela R, Oorni K, Schwab US. Lipidomic changes of LDL after consumption of Camelina sativa oil, fatty fish and lean fish in subjects with impaired glucose metabolism-A randomized controlled trial. J Clin Lipidol. 2021 Sep-Oct;15(5):743-751. doi: 10.1016/j.jacl.2021.08.060. Epub 2021 Sep 7.

Reference Type BACKGROUND
PMID: 34548243 (View on PubMed)

Tatsuno I, Kudou K, Kagawa T. Effect of TAK-085 on Low-density Lipoprotein Particle Size in Patients with Hypertriglyceridemia: A Double-blind Randomized Clinical Study. Cardiovasc Ther. 2015 Dec;33(6):317-23. doi: 10.1111/1755-5922.12146.

Reference Type BACKGROUND
PMID: 26222126 (View on PubMed)

Makni M, Fetoui H, Gargouri NK, Garoui el M, Jaber H, Makni J, Boudawara T, Zeghal N. Hypolipidemic and hepatoprotective effects of flax and pumpkin seed mixture rich in omega-3 and omega-6 fatty acids in hypercholesterolemic rats. Food Chem Toxicol. 2008 Dec;46(12):3714-20. doi: 10.1016/j.fct.2008.09.057. Epub 2008 Oct 1.

Reference Type BACKGROUND
PMID: 18938206 (View on PubMed)

Avila-Nava A, Noriega LG, Tovar AR, Granados O, Perez-Cruz C, Pedraza-Chaverri J, Torres N. Food combination based on a pre-hispanic Mexican diet decreases metabolic and cognitive abnormalities and gut microbiota dysbiosis caused by a sucrose-enriched high-fat diet in rats. Mol Nutr Food Res. 2017 Jan;61(1). doi: 10.1002/mnfr.201501023. Epub 2016 Aug 8.

Reference Type BACKGROUND
PMID: 27352915 (View on PubMed)

Bhatt DL, Steg PG, Brinton EA, Jacobson TA, Miller M, Tardif JC, Ketchum SB, Doyle RT Jr, Murphy SA, Soni PN, Braeckman RA, Juliano RA, Ballantyne CM; REDUCE-IT Investigators. Rationale and design of REDUCE-IT: Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial. Clin Cardiol. 2017 Mar;40(3):138-148. doi: 10.1002/clc.22692. Epub 2017 Mar 15.

Reference Type BACKGROUND
PMID: 28294373 (View on PubMed)

Zheng J, Huang T, Yu Y, Hu X, Yang B, Li D. Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies. Public Health Nutr. 2012 Apr;15(4):725-37. doi: 10.1017/S1368980011002254. Epub 2011 Sep 14.

Reference Type BACKGROUND
PMID: 21914258 (View on PubMed)

Kontostathi M, Isou S, Mostratos D, Vasdekis V, Demertzis N, Kourounakis A, Vitsos A, Kyriazi M, Melissos D, Tsitouris C, Karalis E, Klamarias L, Dania F, Papaioannou GT, Roussis V, Polychronopoulos E, Anastassopoulou J, Theophanides T, Rallis MC, Black HS. Influence of Omega-3 Fatty Acid-Rich Fish Oils on Hyperlipidemia: Effect of Eel, Sardine, Trout, and Cod Oils on Hyperlipidemic Mice. J Med Food. 2021 Jul;24(7):749-755. doi: 10.1089/jmf.2020.0114. Epub 2020 Dec 23.

Reference Type BACKGROUND
PMID: 33370175 (View on PubMed)

Other Identifiers

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INCMNSZ

Identifier Type: OTHER

Identifier Source: secondary_id

FNU-5515-25-27-1

Identifier Type: -

Identifier Source: org_study_id

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