Inflammation Clinical Trial
Official title:
Effect of an Antioxidant and Anti-inflammatory Dietary Supplement Pack on the Adverse Physiological Actions Associated With Acute PM2.5 Exposure
This study will determine if a comprehensive antioxidant/anti-inflammatory dietary
supplement pack can offer protection against a decline in lung function and increase in
inflammation and oxidative stress following acute exposure to particulate matter air
pollution with a diameter <2.5 µm (PM2.5).
The investigators hypothesis is a follows: Compared to an appropriate control,
supplementation with a comprehensive antioxidant/anti-inflammatory dietary supplement pack
for 18 weeks will: 1) reduce the decline in lung function following acute exposure to
naturally occurring elevations in PM2.5 levels as measured by exhaled nitric oxide levels
and forced vital lung capacity; and 2) reduce changes in pro-inflammatory cytokines
following acute exposure to naturally occurring elevations in PM2.5 levels as measured by
plasma levels of C-reactive protein.
The study will be conducted in Cache County, UT. Surrounded by tall mountains (2513-3042 m),
and subject to frequent winter atmospheric inversions characterized by stagnant air that
traps and concentrates pollutants, Cache Valley, home to 120,000 inhabitants, is
particularly susceptible to high particulate air pollution during the winter months.
A total of 70 individuals (with the goal of completing 60) between the ages of 45-80 will be
recruited from Cache County, UT. Eligible participants will be randomly assigned to one of
two treatment arms (Placebo Dietary Supplements, Active Dietary Supplements) in a manner to
provide balanced assignment between the two arms with respect to age, sex and baseline
exhaled nitric oxide levels.
Participants assigned to the Placebo or Active arms will be provided with sealed envelopes
or bottles containing dietary supplements (or matched placebos) along with instructions as
to when to consume the supplements. Participants will be instructed to consume their
supplements twice a day with meals containing a small amount of fat (at least 3 grams) in
order to optimize the absorption of fat soluble nutrients. They will also be instructed to
consume the supplements with liquids in order to enhance absorption and to minimize GI upset
and choking potential. Participants will be asked to maintain their typical diet for the 18
weeks of the study.
Routine Clinic Visits are scheduled at two week intervals for the length of the study (with
accommodations made for Holiday schedules). During these visits, participants will: 1)
receive a sufficient supply of supplements to last until the next routine clinic visit; 2)
return any unused supplements; 3) be provided an opportunity to describe any adverse
events/reactions to the supplements; 4) describe any health issues experienced since the
previous exam; and 5) have their weight and blood pressure assessed.
Endpoint Clinic Visits are scheduled to coincide with low and high PM2.5 exposure. Starting
on Jan 2, participants will be notified of a potential endpoint assessment day when the
PM2.5 levels are predicted by the Utah Department of Environmental Quality, Division of Air
Quality, to rise above 30 µg/m3 (peak event) or fall below 8 µg/m3 (baseline event).
Endpoint visits will take place 24 hrs following these peak and baseline events. Based on
historical patterns, we anticipate at least three peak events, with corresponding baseline
assessments, during the intervention time period. For purposes of analysis, each peak event
will be paired with the nearest baseline event so that both events are captured at a similar
time after initiation of the intervention.
At each endpoint clinic visit, participants will undergo assessments of lung function and
systemic inflammation. Blood samples will be obtained for potential future analysis of
additional markers of systemic inflammation and plasma antioxidant capacity.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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