Obesity Clinical Trial
Official title:
Diet and Metabolic Inflammation
Obesity is a risk factor for several common cancers, including those of the breast, colon, liver, and pancreas. Proposed molecular links between obesity and these types of cancer include systemic inflammation, hyperinsulinemia, and changes in the serum concentrations of sex steroid hormones and adipokines. All of these are strongly linked to low-grade chronic inflammatory processes in expanded adipose tissue. The objective of this proposal is to test the hypothesis that adipose tissue inflammation can be reduced by the foods we eat.
Overweight or obese individuals with evidence of insulin resistance will be enrolled, until
16 have completed all study procedures. Enrolled subjects will be randomized to follow one
of two healthy diets for 12 weeks to determine how each diet affects inflammation in the
body and sugar and insulin levels in the blood.
We will address the following specific aims:
Primary specific aim: To investigate whether the consumption of either diet reduces the
metabolic activation of adipose tissue macrophages (ATM) as assessed by quantifying the ATM
cell surface expression (relative mean fluorescence intensity, rMFI) of the metabolic
activation markers, CD36 and ABCA1.
Secondary specific aim 1: To compare how each of the study diets affects endpoints
downstream of metabolic activation of ATM, specifically (a) adipose tissue expression of the
key pro-inflammatory cytokines tumor necrosis factor α (TNFα) and interleukins (IL)-1 beta
and 6; (b) adipose tissue expression of the key anti-inflammatory adipokine, adiponectin;
(c) systemic insulin sensitivity, as assessed by the Matsuda-DeFronzo Insulin Sensitivity
Index (ISI), based on a 3-hour frequently sampled oral glucose tolerance test (FS-OGTT); and
oral glucose tolerance, as assessed by measuring the total area-under-the-curve glucose in
the FS-OGTT.
Secondary specific aim 2: To compare the impact of each of the study diets on low-grade
chronic systemic inflammation, as assessed by measuring the concentrations of high
sensitivity C-reactive protein (hsCRP), IL-6, and total adiponectin in fasting plasma.
Secondary specific aim 3: To assess dietary adherence in the two dietary intervention
groups. Dietary adherence will be measured by a dietary adherence score (separately for each
diet), based on repeated 4-day diet records completed by all participants in the study.
Because all of our study endpoints are thought to be linked to the gut microbiota, and
because the effects of diet may be mediated through changes in the gut microbiota, we will
also collect stool samples from all participants before and after completing the study.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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