Respiratory Tract Infection Clinical Trial
Official title:
Effects of a Dietary Supplement on the Incidence of Acute Respiratory Infections in Susceptible Adults
The purpose of this study is to determine whether the consumption of a nutritional
supplement with micronutrients and herbal extracts has an effect on the incidence of acute
respiratory infections in susceptible adults.
Our hypothesis is that subjects who consume the nutritional supplement will have a lower
incidence and duration of acute respiratory infections in comparison with the placebo group.
We conducted a randomized, parallel, double-blind, placebo-controlled, 90-day clinical trial
from January to April, 2012. All staff who worked at the Omnilife's Entrepreneur Support
Department (CREO by its initials in Spanish) were invited to participate. This department
within Omnilife has a high incidence of acute respiratory infections (ARI) as reported
internally by the company's medical service (accounting for 55% of doctor visits within the
department in 2010) and hence, they represent a high number of individuals susceptible to
ARI.
We held a preliminary session with the department's entire staff to explain the procedures;
we asked subjects interested to participate in the study to sign an informed consent form
and fill a clinical history. The latter included an assessment of stress, using the
Perceived Stress Scale (in which higher scores indicate higher levels of stress), and
physical activity, using the International Physical Activity Questionnaire or IPAQ (in which
physical activity is categorized in three levels: light, moderate and vigorous).
In a second session the same week, participants visited the company's medical service for
measurements of their weight and height (in accordance with the International Society for
the Advancement of Kinanthropometry or ISAK standards), control laboratory tests and a
medical examination to rule out the presence of infections. Weight measurements were taken
using a Tanita BC553 Ironman Inner Scan Body Fat Scale (capacity of 150 kg, accuracy to 0.1
kg). Height measurements were made using a Seca 206 Stadiometer (accuracy to 0.1 cm,
measuring range to 220 cm). Both measurements were performed by a two certified and
standardized anthropometrists. Body mass index (BMI) was subsequently calculated using both
variables as follows: BMI = weight in kg/(height in m)2.
The medical examination was performed by the attending physician and a nurse. It consisted
of an assessment of vital signs following procedures described in the literature and a
physical examination of bodily organs and systems. Temperature was measured using a
Microlife MT 1931 digital thermometer (measuring range from 32 to 43.9°C, accuracy to
0.1°C). Heart and respiratory rates were measured using a 3M Littmann Classic II S.E.
stethoscope. Blood pressure readings were taken using a 3M Littmann Classic II S.E.
stethoscope and an Aneroid Sphygmomanometer ce0483 (18-300 mmHg measurement range, accuracy
to 2 mmHg).
Laboratory tests were conducted with the support of an external laboratory (Instituto
Diagnostico Especializado Arboledas, IDEA by its initials in Spanish). Included were a blood
test of six items (fasting glucose, uric acid, creatinine, blood urea nitrogen, cholesterol
and triglycerides) analyzed by the spectrophotometric method, a complete blood count with a
flow cytometry/microscopy analysis of platelets, and a spectroscopy analysis to assess liver
function. Subjects of laboratory analyses were tested after a 12-hour fast. This laboratory
has obtained quality control certification from the Quality Assurance for Laboratories
Program (PACAL) and the Internal Evaluation Quality Program (PREVECAL). In addition, its
staff is certified in clinical diagnosis by the National Association of Clinical Chemists
(CONAQUIC).
Subjects who met inclusion criteria were randomly assigned to two groups: one which received
the supplement (n=30), and a control group who received a placebo, which consisted in a
mixture of maltodextrins, colors and flavors. Every day two dietitians prepared the
products, who then gave the prepared products to two different supervisors who in turn gave
the product to each participant for consumption. The supervisors recorded product
administration and consumption for each participant on a control form.
Simultaneously, each week the supervisors provided each participant with an ARI symptom and
side effect diary to be filled in daily (indicating whether or not the symptom in question
had presented). Participants delivered the supervisors their filled-in diaries the following
week. Subjects were also requested not to self-medicate in the event they should feel any of
the symptoms and to notify the principal researcher and attending physician, who would make
a clinical assessment to confirm the presence or absence of ARI and provide any needed
medical treatment. In such cases, participants were not to be excluded from the study, but
treatment provided to them was documented. At the end of the supplementation period, the
initial assessments were performed again. Subjects were also asked about their perceptions
of their own health at that time compared to how they felt at the beginning of the study.
Quantitative variables are expressed as mean (SD). Qualitative variables are expressed as
frequency (%). Fisher's exact test was used to compare distribution percentages of
qualitative variables between groups and to compare the total proportion of ill subjects
across intervention groups using intent-to-treat and per-population concepts. The risk ratio
and the risk difference were also calculated for episodes of ARI. To compare the average of
quantitative variables between treatments, the Mann-Whitney U test was used. Statistical
analyzes were run using the SPSS program version 10 for Windows and Open Epi version 3.01;
p<0.05 was considered as significant.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention
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