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Food, Activity and Behavior Study

Not Applicable
Withdrawn
Conditions
Obesity
Interventions
Other: DGA diet WL & no exercise
Other: Western diet WL & exercise
Other: Western diet WM & exercise
Other: DGA diet WM & no exercise
Other: Western diet WL & no exercise
Other: DGA diet WM & exercise
Other: DGA diet WL & exercise
Other: Western diet WM & no exercise
Registration Number
NCT04577547
Lead Sponsor
USDA Grand Forks Human Nutrition Research Center
Brief Summary

The purpose of this research is to test the effects of the Dietary and Physical Activity Guidelines for Americans on health and on eating and exercise behaviors.

Detailed Description

The Dietary Guidelines for Americans (DGA), which include the Physical Activity Guidelines for Americans (PAGA), is the primary United States (U.S) government resource for weight control. The researchers propose that chronic, low grade inflammation (CLGI) limits weight control by acting upon physiological and behavioral factors that moderate weight control. Diet and exercise reduce CLGI and provide weight control, but no one has investigated the efficacy of the DGA and PAGA to reduce CLGI, whether reduced CLGI promotes greater weight control, and the moderating roles of physiological and behavioral factors on the association of reduced CLGI with weight control. To accomplish this, the researchers will conduct a 6-month trial in 224 obese adults; a 3-month controlled feeding trial with four dietary arms; 1) DGA with weight loss, 2) Western diet with weight loss,3) DGA diet weight maintenance, 4) Western diet weight maintenance. Each dietary arm will have PAGA-recommended exercise and non-exercise arms. Post-trial is a 3-month weight maintenance period. The primary outcome is change in C-reactive protein (CRP), a marker of CLGI. The results will inform the DGA and PAGA; thereby helping clinicians, public health workers, and policymakers to improve the health of Americans.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Obese (BMI 30.0 kg/m2 - 350 lbs [maximum weight for dual energy x-ray absorptiometry (DXA) machine])
  • No contraindications to participate in exercise
  • hs-CRP level ≥3.0 and ≤10.0 mg/L or two consecutive measures of >10.0 mg/L measured two weeks apart
  • Access to high-speed internet
Exclusion Criteria
  • Taking chronic anti-inflammatory medications
  • Being pregnant, lactating, or planning to become pregnant
  • Diagnosed eating disorder
  • Taking weight loss medication
  • Smoking
  • Overt hypothyroidism
  • Cancer
  • Physical conditions that prevent safe exercise
  • Liking of <3 out of 10 for all available physical activity modes
  • Currently exercising for more than 30 minutes per day >3 days per week
  • Unwilling to continue with current exercise routine
  • Not willing to comply with all study requirements
  • Blood pressure greater than 140/90

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
DGA diet with WL & no exerciseDGA diet WL & no exerciseMenu to provide DGA-recommended food group amounts at a calorie level to promote weight loss with no exercise
Western diet with WL & exerciseWestern diet WL & exerciseWestern-type menu to provide a calorie level to promote weight loss with PAGA-recommended exercise
Western diet WM exerciseWestern diet WM & exerciseWestern-type menu to provide a calorie level to promote weight maintenance with PAGA-recommended exercise
DGA diet WM & no exerciseDGA diet WM & no exerciseMenu to provide DGA-recommended food group amounts at a calorie level to promote weight maintenance with no exercise
Western diet with WL & no exerciseWestern diet WL & no exerciseWestern-type menu to provide a calorie level to promote weight loss with no exercise
DGA diet weight maintenance (WM) & exerciseDGA diet WM & exerciseMenu to provide DGA-recommended food group amounts at a calorie level to promote weight maintenance with PAGA-recommended exercise
Dietary Guidelines (DGA) diet with weight loss (WL) & exerciseDGA diet WL & exerciseMenu to provide DGA-recommended food group amounts at a calorie level to promote weight loss with Physical Activity Guidelines for Americans (PAGA)-recommended exercise
Western diet WM no exerciseWestern diet WM & no exerciseWestern-type menu to provide a calorie level to promote weight maintenance with no exercise
Primary Outcome Measures
NameTimeMethod
Relative reinforcing value (RRV) of exerciseWeeks 0,12, 24

The effect of achieving the DGA recommended amounts of exercise during weight loss and weight maintenance on relative reinforcing value of exercise compared to a sedentary activity alternative using a computer choice paradigm. For the computer choice paradigm subjects click the mouse button to play a simulated slot machine games to earn points toward being able to do a chosen physical activity, such as walking on a treadmill, or a sedentary activity (e.g., watching TV).

Fat and carbohydrate oxidationWeeks 0,12

The effect of diet and exercise on carbohydrate and fat oxidation in response to meals and exercise as measured by whole-room calorimetry

Change in C-reactive protein (CRP)Weeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on CRP

Relative reinforcing value (RRV) of energy-dense snack foodsWeeks 0,12, 24

The effect of consuming a healthy DGA style or a Western style diet during weight loss and weight maintenance on the RRV of energy-dense snack food using a computer choice paradigm. For the computer choice paradigm subjects click the mouse button to play a simulated slot machine games to earn points toward receiving a portion of food or being able to do a non-food related sedentary activity (e.g., watching TV).

Secondary Outcome Measures
NameTimeMethod
Cognitive flexibilityWeeks 0, 12, 24

The effect of diet and exercise on cognitive flexibility, one of the three cognitive domains of executive function, using a computerized Trail-Making test B/A.

Change in weight control moderatorsWeeks 0,12, 24

Questionnaires (i.e., three-factor eating questionnaire, reward base eating, food attitudes and behavior survey) that when scored provide a single number will be used to determine the moderating effect of self efficacy, restraint and disinhibition maintaining diet and exercise changes

Change in humoral biomarkers of eating behaviorWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on ghrelin, leptin, thyroid hormones, gut peptides, fatty acids

Change in myokinesWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on plasma myokines (e.g., BDNF, Myostatin, FGF-21, Irisin)

Food Cognitive InterferenceWeeks 0, 12, 24

The effect of diet and exercise on food cognitive interference, one of the three cognitive domains of executive function, using a computerized Food Stroop test.

InflammationWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on plasma pro-inflammatory cytokines (e.g., Il-6, MCP-1, TNF-alpha) and anti-inflammatory cytokines (e.g., IL-10, Soluble TNF receptor I and II)

Change in adipokinesWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on plasma adipokines (e.g., adiponectin, resistin)

Change in bile acidsWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on plasma bile acids (i.e., glycocholic acid, glyco-CDCA, glyco-HDCA, hyocholic acid, hyodeoxycholic acid)

Change in blood lipidsWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on cholesterol, HDL, triglycerides

Gene expression profiles of glucose oxidationWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on gene expression profiles associated with glucose oxidation (i.e., hexokinase, phosphofructokinase, pyruvate dehydrogenase kinase 4, peroxisome proliferator-activated receptor alpha gene expression)

Working memoryWeeks 0, 12, 24

The effect of diet and exercise on cognitive flexibility, one of the three cognitive domains of executive function, using the Wisconsin Card Sorting Task.

Gene expression profiles of fat oxidationWeeks 0, 2, 4, 6, 8, 10, 12, 24

The effect of diet and exercise on on gene expression profiles associated with fat oxidation (i.e., fatty acid translocase, fatty acid synthase, acetyl Co-A carboxylase 2, stearoyl Co-A desaturase gene expression)

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