The Effect of Intermittent Energy Restriction Using Meal Replacements in Overweight Chinese Subjects: a Pilot Randomized Control Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 19
- 试验地点
- 2
- 主要终点
- Change in Total Body Weight (in kg) at 3 months compared to baseline
研究概览
简要总结
Background and Aims: The "5:2 diet", a form of intermittent energy restriction, has been popularized in Europe and USA. The rationale behind this approach is that two days of dieting is potentially more achievable, yet long enough to reduce overall weekly energy intake. However, this specific approach is lacking in evidence. Therefore, we are keen to investigate the effectiveness of this form of intermittent energy restriction compared with a control intervention (providing dietary and exercise advice only), in overweight, Chinese subjects, for an intervention period of 12 weeks.
Design and Methods: This will be a randomized controlled trial, with 15 subjects in each arm, for an intervention period of 12 weeks. Subjects randomized to the treatment group will take three packets of a meal replacement product (Optifast®) per day during two consecutive fasting days, and take a healthy balanced diet that meet estimated energy requirements for the remaining five days. Subjects randomized to the control group will be given general diet advice and allowed to eat ad libitum throughout the study period. Measurements and laboratory tests will be done at baseline, 4 weeks and 12 weeks. Adherence to the dietary interventions will be assessed at 4 weeks and 12 weeks using 7-day food diaries.
Significance: This will be the first study looking at an Asian population and will serve as a pilot towards a larger randomized trial. If this approach is found to be safe, effective and easier to adhere compared to the traditional continuous energy restriction, then it will be a very valuable option in the treatment of obesity, which has become an increasing problem globally including Singapore.
详细描述
- STUDY DESIGN This will be a single centre, randomized controlled trial (RCT), comparing the intervention in question (Intermittent Energy Restriction (IER), "5:2 diet", treatment: 2 consecutive days of fasting (using meal replacement, Optifast®) per week) with a control of "advice only", with 15 participants in each arm, in an adult overweight, Chinese sample, for an intervention period of 12 weeks. Each potential participant will be subjected to a pre-study assessment and a trial of 2 consecutive fasting days with Optifast® as per intervention. Potential participants will be formally enrolled into the study if they successfully tolerated the 2 consecutive fasting days with no contraindications to participation. The actual study period is 12 weeks, consisting of 4 study visits and 3 telephone calls between the study visits.
This study design with a control arm (and randomisation) would provide more conclusive evidence if there is a significant difference between the two groups at the end of the study, with the difference most likely attributed to the intervention (IER, "5:2 diet", treatment). 2. METHODS AND ASSESSMENTS
2.1. Randomisation and Blinding Eligible subjects will be randomised to two groups: the intervention group and the control group. This will be achieved using an online randomisation plan generator (www.randomization.com), with the plan generated by the Clinical Research Unit in Khoo Teck Puat Hospital (KTPH). Assignment will be contained within opaque sealed envelopes, and opened only in the presence of the investigator and the subject.
With regards to blinding, only personnel performing laboratory measurements will be blinded to the group allocation of the subjects. The rest of the study personnel, including the research nurse taking the anthropometric measurements, will not be blinded.
2.2. Contraception and Pregnancy Testing Females of childbearing age included in the trial will be discouraged from getting pregnant during the study period, but contraception will not be strictly enforced. However, if any participant is found to be pregnant or might be pregnant during the course of the study, she will be withdrawn from the study in view of the nutritional demands of pregnancy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Ability to provide informed consent.
- •Chinese. (Both parents must be Chinese)
- •Age above 21 years old. This study will focus only on adult subjects, and 21 years old is chosen as the age cut off, as it is the recognised legal age of independent consent.
- •BMI ≥ 25 kg/m2
排除标准
- •Pregnant, or any possibility of being pregnant (based on last menstrual period).
- •Lactation.
- •Age above 70 years old and/or suffering from cancer, diabetes, or any major cardiovascular disease, respiratory, psychiatric or musculoskeletal morbidity.
- •Currently dieting or losing weight
- •Unable to tolerate or complete two consecutive days of fasting during a two-day trial before recruitment.
- •Unwilling to be randomised into intervention or control group.
研究组 & 干预措施
Intermittent Fasting
The intervention of interest here is the Intermittent Energy Restriction (IER) or the Intermittent Fasting approach, specifically, the "5:2" diet, where adherence to this dietary intervention consists of fasting for two consecutive days and consuming enough to meet energy requirements for the remaining five non-fasting days. In this study, fasting will be achieved by using a meal replacement product (Optifast®) supplemented by two scoops of protein powder (Propass®) and a multivitamin, making a total of 540kcal (54g protein, 60g carbohydrates) for each fasting day.
干预措施: Meal Replacement (Dietary Supplement)
Control
Diet and Physical Activity advice only. No treatment plan.
结局指标
主要结局
Change in Total Body Weight (in kg) at 3 months compared to baseline
时间窗: Baseline to 3 months
次要结局
- Change in Quality of Life (as determined by RAND Short Form-36 health survey) at 3 months compared to baseline(Baseline to 3 months)
- Change in Insulin Sensitivity % (as determined by the Homeostasis Model Assessment (HOMA)) at 3 months compared to baseline(Baseline to 3 months)
- Change in Total Cholesterol levels (in mmol/L) at 3 months compared to baseline(Baseline to 3 months)
- Change in Low Density Lipoprotein (LDL)- Cholesterol levels (in mmol/L) at 3 months compared to baseline(Baseline to 3 months)
- Change in High Density Lipoprotein (HDL)-Cholesterol levels (in mmol/L) at 3 months compared to baseline(Baseline to 3 months)
- Change in Triglyceride levels (in mmol/L) at 3 months compared to baseline(Baseline to 3 months)
- Change in Waist Circumference (in cm) at 3 months compared to baseline(Baseline to 3 months)
- Change in Body Fat % (as determined by bio-electrical impedance analysis) at 3 months compared to baseline(Baseline to 3 months)
- Change in Hip circumference (in cm) at 3 months compared to baseline(Baseline to 3 months)
- Change in Alanine transaminase (ALT) levels (in U/L) at 3 months compared to baseline(Baseline to 3 months)
- Change in Aspartate aminotransferase (AST) levels (in U/L) at 3 months compared to baseline(Baseline to 3 months)
- Change in Gamma-glutamyl transpeptidase (GGT) levels (in U/L) at 3 months compared to baseline(Baseline to 3 months)
研究者
Benjamin Lam
Consultant, Department of Family and Community Medicine, Khoo Teck Puat Hospital
Khoo Teck Puat Hospital