NCT01977885

Brief Summary

Our greatest public health challenge is obesity and the co-morbidities of metabolic syndrome (MetS). Age is an established risk factor for MetS and specific to women, data indicates that the prevalence of MetS increases substantially with the menopausal transition with postmenopausal women having a 60% increased risk of MetS. Menopause also contributes to reductions in strength, physical function and often psychological well-being (e.g. fatigue). Obese individuals also have: a) impaired immune function and chronic inflammatory responses associated with changes in the white blood cell population in blood and fat tissues; and, b) increased secretion of and signaling by proteins in their fat cells. Weight loss, which requires an energy deficit through increased physical activity and/or caloric restriction (EX+CR), reduces risk for MetS in older sedentary obese women by reducing insulin resistance and chronic systemic inflammation. Science and clinical practice will be advanced by examining the molecular mechanisms by which EX+CR affects risk for MetS in older women. The primary aim is to determine if CD4+ T cells will report the differential epigenetic reprogramming of relevant gene expression associated with metabolic indices resulting from EX+CR induced weight loss in older women known to be at risk for MetS. This pilot data will be used to generate an NIH proposal of the same topic. A secondary aim is to assess the impact of weight loss on physical function and psychological well-being which will provide pilot data for an additional grant proposal regarding weight management in postmenopausal women.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
21

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Jun 2013

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2013

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

October 16, 2013

Completed
22 days until next milestone

First Posted

Study publicly available on registry

November 7, 2013

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2014

Completed
Last Updated

September 25, 2015

Status Verified

September 1, 2015

Enrollment Period

1.5 years

First QC Date

October 16, 2013

Last Update Submit

September 24, 2015

Conditions

Keywords

epigeneticsobesityoverweighthigh protein dietexercisepost menopausal women

Outcome Measures

Primary Outcomes (1)

  • Change in CD4+T Cells from Baseline to Post-Intervention

    The primary aim is to determine if CD4+ T cells will report the differential epigenetic reprogramming of relevant gene expression associated with metabolic indices resulting from EX+CR induced weight loss in older women known to be at risk for MetS.

    Baseline (Week 0), Post-Intervention (Week 24)

Secondary Outcomes (2)

  • Change in Physical Function over 6 Months

    Baseline (Week 0), Midpoint (Week 12), Post-Intervention (Week 24)

  • Change in Psychological Well Being over 6 Months

    Baseline (Week 0), Midpoint (Week 12), Post-Intervention (Week 24)

Study Arms (1)

High Protien Diet + Exercise

EXPERIMENTAL

All participants will participate in both interventions (High Protein Diet and Exercise).

Behavioral: High Protein DietBehavioral: Exercise

Interventions

All participants will be individually counseled by an RD for \~ 4 sessions (30 to 60 minutes)to meet weight loss goals. During the duration of the study, participants will be required to attend a 30 to 60 minute group educational/motivational meeting weekly (first 1 to 2 months) and then biweekly (for the remainder of the study). Diet recommendations will include high quality proteins with an emphasis on lean meats with protein being targeted for every meal and snack. Regarding beef intake specifically, the prescribed diet will include a minimum of one serving of beef per day, which is approximately 3 to 3.5 ounces or \~100 grams. This amount of lean cooked beef provides an average of \~25-30 grams of protein per day (www.beefnutrition.org/leanbeef.aspx). This combined with reducing energy from carbohydrates and fat from other sources will create an overall energy deficit of 500 kcal/day. This diet will also include 5 servings/day of vegetables and 2-3 servings/day of fruit

High Protien Diet + Exercise
ExerciseBEHAVIORAL

Participants will be prescribed a supervised exercise program with required attendance of 3 nonconsecutive days per week (75 minutes each session). A program that combines flexibility and balance activities, weight bearing endurance exercise (walking) and resistance training to preserve lean mass will be prescribed. With specific regard to strength training, 50% of the resistance work will involve primary muscle groups of the lower body with the main focus being the gluteal and quadriceps groups (squats, lunges, etc.). The remaining 50% of work will dedicate 25% to the core stabilizers with the final 25% being the upper body. Transitions between segments of training will be used for recovery and social support enhancement. Note that all aspects of the exercise intervention will be progressive in intensity (i.e., starting at lower end of intensity or \~50% of maximal capacity), and duration (i.e., from 15 minutes to 35 minutes of exercise and adding a few minutes each session).

High Protien Diet + Exercise

Eligibility Criteria

Age50 Years - 64 Years
Sexfemale
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Volunteer for the study
  • Age between 50 and 64 years
  • Self-identified as White or Caucasian
  • Postmenopausal
  • Sedentary (less than 1 hour each week of planned physical activity and sedentary job)
  • BMI range \>/= 25 kg/m2
  • Waist circumference \>88cm
  • Weight stable (within 2 kg) for 6 months
  • All allowable medications stable for 3 months
  • Live independently
  • Willing and able to obtain transportation to and from lab sessions
  • Obtains physician clearance to participate in the study

You may not qualify if:

  • Tobacco use
  • Normal weight (BMI \< 25 kg/m2)
  • Males
  • Dietary restrictions that do not allow for the consumption of beef, as required by our dietary protocol
  • Weight loss surgery and/or weight loss medications usage
  • Mini-mental state exam score \< 25
  • Recent or history of unstable CVD
  • Cancer treatment within the last 5 years or active cancer
  • History of lung disease or COPD or severe asthma
  • History or severe arthritis or other medical condition that precludes ability to exercise to level needed by study.
  • Current diagnosis or history of balance disorders
  • History of mental disorders, dementia, clinical depression or other disorders that preclude adherence to protocols.
  • Current weight of 350 pounds or greater, due to weight restrictions on equipment.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Body Composition and Metabolism Lab, UGA, Ramsey Student Center

Athens, Georgia, 30602, United States

Location

MeSH Terms

Conditions

Metabolic SyndromeObesityOverweightMotor Activity

Interventions

Diet, High-ProteinExercise

Condition Hierarchy (Ancestors)

Insulin ResistanceHyperinsulinismGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesOvernutritionNutrition DisordersBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsBehavior

Intervention Hierarchy (Ancestors)

Diet TherapyNutrition TherapyTherapeuticsDietNutritional Physiological PhenomenaDiet, Food, and NutritionPhysiological PhenomenaMotor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological Phenomena

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor of Kinesiology

Study Record Dates

First Submitted

October 16, 2013

First Posted

November 7, 2013

Study Start

June 1, 2013

Primary Completion

December 1, 2014

Study Completion

December 1, 2014

Last Updated

September 25, 2015

Record last verified: 2015-09

Locations