NCT03074643

Brief Summary

This study will evaluate the effects of diet composition (i.e., amount of protein and carbohydrate) during a 6-month weight loss intervention and 12-months of follow-up on physical function, muscle mass, and weight loss maintenance in obese older adults. Participants will receive either a protein or carbohydrate supplement along with a behavioral weight loss intervention.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
187

participants targeted

Target at P75+ for not_applicable obesity

Timeline
Completed

Started May 2017

Longer than P75 for not_applicable obesity

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

First Submitted

Initial submission to the registry

February 28, 2017

Completed
9 days until next milestone

First Posted

Study publicly available on registry

March 9, 2017

Completed
2 months until next milestone

Study Start

First participant enrolled

May 3, 2017

Completed
5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 28, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 28, 2022

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

May 22, 2023

Completed
Last Updated

May 22, 2023

Status Verified

April 1, 2023

Enrollment Period

5 years

First QC Date

February 28, 2017

Results QC Date

April 24, 2023

Last Update Submit

May 19, 2023

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change in Expanded Short Physical Performance Battery Score

    To determine the effects of a higher protein / lower CHO diet vs. lower protein / higher CHO diet during a 6-month weight loss intervention and 12 months of follow-up on change in lower extremity physical function assessed by the expanded Short Physical Performance Battery score over 18 months. The expanded Short Physical Performance Battery score ranges from 0 to 4 with higher scores indicating better lower extremity physical function

    18 months

Secondary Outcomes (6)

  • Lower Extremity Muscle Strength

    18 months

  • Weight Change

    18 months

  • Total Body Lean Mass

    18 months

  • Total Body Fat Mass

    18 months

  • Thigh Muscle Volume

    18 months

  • +1 more secondary outcomes

Study Arms (3)

RecProt

PLACEBO COMPARATOR

Lower protein / higher CHO diet for the 6-month weight loss phase. Exercise intervention months 0-6. Weight loss intervention months 0-6. Carbohydrate supplement for months 0-6 (blinded). Follow-up months 7-18.

Behavioral: Weight loss intervention months 0-6Behavioral: Exercise intervention months 0-6Dietary Supplement: Carbohydrate supplement for months 0-6

6-mon HiProt

ACTIVE COMPARATOR

Higher protein / lower CHO diet for the 6-month weight loss phase. Exercise intervention months 0-6. Weight loss intervention months 0-6. Protein supplement for months 0-6 (blinded). Follow-up months 7-18.

Behavioral: Weight loss intervention months 0-6Behavioral: Exercise intervention months 0-6Dietary Supplement: Protein supplement for months 0-6

18-mon HiProt

ACTIVE COMPARATOR

Higher protein / lower CHO diet for the 6-month weight loss and 12-month follow-up phases. Exercise intervention months 0-6. Weight loss intervention months 0-6. Protein supplement for months 0-6 (blinded). Protein supplement for follow-up months 7-18.

Behavioral: Weight loss intervention months 0-6Behavioral: Exercise intervention months 0-6Dietary Supplement: Protein supplement for months 0-6Dietary Supplement: Protein supplement for follow-up months 7-18

Interventions

All participants will undergo a dietary weight loss intervention designed to elicit behavioral changes leading to decreased caloric intake sufficient to yield a \~10% loss of initial body mass. The weight loss intervention will incorporate nutrition education (via group and individual meetings with the study dietitian), self-monitoring skills, cognitive-behavioral strategies for promoting lifestyle behavior modifications, and planned meals. Behavioral and educational group and individual sessions will be held weekly in a 3:1 ratio (3 group and 1 individual session per month).

18-mon HiProt6-mon HiProtRecProt

All participants will be expected to participate in a supervised, center-based exercise program involving moderate-intensity aerobic exercise (e.g., treadmill walking) 3 days/wk during the 6-month weight loss intervention in accordance with the American Heart Association and the American College of Sports Medicine physical activity recommendations for older adults.

18-mon HiProt6-mon HiProtRecProt

Participants in the lower protein / higher CHO diet group (RecProt) will be provided a carbohydrate supplement (\~50 g of carbohydrate and 220 calories) to consume daily during the 6 month weight loss intervention.

RecProt

Participants in the higher protein / lower CHO diet groups (6-mon HiProt and 18-mon HiProt) will be provided a protein supplement (\~50 g of protein and 220 calories) to consume daily during the 6 month weight loss intervention.

18-mon HiProt6-mon HiProt

Participants in the higher protein / lower CHO diet (18-mon HiProt) will be provided a protein supplement (\~50 g of protein and 220 calories) to consume daily during the 12-month follow-up.

18-mon HiProt

Eligibility Criteria

Age65 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsOlder Adult (65+)

You may qualify if:

  • years
  • BMI: 27-45 kg/m2
  • No regular resistance training and/or aerobic exercise (\>20 mins/d) for past 6 months
  • eSPPB \<2.5
  • No contraindications for safe and optimal participation in exercise training
  • Approved for participation by Medical Director (Dr. Lyles)
  • Willing to provide informed consent
  • Agree to all study procedures and assessments
  • Willing to consume protein/CHO supplements for up to 18 months
  • Able to provide own transportation to study visits and intervention sessions

You may not qualify if:

  • Weight loss (≥5%) in past 6 months
  • Dependent on cane or walker
  • Cognitive impairment (MoCA score \<22)
  • Severe arthritis, or other musculoskeletal disorder
  • Joint replacement or other orthopedic surgery in past 6 months
  • Uncontrolled resting hypertension (\>160/90 mmHg);
  • Insulin-dependent or uncontrolled diabetes (HbA1c ≥8%)
  • Current or recent past (within 1 year) severe symptomatic heart disease, uncontrolled angina, stroke, chronic respiratory disease requiring oxygen; uncontrolled endocrine/metabolic disease; neurological or hematological disease; cancer requiring treatment in past year, except non-melanoma skin cancers; liver or renal disease; or clinically evident edema
  • Unstable, severe depression
  • Serious conduction disorder, uncontrolled arrhythmia, or new Q waves or ST-segment depressions (\>3 mm at rest or ≥2 mm with exercise)
  • Abnormal kidney function (eGFR \<30 based on serum creatinine, age, gender, and race)
  • Anemia (Hb\<13 g/dL in men; \<12 g/dL in women)
  • Drug abuse or excessive alcohol use (\>7 drinks/week women; \>14 drinks/week men)
  • Use of any tobacco or nicotine products in the past year
  • Osteoporosis (T-score \< -2.5 on hip or spine scan)
  • +3 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Geriatric Research Center at Wake Forest Baptist Health

Winston-Salem, North Carolina, 27157, United States

Location

MeSH Terms

Conditions

ObesityWeight LossBody Weight ChangesFeeding Behavior

Condition Hierarchy (Ancestors)

OverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsBehavior, AnimalBehavior

Limitations and Caveats

We initially planned to end recruitment in August of 2020. However, our institution paused all in-person research from March 13, 2020 through May 31, 2020 due to the COVID19 pandemic. We extended our recruitment window through September 2020 but did not reach our target enrollment. The COVID19 pandemic also affected participant follow-up (a large number of out of window visits and a few who refused to return for in-person visits). The 6-month intervention also had to go remote for \~4 months.

Results Point of Contact

Title
Dr. Denise Houston
Organization
Wake Forest University School of Medicine

Study Officials

  • Denise Houston, PhD

    Wake Forest University Health Sciences

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: All participants will undergo a 6-month weight loss intervention of caloric restriction and supervised exercise followed by 12 months of follow-up with randomization to one of three groups (n=75/group): 1) Lower protein / higher CHO diet for the 6-month weight loss phase only (RecProt); 2) Higher protein / lower CHO diet for the 6-month weight loss phase only (6-mo HiProt); or 3) Higher protein / lower CHO diet for the 6-month weight loss and 12-month follow-up phases (18-mo HiProt).
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 28, 2017

First Posted

March 9, 2017

Study Start

May 3, 2017

Primary Completion

April 28, 2022

Study Completion

April 28, 2022

Last Updated

May 22, 2023

Results First Posted

May 22, 2023

Record last verified: 2023-04

Data Sharing

IPD Sharing
Will not share

Locations