NCT06931730

Brief Summary

The RESILIENT project is a clinical trial investigating leptin sensitivity in both children and adults with overweight or obesity. The study examines the additive effects of Cognitive Training (CT) and Social Training (ST) on leptin sensitivity, compared to stand-alone Intensive Health Behaviour Treatment (IHBT), which includes diet and Physical Activity (PA). The intervention will last for 8 weeks, followed by a 12-week washout period. A multilevel assessment will be conducted, evaluating in vivo leptin sensitivity (through the ratio of leptin levels to caloric intake) as well as ex vivo molecular analysis of leptin signaling in Peripheral Blood Mononuclear Cells (PBMCs). Additionally, clinical, psychological, cognitive, and physiological assessments will be performed to assess the efficacy of each intervention. By investigating leptin resistance as a potential molecular bridge between metabolic dysregulation and cognitive dysfunctions, this study may contribute to the development of more effective, long-term treatments for obesity and overweight. Additionally, in vivo investigation of leptin sensitivity may be particularly important for providing evidence of the metabolic and cognitive effects necessary for developing novel anti-obesity treatments.

Trial Health

57
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
240

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2024

Typical duration for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

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

February 8, 2024

Completed
1.1 years until next milestone

First Submitted

Initial submission to the registry

March 24, 2025

Completed
24 days until next milestone

First Posted

Study publicly available on registry

April 17, 2025

Completed
9 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2025

Completed
Last Updated

April 17, 2025

Status Verified

March 1, 2025

Enrollment Period

1.9 years

First QC Date

March 24, 2025

Last Update Submit

April 9, 2025

Conditions

Keywords

childhood obesitycognitive trainingsocial trainingenvironmental enrichmentleptinlifestyle modificationoverweightobesityenergy expenditurethermogenesisphysical activityleptin sensitivityleptin resistance

Outcome Measures

Primary Outcomes (6)

  • In Vivo Leptin Sensitivity

    Leptin sensitivity will be evaluated as the ratio between caloric intake during an experimental meal and circulating leptin levels. Participants will receive a standardized breakfast and after 3 hours an ad libitum lunch, with detailed records of consumption, additional food requests, and portion sizes. Hunger and satiety will be measured using a 5-item Visual Analogue Scale (VAS) at multiple time points, recorded in millimeters. Energy and nutrient intake will be assessed using nutritional labels from each food item, and leptin sensitivity will be determined via plasma fasting.

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Ex Vivo Leptin Sensitivity

    Since direct assessment of leptin sensitivity in the central nervous system is not feasible in humans, peripheral leptin sensitivity ex vivo will be evaluated using Peripheral Blood Mononuclear Cells (PBMCs). PBMCs will be collected from the same individuals before and after the intervention and exposed to recombinant leptin to assess intracellular signalling activation. The primary leptin effector pathway is Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3), though Extracellular signal-regulated protein kinases 1 and 2 (ERK1/2) activation has also been reported among others. The activation of these pathways will be measured using immunoassays such as Enzyme Linked Immunosorbent Assay (ELISA) and Western blot, quantifying the ratio of phosphorylated to total protein levels for each intracellular effector.

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Insulin Sensitivity and Secretion

    Insulin sensitivity and secretion will be assessed both during fasting and the oral glucose tolerance test (OGTT).

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Energy Metabolism

    Energy metabolism, including resting metabolic rate and diet-induced thermogenesis, will be measured by indirect calorimetry.

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Fat Mass (percentage)

    Fat mass will be estimated using bioelectrical impedance analysis and expressed as a percentage of total body weight.

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Fat Mass (kilograms)

    Fat mass will be estimated using bioelectrical impedance analysis and expressed in kilograms.

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

Secondary Outcomes (26)

  • Non-Verbal Fluid Intelligence

    At baseline (T0)

  • Working Memory

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Sustained Attention and inhibitory control

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Episodic Long-Term Memory

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • Visual-Motor Integration

    At baseline (T0), at the end of the 8-week intervention (T1, end of month 2), and 12 weeks after the intervention (T2, end of month 5) to verify the persistence of effects.

  • +21 more secondary outcomes

Study Arms (3)

Intensive Health Behavior Treatment group: Physical Activity and Diet

ACTIVE COMPARATOR

Participants will be provided with a personalized dietary plan and a Physical Activity training

Other: Nutritional InterventionOther: Physical Activity training

Cognitive Training group: Physical Activity, Diet and an online cognitive training

ACTIVE COMPARATOR

Participants will be provided with personalized dietary plan, a Physical Activity training, and an online cognitive training.

Other: Nutritional InterventionOther: Physical Activity trainingOther: Cognitive training

Social Training group: Physical Activity, Diet and cognitive training

ACTIVE COMPARATOR

Participants will be provided with personalized dietary plan, a Physical Activity training, and a peer interaction program in ecological context.

Other: Nutritional InterventionOther: Physical Activity trainingOther: Social Training

Interventions

Participants will receive comprehensive dietary education from the nutritionists of the research team, aimed at improving their baseline diet by incorporating nutritional recommendations based on the Mediterranean diet and the Italian dietary guidelines for healthy eating.

Cognitive Training group: Physical Activity, Diet and an online cognitive trainingIntensive Health Behavior Treatment group: Physical Activity and DietSocial Training group: Physical Activity, Diet and cognitive training

Participants will engage in a structured exercise program designed to improve motor competence and confidence. Tailored to each individual's baseline physical abilities and cardiorespiratory capacity, the program will focus on enhancing aerobic fitness, flexibility, and coordination.

Cognitive Training group: Physical Activity, Diet and an online cognitive trainingIntensive Health Behavior Treatment group: Physical Activity and DietSocial Training group: Physical Activity, Diet and cognitive training

Participants will undergo an online cognitive training program, with a particular focus on memory enhancement.

Cognitive Training group: Physical Activity, Diet and an online cognitive training

A peer interaction program within an ecological setting, meant as a natural context of daily life, will be offered to participants. The program aims to improve active listening skills, comprehension of various communication styles (passive, assertive, aggressive), and the efficient recognition and management of emotions.

Social Training group: Physical Activity, Diet and cognitive training

Eligibility Criteria

Age6 Years - 11 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • a condition of overweight or obesity
  • Intelligence Quotient (IQ) ≥ 85

You may not qualify if:

  • genetic or syndromic obesity;
  • reduced mobility;
  • systemic diseases;
  • ongoing pharmacological treatment for chronic conditions.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Ospedale Pediatrico Bambino Gesù

Rome, Italy, 00146, Italy

RECRUITING

Bambino Gesù Hospital and Research Institute,

Rome, Rome, 00165, Italy

RECRUITING

Related Publications (1)

  • Russo V, Menghini D, Mainardi M, Fintini D, Aureli A, Gianni N, Rava L, Rea MA, Scozia G, Spiezia C, Scabia G, Furini G, Vicari S, Cianfarani S, Maffei M, Manco M. Reprogramming energy homeostasis in children with overweight through cognitive training and social interaction. A study protocol to estimate leptin sensitivity. Front Endocrinol (Lausanne). 2025 Jun 18;16:1606132. doi: 10.3389/fendo.2025.1606132. eCollection 2025.

MeSH Terms

Conditions

ObesityOverweightPediatric ObesityMotor Activity

Interventions

Cognitive Training

Condition Hierarchy (Ancestors)

OvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsBehavior

Intervention Hierarchy (Ancestors)

Neurological RehabilitationRehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Medical Director, Preventive and Predictive Medicine

Study Record Dates

First Submitted

March 24, 2025

First Posted

April 17, 2025

Study Start

February 8, 2024

Primary Completion

December 31, 2025

Study Completion

December 31, 2025

Last Updated

April 17, 2025

Record last verified: 2025-03

Data Sharing

IPD Sharing
Will share

Data will be shared upon reasonable request, subject to validation by the OPBG Ethics Committee, in compliance with GDPR and European regulations. Alternatively, aggregated data may be considered.

Shared Documents
STUDY PROTOCOL
Time Frame
The time frame for data availability will be determined in accordance with GDPR and relevant European regulations.
Access Criteria
Access to the IPD and supporting information will be granted to the Principal Investigator (PI) of the research, Dr. Melania Manco (melania.manco@opbg.net).
More information

Locations