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| Name | Class |
|---|---|
| National Institutes of Health (NIH) | NIH |
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The goals of this study are to uncover the influence of diet on the human circadian timing system. The protocol is a 46-day (28 outpatient days, 18 inpatient days over two 9 day visits) randomized cross-over study designed to elucidate the speed of entrainment in response to a high-fat diet.
Synchronization of the timing of biological processes and behaviors with the 24-hour light-dark cycle is fundamental to almost every physiological process, cognitive function, and overall health. As the average circadian period in humans is ~9 min longer than the 24-h day, and artificial lighting allows a further delay in the clock, circadian entrainment must occur every day. This makes the process of circadian entrainment of the internal clock with the external environment a commonly overlooked process, but one that has serious ramifications if impaired.
In rodent models, high-fat diets have been shown to disorganize the circadian timing system. There has been limited examination, however, of how composition of diet acts on the circadian timing system in humans. The ability to entrain to a new light schedule has been briefly examined after a high-fat diet in rodent models.When mice are exposed to a 6-h shift in the light-dark cycle and fed a diet composed of ~50% fat for 3 weeks, they experience a 20% slower rate of re-entrainment to the new light cycle as compared to mice fed a low-fat diet. Further, these mice had an attenuated response to a phase-advancing light pulse. Moreover, simply providing a high-fat diet to mice results in a lengthened circadian period and a shift in ad libitum eating patterns into the typical rest phase.
The goals of this study are to uncover the influence of diet on the human circadian timing system. The protocol is a 46-day (28 outpatient days, 18 inpatient days over two 9 day visits) randomized cross-over study designed to elucidate the speed of entrainment in response to a high-fat diet. Participants will be provided 3 weeks of a high-fat diet (2-weeks outpatient, 1-week inpatient) of 50% calories from fat. The protocol includes two types of data collection; ambulatory monitoring on strict sleep-wake schedules with either high-fat or low-fat meals provided by the study team and precise in-laboratory measurements of circadian timing, entrainment, and other physiological markers of sleep and cardiometabolic health.
After instrumentation, participants will be given a sleep opportunity and will awakened to dim-lighting and maintaining a constant posture protocol for accurate assessment of circadian phase, resting metabolic rate, and other physiological outcomes. After the constant posture protocol, participants' light-dark cycle will be changed for 6 identical days, followed by a second constant posture protocol for re-assessment of circadian phase. This protocol will be repeated while participants are provided the other cross-over meal. Investigators/nurses will be present in the lab or in a central control room 24 h per day to monitor subject health, data acquisition, provide meals, collect biologic specimens, perform tests, and record sleep. A physician is always on call when a participant is in the laboratory. An extensive series of protocols and checklists and team practices are used to ensure uniformity in execution of standard procedures.
Energy content of diets will be designed to meet individual daily energy requirements. Dietitians will prepare isocaloric meals containing macronutrient contents of high or low-fat diet and no caffeine. Caloric intake will be the same caloric and macronutrient composition for each day of laboratory study and will be provided as miniature snacks frequently during each constant posture protocol (e.g., ¼ turkey & cheese sandwich, juice and water).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High-Fat Diet | Experimental | 50% fat, 35% carbohydrate and 15% protein; 33% of each mono, poly and saturated fat |
|
| Low-Fat Diet | Active Comparator | 30% fat, 55% carbohydrate and 15% protein |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High-Fat Diet | Other | The diet will consist of a breakfast, lunch, dinner, and snack |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Speed of entrainment | Entrainment will be determined as a stable phase angle between sleep and both melatonin onset. Blood and/or saliva will be assayed for melatonin using standardized assays. Melatonin onset will be calculated using the linear interpolated time at which melatonin levels reach 25% of a fitted peak-to-trough amplitude. This will be analyzed using phase angle between sleep and melatonin onset. | Over 18 days |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Phase Angle of entrainment | Phase angle will be calculated as dim-light melatonin onset minus sleep onset during each constant posture protocol. Differences in phase angle of entrainment between sleep and melatonin onset will be first examined using planned comparison dependent t-tests between the high-fat and low-fat visits. The study will use planned comparison dependent t-tests to compare phase angle of entrainment from constant posture day 1 vs constant posture day 2 to uncover potential differences in phase angle in response to an advance in light exposure under differing diet conditions |
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Inclusion Criteria:
Exclusion Criteria:
Major dietary restrictions (such as entirely dairy-free and/or meat-free diets)
A body mass index (BMI) of 18.5< [BMI] < 24.9 kg/m^2 and a waist circumference <94/80cm
Currently psychiatrically/psychologically unsuitable for participation
Drug/alcohol use, including smoking
Medication/drug use, including prescribed and over-the-counter medications
History of working irregular day and night hours, regular night work, or rotating shift work for the 1 year prior to the study.
Traveled across more than 1 time zone during the 3 months prior to the study
Currently consuming a habitual high-fat diet
Chronobiologic and sleep disorders
Diseases of the Cardiovascular System
Metabolic Syndrome; Two or more of these factors will be excluded from the study:
Pre-Diabetes/Diabetes
Hypertension
Disorders of the Respiratory System
Disorders of the Kidney and Urinary Tract
Infectious Diseases
Disorders of the Gastrointestinal System
Disorders of the Immune System
Disorders of the Hematopoietic System
Neoplastic Diseases
Endocrine and Metabolic Diseases
Neurologic Disorders
Subjects must not be currently participating in another research study that would influence their safe participation in our study
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Andrew McHill, PhD | Contact | 503-494-2594 | mchill@ohsu.edu |
| Name | Affiliation | Role |
|---|---|---|
| Andrew McHill, PhD | Oregon Health and Science University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oregon Health & Science University | Recruiting | Portland | Oregon | 97239 | United States |
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| ID | Term |
|---|---|
| D059305 | Diet, High-Fat |
| D018752 | Diet, Fat-Restricted |
| ID | Term |
|---|---|
| D004032 | Diet |
| D009747 | Nutritional Physiological Phenomena |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
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As it will be easy to discern meal fat content, participant blinding is not possible. Participants will be blinded to clock time and light-dark cues and statisticians will be blinded of condition.
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| Low-Fat Diet |
| Other |
The diet will consist of a breakfast, lunch, dinner, and snack |
|
| Over 18 days |
| Change in Core Body Temperature Entrainment | Core body temperature entrainment will be determined as a stable phase angle between sleep and core body temperature minimum. Temperature data will be collected every minute though rectal thermistors. | Over 18 days |
| Change in Core Body Temperature Phase angle of Entrainment | Core body temperature entrainment will be determined as core body temperature minimum minus sleep onset. Temperature data will be collected every minute though rectal thermistors. | Over 18 days |
| Change in glucose tolerance | The participant's glucose and insulin response to a mixed meal diet high in carbohydrates may be tested. During this mixed meal test, a baseline blood draw will occur ~7-min before the meal and then the frequency of blood samples will increase to every 10-min after the meal for 90 min and then every 30 min for 90 min for a total of 12 samples over 180 min to measure glucose and hormone response in detail. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Energy Metabolism | Resting energy metabolism will be measured every ~4h via indirect calorimetry. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Blood Pressure | Resting blood pressure will be measured every ~2h via blood pressure cuff. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Heart Rate | Resting heart rate will be measured every ~2h via blood pressure cuff. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Malondialdehyde | Malondialdehyde will be measured every ~4h via blood from IV catheter. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Total Antioxidant Capacity | Total Antioxidant Capacity will be measured every ~4h via blood from IV catheter. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in C-reactive protein | C-reactive protein will be measured every ~4h via blood from IV catheter. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in TNF-alpha | TNF-alpha will be measured every ~4h via blood from IV catheter. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Triglycerides | Triglycerides will be measured every ~4h via blood from IV catheter. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Fatty Acids | Fatty acids will be measured every glucose tolerance test from IV catheter. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Vascular Endothelial Function | We will measure vascular endothelial function starting ~10-min after each awakening in a constant posture following a fast. Brachial artery flow-mediated dilation will be measured in the supine position. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Psychomotor Vigilance Task | The psychomotor vigilance task will be administered via computer test every 2h to assess sustained attention. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Digit Symbol Substitution Task | The digit symbol substitution task will be administered via computer test every 2h to assess attention and accuracy. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Addition Task | The addition task will be administered via computer test every 2h to assess working memory. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Subjective Alertness | Visual analog scales will be administered via computer test every 2h to subjective alertness. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Profile of Mood States | Profile of mood states (POMS scale) will be administered via paper questionnaire every 2h to subjective alertness. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| Change in Positive and Negative Affect Schedule | Positive and negative affect schedule (PANAS scale) will be administered via paper questionnaire every 2h to subjective alertness. Examined using planned comparison dependent t-tests between the high-fat and low-fat visits. | Over 18 days |
| D004035 | Diet Therapy |
| D044623 | Nutrition Therapy |
| D013812 | Therapeutics |