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This study aims to evaluate the efficacy of Triticum aestivum as a treatment for improving the vascular function in Mexican obese patients. We conducted a triple-blind, randomized, placebo controlled clinical trial, involving obese individuals from the metropolitan area of Guadalajara. The participants were randomly assigned to either Triticum aestivum (intervention group) or placebo supplementation (control). The primary outcome measures were those related with the vascular function using non-invasive methods such as flow-mediated dilation and wave pulse velocity measurements. Secondary outcomes included changes in anthropometric or clinical measures, laboratory results and molecular markers (endothelin-1 and nitric oxide). Data were collected at baseline and after the intervention period. Statistical analyses were performed to determine the significance of the observed changes.
Background:
Obesity is a multifactorial disease highly prevalent among Mexican population. It is closely related to the maintenance of a pro-inflammatory syndrome. This promotes the development of physiopathological mechanisms that support and perpetuate the vascular disfunction which can contribute to the development of cardiovascular disease.
The vascular disfunction is closely related to the impaired endothelial function and increase arterial stiffness. Currently there is no specific treatment for vascular disfunction. Triticum aestivum, or wheatgrass, is a known plant, used primary for its anti-inflammatory and antioxidant properties. This trial aim to investigate the potential health benefits in vascular function of Mexican obese patients. Triticum aestivum is rich in fibers, vitamins, minerals, and polyphenols. Polyphenols, such as flavonoids have antioxidant and anti-inflammatory properties. The flavonoids in wheat grass can scavenge free radicals, preventing cellular damage and preserving endothelial function. In addition, flavonoids have demonstrated anti-inflammatory effects, modulating inflammatory processes within the vascular system. Moreover, the flavonoids can contribute to a improve lipid profile by reducing low density cholesterol levels.
Objetive:
Evaluate the efficacy of Triticum aestivum versus placebo over the vascular function of Mexican obese patients.
Study Design:
A randomized, triple-blind, placebo-controlled clinical trial in Mexican patients with obesity from the metropolitan area of Guadalajara diagnosed according to WHO criteria, who agreed to participate in the protocol through informed consent, randomly assigned to two groups: an intervention group that will receive 1 capsule of 500 mg of Triticum aestivum every 12 hours for 120 days (n=10), and a control group that will receive placebo with the same organoleptic characteristics for the same period of time (n=10).
Participants:
20 Mexican patients with obesity from the metropolitan area of Guadalajara diagnosed according to WHO criteria (BMI between ≥30 and <40 kg/m2), both sexes, who agreed to participate in the protocol through informed consent, with no known co-mobilities, use of current medication or any contraindication.
Intervention:
Intervention group that received 1 capsule of 500 mg of Triticum aestivum every 12 hours for 120 days (n=10), and a control group that received placebo with the same organoleptic characteristics for the same period (n=10). Both groups received general lifestyle and dietary recommendations.
Outcome Measures:
Primary outcome measures included flow-mediated dilation and arterial stiffness assessed by wave pulse velocity using non-invasive techniques. Secondary outcome measures encompassed anthropometric and clinical parameters, as well as laboratory results, and molecular markers such as endothelin-1 and nitric oxide.
Data Collection:
Baseline and post-intervention data were collected through standardized assessments and laboratory tests.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Triticum aestivum | Active Comparator | A group of 20 patients with a diagnosis of obesity without current treatment or other associated pathologies, who will receive 500 mg of triticum aestivum orally every 12 hours for 120 days. | |
| Calcined magnesia | Placebo Comparator | A group of 20 patients with a diagnosis of obesity without current treatment or other associated pathologies, who will recive 500 mg of calcined magnesia oraly every 12 hours for 120 days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Triticum aestivum | Drug | During the intervention period, the aim is to evaluate changes in the patient's vascular function. | ||
| Measure | Description | Time Frame |
|---|---|---|
| Wave Pulse Velocity | The transit time of an aortic pressure wave between the common carotid artery and the common femoral artery. It is a standard measure of arterial stiffness. | 12 weeks |
| Flow-mediated dilatation | Ecosonographic assessment of diameter changes in of the brachial artery secondary to increased blood flow. | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Body Max Index | An indicator of body density as determined by the relationship of body weight to body height. BMI=weight (kg)/height squared (m2). BMI correlates with body fat (adipose tissue). Their relationship varies with age and gender. For adults, BMI falls into these categories: below 18.5 (underweight); 18.5-24.9 (normal); 25.0-29.9 (overweight); 30.0 and above (obese). | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Endotelin -1 Concentration | Plasma concentration of A 21-amino acid peptide produced in a variety of tissues including endothelial and vascular smooth-muscle cells, neurons and astrocytes in the central nervous system, and endometrial cells. It acts as a modulator of vasomotor tone, cell proliferation, and hormone production. | 12 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sandra O Hernández González, PhD | Instituto Mexicano del Seguro Social, Unidad de Investigación Biomédica 02. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Biomedical Unit Research 02, Specialties Hospital, Medical Unit of High Speciality, West National Medical Center, Mexican Social Security Institute. | Guadalajara | Jalisco | 44380 | Mexico |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32059369 | Background | Kopustinskiene DM, Jakstas V, Savickas A, Bernatoniene J. Flavonoids as Anticancer Agents. Nutrients. 2020 Feb 12;12(2):457. doi: 10.3390/nu12020457. | |
| 28507008 | Background | Hostetler GL, Ralston RA, Schwartz SJ. Flavones: Food Sources, Bioavailability, Metabolism, and Bioactivity. Adv Nutr. 2017 May 15;8(3):423-435. doi: 10.3945/an.116.012948. Print 2017 May. |
| Label | URL |
|---|---|
| Cardiovascular Diseases | View source |
Not provided
All data resulting from the clinical investigation, except the personal identification of the subjects (name, address, teelephone, etc.)
Starting 6 months after publication.
The data can be shared through a request addressed to the principal investigator Dr. Sandra Ofelia Hernández González, basing the reason for what they are requested.
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| ID | Term |
|---|---|
| D009765 | Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D005433 | Flour |
| D008277 | Magnesium Oxide |
| ID | Term |
|---|---|
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
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Intervention group that received 1 capsule of 500 mg of Triticum aestivum every 12 hours for 120 days (n=10), and a control group that received placebo with the same organoleptic characteristics for the same period (n=10). Both groups received general lifestyle and dietary recommendations.
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Stratified random sampling with a closed envelope, random number assigned by software.
| calcined magnesia |
| Drug |
During the intervention period, the aim is to evaluate changes in the patient's vascular function. |
|
|
| Blood Pressure | The blood pressure in the arteries. It is commonly measured with a sphygmomanometer on the upper arm which represents the arterial pressure in the brachial artery. | 12 weeks |
| Waist Hip Ratio | The waist circumference measurement divided by the hip circumference measurement. For both men and women, a waist-to-hip ratio (WHR) of 1.0 or higher is considered "at risk" for undesirable health consequences, such as heart disease and ailments associated with overweight. A healthy WHR is 0.90 or less for men, and 0.80 or less for women. | 12 weeks |
| Medication Adherence | Voluntary cooperation of the patient in taking drugs or medicine as prescribed. This includes timing, dosage, and frequency. | 12 weeks |
| Atherogenic Index | Logarithmically transformed ratio of molar concentrations of triglycerides to HDL-cholesterol | 12 weeks |
| Nitric Oxide concentration |
Plasma concentration of A free radical gas produced endogenously by a variety of mammalian cells, synthesized from arginine by nitric oxide synthase. Nitric oxide is one of the endothelium-dependent relaxing factors released by the vascular endothelium and mediates vasodilation. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. |
| 12 weeks |
| 34890431 | Background | Bitew M, Desalegn T, Demissie TB, Belayneh A, Endale M, Eswaramoorthy R. Pharmacokinetics and drug-likeness of antidiabetic flavonoids: Molecular docking and DFT study. PLoS One. 2021 Dec 10;16(12):e0260853. doi: 10.1371/journal.pone.0260853. eCollection 2021. |
| 32967119 | Background | Ciumarnean L, Milaciu MV, Runcan O, Vesa SC, Rachisan AL, Negrean V, Perne MG, Donca VI, Alexescu TG, Para I, Dogaru G. The Effects of Flavonoids in Cardiovascular Diseases. Molecules. 2020 Sep 21;25(18):4320. doi: 10.3390/molecules25184320. |
| 31613843 | Background | Yamagata K, Yamori Y. Inhibition of Endothelial Dysfunction by Dietary Flavonoids and Preventive Effects Against Cardiovascular Disease. J Cardiovasc Pharmacol. 2020 Jan;75(1):1-9. doi: 10.1097/FJC.0000000000000757. |
| 30513729 | Background | Rees A, Dodd GF, Spencer JPE. The Effects of Flavonoids on Cardiovascular Health: A Review of Human Intervention Trials and Implications for Cerebrovascular Function. Nutrients. 2018 Dec 1;10(12):1852. doi: 10.3390/nu10121852. |
| 33559970 | Background | Micek A, Godos J, Del Rio D, Galvano F, Grosso G. Dietary Flavonoids and Cardiovascular Disease: A Comprehensive Dose-Response Meta-Analysis. Mol Nutr Food Res. 2021 Mar;65(6):e2001019. doi: 10.1002/mnfr.202001019. Epub 2021 Feb 25. |
| 30400131 | Background | Yahfoufi N, Alsadi N, Jambi M, Matar C. The Immunomodulatory and Anti-Inflammatory Role of Polyphenols. Nutrients. 2018 Nov 2;10(11):1618. doi: 10.3390/nu10111618. |
| 25241774 | Background | Luyen BT, Thao NP, Tai BH, Lim JY, Ki HH, Kim DK, Lee YM, Kim YH. Chemical constituents of Triticum aestivum and their effects on adipogenic differentiation of 3T3-L1 preadipocytes. Arch Pharm Res. 2015 Jun;38(6):1011-8. doi: 10.1007/s12272-014-0478-2. Epub 2014 Sep 23. |
| 25936595 | Background | Poudel B, Nepali S, Xin M, Ki HH, Kim YH, Kim DK, Lee YM. Flavonoids from Triticum aestivum inhibit adipogenesis in 3T3-L1 cells by upregulating the insig pathway. Mol Med Rep. 2015 Aug;12(2):3139-45. doi: 10.3892/mmr.2015.3700. Epub 2015 Apr 29. |
| 25925980 | Background | Im JY, Ki HH, Xin M, Kwon SU, Kim YH, Kim DK, Hong SP, Jin JS, Lee YM. Anti-obesity effect of Triticum aestivum sprout extract in high-fat-diet-induced obese mice. Biosci Biotechnol Biochem. 2015;79(7):1133-40. doi: 10.1080/09168451.2015.1006567. Epub 2015 Apr 30. |
| 31329009 | Background | Bueno PCDS, Barbalho SM, Guiguer EL, Souza MDSS, Medeiros IRA, Zattiti IV, Bueno MDS, Nutels GS, Goulart RA, Araujo AC. Effects of Green Wheat (Triticum turgidum) and Common Wheat (Triticum aestivum) on the Metabolic Profile of Wistar Rats. J Med Food. 2019 Dec;22(12):1222-1225. doi: 10.1089/jmf.2019.0089. Epub 2019 Jul 18. |
| 7249508 | Background | Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981 Aug;30(2):239-45. doi: 10.1038/clpt.1981.154. No abstract available. |
| 28275588 | Background | Townsend RR. Arterial Stiffness: Recommendations and Standardization. Pulse (Basel). 2017 Jan;4(Suppl 1):3-7. doi: 10.1159/000448454. Epub 2016 Dec 23. |
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| What Is Cardiovascular Disease. | View source |
| Atención oportuna, fundamental para prevenir y atender enfermedades cardiovasculares. | View source |
| Obesity and Overweight. | View source |
| Programa de Acción Específico Prevención y Control de la Obesidad y Riesgo Cardiovascular 2013-2018 | View source |
| Sobrepeso y Obesidad: factores de riesgo para desarrollar diabetes. México. | View source |
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017616 |
| Magnesium Compounds |
| D007287 | Inorganic Chemicals |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |