Relation of Obesity With Frequency of Meals (MST 0557)

Study Overview
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Brief Summary
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The purpose of this study is to test the relationship between frequency of meals and hepatic fat content and insulin sensitivity. We, the researchers at Rockefeller University, hypothesize that low plasma insulin levels (as achieved by periods of fasting) will prevent insulin resistance and reduce hepatic lipid content. In contrast, frequent, carbohydrate-rich meals will predispose to hepatic steatosis (non-alcoholic) and insulin resistance. This is a 6 week inpatient study.

Detailed Description
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The hypothesis will be tested by studying two groups of normal subjects who will receive a defined weight maintenance diet: one group will be given meals twice a day and other group will be given eight meals (snacks) per day. At the beginning of the study period and after 4 weeks following the specified frequency of meals, the study subjects will have their whole body insulin sensitivity and hepatic fat content measured by the euglycemic-hyperinsulinemic clamp and MRI of the liver, respectively.

Official Title
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Relation of Obesity With Frequency of Meals (MST 0557)

Conditions
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Obesity, Insulin Resistance, Fatty Liver

Intervention / Treatment
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* Other: high frequency of meals
* Other: twice a day meals


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy individuals Age between 18-45 years Body mass index (BMI) between 18.5 - 24.9 Exclusion Criteria: Diabetes mellitus Chronic drug treatment for any medical condition like hypertension or hyperlipidemia, hyperthyroidism or taking weight control medications. Inability to give informed consent. Inability to give contact information including permanent residence or provide evidence of stable living environment for the study period. Active weight reduction of more than 7 pounds in the last 3 months. History of bleeding or blood clotting disorders. Pregnancy or breast-feeding in the women. History of anaphylaxis or anaphylactoid-like reaction as a result of food allergies. HIV or hepatitis B and C positive subjects. Subjects with hemoglobin < 8.5 gm/dl. Abnormal liver function test (ALT, AST, alkaline phosphate, LDH, GGT or total bilirubin). Serum creatinine or BUN greater than the upper limit of the normal, serum albumin less than 3.5g/dl, or proteinuria 1+ or greater. History of alcohol intake of more than 40 g/day. Contraindications to magnetic resonance imaging (MRI) including pacemakers, surgical clips, metallic implants, neuromuscular- skeletal stimulators and internal orthopedic screws or rods.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: high frequency meals group<br>High carbohydrate diet i.e. 65% carbohydrate, 15% protein, 20% fat for 4 weeks. | Other: high frequency of meals<br>* high carbohydrate diet i.e. 65% carbohydrate, 15% protein, 20% fat for 4 weeks.<br>|
| Active Comparator: twice-a -day meals<br>high carbohydrate diet i.e. 65% carbohydrate, 15% protein, 20% fat for 4 weeks | Other: twice a day meals<br>* high carbohydrate diet i.e. 65% carbohydrate, 15% protein, 20% fat for 4 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| We will determine total body insulin sensitivity with the help of the hyperinsulinemic-euglycemic clamp. We will also assess hepatic steatosis by conducting MRI scans on our subjects. |  | days 8,9,11 41 and 42 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight, waist and hip circumference, fasting glucose and insulin, serum ketones, lipids and lipoproteins including VLDL and apolipoprotien B100, liver function tests, serum adiponectin (marker for insulin resistance), and measures of hunger. |  | days 1-42 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Non-Alcoholic hepatic steatosis