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Completed

NCT Number: NCT05766657

Evaluation of an Anti-inflammatory Diet in Autoimmune and Metabolic Diseases

The overall objective of the study is to provide personalized nutritional advice based on the gut microbiota profile of children with type 1 diabetes (T1D) or obesity.

Specifically, the primary objective of NUTRI-DIET is to validate a dietary model aimed at restoring bacterial species and/or anti-inflammatory metabolites in order to prevent extra-intestinal diseases characterized by dysbiosis, such as T1D and obesity.

The primary endpoints of the study will be to monitor the glycemic control indices, i.e., blood glucose (mean of glycemic values, percentage of time-in-range value (TIR), which will be displayed by glycemic sensor) and glycated hemoglobin for diabetic children and Body mass index (BMI) z-score according to World Health Organization (WHO) recommendations (WHO BMI-for-age boys; WHO BMI-for-age girls) for obese children.

The secondary objective of the study is to characterize the microbiota profile of the study patients and to test the algorithm under development built from the integration of diet and and gut microbiota composition data that were obtained during the previous observational study NUTRI-T1D.

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Key information

Age range

8 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Autoimmune Pathogenesis Unit, Milan, Italy

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About this study

Randomized, multicenter, 2-arm, parallel-group, single-blind controlled clinical trial (1:1 allocation ratio) with 1 group of patients with obesity (N=20) or type 1 (n=20) treated with standard obesity treatment diet or usual diet (diabetic children) and 1 group (N=20 for obesity and (N=20 for type 1 diabetes) treated with the same diets to which nutritional advice derived from microbiota analysis (NUTRI-DIET) will be added.

The study will last 12 months with an intervention phase (personalized diet) lasting 3 months.

The research includes an enrollment phase that may extend up to 9 months depending on the number of patients enrolled. The enrollment phase will be considered finished once a total of 80 patients (i.e., 40 pediatric patients with type 1 diabetes and 40 obese pediatric patients) are enrolled. During the patient enrollment phase, relevant clinical information (biological samples as faeces, urines and blood and questionnaires on diet habits, physical activity and stress) will be collected concurrently. Tests will be performed once enrollment is completed on samples from all patients collected at the time of enrollment (microbiota analysis on stool, metabolome analysis on stool and urine, serological gut barrier markers analysis on serum). Obese and/or diabetic children will be randomized to the intervention or control group. Randomization will be done according to age (≤12: >12), gender and pathology (diabetes or obesity).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Eligible for participation will be children diagnosed with obesity (BMI > 95th percentile) and type 1 diabetes aged 8-18 years
  • Signature of informed consent

Exclusion criteria

  • Children with any acute or chronic disease (cancer, infection, other), gastrointestinal disease, cardiovascular disease, chronic kidney disease, parathyroid disease, diseases requiring regular phlebotomies, and other chronic diseases that could affect the results of the present study
  • Taking medications other than insulin, including hypolipidemic and antihypertensive drugs
  • Use of medications that could affect the results of the study, including systemic glucocorticoids and antibiotics (in the three months prior to the study)
  • Recent weight loss or weight gain (> 3 kg), (in the 3 months preceding the study)
  • Blood transfusion in the last 3 months prior to blood sampling
  • Use of dietary supplements, including multivitamins, fish oil capsules, minerals and trace elements (three months prior to and throughout the study period)
  • Inability (physically or psychologically) to comply with the procedures required by the protocol
  • Children with specific eating disorders, which may hinder the research results

Treatment and study plan

Microbiome-targeted diet

Dietary Supplement

The gut microbiota (on stool) and metabolic profile (on stool and urine) will be analyzed at time 0, and the dietary plan will contain specific directions aimed at restoring a proper metagenomic and metabolomic profile of the microbiota.

Usual care diet

Dietary Supplement

Subjects on the control group will receive general dietetic advice for Obesity or T1D

Primary outcomes

  1. Glycemia

    Time frame: Up to 3 months

    Blood glucose levels (mg/dL) will be measured in diabetic children.

  2. Glycemic control by glycated hemoglobin (HbA1c) monitoring

    Time frame: Up to 3 months

    The percentage of glycated hemoglobin (HbA1c, %) in the blood will be measured in diabetic children.

  3. Glycemic control by Time-in-Range (TIR) monitoring

    Time frame: Up to 3 months

    TIR values - that is the percentage of time in which blood glucose (blood sugar) remains in the safe target range of 70-180mg/dL - will be monitored in diabetic children by extracting the recorded data from the continuous glucose monitoring (CGM) device (sensor).

  4. Body mass index (BMI)

    Time frame: Up to 3 months

    The BMI z-score in obese children will be measured, according to WHO recommendations (WHO BMI-for-age boys; WHO BMI-for-age girls).

Secondary outcomes

  1. Metagenomic analysis

    Time frame: Up to 3 months

    Changes in gut microbiota composition following personalized microbiome-targeted diet, as assessed by 16S ribosomal RNA (rRNA) sequencing on DNA extracted from patient-derived fecal samples.

  2. Metabolomic analysis

    Time frame: Up to 3 months

    Changes in microbiota-derived metabolites following personalized microbiome-targeted diet, as assessed by Mass Spectrometry on patient-derived fecal and urine samples.

Sponsors and collaborators

Lead sponsor

IRCCS San Raffaele

Other

Registry information

Official study title

Evaluation of the Effect of an Anti-inflammatory Diet Built on the Basis of the Gut Microbiota in Children with Type 1 Diabetes and Obesity

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Mar 13, 2023
Registry last updated
Jan 23, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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