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Trial registered on ANZCTR
Registration number
ACTRN12612000429853
Ethics application status
Approved
Date submitted
12/04/2012
Date registered
17/04/2012
Date last updated
22/09/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
Targeting the ileal brake – effects of carbohydrate (CHO) on hunger, satiety and energy intake
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Scientific title
Targeting the ileal brake – effects of carbohydrate (CHO) on hunger, satiety and energy intake: A Tube Feeding Study in healthy male participants
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Secondary ID [1]
280307
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Appetite regulation
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Condition category
Condition code
Oral and Gastrointestinal
286487
286487
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0
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Normal oral and gastrointestinal development and function
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is a gastrointestinal infusion study where a CHO load or saline control will be infused directly into the distal ileum and the proximal duodenum using an extended naso-gastric (NG) feeding tube (catheter). Introduction of an NG catheter is a commonly used clinical procedure in enterally fed patients.
The objective of this study is to determine whether direct infusion of dietary CHO into the distal small intestine (terminal ileum) alters appetite-related sensations and food intake in a group of lean healthy men.
The study aims to determine the effect of CHO infused into the ileum using a naso-ileal (NI) tube on:
(i) subjective VAS-rated feelings of hunger, fullness and associated measures of satiety
(ii) energy intake at a subsequent lunch and dinner meal
(iii) gut peptides associated with satiety including cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1) and peptide YY (PYY)
The primary hypotheses are:
1. Infusion of a CHO load into the ileum will increase satiety and decrease subsequent food intake when compared with a duodenal infusion
2. Infusion of a CHO load into the ileum will increase circulating levels of the appetite-related gut peptides CCK, GLP-1 and PYY.
This is a 5 day residential study.
Infusions:
Four treatments comprising:
1. Saline control – infused into the duodenum
2. Glucose - infused into the duodenum
3. Saline control - infused into the ileum
4. Glucose - infused into the ileum
The CHO dose will be a 15g bolus of glucose
The infusions wil be administered over a duration of 1.5 hours. Participants will receive all 4 infusion treatments in a random order
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Intervention code [1]
284657
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Treatment: Other
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Comparator / control treatment
Saline
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Visual Analogue Scale (VAS) scores for hunger and fullness.
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Assessment method [1]
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Timepoint [1]
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Subjective ratings of satiety and nausea measured using visual analogue scales (VAS) at -120, -105, -90, -60, -30 & 0 (immediately before the test preload), 15, 30, 45, 60, 90, 120 (ad lib lunch), 150, 180, 240, 300, 360, 420 and 480 (ad lib dinner) and 510 minutes post preload.
t = 0 is the time that the infusion (treatment) begins
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Secondary outcome [1]
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Energy Intake at ad libitum lunch meal. Energy, fat, carbohydrate (CHO) and protein intake will be calculated using the dietary program Foodworks Copyright (c) 1998-2007 Xyris Software.
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Assessment method [1]
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Timepoint [1]
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Immediately post the ad libitum lunch, snack & dinner meals (t=150, t=255 and t=510)
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Eligibility
Key inclusion criteria
Male
Age 18-60 years
Lean, as defined by BMI <25kg/m2
Healthy, as ascertained by self-report and blood test
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Minimum age
18
Years
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Maximum age
60
Years
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Sex
Males
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Overweight
Any medical conditions or medications known to affect appetite -related parameters, including depression
Low iron status, hence unsuitable for cannulation studies
Participation in an active diet program and/or loss/gain of >10% body weight within the last 6 months
Smoker or ex-smoker who quit within the last 6 months
Hypersensitivities or allergies to any foods or ingredients included in the study
Dislike and/or unwilling to consume items listed as study foods
Unwilling/unable to comply with study protocol
Participating in another clinical intervention trial
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
This is a randomised, cross-over trial. Randomisation is carried out using a Latin square design, whereby the order at which participants agree to commence the study determines the order at which they receive the treatments Participants are randomized to receive all 4 treatments. the person who determined if a subject was eligible for inclusion in the trial was unaware, when this decision was made, to which group the subject would be allocated.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A Latin square will be used to randomise the subjects to each of the 4 intervention arms. Each participant is randomized to complete all 4 intervention arms.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
19/10/2011
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Actual
19/10/2011
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Date of last participant enrolment
Anticipated
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Actual
21/05/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Foundation for Science and Research (FRST)/Ministry of Science Innovation
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Address [1]
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Wellington office
Level 3, 33 Bowen Street.
PO Box 5762
Wellington 6145
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Country [1]
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New Zealand
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Primary sponsor type
Government body
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Name
Foundation for Science and Research (FRST)Ministry of Science Innovation
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Address
Wellington office
Level 3, 33 Bowen Street.
PO Box 5762
Wellington 6145
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
283939
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Country [1]
283939
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Other collaborator category [1]
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University
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Name [1]
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The University of Auckland
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Address [1]
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Human Nutrition Unit
University of Auckland
18 Carrick Place
Mt Eden
Auckland 1024
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Country [1]
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New Zealand
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Other collaborator category [2]
260720
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Commercial sector/Industry
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Name [2]
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Plant & Food Research Ltd
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Address [2]
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120 Mt Albert Road
Sandringham 1142
Auckland
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Country [2]
260720
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
287088
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Northern Y Regional Ethics Committee
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Ethics committee address [1]
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C/o Ministry of Health PO Box 1031 Hamilton 3240
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
287088
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Approval date [1]
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16/08/2011
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Ethics approval number [1]
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NTY/11/03/034
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Summary
Brief summary
The GI tract is the source of a large number of signals and mechanisms purported to be involved in the control of satiety, and which are generated by various types of mechanical or chemical stimuli. Mechanical stimulation is provided by distension of the luminal wall as foods transit the length of the gut, whilst chemical stimulation is provided by the nutrients entering the small and possibly also the large intestine. These stimuli then result in release of GI peptides and/or the activation of neural signals which may alter appetite-related sensations and eating behaviour. Secretion of GI peptides, when combined with neural signals from the stomach and small intestine generated by GI distension during and after meal ingestion, may lead to meal termination (=satiation) or may influence hunger and fullness between meals (=satiety). The ileum, or distal small intestine, has become the focus of recent studies which have hypothesised that stimulation of the ileum as a consequence of nutrient arrival may generate a range of satiety signals which enhance fullness, suppress hunger and decrease food intake. The mechanism by which this may occur has been termed the ‘Ileal Brake’. There are a range of feeding studies (Burns et al., 2000; Burns et al., 2001; Burns et al., 2002; Diepvens et al., 2007; Chan et al., 2010; Smit et al., 2010) which have shown appetite suppression in which the authours have attributed the effect to the delivery of nutrients to the ileum which in turn has stimulated the ileal brake. Studies conducted to date have focused on the delivery of dietary lipids, in particular lipid emulsions (Read et al., 1984a; Van Citters & Lin, 1999). Long-chain fatty acids are potent triggers of the ileal brake & several studies have demonstrated that the ileal brake may be activated by small amounts of fat or free fatty acids. The ileal brake has also been identified as a potentially important mechanism following delivery of CHO's.
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Trial website
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Trial related presentations / publications
The results of this trial have not been published, yet.
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Public notes
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Contacts
Principal investigator
Name
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Prof Sally Poppitt
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Address
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Human Nutrition Unit
18 Carrick Place, Mt Eden, Auckland, 1024
New Zealand
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Country
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New Zealand
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Phone
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+6496306160
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Sally Poppitt
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Address
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Human Nutrition Unit
University of Auckland
18 Carrick Place
My Eden
Auckland 1024
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Country
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New Zealand
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Phone
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+64 9 630 5160
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Fax
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+64 9 630 5764
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Email
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[email protected]
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Contact person for scientific queries
Name
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Sally Poppitt
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Address
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Human Nutrition Unit
University of Auckland
18 Carrick Place
My Eden
Auckland 1024
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Country
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New Zealand
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Phone
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+64 9 630 5160
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Fax
8225
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+64 9 630 5764
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Duodenal and ileal glucose infusions differentially alter gastrointestinal peptides, appetite response, and food intake: A tube feeding study.
2017
https://dx.doi.org/10.3945/ajcn.117.157248
N.B. These documents automatically identified may not have been verified by the study sponsor.
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