Role of Race in Nutritional Approach in Men on ADT

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexMale
Age18+
SponsorUniversity of California, Los Angeles

About this trial

There is a well-documented association between androgen deprivation therapy (ADT) and cardiovascular morbidity. A majority of men on ADT gain weight contributing to an increase in cardiovascular risk factors (CVRFs) and cardiovascular morbidity. Dietary intervention combined with exercise have shown success in reducing weight/fat mass and improving cardiovascular risk factors (CVRF). There is little data on whether African American men would respond to diet and exercise interventions differently from non-Hispanic white men. We will conduct a pilot, controlled two-phase intervention study stratified by race to investigate the following objectives:

1. Compare effect of a hypocaloric, anti-inflammatory diet on changes in fat mass between African- American vs non-Hispanic white men with metastatic prostate cancer on ADT therapy. 2. Compare effect of a hypocaloric, anti-inflammatory diet on changes in cardiovascular risk factors (body weight, lean body mass, waist-to-height ratio, blood pressure, lipids and HbA1C) and inflammatory markers (hs-CRP and cytokines) between African-American vs non-Hispanic white men with metastatic prostate cancer on ADT therapy. 3. Compare effect of a hypocaloric, anti-inflammatory diet on changes in cancer-related fatigue and quality of life between African-American vs non-Hispanic white men with metastatic prostate cancer on ADT therapy.

We will enroll 35 African American and 35 non-Hispanic white men with prostate cancer undergoing ADT therapy. In phase 1, after baseline assessment, men will consume their habitual diet and continue their habitual activity level for 3 months. During phase 2, participants will be instructed to consume a hypocaloric (-500 kcal), anti- inflammatory diet and walk for 1 hour on 3 days per week for 3 months. At baseline, after phase 1 and 2 primary outcome (fat mass) and secondary outcomes (CVRF and inflammatory markers) and tertiary outcomes (cancer-related fatigue and quality of life) will be determined.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

>12 months on ADT

Expected continuation of ADT for >6 months upon initiation of study procedures

Serum testosterone <50 ng/dL

BMI >25

Disqualifiers

Life expectancy < 1 year

Females

Radiation or chemotherapy treatment

History of diabetes or serious medical condition including uncontrolled hypertension, liver, kidney, and cardiovascular disease

Trial design

Design model

Single group

Treatments tested in this trial

  • Hypocaloric anti-inflammatory diet

    Behavioral

    The anti-inflammatory hypocaloric diet combines the exclusion of pro- inflammatory constituents and inclusion of anti-inflammatory nutrients. Excluded food items will be refined carbohydrates, soda and alcoholic beverages, ultra- processed foods, smoked foods, fatty foods, packaged foods, canned products, preservatives, emulsifiers, and sauces. Reduce or eliminate red/processed meats. Included food items will be a defined minimum diversity of fruits, vegetables, and nuts based on complementary phytonutrient contents, particularly those rich in phenolic compounds such as ellagitannins and sulforaphanes. Selected herbs (e.g., turmeric, ginger, garlic, black pepper, rosemary, cardamon, cinnamon), green tea, fermented foods, fats (e.g., avocado), and oils (e.g., olive oil) will be encouraged. The goal is to have 5 servings of vegetables, 2 fruits per day, and 5 vegetable color groups per week. Participants will also be asked to reduce their kcal by 500/day and walk for 1 gr 3x per week.

Treatment groups

70 Participants
are divided into 2 treatment groups
Group A: Habitual dietary and physical activity regimenNo intervention 0 interventions
Group B: Hypocaloric anti-inflammatory dietExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Fat mass

Bioelectric impedance measurement will provide information about body composition including percent body fat, fat mass, lean body mass, total body water and basal metabolic rate using the portable BIA310e (Biodynamics Corp.). BIA is based on the principle that the flow of an electrical current through an object can be used to determine the object's physical properties.

Time frame
At baseline, 3 months and 6 months
2

Waist circumference

Waist circumference will be measured with a tape measure in standing position horizontally, just above the hip bone, without compressing the skin.

Time frame
At baseline, 3 months and 6 months

Secondary outcomes

1

Blood lipids and lipoproteins (triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol)

Blood lipids and lipoproteins will be analyzed spectrophotometrically using reagent from Pointe Scientific (Canton, MI, USA).

Time frame
At baseline, 3 months and 6 months
2

HbA1c

HbA1c will be analyzed spectrophotometrically using reagent from Pointe Scientific (Canton, MI, USA).

Time frame
At baseline, 3 months and 6 months
3

Total testosterone

Total testosterone will be analyzed spectrophotometrically using reagent from Pointe Scientific (Canton, MI, USA).

Time frame
At baseline, 3 months and 6 months
4

Inflammatory markers (hs-CRP, IL-6, IL-1b, TNFa)

Concentrations of hs-CRP and cytokines will be quantified using the MagPix® analyzer (Luminex, Austin TX) with MILLIPLEX MAP Human CVD Panel 3 kit (hs-CRP) and Milliplex Human Cytokine/Chemokine MAGNETIC BEAD kit (IL-6, IL-1β, TNFα,) from EMD Millipore (Billerica, MA) at the Center for Human Nutrition Biomarker Laboratory.

Time frame
At baseline, 3 months and 6 months

Other outcomes

1

Cancer-related fatigue

Participants will be asked to fill out a questionnaire about cancer-related fatigue.

Time frame
At baseline, 3 months and 6 months
2

Quality of life

Participants will be asked to fill out a questionnaire about quality of life.

Time frame
At baseline, 3 months and 6 months

Sponsors and contacts

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University of California, Los Angeles

Lead sponsor

National Comprehensive Cancer Network

Collaborator