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Trial registered on ANZCTR
Registration number
ACTRN12615000851561
Ethics application status
Approved
Date submitted
22/07/2015
Date registered
14/08/2015
Date last updated
17/12/2019
Date data sharing statement initially provided
6/03/2019
Date results provided
10/12/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating the efficacy of improved diet on the risk of asthma attacks in children (the ImpACt study)
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Scientific title
Evaluating the efficacy of improved diet quality to reduce the risk of exacerbations in children with asthma in a randomised controlled trial.
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Secondary ID [1]
287106
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None
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Universal Trial Number (UTN)
U1111-1172-2802
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Trial acronym
ImpACt
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Asthma
295633
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Condition category
Condition code
Respiratory
295912
295912
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0
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Asthma
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Inflammatory and Immune System
295913
295913
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0
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Normal development and function of the immune system
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Diet and Nutrition
295914
295914
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0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention group will be allocated an age-appropriate high fruit and vegetable diet (that is, according to the Australian Dietary Guidelines for their age group; for 2-3 years: 3.5 combined serves per day; for 4-8 years: 6 combined serves per day; and for 9-11 years: 7 combined serves per day) and provided with weekly food hampers containing a variety of fruit and vegetable products for 6 months. Participants will be asked to limit juice intake to no more than 1/2 cup per day. No other changes will be made to the diet. Participants and their carer will have a 1 hour face-to-face consult with a dietitian at baseline, 2 weeks, 4 weeks, 3 and 6 months, where they will be counselled on their assigned dietary intervention, including the provision of recipes and ideas to help the child adhere to the dietary recommendations. Between weeks 4 and 26, the participant's carer will receive fortnightly calls from a dietitian to address any issues relating to dietary adherence.
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Intervention code [1]
292355
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Lifestyle
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Intervention code [2]
292462
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Treatment: Other
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Comparator / control treatment
The control group will continue with their usual consumption of fruits and vegetables, and will receive a hamper containing foods consistent with their usual intake. To ensure they are adhering to their usual diet, participants and their carer will have a face-to-face consult with a dietitian at baseline, 2 weeks, 4 weeks, 3 and 6 months, and will receive fortnightly calls from a dietitian between weeks 4 and 26. The child and their family will be provided with an information brochure on general healthy eating for their age and a personalised consultation with a dietitian at the end of the trial.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to first asthma exacerbation requiring medical intervention (unscheduled GP visit, emergency department presentation, hopsitalisation, or oral corticosteroids), reported by parent and/or medical records.
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Assessment method [1]
295589
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Timepoint [1]
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At first occurrence of an exacerbation, that is, any point during the 6 month study period.
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Secondary outcome [1]
315903
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The rate of asthma exacerbations requiring medical intervention (unscheduled GP visit, emergency department presentation, hopsitalisation, or oral corticosteroids), over the 6-month study period, reported by parent and/or medical records
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Assessment method [1]
315903
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Timepoint [1]
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Assessed per-patient-month of follow-up, i.e. at 6-months or study finalisation (whichever comes first)
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Secondary outcome [2]
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The change in plasma antioxidants over the 6-month period
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Assessment method [2]
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Timepoint [2]
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Assessed at baseline, 3 months and 6 months.
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Secondary outcome [3]
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The change in plasma and faecal short chain fatty acids over the 6-month period
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Assessment method [3]
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Timepoint [3]
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Assessed at baseline, 3 months and 6 months.
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Secondary outcome [4]
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The rate of viral infections, reported by parents and confirmed by polymerase chain reaction (PCR) analysis of nasal swabs, over the 6-month period
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Assessment method [4]
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Timepoint [4]
315906
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Assessed per-patient-month of follow-up, i.e. at 6-months or study finalisation (whichever comes first)
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Secondary outcome [5]
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The change in asthma control over the 6-month period, using the childhood asthma control test (cACT)
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Assessment method [5]
315907
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Timepoint [5]
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Assessed weekly from randomisation for 6 months
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Secondary outcome [6]
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The severity and duration of asthma exacerbations, documented using the Asthma Flare-up Diary for Young Children (ADYC) and the childhood asthma control test (cACT).
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Assessment method [6]
315908
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Timepoint [6]
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Assessed at each event during the 6 month study period.
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Secondary outcome [7]
315909
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The severity and duration of upper respiratory tract infections, documented by parents on the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K) and the Canadian Acute Respiratory Infection & Flu Scale (CARFIS).
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Assessment method [7]
315909
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Timepoint [7]
315909
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Assessed at each event during the 6 month study period.
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Secondary outcome [8]
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Innate antiviral response of rhinovirus-infected peripheral blood monocytes (PBMCs) compared to untreated PBMCs at each time-point, including the release of interferons measured via ELISA or cytometric bead array.
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Assessment method [8]
315910
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Timepoint [8]
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At baseline, 3 months and 6 months
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Secondary outcome [9]
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The change in HDAC/ HAT activity in nuclear and cytosolic extracts from peripheral blood monocytes and granulocytes
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Assessment method [9]
315911
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Timepoint [9]
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At baseline, 3 months and 6 months
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Eligibility
Key inclusion criteria
Physician diagosed asthma
History of one or more exacerbations in the past 6 months, or at least two in the past 12 months that resulted in medical intervention
usual F&V intake (assessed over the past week) below the current Australian Dietary Guidelines for their age group
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Minimum age
3
Years
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Maximum age
11
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Chronic respiratory condition other than asthma; clinically important medical illness, including psychiatric or behavioural disorders and chronic medical conditions requiring regular treatment with medications, likely to affect participation; chronic use of anti-inflammatory medications, e.g. low-dose systemic corticosteroids; unable or unwilling to modify diet; diagnosed intestinal disorders such as irritable bowel syndrome, inflammatory bowel disease and coeliac disease
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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)
Randomisation will be carried out by an independent statistician and the participant's group allocation and number will be provided to the research dietitian on enrolment, who will assign the necessary dietary recommendations (unblinded).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be carried out using a computerised random number generator, in variable block sizes, stratified by age group and gender. The randomisation service will be managed by an independent statistician at the Hunter Medical Research Institute.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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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
24/08/2015
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Actual
28/09/2015
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Date of last participant enrolment
Anticipated
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Actual
12/12/2017
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Date of last data collection
Anticipated
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Actual
22/06/2018
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Sample size
Target
78
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Accrual to date
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Final
67
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
4059
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Hunter Medical Research Institute - New Lambton Heights
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Recruitment hospital [2]
4060
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John Hunter Children's Hospital - New Lambton
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Funding & Sponsors
Funding source category [1]
291665
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Other Collaborative groups
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Name [1]
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Hunter Medical Research Institute Donor grants
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Address [1]
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HMRI Building
1 Kookaburra Circuit, New Lambton Heights
NSW 2308
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Country [1]
291665
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Lisa Wood
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Address
Centre for Asthma & Respiratory Disease,
Level 2, West Wing, HMRI Building
Care of: the University of Newcastle
University Drive, Callaghan
NSW 2308
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Country
Australia
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Secondary sponsor category [1]
290339
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University
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Name [1]
290339
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The University of Newcastle
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Address [1]
290339
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University Drive, Callaghan
NSW 2305
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Country [1]
290339
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293194
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Hunter New England Health Research Ethics Committee
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Ethics committee address [1]
293194
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Locked Bag 1 New Lambton NSW 2305
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Ethics committee country [1]
293194
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Australia
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Date submitted for ethics approval [1]
293194
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17/06/2015
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Approval date [1]
293194
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08/07/2015
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Ethics approval number [1]
293194
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15/06/17/4.03
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Ethics committee name [2]
293195
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The University of Newcastle Human Research Ethics Committee
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Ethics committee address [2]
293195
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University of Newcastle University Drive, Callaghan NSW 2308
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Ethics committee country [2]
293195
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Australia
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Date submitted for ethics approval [2]
293195
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10/07/2015
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Approval date [2]
293195
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15/07/2015
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Ethics approval number [2]
293195
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H-2015-0256
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Summary
Brief summary
Asthma is the most common chronic childhood disease, affecting one in seven children. Many children have asthma flare-ups, which often results in several sick days requiring increased use of medications, such as ventolin, and may lead to an emergency room visit or even a hospital admission. We have conducted studies in adults, which indicate that certain dietary changes can reduce the risk of an asthma flare-up. However, we do not know whether this is true in children. This study will examine whether the frequency of asthma flare-ups in children can be reduced, by making specific changes to the diet. We hope to gain insight into how diet may be useful for managing children with asthma.
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Trial website
http://www.hmri.com.au/research/clinical-trials/improving-asthma-in-childhood-through-diet/
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Trial related presentations / publications
Nutrition Society of Australia, 43rd Annual Scientific Meeting, 2-5 December, 2019, Newcastle, NSW: -A high fruit and vegetable intervention improves lung function and decreases asthma related illness in children with asthma. Berthon BS, McLoughlin RF, Hosseini B, Jensen ME, Williams EJ, Collison A, Starkey MR, Mattes J, Wark PAB, Wood LG. -A high fruit and vegetable diet modulates inflammation in children with asthma McLoughlin RF, Berthon BS, Hosseini B, Jensen ME, Williams EJ, Collison A, Starkey MR, Mattes J, Wark PAB, Wood LG.
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Public notes
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Contacts
Principal investigator
Name
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Prof Lisa Wood
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Address
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Centre for Asthma & Respiratory Disease,
Level 2, West Wing, HMRI Building
Care of: the University of Newcastle
University Drive, Callaghan
NSW 2308
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Country
58850
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Australia
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Phone
58850
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+61 2 40420147
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Fax
58850
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Email
58850
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[email protected]
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Contact person for public queries
Name
58851
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Bronwyn Berthon
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Address
58851
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Centre for Asthma & Respiratory Disease,
Level 2, West Wing, HMRI Building
Care of: the University of Newcastle
University Drive, Callaghan
NSW 2308
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Country
58851
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Australia
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Phone
58851
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+61 240420116
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Fax
58851
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Email
58851
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[email protected]
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Contact person for scientific queries
Name
58852
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Lisa Wood
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Address
58852
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Centre for Asthma & Respiratory Disease,
Level 2, West Wing, HMRI Building
Care of: the University of Newcastle
University Drive, Callaghan
NSW 2308
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Country
58852
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Australia
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Phone
58852
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+61 2 40420147
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Fax
58852
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+61 2 40420046
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Email
58852
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
There is no plan to share IPD for this trial
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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
No additional documents have been identified.
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