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Trial registered on ANZCTR
Registration number
ACTRN12616000492459
Ethics application status
Approved
Date submitted
5/04/2016
Date registered
14/04/2016
Date last updated
17/01/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The prophylactic potential of a Mediterranean dietary pattern enriched with oily fish in improving respiratory function in asthmatic children.
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Scientific title
The prophylactic potential of a Mediterranean dietary pattern enriched with oily fish in improving respiratory function in asthmatic children: a randomized control trial.
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Secondary ID [1]
288883
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NONE
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Universal Trial Number (UTN)
U1111-1181-3989
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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:
CHILDHOOD ASTHMA
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Condition category
Condition code
Diet and Nutrition
298345
298345
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0
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Other diet and nutrition disorders
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Respiratory
298346
298346
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0
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Asthma
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Respiratory
298347
298347
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0
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Normal development and function of the respiratory system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention group will be instructed to consume 2 fatty fish meals (at least 150g cooked fish)/week as part of the Mediterranean diet for a period of 6 months. Emphasis to consume fatty fish only ( such as sardines, salmon, trout, mackerel etc) and no lean fish or seafood. Prior to commencement participants will be provided with an information sheet and consent form. At baseline and at 6 months during usual medical consultations, children will be assessed using anthropometry, spirometry, exhaled Nitric Oxide Analysis. And children together with parents will complete socio-demographics, Asthma Control Questionnaire, Paediatric Asthma Quality of life Questionnaire and food frequency questionnaires (requiring approximately 30 mins) as well as biochemical tests. During enrolment, a telephone-interview (lasting approximately 60 minutes) will be conducted by the dietitian to collect medical, dietary and lifestyle information. Dietary advice based on the Greek Mediterranean dietary guidelines ( Greek Ministry of Health & Welfare, 1999) including instructions on the dietary intervention will be explained to parents. Participants will be monitored fortnightly via telephone, text, e-mails and face-to-face consultations from the dietitian to address any problems relating to dietary adherence
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Intervention code [1]
294341
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Lifestyle
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Intervention code [2]
294422
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Treatment: Other
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Comparator / control treatment
The control group will continue with their usual diet and will be provided with general healthy dietary guidelines according to the Greek Ministry of Health and Welfare (1999). At baseline and at 6 months during usual medical consultations children will be assessed using anthropometry, spirometry and exhaled Nitric Oxide analysis. Children together with parents will complete socio-demographic, Asthma Control Questionnaire, Paediatric Asthma Quality of life and food frequency questionnaires as well as biochemical tests. At both time-points, telephone-interviews will be conducted by the dietitian (lasting approximately 60 minutes) to collect medical, dietary and lifestyle information. Patients will be monitored fortnightly via telephone, text, e-mails, face-to-face consultations from the dietitian until the end of the study. At the end of 6 months, the child and their family will have a personalized consultation with the dietitian and will be provided with an information brochure on general healthy eating guidelines based on the Greek Mediterranean dietary guidelines (Greek Ministry of Health and Welfare, 1999) .
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Control group
Active
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Outcomes
Primary outcome [1]
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Respiratory function as assessed by spirometry (FEV1, FVC, FEV1/FVC, PEF, FEF 25-75%) and bronchial inflammation by exhaled Nitric Oxide (eNO) analysis.
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Assessment method [1]
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Timepoint [1]
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Measured at baseline and 6 months
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Primary outcome [2]
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Composite outcome of asthma status as indicated by the number of asthma episodes, day and night symptoms, need for reliever medication, hospitalization/medical care and by parent's report ( GINA, 2016)
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Assessment method [2]
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Timepoint [2]
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Evaluated at baseline and 6 months
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Secondary outcome [1]
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Asthma Control assessed by Asthma Control (ACQ) questionnaire
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Assessment method [1]
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Timepoint [1]
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Measured at baseline and 6 months
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Secondary outcome [2]
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Dietary habits evaluated using a Food Frequency Questionnaire
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Assessment method [2]
322328
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Timepoint [2]
322328
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Assessed at baseline and at 6 months
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Secondary outcome [3]
322329
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Quality of life using the mini Paediatric Asthma Quality of Life Questionnaire(PAQLQ) (Juniper, 1996; 1999)
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Assessment method [3]
322329
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Timepoint [3]
322329
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Measured at baseline and at 6 months
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Secondary outcome [4]
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This is a composite secondary outcome. Change in plasma fatty acid composition, organic acids, Methyltetrahydrofolate, Vitamin D status assessed using Metabolomics ( urine and serum assay)
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Assessment method [4]
322330
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Timepoint [4]
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Measured at baseline and at 6 months
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Secondary outcome [5]
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Adherence to Mediterranean dietary pattern assessed using KIDMED Index (Serra-Majem, 2003;2004)
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Assessment method [5]
342060
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Timepoint [5]
342060
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baseline and 6 months
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Eligibility
Key inclusion criteria
Asthma was defined as physician-diagnosed 'mild asthma.'
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Minimum age
5
Years
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Maximum age
12
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
Children suffering from cystic fibrosis, GERD, pneumonia, congenital respiratory disease, food allergies, requiring regular treatment with multiple glucocorticoids drugs or cortisone, taking high dose multi-vitamins or fish oil capsules, unwilling to modify diet or being vegetarian.
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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)
Randomization will be carried out by an independent private statistician and the participant's group allocation and number will be provided to the pediatric pneumologist and research dietitian on enrolment who will provide participants with the appropriate dietary instructions
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization will be conducted by an independent private statistitian using an online computerised random number generator
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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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
The number of children enrolled was adequate to evaluate two-sided hypotheses regarding differences in FEV1 between groups. We used 90% power, effect size 0.4, alpha of 0.05 at a probability level of less than 0.05 gave a sample size of 52 children. Allowing for a 20% drop out rate gave a final sample size of 64 children.
Data analysis will be performed using SPSS. Continuous variables will be assessed for normality applying graphical methods, descriptive statistics, and Shapiro-Wilks test. Differences between groups will be assessed using t-test and ANOVA for variables found to be normally-distributed; Kruskal-Wallis and Mann-Whitney in the case of non-normality. And categorical variables using Chi square tests. P-value will be considered to be statistically significant at the 5% level
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/10/2016
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Actual
11/11/2016
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Date of last participant enrolment
Anticipated
30/06/2018
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Actual
31/12/2016
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Date of last data collection
Anticipated
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Actual
31/08/2017
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Sample size
Target
64
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Accrual to date
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Final
72
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Recruitment outside Australia
Country [1]
7756
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Greece
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State/province [1]
7756
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Attiki
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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La Trobe University
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Address [1]
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La Trobe University
Department of Rehabilitation, Nutrition and Sport
School of Allied Health
Bundoora, 3086
Victoria Australia
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Country [1]
293232
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Australia
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Primary sponsor type
University
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Name
La Trobe University
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Address
La Trobe University
Department of Rehabilitation, Nutrition and Sport
School of Allied Health
Bundoora, 3086
Victoria Australia
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Country
Australia
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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]
292035
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Country [1]
292035
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Other collaborator category [1]
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Individual
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Name [1]
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Dr.Charis Katsardis
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Address [1]
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Private Pediatric Respiratory Allergy Clinic
1 Pafou St
Marousi
Athens, 15125
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Country [1]
278920
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Greece
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Other collaborator category [2]
279370
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Individual
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Name [2]
279370
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Doctor Dimitris Tsoukalas
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Address [2]
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Metabolomic Clinic
5 Koumbari Street
Kolonaki Square
Athens
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Country [2]
279370
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Greece
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294712
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Latrobe University Ethics Committee
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Ethics committee address [1]
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Latrobe University Bundoora, 3086 Victoria
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Ethics committee country [1]
294712
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Australia
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Date submitted for ethics approval [1]
294712
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30/04/2016
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Approval date [1]
294712
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08/07/2016
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Ethics approval number [1]
294712
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HEC 16-035
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Summary
Brief summary
Globally, asthma has become one of the most frequent chronic diseases in children during the past two to three decades. Furthermore, it is a debilitating disease and is one of the most common reasons for hospitalization and days absent from school. The change in dietary habits has been implicated in causing childhood asthma. Observational studies revealed that adherence to a Mediterranean type diet by children was inversely associated with asthma symptoms. More specifically, some studies performed to date have reported that fish in the child’s diet was associated with reduced risk of wheeze and asthma, whereas others not. However, clinical trials investigating the effect of fatty fish consumption in the context of the Mediterranean diet in asthmatic children are limited. Therefore, there is a need for further investigation in order to clarify whether a Mediterranean diet enriched with fatty fish is a useful therapy for childhood asthma
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Catherine Itsiopoulos
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Address
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La Trobe University
Department of Rehabilitation, Nutrition and Sport
School of Allied Health
Bundoora, 3086
Victoria
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Country
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Australia
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Phone
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+61 3 94791721
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Fax
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+ 61 3 94792552
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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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Charis Katsardis
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Address
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Private Pediatric Respiratory Allergy Clinic
1 Pafou St
Marousi
Athens, 15125
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Country
64735
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Greece
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Phone
64735
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+ 30-210-9322946
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Fax
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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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Charis Katsardis
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Address
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Private Pediatric Respiratory Allergy Clinic
1 Pafou Street
Marousi
Athens, 15125
Greece
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Country
64736
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Greece
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Phone
64736
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+30-210-9322946
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Fax
64736
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Email
64736
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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
No additional documents have been identified.
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