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Trial registered on ANZCTR
Registration number
ACTRN12618000201279
Ethics application status
Approved
Date submitted
22/01/2018
Date registered
7/02/2018
Date last updated
8/01/2019
Date data sharing statement initially provided
8/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Effects of dietary fat structure on fat deposition in healthy Australian adults
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Scientific title
Effect of positional distribution of fatty acids at the triglyceride backbone of dietary vegetable fats on fat deposition and selected health outcome measures in healthy Australian men and women
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Secondary ID [1]
293849
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None
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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:
Cardio-metabolic disease
306309
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Non-alcoholic Fatty Liver Disease (NAFLD)
306310
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Obesity
306311
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Cardiovascular disease
306312
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Condition category
Condition code
Diet and Nutrition
305390
305390
0
0
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Obesity
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Metabolic and Endocrine
305391
305391
0
0
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Diabetes
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Cardiovascular
305392
305392
0
0
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Diseases of the vasculature and circulation including the lymphatic system
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Diet and Nutrition
305393
305393
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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
Palm olein (POo), Cocoa butter (COB) and Soybean oil (SBO) (control) will be compared using a 16-week blinded, randomised, 3-arm parallel feeding study design preceded by a 2-week run-in period.
A highly controlled feeding protocol will be used - Participants will consume the same background diet (35%E fat, 18%E protein, 48%E carbohydrate) differing in test fats only. Test fats will provide 20%E as either POo, COB or SBO and will be delivered through meals and snacks. The run-in diet will be the same background diet as the intervention diet containing POo as major fat type.
The prescribed diets will be eucaloric to maintain body weight stability. Whole diets will be designed at different levels of energy in increments of 1500 kJ for adjustment to individual energy requirements. Participant’s individual energy requirements will be determined using the Schofield equation based on age and gender. Participants will then be assigned the closest 1500 kJ bracket. Participants will be requested not to consume any other high-fat foods and to consume all food supplied. All test meals and snacks will be provided to participants for the duration of the study. The test fats will be delivered within one main meal per day (either lunch or dinner) and snacks consumed in-between meals (biscuits/cake). The remaining diet will consists of low-fat meals and snacks including breakfast cereal (supplied) and a low-fat meal prepared by participants themselves according to prescribed guidelines. Daily ‘low-fat snacks’ (non-study snacks) will be prescribed as part of the dietary pattern. These will be fruit, low-fat dairy or bread and cereal options, and participant will have some flexibility to swap their low-fat snack allowances for low-fat discretionary product/s from a prescribed list which includes alcoholic beverages.
Pre-intervention, participants will attend a dietetic consultation regarding the dietary intervention (~45 minutes).
Compliance will be monitored using an online checklist that participants complete weekly. If deviations from the dietary protocol is reported, participants will be contacted by the dietitian to determine possible reasons for the deviation and adjustments to the prescribed energy intake level will be made if required. Compliance will also be cross-monitored during a brief consultation with a dietitian at each visit (~10 min per 4 weeks over 16 weeks).
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Intervention code [1]
300107
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Treatment: Other
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Intervention code [2]
300108
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Lifestyle
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Comparator / control treatment
Soybean oil
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Control group
Active
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Outcomes
Primary outcome [1]
304529
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Liver fat content as measured by proton magnetic resonance spectroscopy (MRS)
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Assessment method [1]
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Timepoint [1]
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Weeks 0 and 16
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Secondary outcome [1]
342268
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Liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST)) using a Beckman AU480 clinical analyser
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Assessment method [1]
342268
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Timepoint [1]
342268
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [2]
342269
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Composite secondary outcome: Adipose tissue (visceral and sub-cutaneous) as measured by magnetic resonance imaging (MRI)
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Assessment method [2]
342269
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Timepoint [2]
342269
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Weeks 0 and 16
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Secondary outcome [3]
342270
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Total body fat content as measured by bioelectrical impedance analysis (BIA)
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Assessment method [3]
342270
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Timepoint [3]
342270
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [4]
342271
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Composite secondary outcome: Obesity indices (body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), visceral adiposity index (VAI) and body adiposity index (BAI)) calculated using anthropometric data (height, weight, waist- and hip circumference) and serum lipid data (triacylglycerol and HDL-C).
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Assessment method [4]
342271
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Timepoint [4]
342271
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [5]
342272
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Serum lipid profile - total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triacylglycerol (TAG), low density lipoprotein cholesterol (LDLC) using a Beckman AU480 clinical analyser
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Assessment method [5]
342272
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Timepoint [5]
342272
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [6]
342273
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Emerging blood lipid biomarkers - apolipoprotein A1 (apoA1) and B (apoB) using immunoturbidimetric assays
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Assessment method [6]
342273
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Timepoint [6]
342273
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [7]
342274
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Emerging blood lipid biomarker - lipoprotein (a) (LPa) using immunoturbidimetric assay
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Assessment method [7]
342274
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Timepoint [7]
342274
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [8]
342275
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Emerging blood lipid biomarker - LDL sub-fractions using a Lipoprint testing system
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Assessment method [8]
342275
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Timepoint [8]
342275
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [9]
342276
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Faecal fatty acids using GCMS
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Assessment method [9]
342276
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Timepoint [9]
342276
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [10]
342277
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Serum leptin using ELISA test kits on a microplate reader
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Assessment method [10]
342277
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Timepoint [10]
342277
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [11]
342278
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Plasma glucose using Beckman AU480 clinical analyser
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Assessment method [11]
342278
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Timepoint [11]
342278
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Weeks 0, 4, 8, 12, 16
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Secondary outcome [12]
342279
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Blood pressure using an automated blood pressure monitor
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Assessment method [12]
342279
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Timepoint [12]
342279
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Weeks 0, 4, 8, 12, 16
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Eligibility
Key inclusion criteria
1. Healthy adults
2. BMI 18.5-27.5 kg/m2
3. Understand the study requirements and willing to adhere closely to prescribed food consumption as per the research protocol
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Minimum age
20
Years
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Maximum age
45
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Self-reported history of any of the following chronic diseases - type 2 diabetes, hypertension, coronary heart disease, hyperlipidemia, liver disease, cancer (excluding skin cancer), haemochromatosis
2. Self-reported history of pancreatic insufficiency or other conditions resulting in fat malabsorption - chronic pancreatitis, cystic fibrosis, coeliac disease, Crohns disease, gastric bypass surgery, small bowel resection, abnormal thyroid function
3. On medication/nutraceuticals that may affect liver function, blood lipids, blood pressure or body weight, as assessed by the Principal Investigator or designee
4. Self-reported history of claustrophobia – to enable MRS/MRI assessments to be performed
5. Presence of any ferrous metal in the body - to enable MRS/MRI assessments to be performed.
6. Self-reported pregnant or currently lactating women
7. Females who are post-menopausal, on hormone replacement therapy or on hormone based contraceptives, unless they are stable for at least 3 months prior to study commencement (no changes in type and dose) and have no intention to change during study
8. History of smoking during the 6 months prior to the study
9. Alcohol consumption >21 units per week for men & >14 units per week for women
10. Mean blood pressure >140/90 mmHg assessed at screening visit
11. Hyperlipidemia (fasting TC>6.2 mmol/L or TAG >2.0 mmol/L) assessed at screening visit
12. Abnormal serum liver enzymes (ALT, AST) assessed at screening visit
13. Extended absences due to travel or other commitments
14. Self-reported known allergies to intervention foods
15. On any weight-loss program
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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 of eligible participants will be conducted by a different person than the person who decides that a participant is eligible for inclusion in the trial. Hence the person who makes decision regarding eligibility will not be aware at the time and have no influence over which groups participant are allocated to.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Eligible participants will be assigned to interventions using stratified random assignment based on gender. The randomisation scheme will be computer generated.
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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 administering the treatment/s
The people assessing the outcomes
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
Statistical power for this study is based on the primary outcome; liver fat content. A sample size of 24 participants per group will provide 80% power at a=0.05 to detect a minimum difference of 1.5% in liver fat content between treatments. The calculation is based on an average SD of 1.8% observed within healthy lean Caucasian populations. Considering a dropout rate of ~20% a total sample of 90 participants (30/group) will be recruited. Main intervention effects will be assessed using mixed effects longitudinal models. Statistical analyses will be performed using IBM SPSS statistics for WINDOWS (Chicago, USA). All statistical tests will be performed with = level =0.05 (2-tailed).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
3/04/2018
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Actual
30/04/2018
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Date of last participant enrolment
Anticipated
3/08/2018
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Actual
6/08/2018
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Date of last data collection
Anticipated
14/12/2018
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Actual
14/12/2018
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Sample size
Target
90
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Accrual to date
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Final
92
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment postcode(s) [1]
18631
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
298469
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Commercial sector/Industry
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Name [1]
298469
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Malaysian Palm Oil Board
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Address [1]
298469
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6, Persiaran Institusi
Bandar Baru Bangi
43000 Kajang
Selangor
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Country [1]
298469
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Malaysia
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Primary sponsor type
Government body
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Name
CSIRO Health and Biosecurity
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Address
PO Box 10041
Adelaide SA, 5000
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Country
Australia
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Secondary sponsor category [1]
297609
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None
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Name [1]
297609
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Address [1]
297609
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Country [1]
297609
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Other collaborator category [1]
279908
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University
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Name [1]
279908
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University of Sydney
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Address [1]
279908
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75 East Street Lidcombe, New South Wales, Australia, 2141
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Country [1]
279908
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299458
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CSIRO Health and Medical Research Human Research Ethics Committee
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Ethics committee address [1]
299458
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GPO Box 2683 Brisbane Queensland, 4000
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Ethics committee country [1]
299458
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Australia
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Date submitted for ethics approval [1]
299458
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21/11/2017
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Approval date [1]
299458
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16/01/2018
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Ethics approval number [1]
299458
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11/2017
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Summary
Brief summary
Excessive accumulation of fat in the body, particularly around the internal organs, is associated with increased risk of type 2 diabetes and cardiovascular disease. Hence the prevention and management of body fat accumulation is important and diet plays an important role. Dietary saturated fatty acids are often implicated to cause more fat deposition than unsaturated fatty acids, despite limited scientific evidence to support this notion. Very few studies to date have directly compared different types of fats and the results are inconsistent. Inconsistencies may be explained by differences in the chemical structure of different dietary saturated fat sources. Specifically the way in which fatty acids are distributed within triglyceride (lipid) molecules may affect their absorption and hence their physiological and biochemical responses. In light of this, the main aim of the study is to compare the effects of three vegetable fats (palm olein, cocoa butter and soybean oil), differing in their content of saturated fatty acids but comparable in chemical structure, on changes in fat deposition in the body (specifically liver and fat tissue content) in a healthy population. The primary hypothesis is that consumption of dietary fats high in SFA (palm olein and cocoa butter), but containing the majority of SFA in sn-1, 3 positions with mostly unsaturated fatty acids in the sn-2 position will not result in unfavourable body fat accretion compared to a dietary fat high in unsaturated fatty acids (soybean oil).
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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
80470
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Dr Welma Stonehouse
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Address
80470
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CSIRO Health and Biosecurity
PO Box 10041
Adelaide, SA, 5000
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Country
80470
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Australia
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Phone
80470
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+61 8 8303 8919
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Fax
80470
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Email
80470
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[email protected]
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Contact person for public queries
Name
80471
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Bianca Benassi-Evans
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Address
80471
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CSIRO Health and Biosecurity
PO Box 10041
Adelaide, SA, 5000
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Country
80471
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Australia
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Phone
80471
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+61 8 8303 8982
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Fax
80471
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Email
80471
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[email protected]
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Contact person for scientific queries
Name
80472
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Welma Stonehouse
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Address
80472
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CSIRO Health and Biosecurity
PO Box 10041
Adelaide, SA, 5000
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Country
80472
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Australia
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Phone
80472
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+61 8 8303 8919
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Fax
80472
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Email
80472
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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
Undecided
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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
Source
Title
Year of Publication
DOI
Embase
Eucaloric diets enriched in palm olein, cocoa butter, and soybean oil did not differentially affect liver fat concentration in healthy participants: A 16-week randomized controlled trial.
2021
https://dx.doi.org/10.1093/ajcn/nqaa347
N.B. These documents automatically identified may not have been verified by the study sponsor.
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