Body Composition, Beneficial, Insulin Resistance, Liver Steatosis, Whole Body Protein Metabolism
Conditions
Keywords
Protein kinetics, liver steatosis
Brief summary
The purpose of this study is to assess the effect of an eight-week dietary supplementation with essential amino acids plus arginine on liver and plasma lipid content, whole-body fat oxidation, whole-body insulin sensitivity, whole body protein metabolism, and body composition in obese pre-pubertal children.
Detailed description
Up to thirty-two obese pre-pubertal children will be recruited for this study. Up to sixteen will be boys and up to sixteen will be girls. The study will be a double-blinded, placebo-controlled trial using a randomized, but counter-balanced design. This will ensure equal numbers in the two groups that the children are randomized to, for each sex. The control group will receive placebo and the intervention group will receive essential amino acids plus arginine. The supplements (essential amino acids plus arginine, and placebo) will be given in the form of a drink twice a day for a total of 8 weeks. Both the participants and the investigators will be blinded to group assignment. The primary endpoints of this study are to assess the effect of essential amino acids (EAA) plus arginine supplementation on lipid and protein metabolism. For this, liver lipid content, hepatic apoptosis, plasma lipids, apolipoprotein B-100 (apo B-100) levels, hepatic fatty oxidation, whole body insulin sensitivity, body composition and whole body protein turnover. will be compared between the intervention and placebo groups.
Interventions
DIETARY_SUPPLEMENTEssential amino acids plus arginine
Flavored drink containing essential amino acids plus arginine.
DIETARY_SUPPLEMENTPlacebo
Flavored drink without essential amino acids plus arginine.
Sponsors
Arkansas Children's Hospital Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
7 Years to 10 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy boy or girl * Age 7-10 years of age and Tanner stage no greater than stage 1 * BMI ≥ 95th percentile * Not participating for more than 1 hour/week in a regular physical activity program
Exclusion criteria
* Tanner stage greater than stage 1 * Having known chronic illnesses/disorders that may independently affect study outcome measures: type 2 or type 1 diabetes mellitus, neurologic (e.g. epilepsy), neurobehavioral (e.g. Attention deficit disorder and hyperactivity, ADHD) endocrine, hepatic, autoimmune, cardiac and renal disorders. Also, chronic lung disorders except well controlled asthma that does not require permanent use of inhaled/oral steroids * Taking permanent medications: thyroid hormone replacement therapy, inhaled/oral steroids, insulin, metformin, anabolic drugs (growth hormone replacement therapy and oxandrolone) anti-lipid medication, blood pressure medication, ADHD medication (methylphenidate, amphetamines, atomoxetine)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Liver lipid content before and after 8 weeks of supplementation with essential amino acids plus arginine vs placebo. | Baseline and 8 weeks | Nuclear Magnetic Resonance Spectroscopy will be used to assess changes in liver lipid content following an 8-week supplementation period with essential amino acids plus arginine vs. placebo. |
| Serum levels of markers of lipid metabolism before and after 8 weeks of supplementation with essential amino acids plus arginine vs placebo. | Baseline and 8 weeks | Change in serum levels of triglycerides, cholesterol, very low density lipoprotein (VLDL), low density lipoprotein (LDL), beta-hydroxybutyrate, Apo-lipoprotein B and plasma cytokeratin 18 will be assessed after 8 weeks of essential amino acids plus arginine vs placebo. |
| Whole body protein turnover before and after 8 weeks of supplementation with essential amino acids plus arginine vs. placebo. | Baseline and 8 weeks | Change in whole body protein metabolism (synthesis and breakdown) following 8 weeks of essential amino acids plus arginine vs placebo. This outcome will be assessed using a stable isotope of an amino acid (15N-alanine). |
| Body composition before and after 8 weeks of supplementation with essential amino acids plus arginine vs. placebo. | Baseline and 8 weeks | Changes in body composition (fat free mass and fat mass) will be assessed using Dual-Energy X-ray Absorptiometry. Measurements will be carried out at baseline and following 8 weeks of supplementation with essential amino acids plus arginine vs. placebo. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HOMA-IR index before and after 8 weeks of supplementation with essential amino acids plus arginine vs placebo. | Baseline and 8 weeks | Fasting glucose and insulin levels will be used to assess changes in the HOMA-IR index after 8 weeks of supplementation with essential amino acids plus arginine vs. placebo. |
Outcome results
None listed