Surgery, Time Restricted Feeding
Conditions
Brief summary
The overarching goal of this project is to assess whether a controlled short-term Time restricted feeding (TRF) intervention leads to metabolic benefits, improves recovery after vascular surgery and that TRF is safe. Participants suffering from intermittent claudication (Fontaine stage II peripheral artery disease, PAD) will be randomly assigned to a 2-week TRF or active control dietary advices before open surgical revascularization. Prior to the surgery, the investigators will assess the eating patterns of participants with an innovative smartphone application ('app') which is less intrusive and more reliable than food diaries/questionnaires to assess eating behavior and patterns. In the second part of the study, the investigators will investigate whether a short term TRF intervention improves surgical recovery, in the short-term (1 month, primary endpoint) and long-term (optional, up to 1 year), as part of the routine clinical follow-up. This proposal builds on established expertise in the biology of dietary intervention, surgery, and study of eating patterns in human.
Interventions
BEHAVIORALTime restricted feeding
Participants will be advised to eat only during a selected window of 8 hours, and no later than 4pm, with no advice on nutrition quality, quantity or caloric intake. The intervention will include no medication, no medical device, and will last for 2 weeks prior to surgery.
BEHAVIORALStandard dietary advices
Participants will be given standard dietary advices, as recommended by the international nutrition guidelines, and thus are not different from common clinical practice.
Sponsors
Centre Hospitalier Universitaire Vaudois
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Fontaine stage II peripheral artery disease planned for open femoral endarterectomy * Body mass index ≥ 20 kg/m2 * Smartphone compatible with the app (iOS or Android systems) * Hypertensive (or on 1 or more blood pressure lowering medication) * Hypercholesterolemia (or on 1 or more lipid lowering medication)
Exclusion criteria
* Diabetes on insulin therapy or sulfonylureas * Fontaine stage III and IV peripheral artery disease * Prior revascularization on the index leg within 14 days of the qualifying revascularization. * Major surgery in the past 3 months * Myocardial infarction or revascularization (PTA, stent, CABG) in the past 3 months * Major illness / fever over the previous month, active cancer * On a diet / weight management or prior bariatric surgery * Major mental illness, unable to give consent, inability to follow study procedures (language barrier, dementia) * Current shift work or travel abroad planned in the next month * Major sleep disorder * Enrolled in another interventional clinical trial * Ongoing pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with: Death, Myocardial infarction, Stroke, Surgical re-intervention. | 1 month | Safety of TRF before vascular surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in ankle and toe brachial index [0.2-1.4] | 1 month | Improvement in limb perfusion measured as an increase in the reported index |
| Change in weight [gram] | 1 month | — |
| Change in BMI [kg/m^2] | 1 month | — |
| Change in total cholesterol levels [mg/dl] | 1 month | — |
| Change in LDL cholesterol levels [mg/dl] | 1 month | — |
| Change in HDL cholesterol levels [mg/dl] | 1 month | — |
| Change in triglyceride levels [mg/dl] | 1 month | — |
| Change in glycemia [mmol/L] | 1 month | — |
| Change in insulin levels [pmol/L] | 1 month | — |
| Change in HbA1c levels [%] | 1 month | — |
| Adherence to TRF intervention | 1 month | Adherence will be determined using the smartphone app, by the number of days in which a participant will be adherent to logging and all caloric food items were contained within a 15-min buffer on each side of the selected eating window. |
| Time from randomization to the first occurrence of any of the following major thrombotic vascular events: MI (Myocardial infarction), ischemic stroke, CV (Cardiovascular) death, ALI (Acute limb ischemia), and major amputation or death (any cause). | 1 year | — |
| Length of Stay [days] | 1 month | — |
| Change in systolic and diastolic blood pressure [mmHg] | 1 month | — |
Other
| Measure | Time frame |
|---|---|
| Change in transforming growth factor beta levels [ng/mL] | 1, 2 days ans 1 month |
| Change in interferon gamma levels [pg/mL] | 1, 2 days ans 1 month |
| Change in cortisol levels [nmol/L] | 1, 2 days ans 1 month |
| Change in thyroid stimulating hormone levels [mIU/L] | 1, 2 days ans 1 month |
| Change in triiodothyronine levels [nmol/L] | 1, 2 days ans 1 month |
| Change in thyroxine levels [μg/d] | 1, 2 days ans 1 month |
| Change in circulating hydrogen sulphide levels | 1, 2 days ans 1 month |
| Change in circadian hormone secretion | 1, 2 days ans 1 month |
| Change in gut microbiome | 1, 2 days ans 1 month |
| Change in interleukin-6,-1, -10 levels [pg/ml] | 1, 2 days ans 1 month |
| Change in tumor necrosis factor alpha levels [pg/mL] | 1, 2 days ans 1 month |
Countries
Switzerland, United States
Contacts
Primary ContactAlban Longchamp, MD, PhD
Outcome results
None listed