Current projects of the CHORI-bar team
1. Can the CHORI-bar, by improving metabolism naturally, without drugs, secondarily improve quality of life of individuals with the co-morbidities of obesity, such as asthma, diabetes, and hypertension?
A clinical trial in obese adolescent asthmatics has been initiated, in collaboration with Dr. Karen Hardy (link to her webpage) who directs the Pulmonary Medical Group at CHO, and led by Dr. Mustafa Bseirki, a pulmonary fellow. A brief description of the study follows.
Obese asthma is now generally considered to be a distinct asthma phenotype. Responses to standard asthma treatments (e.g., corticosteroids) are altered in obese asthmatics in ways that, while not yet well understood, appear to involve altered metabolism rather than purely mechanical complications due to obesity (e.g., airway mechanics). Recent evidence suggests that asthma prevalence and severity are increased as a function of worsening metabolic dysregulation common in the obese -- specifically, insulin resistance, increased oxidative stress, dyslipidemia, and vitamin/mineral deficiencies. However, there have not yet been controlled interventions to test whether improving these metabolic imbalances will have an ameliorative effect on existing asthma symptoms. In collaboration with the United States Department of Agriculture (USDA), we have developed a low-calorie, nutrient-rich supplement bar consisting of a fruit matrix containing essential vitamins, minerals, soluble and insoluble fiber, omega-3 fatty acids, and other ingredients. This supplement bar has been shown to improve insulin sensitivity, antioxidant defenses, and dyslipidemia. We propose to conduct a 6-month randomized clinical trial within a pre-tested family-based intervention model to evaluate effects of bar consumption in addition to conventional care on asthma control and quality of life in obese adolescent asthmatics. The subject and one parent will participate in interactive sessions for diet and activity modification with or without nutritional bar supplementation. The primary outcome will be improvement in the asthma control (ACT) score. Secondary outcomes will include quality of life, spirometric evaluation, exercise tolerance, and exhaled NO. Changes in weight, insulin sensitivity, redox status, lipid profiles, and several indicators of inflammation including altered arginine metabolism and a cytokine panel will also be measured. A successful outcome will provide preliminary evidence for an RO1 to conduct a large-scale trial, and may also shed light on underlying mechanisms linking the metabolic dysregulation of obesity and asthma.
2. Following suggestions in our recent publication (Mietus-Snyder et al, 2012), a series of in-house small clinical trials are aimed at broadening the disease-related biomarkers improved by the CHORI-bar and deconstructing the bar it to determine which major ingredients or combinations of ingredients are responsible for improvements in biomarkers linked to disease, such as HDL. We are also interested in identifying mechanisms by which the CHORI-bar elicits these changes.
3. Can the CHORI-bar aid in weight reduction and can it, by making people feel better, motivate them to transition to healthier eating habits?
Anecdotal results from our 11 clinical trials strongly suggest that the CHORI-bar is very satiating and regular consumption has elicited feelings of well-being in many participants. These findings suggest the bar may be effective in promoting weight loss and in transitioning people to healthier eating habits, but testing these hypotheses will require randomized controlled trials. We are working with the United State Department of Agriculture (USDA) Food Processing Unit in Albany, CA to develop a placebo bar to be used in these trials.
Collaborations have been initiated with Dr. Janet King (link to her webpage) and Dr. Larry Gold at Somalogic, Inc. (link to Somalogic webpage) to explore effects of modest zinc deficiency on plasma proteins, and, following our publication on vitamin K (McCann & Ames, 2009), with Dr. Jung Suh in our group to measure the relative sensitivities of plasma vitamin K-dependent proteins to vitK deficiency. With Drs. Ames and Suh, Dr. McCann is also initiating a literature-based analysis and discussion of potential “longevity vitamins” (see Ames webpage link).
Revised: Monday, March 30, 2015 1:20 PM