Evaluation of the Impact of Physical Reconditioning Associated With Specific Nutritional Supplementation in Obese Patients Suffering From Metabolic Syndrome (OBEFITT)

University Hospital, Rouen

Status: Completed

Conditions: Obesity; Metabolic Syndrome

Treatments: Dietary Supplement: L-Leucine and L-arginine; Other: Physical Reconditioning by a trainer

Study type: Interventional

Funder types: Other

Identifiers

NCT01326416

2008/066/HP

Details and patient eligibility

About

Android obesity contributes, via insulin resistance and endothelial dysfunction, to the development of cardiovascular atherosclerosis. It leads to poor quality of life. It is often associated with metabolic syndrome which includes, whatever the definitions used (National Education Cholesterol Program, NECP / Adult Treatment Panel III, ATP III or International Diabetes Federation, IDF), an increased waist measurement, an arterial high blood pressure and disorders of the glucide and lipid metabolism. The treatment of the current "epidemic" of obesity and metabolic syndrome in France (12.4 % of obese and 14 % of subjects with metabolic syndrome) thus requires new therapeutic approaches.

A well-balanced diet and a daily physical activity are the indispensable requirements for the treatment of obesity and metabolic syndrome. It is possible to associate it to pharmacological agents, but the results are often partial and transient. Preliminary data suggest that leucine or arginine supplementation could facilitate the loss of fat mass. Moreover, the physical exercise has also demonstrated benefits.

Sessions of physical reconditioning (aerobic work + muscular intensification) associated with a program of specific nutritional supplementation by a mixture of Leucine and Arginine (in the daytime) could improve the treatment of obese subjects affected by metabolic syndrome.

Enrollment: 79 patients

Sex: All

Ages: 18 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Suffering from obesity (Body Mass Index (BMI) > 30kg.m-2) with a maximal weight of 135 kg
• Suffering from metabolic syndrome (International Federation of Diabetes(FID) definition)
• Hospitalized or followed in consultation
• Age 18 to 55 years old
• Not having recently participated in other clinical studies during the last days before pre-inclusion consultation
• Affiliated to a National Insurance scheme
• Having National Social Security insurance

Exclusion criteria

• Asthma, chronic respiratory failure, obstructive chronic bronchitis
• Current or recent Pneumothorax, recent pleural draining or biopsy, current hemoptysis, untreated / in course of treatment active tuberculosis
• Coronaropathy, myocardiopathy, myocarditis, unstable cardiac failure, ventricular rhythm disorders
• Severe Anemia
• Severe inferior members Arteritis
• Incapacity to walk or cycle
• Severe renal failure (Creatinine Clearance <or = 30 mL/min)
• Severe Sepsis
• Psychiatric Disorders (Diagnostic and Statistical Manual - Revision 4 (DSM IV) criteria) such as schizophrenia, other psychoses or major depressive non treated syndromes
• Severe or non treated Eating Disorders implicated in obesity (compulsive access, bulimia)
• Patients under guardianship or with curators
• Women in age of procreation without means of effective contraception
• Pregnant or breast-feeding women
• Taking medicates such as: proteinate powder (Protifar ®, SP95 ®, Orlistat (Xenical ®, Ally ®), exenatide (Byetta ®), sitagliptin (Januvia ®, Xelevia ®), vildagliptin (Galvus ®), sitagliptin-metformin (Janumet ®), Vildagliptin-metformin (Eucreas ®), tadalafil (Cialis ®) sildenafil (Viagra ®)
• Drug addiction to opiates in the last six months
• Alcohol or drug abuse
• Infection by Human Immunodeficiency Virus (HIV) , viral hepatitis B and viral hepatitis C
• Active addiction to smoking in more than 8 cigarettes a day
• Understanding badly spoken or written French
• Performed, in 2 to 3 days preceding the Dual-energy X-Ray Absorptiometry (DEXA) exam, of a bone scintigraphy or a digestive tract radiological examination with the use of barium type of contrast agent.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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79 participants in 4 patient groups

S: Nutritional Supplementation alone

Active Comparator group

Description:

Specific nutritional supplementation for six months by 30g per day of a mixture of amino acids (21 g of L-Leucine and 9 g of L-arginine), to distribute during each of the 3 main meals.

Treatment:

Dietary Supplement: L-Leucine and L-arginine

A: Physical Reconditioning alone

Active Comparator group

Description:

Physical reconditioning sessions led by a trainer three times a week for 6 months.

Treatment:

Other: Physical Reconditioning by a trainer

AS: Physical Reconditioning + Nutritional Supplementation

Active Comparator group

Description:

Association for six months of a specific nutritional supplementation by 21 g of L-Leucine and 9 g of L-arginine per day (to distribute during each of the 3 main meals) and of physical reconditioning sessions three times a week.

Treatment:

Other: Physical Reconditioning by a trainer

C: Lifestyle counseling

No Intervention group

Description:

Usual advice given in consultation on the need for a balanced diet and regular physical activity