What is the Purpose of this Study?
Enroll an inclusive cohort of approximately 10,000 diverse individuals from the All of Us
Research Program that is representative of the U.S. population, heterogeneous in
demographics, clinical characteristics, health parameters, and disease risk factors, into
the NPH study.
■ Apply high density data analysis and Artificial Intelligence (AI) methods to the combined
NPH and All of Us data in a discovery science approach to understand and predict an
individual's response to foods, nutrients, food components, and dietary patterns.
■ Assess dietary intake in community-dwelling and controlled feeding studies within the
NPH to improve innovative dietary assessment methodologies through validation,
evaluation, and modeling efforts to further future nutrition- and diet-related science.
■ Integrate NPH data, enriched with information derived from the AI algorithms, into the
existing All of Us Researcher Workbench to serve as a long-standing data repository
that can be interrogated to understand and improve human health and treat or prevent
chronic disease.
Eligibility
- * Overall Inclusion -- Participants 18 years of age or older who have completed the primary All of Us consent process, Electronic Health Record consent process, and genetic Return of Results consent process (any answer), have provided at least one All of Us biospecimen suitable for DNA sequencing, and have completed All of Us Participant Provided Information (PPI) Modules 1-3 (Basics, Overall Health, and Lifestyle); Speak English or Spanish; Able and willing to comply with study requirements and consent to participate.
- * Module 1 -- Must be willing and able to comply with Module 1 protocol; Must provide informed consent for Module 1.
- * Module 2 -- Must have completed Module 1; Must provide informed consent for Module 2; Must agree to comply with protocol over a period of approximately 10 to 12 weeks and up to six months. This includes consuming only the foods provided during periods of controlled feeding. Module 2 has three controlled feeding periods each lasting approximately two weeks with at least two weeks between feeding periods, and up to 6 months allowed for completion of the Module.
- * Module 3 -- Must have completed Module 1; Must provide informed consent for Module 3; Must agree to comply with protocol over a period of approximately 10 to 12 weeks and up to 6 months. This includes being domiciled three times, for two weeks each, and consuming only the foods provided during the domiciled periods. There is at least two weeks between domiciled periods, and up to 6 months allowed for completion of the Module.
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Inclusion Criteria:
- * Overall Inclusion -- Participants 18 years of age or older who have completed the primary All of Us consent process, Electronic Health Record consent process, and genetic Return of Results consent process (any answer), have provided at least one All of Us biospecimen suitable for DNA sequencing, and have completed All of Us Participant Provided Information (PPI) Modules 1-3 (Basics, Overall Health, and Lifestyle); Speak English or Spanish; Able and willing to comply with study requirements and consent to participate.
- * Module 1 -- Must be willing and able to comply with Module 1 protocol; Must provide informed consent for Module 1.
- * Module 2 -- Must have completed Module 1; Must provide informed consent for Module 2; Must agree to comply with protocol over a period of approximately 10 to 12 weeks and up to six months. This includes consuming only the foods provided during periods of controlled feeding. Module 2 has three controlled feeding periods each lasting approximately two weeks with at least two weeks between feeding periods, and up to 6 months allowed for completion of the Module.
- * Module 3 -- Must have completed Module 1; Must provide informed consent for Module 3; Must agree to comply with protocol over a period of approximately 10 to 12 weeks and up to 6 months. This includes being domiciled three times, for two weeks each, and consuming only the foods provided during the domiciled periods. There is at least two weeks between domiciled periods, and up to 6 months allowed for completion of the Module.
Exclusion Criteria:
- * Module 1
- 1. Any change to the participant's status from the time of All of Us enrollment that would render them ineligible for All of Us (e.g., being incarcerated, no longer living in the United States, or withdrawn from that study).
- 2. Inability to provide informed consent and engage in informed consent procedures
- 3. Participants who suffer from allergic reactions to, or are unwilling to consume, any components of the liquid mixed meal (e.g., milk products, soy products)
- 4. Barriers to safe insertion of peripheral IV canula:
- 1. Contraindications to peripheral IV canula insertion such as local skin infection, inflammation, trauma or burns if all the upper extremities were involved and there is no unaffected extremity available for IV placement; or
- 2. A need for long-term IV access (e.g., ESRD); or
- 3. Lymphedema or deep vein thrombosis (DVT) in the extremity of the IV (in the case where another extremity is not available); or
- 4. Coagulopathy requiring blood thinning products; or
- 5. Arteriovenous (AV) graft or fistula in the extremity of the IV (in the case where another extremity is not available)
- 5. Pregnancy-related conditions:
- 1. Gestational age precluding completion of the Module by 36 weeks. A pregnant participant should complete visit 1 by gestational age 34 weeks, 0 days and complete Module 1 by week 36.
- 2. Severe morning sickness limiting mixed meal tolerance test (MMTT) consumption
- 6. Certain types of disease states:
- 1. Dumping syndrome or inability to consume the volume of the MMTT liquid
- 2. Severe malabsorption such as history of short gut syndrome or need for parenteral or enteral nutrition
- 3. Less than 12-months post-metabolic or bariatric surgery
- 4. History of chronic pancreatitis (e.g., Cystic fibrosis) complicated by inability to tolerate the volume of the MMTT liquid
- 5. Health conditions requiring chronic blood transfusions or iron infusions
- 6. Hemoglobin \<9.5 g/dL at screening
- 7. Serious illness and in hospice or palliative care for terminal disease
- 8. Swallowing issues:
- 1. Self-reported difficulty tolerating solids or liquids
- 2. Aspiration risks that require change in thickness of liquid or dietary modifications
- 9. Short term antibiotic use. For example, active antibiotics use for an ongoing acute infection
- * Module 2
- 1. Any change to the participant's status from the time of All of Us enrollment that would render them ineligible for All of Us (e.g., being incarcerated, no longer living in the United States, or withdrawn from that study)
- 3. Inability to provide informed consent and engage in informed consent procedures
- 4. Inability or failure to complete all critical elements from Module 1 (dietary, physical activity and sleep assessments, continuous glucose monitoring, MMTT)
- 5. Participants who are already enrolled in Module 3
- 6. Participants who are unlikely to be able to adhere to the protocol, based on structured adherence assessment by a study registered dietitian or other trained staff. This includes participants who have known allergic reactions to, or unwillingness to consume, study foods in Module 2 (e.g., gluten, meat, fish, nuts, dairy products) that cannot be reasonably accommodated by the metabolic kitchen within allowable criteria for the test diets.
- 7. Participants who plan to relocate to an area not served by NPH or travel plans that do not permit completion of the Module over a period of up to 6 months.
- 8. Pregnancy-related conditions:
- 1. Gestational age precluding completion of the Module by week 36. A pregnant participant must be able to begin the first dietary intervention by gestational age 26 weeks, 0 days and complete the Module by week 36.
- 2. High risk pregnancy defined as fetal anomaly, gestational hypertension (SBP \>140 mmHg and DBP \>90 mmHg), pre-eclampsia, or gestational diabetes mellitus
- 9. Possible ethanol (alcohol) use disorder defined by Alcohol Use Disorders Identification Test (AUDIT) score of \>15
- 10. History of surgery for the treatment of obesity and:
- 1. Self-reported dumping syndrome; or
- 2. Following a special diet prescribed by their practitioner
- 11. Uncontrolled disease states:
- 1. Hypertension \>160/100mmHg
- 2. Exacerbation of underlying gastrointestinal disease, including inflammatory bowel disease or other malabsorptive disorders
- 3. Decompensated cirrhosis
- 4. Previously diagnosed diabetes Mellitus with HbA1c \>12% at screening
- 5. Newly diagnosed diabetes within the past three months, or HbA1c \>6.5% at screening in a person not previously diagnosed with diabetes.
- 12. Participants with a history of end-stage renal disease (ESRD) on hemodialysis
- 13. Active infectious diseases (e.g., active tuberculosis \< 3 months from symptom onset or positive test, COVID \< 1 month from symptom onset or positive test)
- 14. Malignancy (e.g., cancer) actively receiving cytotoxic chemotherapy (oral or infusions) treatment except for nonmelanoma skin cancers during the study period
- 15. Participants who require dietary restrictions due to a medical condition or are on a prescribed diet for underlying chronic diseases
- 16. Participants with type 1 or type 2 diabetes on insulin
- 17. Participants aged ≥ 75 years with type 2 diabetes taking prescribed medications that can cause hypoglycemia (e.g. sulfonylureas, glinides), or on a prescribed diet
- 18. Hospitalization for a chronic disease (e.g., congestive heart failure, stroke) within the past three months
- 19. Requiring transfusions/apheresis during study period
- 20. Participants with a current diagnosis of, or who have received treatment for, bulimia or anorexia nervosa within the past 3 years
- 21. Participants with major psychiatric disorders, including major depression, schizophrenia, or psychosis, who have been hospitalized in the past six (6) months or are currently enrolled in treatment programs
- 22. Hemoglobin \<9.5 g/dL at screening
- 23. Myocardial infarction, invasive cardiac procedure, participation in a cardiac or acute rehabilitation programs, transient ischemic attacks, or unstable arrhythmias within the past 3 months
- * Module 3
- 2. Participants who are already enrolled in Module 2
- 4. Inability to abstain from tobacco or nicotine use, vaping, alcohol, illicit drug use, or recreational drug use for two (2) consecutive weeks while domiciled in the clinical unit. Nicotine gum, pouch, or patch are permitted.
- 5. Any condition requiring in-person treatments or visits during the study period. This will not be accommodated by the domiciling protocol; however, tele-health visits with the participants regular doctor are permitted.
- 6. Lactation or other infant care needs that cannot be accommodated while domiciled in the clinical unit
- 7. Depression as assessed by:
- 1. Patient Health Questionnaire (PHQ-9) score ≥ 15; or
- 2. Affirmative answer to PHQ-9 suicidality question: "Thoughts that you would be better off dead or of hurting yourself in some way"
- 8. Unable to engage in daily self-care activities (e.g., bathing, transferring, toileting, feeding, dressing)
- 9. Uncontrolled endocrine disorders (such as Cushing's disease, pituitary disorders, diabetes)
- 10. Uncontrolled pain requiring frequent or daily treatment, or adjustment of medication requiring weekly or bi-weekly visits. Pain medications used on an as-needed basis (PRN), such as acetaminophen or NSAIDs, are not excluded.
- 11. Chronic prescription medications that would pose logistical and safety issues for participation
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Where can I participate?
CS Cancer at Cedars-Sinai Medical Center : Christina Lombardi
More about this Clinical Trial
What is the full name of this clinical trial?
STUDY00002563: Nutrition for Precision Health