Best Foods For your heart trial: dietary intervention to reduce cardiovascular risk in HIV dyslipidaemia

ISRCTN ISRCTN32090191
DOI https://doi.org/10.1186/ISRCTN32090191
Secondary identifying numbers 14823
Submission date
08/08/2013
Registration date
08/08/2013
Last edited
14/10/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Successful treatment for HIV has lead to an ageing HIV-positive population with heart disease as the most common cause of death. The underlying cause of the increased risk of heart disease observed in HIV is not understood, and cannot be explained by traditional risk factors. Lifestyle intervention is recommended, with a low-fat diet to promote cholesterol reduction. The addition of functional foods (such as plant stanols and nuts) produces more dramatic reductions in cholesterol. This is based on evidence from the general population. This study will find out if the Ultimate Cholesterol Lowering Plan (UCLP) will have a similar effect in people who have raised cholesterol due to their HIV infection and treatment.

Who can participate?
Adults with HIV infection on stable antiretroviral therapy and raised cholesterol can take part in this study.

What does the study involve?
Participants will be randomly allocated to receive dietary advice on either reducing saturated fat alone, or together with increasing intake of nuts, plant stanols, soya protein, olive oil, beans and oats (components of the UCLP), delivered for 6 months. Results from blood tests, questionnaires and interviews will assess the impact of the UCLP on the risk of heart disease in adults with HIV infection on antiretroviral therapy.

What are the possible benefits and risks of participating?
If this diet can significantly reduce blood cholesterol levels, patients may reduce their risk of a heart attack. Risks to participants are not expected in this study. Potential malabsorption of fat soluble vitamins will be monitored. Participants will be directed to their doctor in the case of any health concerns arising during the study.

Where is the study run from?
The study is run from the Heart of England NHS Foundation Trust (UK), University Hospital Birmingham (UK) and Coventry and Warwickshire Partnership NHS Trust (UK).

When is the study starting and how long is it expected to run for?
The study starts in September 2013 and is expected to run until September 2016.

Who is funding the study?
National Institute for Health research (NIHR) (UK)

Who is the main contact?
Mrs Clare Stradling
clare.stradling@heartofengland.nhs.uk

Contact information

Mrs Clare Stradling
Scientific

Birmingham Heartlands Hospital
3 Bordesley Green East
Bordesley Green
Birmingham
B9 5SS
United Kingdom

Email clare.stradling@heartofengland.nhs.uk

Study information

Study designRandomised; Interventional; Design type: Treatment
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleA randomised controlled pilot study to assess the feasibility of the ultimate cholesterol lowering plan dietary intervention for cardiovascular risk reduction in HIV dyslipidaemia
Study acronymBFF Trial
Study objectivesTo test the feasibility and acceptability of the ultimate cholesterol lowering plan (UCLP).
Ethics approval(s)West Midlands - Solihull Research Ethics Committee, 24/06/2013, ref: 13/WM/0225
Health condition(s) or problem(s) studiedTopic: Infection; Subtopic: Infection (all Subtopics); Disease: Infectious diseases and microbiology
InterventionDietary intervention:
Diet 1: low saturated fat
Diet 2: low saturated fat, Ultimate Cholesterol Lowering Plan within Mediterranean style diet
The intervention is for 6 months, the follow up is for 12 months.
Intervention typeBehavioural
Primary outcome measureFeasibility and acceptability of trial procedures for recruitment, allocation, retention and the intervention. They will be measured at baseline, 6 and 12 months. Method used to measure these outcomes: recruitment rate, attrition rate, process evaluation questionnaires and qualitative interviews, compliance rate of participation, adherence to dietary intervention using food diaries and 5 question compliance score.
Secondary outcome measures1. Difference in LDL-cholesterol between groups at 6 months
2. Estimates of variability and effect size for waist circumference, arterial stiffness, and other cardiovascular risk factors
Overall study start date02/09/2013
Completion date02/09/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 60; UK Sample Size: 60
Total final enrolment60
Key inclusion criteria1. Aged 18 years of age with stable HIV infection
2. On antiretroviral therapy for more than 6 months
3. Low Density Lipoprotein (LDL)-cholesterol >3mmol/l
4. Willing to make dietary changes
5. Able to give informed consent
Target Gender: Male & Female; Lower Age Limit 18 years
Key exclusion criteria1. Current opportunistic infection or recent weight loss in last 3 months
2. Pregnancy, or planning pregnancy in the next 6 months
3. Diagnosis of familial hyperlipidaemia (LDL-cholesterol >6mmol/l and family history)
4. Secondary causes of hypercholesterolemia
5. Renal or liver disease, diabetes, hypothyroidism (unless treated and on a stable dose of L-thyroxine)
6. Gross xanthoma, as this may predispose to hyper-absorption of plant sterols
7. Blood triglyceride level >10mmol/l, as this constitutes risk of pancreatitis
8. Nut allergy
9. Current use of lipid lowering agents, or any other interfering drug/diet
10. Cannot read and write in English, or inability to understand the printed materials
11. Any unstable psychiatric disorder, including known eating disorders
12. Current participation in a weight loss programme or other dietary intervention
Date of first enrolment02/09/2013
Date of final enrolment02/09/2016

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Birmingham Heartlands Hospital
Birmingham
B9 5SS
United Kingdom

Sponsor information

University of Birmingham (UK)
University/education

Edgbaston
Birmingham
B15 2TT
England
United Kingdom

ROR logo "ROR" https://ror.org/03angcq70

Funders

Funder type

Government

NIHR Doctoral Research Fellowship, UK; Grant Codes: NIHR-DRF-2012-05-204

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination plan08/06/2018: Results presented at Conference on Retroviruses and Opportunistic Infections (CROI) 2018: http://www.croiconference.org/sessions/mediterranean-portfolio-diet-hiv-dyslipidaemia-randomized-controlled-trial
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 08/02/2016 Yes No
Results article results 01/03/2021 14/10/2020 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

14/10/2020: Publication reference and total final enrolment number added.
28/05/2019: Internal review.
08/06/2018: The following changes were made to the trial record:
1. The public title was changed from 'Which Healthy Heart Diet for people living with HIV?' to 'Best Foods For your heart trial: dietary intervention to reduce cardiovascular risk in HIV dyslipidaemia'.
2. The acronym was changed from HHD Trial to BFF Trial.
3. Publication reference added.