GEMLIFE: Genetic Evaluation and Modification of Lifestyles to Improve Female Life Expectancy

Sponsor

Rush University Medical Center (Other)

Overall Status

Terminated

CT.gov ID

NCT05715372

Collaborator

(none)

Enrollment

Location

Arms

Study Details

Study Description

Brief Summary

The GEMLIFE Study is a 12-month clinical trial for menopausal women. The purpose of this study is to promote an improved aging process for women in menopause through lifestyle changes. The changes will include a heart healthy diet, structured walking program, and mindfulness-based stress reduction. During the study, the investigators will monitor components of your genetic make-up that will tell us how you are aging. Investigators will also monitor bloodwork for inflammation that can affect medical conditions. Study participants may qualify if you are within 5 years of your last menstrual period and have well controlled medical conditions. There is no cost to participants to enroll in the study- only potential benefits to the participant's health and aging process.

Condition or Disease	Intervention/Treatment	Phase
Menopause Syndrome Inflammation Inflammatory Response Aging Menopause Telomere Shortening Stress Oxidative	Behavioral: Mediterranean diet Behavioral: AHA walking program Behavioral: Mindfulness-based stress reduction Behavioral: Unstructured Mediterranean diet Behavioral: Unstructured walking program Behavioral: Unstructured stress reduction	N/A

Detailed Description

The long-term goal of this research is to create and implement lifestyle interventions that will prevent or delay morbidities associated with accelerated aging in the menopausal women. By the end of this year, it is estimated that approximately 50 million women will be in the menopausal phase of their life. Menopause is defined by the decline in estrogen levels and subsequent increase in inflammatory markers which are associated with multiple morbidities involving the brain, bone and cardiovascular systems. Various lifestyle changes have been found to prevent or decrease these morbidities. Hormone replacement therapy in the early years of menopause is also a known therapeutic modality for the treatment of menopausal symptoms. The investigators will evaluate if hormone replacement and lifestyle change will have an enhanced effect on the prevention of morbidity and mortality.

Telomeres are distinct structures found at the end of chromosomes. As women enter into menopause, which is the biomarker for aging, there is a shortening of the telomere length. Poor lifestyle factors which cause oxidative stress, can lead to poor cell replication and critical shortening of telomere length. Telomerase, an enzyme which aids in gene sequencing, also declines. Shortened telomere length and low levels of telomerase lead to cell aging and apoptosis, a reduction in normal organ function, and an increase in morbidity and mortality. It has been found that lifestyle intervention, and possibly hormone replacement, can enhance telomere length and telomerase production.

This research will focus on the acute menopausal woman (within 5 years of the last menstrual period), with and without hormone replacement, .and multiple lifestyle interventions. Early intervention within the first five years of menopause is most important in affecting long term morbidity and mortality in women. Serial measurement of various biomarkers and cytokines associated with aging, and measurements of telomere length and telomerase levels will be performed over a 9 month period of time. Evidence shows that diet, physical activity and cognitive intervention may synergize when combined in a multimodal intervention as each targets different mechanisms. The Investigators will evaluate the efficacy of each 12-week interventions on telomere length, telomere production, serum biomarkers and cytokine levels before and after each intervention, and as a multimodal approach. Approximately 100 women will be recruited once they have been confirmed to be in the early stages of menopause, then further divided based on the use of hormone replacement. Aims are to: (1) determine the independent and combined efficacies of lifestyle interventions on telomere length, (2) determine the independent and combined efficacies of lifestyle interventions on biomarkers and and cytokines, (3) Determine other mechanisms of aging associated with the acute phase of menopause . This key knowledge will aid in practical and early lifestyle interventions to deter detrimental morbidities in the menopausal women.

Study Design

Study Type:

Interventional

Actual Enrollment :

5 participants

Allocation:

Randomized

Intervention Model:

Factorial Assignment

Intervention Model Description:

Randomized, single-blinded prospective study.Randomized, single-blinded prospective study.

Masking:

Single (Participant)

Masking Description:

Computer-assigned.

Primary Purpose:

Prevention

Official Title:

Genetic Evaluation and Modification of Lifestyles to Improve Female Life Expectancy

Actual Study Start Date :

Jun 22, 2021

Actual Primary Completion Date :

Jun 22, 2021

Actual Study Completion Date :

Jun 22, 2021

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Intervention group of menopausal women on hormone replacement This group of women on hormone replacement will have specific, structured diet, physical activity, and mindfulness-based stress reduction programs.	Behavioral: Mediterranean diet 12-week structured program for Mediterranean diet. Behavioral: AHA walking program 12-week structured AHA walking program. Behavioral: Mindfulness-based stress reduction 8-week structured mindfulness-based stress reduction (Cabot).
Placebo Comparator: Control group of menopausal women on hormone replacement This group of women on hormone replacement will be given unstructured guidelines for diet, physical activity, and stress-reduction.	Behavioral: Unstructured Mediterranean diet Unstructured 12-week program with basic outline for Mediterranean diet. Behavioral: Unstructured walking program Unstructured 12-week walking program. Behavioral: Unstructured stress reduction Unstructured program using mobile application for stress reduction.
Active Comparator: Intervention group of menopausal women without hormone replacement This group of women will have specific, structured diet, physical activity, and mindfulness-based stress reduction programs.	Behavioral: Mediterranean diet 12-week structured program for Mediterranean diet. Behavioral: AHA walking program 12-week structured AHA walking program. Behavioral: Mindfulness-based stress reduction 8-week structured mindfulness-based stress reduction (Cabot).
Placebo Comparator: Control group of menopausal women without hormone replacement This group of women will be given unstructured guidelines for diet, physical activity, and stress-reduction.	Behavioral: Unstructured Mediterranean diet Unstructured 12-week program with basic outline for Mediterranean diet. Behavioral: Unstructured walking program Unstructured 12-week walking program. Behavioral: Unstructured stress reduction Unstructured program using mobile application for stress reduction.

Outcome Measures

Primary Outcome Measures

Independent Lifestyle Interventions on Telomere Length [12 months]
Measurement of telomere length after 12 months of a Mediterranean diet, American Heart Association walking program, and mindfulness-based stress reduction program.

Secondary Outcome Measures

Lifestyle Interventions on Inflammatory Biomarkers and Cytokines [12 months]
Inflammatory biomarkers ( C-Reactive Protein, WBC count) and cytokines (IL-6, TNFa)will be measured before 12 months of Mediterranean diet, the American Heart Association walking program and mindfulness based stress reduction
Measurement of Interventions on Inflammatory Biomarkers and Cytokines [12 months]
Inflammatory biomarkers C-Reactive Protein, WBC count)after 12 months after a Mediterranean diet, American Heart Association walking program and mindfulness based stress reduction program

Other Outcome Measures

Measurement of Menopausal aging due to stress and inflammation of the microbiome [12 months]
Measurement of association between levels of cytokines (IL-6,TNFa)in the microbiome and telomere length