CClinicalTrials.gg
CompletedNCT02561143Updated Jun 22, 2017

Effectiveness of Nutritional Counselling and "Improved Atta" Supplementation in Cachexic Adult Indian Cancer Patients

An interventional study of Improved Atta and Wheat flour in Cachexia and Cancer, sponsored by University of Westminster. Completed at 2 sites in 2 countries. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-06-22.

Sponsored by University of Westminster · Not applicable, Interventional, and Supportive care

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Apr 2015, registered Sep 2015).
Phase
Not applicable
Study type
Interventional
Enrollment
150
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

Investigators are evaluating the nutritional role of IAtta supplementation along with nutritional counselling in delaying the progression of cachexia to refractory cachexia in adult cancer Indian patients. Patients will receive IAtta (100 g) or whole wheat flour (100 g) for daily consumption for 6 months. Dietary and physical activity counseling will be imparted every fortnight to patients.

Nutritional, biochemical, quality of life and anthropometric estimations will be assessed at baseline, after 3 months and at 6 months of intervention for all patients.

Investigators hypothesize that intake of nutrient rich bread mix IAtta (along with dietary and physical activity counselling) for six months will improve the health status and quality of life in free-living patients suffering from cancer cachexia.

Read the detailed description

Patients will be randomly distributed into two groups i.e. control and intervention group. 75 patients will be allocated in intervention group and receive nutrient rich flour mix i.e. IAtta (100 g) along with dietary and physical activity counseling and 75 patients will be allocated in the control group who will receive whole wheat flour with dietary and physical activity counseling. Intervention group patients will collect 14 packets of 100 g of IAtta every fortnight during their clinician appointments while the control patients will collect 14 packets of 100 g of whole wheat flour at every clinician visit for 6 months.

Dietary counseling for 30 minutes will be imparted to all patients on each visit by the nutritionist. Depending on the physical status of the patients, low level of physical activity (walking and/or stairs), will be encouraged daily during counseling sessions.

Nutritional, biochemical, quality of life and anthropometric estimations would be assessed at baseline, after 3 months and at 6 months of intervention for all patients.

02

Conditions studied

  • Cachexia
  • Cancer

Keywords

  • cachexia
  • nutrition supplementation
  • IAtta
  • palliative care
  • quality of life
03

In context

Wasting Syndrome

196 studies on the registry are indexed under Wasting Syndrome; 22 are open to participants now.

This study's enrollment of 150 is above the median of 58 across 130 interventional studies indexed under Wasting Syndrome.

Browse Wasting Syndrome studies →

Lead sponsor

University of Westminster is the lead sponsor of 9 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Female, age 18 years and above.
  • Diagnosed with cancer.
  • Weight loss >5% from pre-treatment weight or BMI\<20kg/m2.
  • Hemoglobin level \<12 g/dl.
  • Energy intake \< 1500 kcal/d (to be assessed on consultation)

Exclusion criteria

Exclusion Criteria:

  • Incapable to provide written consent.
  • Patient diagnosed with refractory cachexia.
  • Life expectancy \< 3 months.
  • Unresponsive to anti-cancer therapy.
  • Patient is a pregnant woman or a nursing mother.
  • Suffering from secondary illnesses.
  • Gastrointestinal tract defects which affect nutrient absorption.
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Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
150 participants (actual)

Study arms

  • Experimental
    Intervention group

    Patients in the intervention group will be given dietary supplement (Improved Atta: 100 g) daily along with nutritional counseling and physical activity counseling for six months.

    Dietary Supplement: Improved Atta · Behavioral: Physical activity counseling · Other: Nutritional counseling

  • Placebo comparator
    Control group

    Patients in the control group will be given whole wheat flour (100 g) daily along with nutritional counseling and physical activity counseling for six months.

    Dietary Supplement: Wheat flour · Behavioral: Physical activity counseling · Other: Nutritional counseling

Interventions

  • Dietary supplementImproved Atta

    Improved Atta is a multi macro- micronutrient bread mix. Patients will be given 100 grams of Improved Atta (to make unleavened bread) everyday for consumption for six months.

  • Dietary supplementWheat flour

    Whole wheat flour 100 grams (to make unleavened bread) will be given everyday for consumption for six months to the patients.

  • BehavioralPhysical activity counseling

    Depending on the physical status of the patients, low level of physical activity (walking and/or stairs), will be encouraged daily during counseling sessions.

  • OtherNutritional counseling

    Dietary counseling for 30 minutes will be imparted to all patients on every hospital visits by the nutritionist. Consumption of cereals, roots and tubers, vegetables, legumes, nuts, energy dense fruits, milk products (and eggs for non-vegetarians) will be encouraged in their daily diets.

06

What researchers measure

Primary outcomes

  1. Change in body weight at 6 months

    Body weight in kilograms will be assessed using a Tanita segmental composition scale at baseline, mid-intervention (3 months) and at the end of intervention (6 months).

    Time frame: Baseline, 3 months & 6 months

Secondary outcomes

  1. Change in mid upper arm circumference (MUAC) at 6 months

    MUAC in centimeters will be measured using a non-stretchable measuring tape at baseline, mid-intervention (3 months) and at the end of intervention (6 months).

    Time frame: Baseline, 3 months & 6 months

  2. Change in body fat percentage (BF%) at 6 months

    Four site skin fold thickness (SFT) measurement (i.e. triceps, biceps, subscapular and suprailiac) by the help of scientific Harpenden Skinfold Caliper will be noted to the nearest 0.2mm reading, to calculate percentage body density. Body fat percentage will be calculated using body density value in Siri equation. SFT will be measured at baseline, mid-intervention (3 months) and end of intervention (6 months) to determine the BF%.

    Time frame: Baseline, 3 months & 6 months

  3. Indian Migrant study food frequency questionnaire (IMS-FFQ)

    IMS-FFQ will be used to assess patient's daily energy (kcal), protein (g) and fat (g) intake at baseline, mid-intervention and end of intervention (6 months). Food frequency questionnaire is an accurate method to record the frequency of consumption of individual foods and can help provide information on patients' eating patterns. IMS-FFQ (Indian Migrant Study- Food Frequency Questionnaire) consists of 184 commonly consumed food items and is validated among the rural and urban Indian population.

    Time frame: Baseline, 3 months & 6 months

  4. Two day 24 hour dietary recall

    Two day 24 hour dietary recall will be used to assess patient's daily energy (kcal), protein (g) and fat (g) intake at baseline, mid-intervention and end of intervention (6 months). 24 hour dietary recall is an accurate method to understand patients' eating patterns.

    Time frame: Baseline, 3 months & 6 months

  5. Patient generated subjective global assessment (PGSGA)

    PGSGA will be used to assess patient nutritional status (category: well nourished, malnourished \& severely malnourished) at baseline, mid-intervention and end of intervention (6 months). PG-SGA is most effective and sensitive tool for assessing and evaluating cancer patients' nutritional status and validated on Indian cancer patients.

    Time frame: Baseline, 3 months & 6 months

  6. Indian Migrant Study Physical Activity Questionnaire (IMS-PAQ)

    IMS-PAQ will assess patients' physical activity throughout the day. Investigators will asses physical activity at three time points during the study: baseline, at 3 months of intervention and at 6 months end of intervention. IMS-PAQ is a validated questionnaire on both Indian rural and urban population. Patients' will report every activity performed with the average amount of time spent for each activity in the questionnaire. Thereafter, investigators will calculate the average calories spent by every patient in the whole day.

    Time frame: Baseline, 3 months & 6 months

  7. Change in quality of life by EORTC-QLQ- C30 (Quality of life Questionnaire) at 6 months

    EORTC-QLQ- C30 (European Organization for Research \&Treatment of cancer) questionnaire will be used to analyse patients' quality of life at baseline, mid- intervention and at the end of intervention period. A score will be calculated for all the15 domains covered in the questionnaire of 30 questions.These domains will be analysed and compared for the outcome in the two groups.

    Time frame: Baseline, 3 months & 6 months

  8. Change in haemoglobin levels at 6 months

    Haemoglobin levels (g/dl) will be monitored at baseline, at three months and at the end of intervention (6 months).

    Time frame: Baseline, 3 months & 6 months

  9. Change in serum albumin levels

    Serum albumin (g%) levels will be monitored at baseline, at three months and at the end of intervention (6 months).

    Time frame: Baseline, 3 months & 6 months

  10. Change in C-reactive protein levels at 6 months

    C-reactive protein (mg/L) levels will be monitored at baseline and at the end of intervention (6 months).

    Time frame: Baseline & 6 months

07

Study locations

2 sites
  • All India Institute of Medical Sciences
    New Delhi, 110029, India
  • University of Westminster
    London, W1W 6UW, United Kingdom
08

References and documents

Publications

  • Kapoor N, Naufahu J, Tewfik S, Bhatnagar S, Garg R, Tewfik I. A public health nutrition intervention to delay the progression of cachexia to refractory cachexia in indian female cancer patients. Int. J. Food, Nutrition and Public Health. 2014;7:1-11.
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 22, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02561143
Lead sponsor
University of Westminster
Collaborators
All India Institute of Medical Sciences, New Delhi
Responsible party
Neha Kapoor (Research Scholar, University of Westminster) — Principal investigator
First posted
Sep 25, 2015
Start date
Apr 2015
Primary completion
Nov 2015
Completion
May 2016
Last update
Jun 22, 2017

Study contacts

Neha Kapoor, PhD
principal investigator · University of Westminster
Ihab Tewfik, PhD
study director · University of Westminster

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jun 2017. You cannot join it, but the record below documents what was studied.

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