ClinicalTrials.gg
TerminatedNCT03394664Updated Jun 18, 2021

FB4 (Framingham, Boston, Bloomington, Birmingham, and Baylor)

An interventional study of Feeding Study in Obesity, sponsored by Boston Children's Hospital. Terminated at 1 site in United States. Open to participants aged 18 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-06-18.

Sponsored by Boston Children's Hospital · Not applicable, Interventional, and Treatment

Why this study was terminated
The FB4 trial has been terminated due to COVID-19.
Phase
Not applicable
Study type
Interventional
Enrollment
166
Allocation
Randomized
Ages
18 Years to 50 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 19 studies in Obesity by Boston Children's Hospital — 2 open to participants now, 2 under way, none of them phase 3. Obesity · Boston Children's Hospital.

Enrollment
7th of 18
166 · median 123
Started
2018
the only one that year
No phase
19 of 19
2 open now
Registered
16th of 19
by date

Among the 19 studies in Obesity by Boston Children's Hospital, this one is the 7th largest by enrollment of the 18 interventional ones that give a count, is the only one that started in 2018, is one of 19 with no phase, and was the 16th registered.

Obesity

11,522 studies on the registry are indexed under Obesity; 2,033 are open to participants now.

Browse Obesity studies →

Open to participants now

2 of the 19 studies in Obesity by Boston Children's Hospital are open now, in 1 country. Recruiting first, the newest first:

By country, each count listing its studies:

All 2 open studies →

Where they have run

Who these studies take

Of the 1,336 Obesity studies recruiting now, 377 (28%) set no upper age limit and 856 (64%) stop at 75 or younger; 168 take children under 18; 491 take healthy volunteers.

This study: 18 Years to 50 Years · all sexes · healthy volunteers too.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 19 studies in Obesity by Boston Children's Hospital, or all of them as a file.
02

Study summary

This study will evaluate the effects of dietary carbohydrate and sugar consumption, independent of energy content, on body fatness and metabolism in a rigorous feeding study.

Read the detailed description

Many people with obesity can lose weight for a few months, but most have difficulty maintaining weight loss over the long term. Extensive research has shown that weight loss elicits biological adaptations - including a decline in energy expenditure and an increase in hunger - that promote weight regain. However, this observation leaves unanswered why average body weight has recently increased among populations that are mostly genetically stable. According to the Carbohydrate-Insulin Model, increased consumption of processed carbohydrates during the low-fat diet era of the last 40 years has raised the average body weight being defended by biological mechanisms on a population basis. Specifically, the investigators hypothesize that diets high in total carbohydrate (with or without added sugar) acting through increased insulin secretion, alter substrate partitioning toward storage in body fat, leading to increased hunger, slowing metabolism, and accumulation of body fat.

To test this hypothesis, the investigators plan a randomized-controlled feeding study involving 125 adults with obesity. During the run-in phase, participants will be given a hypocaloric very-low-carbohydrate (VLC) diet, with adjustment of energy intake to produce 15 ± 3% weight loss over 3 to 4 months on an outpatient basis. After weight stabilization, participants will be admitted to a residential center for 13 weeks. During the first 3 weeks, energy intake and expenditure will be closely monitored during weight-loss maintenance. Then, energy intake will be individually "locked" at levels equal to energy expenditure and participants will be administered one of three randomly-assigned test diets for 10 weeks. The test diets include VLC, High Carbohydrate-Low Sugar (HC-LS), and High Carbohydrate-High Sugar (HC-HS).

03

Conditions studied

  • Obesity

Keywords

  • Body composition
  • Feeding study
  • Ketogenic diet
  • Weight loss
  • Energy Expenditure
04

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Aged 18 to 50 years
  • ≥ 27 kg/m2
  • Weight ≤ 350 lb
  • Medical clearance from a primary care provider
  • Willingness to follow a VLC weight-loss diet
  • Willingness to reside in a research unit for 3 months and eat/drink only provided study foods and beverages
  • No major food allergies or aversions
  • Willingness to obtain seasonal flu shot or provide documentation of flu shot for current flu season (winter/spring cohort only)
  • Willingness to discuss work options (e.g., remote work) with employer, and make appropriate arrangements prior to the Residential phase.

Exclusion criteria

Exclusion Criteria:

  • Change in body weight ≥ 10% during prior 6 months
  • Specialized diets (e.g., for medical or religious reasons)
  • Chronic use of any medication or dietary supplement that could affect study outcomes (e.g., insulin, metformin, thyroxine)
  • Current smoking (1 cigarette in the last week)
  • Greater than moderate alcohol consumption (> 14 drinks/wk) or history of binge drinking (≥5 drinks in 1 day within past 6 months)
  • Physician diagnosis of a major medical illness or eating disorder
  • History of kidney stones
  • Laboratory tests: >2x upper limit; abnormal HgA1c; abnormal TSH; abnormal creatinine; abnormal uric acid (using the male upper limit for both sexes)
  • Failed criminal offender background check or sex offender background check
  • Use of recreational drugs
  • Current diagnosis or history of kidney stones, gout, or gall stones; or removal of gall bladder
  • Exercise restrictions or at high risk for complications during exercise

Female-specific exclusion criteria:

  • Menopausal
  • Any change in medication during the 3 months prior to enrollment
  • Pregnancy or lactation during the 12 months prior to enrollment, or intent to become pregnant during study participation
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
166 participants (actual)

Study arms

  • Experimental
    Very-Low Carbohydrate Diet

    Feeding study. Dietary composition (approximately): 75% fat

    Behavioral: Feeding Study

  • Experimental
    High-Carbohydrate Low-Sugar Diet

    Feeding study. Dietary composition (approximately): 25% fat 0% added sugars.

    Behavioral: Feeding Study

  • Experimental
    High-Carbohydrate High-Sugar Diet

    Feeding study. Dietary composition (approximately): 25% fat, 20% added sugars.

    Behavioral: Feeding Study

Interventions

  • BehavioralFeeding Study

    Food provision throughout the study: 1) Run-In Phase (VLC diet, weight loss); 2) Residential Phase (3 different test diets, weight-loss maintenance).

    Also known as: weight loss, weight-loss maintenance

06

What researchers measure

Primary outcomes

  1. Body fat mass

    Body composition assessed using a multi-component model

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

Secondary outcomes

  1. Lean body mass

    Assessed using a multi-component model (difference between total body mass and fat mass)

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  2. Body weight

    Anthropometrics, assessed by calibrated scale, in kilograms (kg)

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  3. Total energy expenditure (TEE)

    Assessed using doubly labeled water methodology

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  4. Resting energy expenditure (REE)

    Assessed by indirect calorimetry using respiratory gas exchange methodology with a ventilated hood system

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  5. Physical activity level, (moderate to vigorous)

    Total minutes of moderate- to vigorous-intensity physical activity, assessed by accelerometry

    Time frame: Measurements made daily during 2 weeks at PWL, 2 weeks at END, and alternating non-assessment weeks of the residential phase and integrated into a unified outcome

  6. Insulin sensitivity

    Assessed by frequently-sampled oral glucose tolerance test \[OGTT\], calculated using plasma insulin and glucose values

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  7. Insulin secretion

    Assessed by frequently-sampled oral glucose tolerance test \[OGTT\], using plasma insulin at 30 minutes following the dose of dextrose

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  8. Glycemic control

    Hemoglobin A1c \[HbA1c\]

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  9. Total cholesterol

    Chronic disease risk factor

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  10. HDL-cholesterol

    Chronic disease risk factor

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  11. LDL-cholesterol

    Chronic disease risk factor

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  12. Non-HDL cholesterol

    Chronic disease risk factor

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  13. Triglycerides

    Chronic disease risk factor

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  14. Plasminogen Activator Inhibitor-1 [PAI-1]

    Indicator of coagulopathy

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  15. High-sensitivity C-reactive protein [hsCRP]

    Indicator of chronic inflammation

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  16. Uric acid

    Indicator of risk for kidney stones, measured in blood

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  17. Systolic blood pressure

    Assessed by auscultation, mmHg

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  18. Diastolic blood pressure

    Assessed by auscultation, mmHg

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  19. Thyroxine (T4)

    Thyroid function

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  20. Free T4

    Thyroid function

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  21. Thyroid stimulating hormone [TSH]

    Thyroid function

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  22. Insulin-like growth factor-1 [IGF-1]

    Growth hormone action

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  23. Urine cortisol

    Stress hormone, assessed using 24-hour urine collection

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  24. Urine catecholamines

    Stress hormone, assessed using 24-hour urine collection

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  25. Leptin

    Adipokine

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  26. Total Adiponectin

    Adipokine

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  27. High-molecular weight adiponectin

    Adipokine

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  28. Sleep

    Total sleep time, sleep onset latency, wake after sleep onset, and sleep efficiency, assessed by accelerometry

    Time frame: Measurements made daily during 2 weeks at PWL, 2 weeks at END, and alternating non-assessment weeks of the residential phase and integrated into a unified outcome

  29. Blood glucose

    Assessed by continuous glucose monitoring (CGM)

    Time frame: Measurements made daily during residential phase (0 to 10 weeks) and integrated into a unified outcome

  30. Ghrelin

    Hormonal Control of Appetite

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  31. Body Circumference

    Assessed using a 3D body scan

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  32. Post-prandial energy expenditure and respiratory quotient

    Optional testing, assessed by indirect calorimetry using respiratory gas exchange

    Time frame: Single assessment in weeks 6 to 8 of residential study

  33. Activation of insulin signaling pathways

    Assessed by immunohistochemistry of phosphorylated insulin receptor and signaling proteins

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

Other outcomes

  1. 1,5-anhydroglucitol (1,5-AG)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  2. Lipoprotein particle subfraction distribution

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  3. Fibrinogen

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  4. Interleukin-6 (IL-6)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  5. Reverse triiodothyronine (rT3)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  6. Insulin-like growth factor-binding protein 3 (IGF-BP3)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  7. Luteinizing hormone (LH)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  8. Follicle stimulating hormone (FSH)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  9. Estradiol (E2)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  10. Testosterone (TST, total)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  11. Testosterone (TST, free)

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  12. Metabolomics profile

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  13. Biomarker of cholesterol synthesis

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  14. Biomarker of cholesterol absorption

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  15. MicroRNA

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  16. Gut microbiome

    Possible future analyses of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  17. Demographics (mediator/modifier)

    Baseline covariate

    Time frame: Pre-weight loss baseline

  18. Body composition (mediator/modifier)

    Baseline covariate

    Time frame: Pre-weight loss baseline

  19. Measure of glucose homeostasis (insulin-30) (mediator/modifier)

    Baseline covariate

    Time frame: Pre-weight loss baseline

  20. Measure of glucose homeostasis (insulin sensitivity) (mediator/modifier)

    Baseline covariate

    Time frame: Pre-weight loss baseline

  21. Measure of glucose homeostasis (glycemic control) (mediator/modifier)

    Baseline covariate

    Time frame: Pre-weight loss baseline

  22. Obesity related genetic risk (mediator/modifier)

    Baseline covariate

    Time frame: Pre-weight loss baseline

  23. Body composition (mediator/modifier)

    Time varying covariate

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  24. Measure of glucose homeostasis (insulin-30) (mediator/modifier)

    Time varying covariate

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  25. Measure of glucose homeostasis (insulin sensitivity) (mediator/modifier)

    Time varying covariate

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  26. Measure of glucose homeostasis (glycemic control) (mediator/modifier)

    Time varying covariate

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  27. Physical activity level (moderate to vigorous) (mediator/modifier)

    Time varying covariate for total minutes of moderate to vigorous intensity physical activity, assessed by accelerometry.

    Time frame: Measurements made daily during 2 weeks at PWL, 2 weeks at END, and alternating non-assessment weeks of the residential phase and integrated into a unified outcome

  28. Sex Hormone-Binding Globulin (SHBG)

    Possible future analysis of archived specimen

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  29. Urinary nitrogen

    Archived for future analysis

    Time frame: End of residential (END, 10 weeks)

  30. Glucagon-like peptide-1 (GLP-1)

    Possible future analyses of archived samples

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  31. Glucose-dependent insulinotropic polypeptide (GIP)

    Possible future analyses of archived samples

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  32. Glucagon

    Possible future analyses of archived samples

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  33. Oxytocin

    Possible future analyses of archived samples

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

  34. Oxyntomodulin

    Possible future analyses of archived samples

    Time frame: Change from post-weight loss (PWL, 0 weeks) to end of residential study (END, 10 weeks)

07

Study locations

1 site
  • Warren Conference Center and Inn
    Ashland, Massachusetts 01721, United States
08

References and documents

Publications

  • Ludwig DS, Friedman MI. Increasing adiposity: consequence or cause of overeating? JAMA. 2014 Jun 4;311(21):2167-8. doi: 10.1001/jama.2014.4133. No abstract available. Erratum In: JAMA. 2014 Jun 4;311(21):2168. PubMed 24839118 ↗
  • Ebbeling CB, Swain JF, Feldman HA, Wong WW, Hachey DL, Garcia-Lago E, Ludwig DS. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2012 Jun 27;307(24):2627-34. doi: 10.1001/jama.2012.6607. PubMed 22735432 ↗
  • Jansen LT, Yang N, Wong JMW, Mehta T, Allison DB, Ludwig DS, Ebbeling CB. Prolonged Glycemic Adaptation Following Transition From a Low- to High-Carbohydrate Diet: A Randomized Controlled Feeding Trial. Diabetes Care. 2022 Mar 1;45(3):576-584. doi: 10.2337/dc21-1970. PubMed 35108378 ↗
  • Wong JMW, Yu S, Ma C, Mehta T, Dickinson SL, Allison DB, Heymsfield SB, Ebbeling CB, Ludwig DS. Stimulated Insulin Secretion Predicts Changes in Body Composition Following Weight Loss in Adults with High BMI. J Nutr. 2022 Mar 3;152(3):655-662. doi: 10.1093/jn/nxab315. PubMed 34587231 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from May 2018 to primary completion in May 2020, 23 months.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 29, 2017
First posted
Jan 9, 2018
StartActual
May 9, 2018
Primary completionActual
May 3, 2020
CompletionActual
May 3, 2020
Last update
Jun 18, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 18, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03394664
Collaborators
Indiana University, University of Alabama at Birmingham, Framingham State University, Baylor University
Responsible party
David S. Ludwig, MD, PhD (Co-Director, New Balance Foundation Obesity Prevention Center, Boston Children's Hospital) — Principal investigator
First posted
Jan 9, 2018
Start date
May 9, 2018
Primary completion
May 3, 2020
Completion
May 3, 2020
Last update
Jun 18, 2021

Study contacts

David S Ludwig, MD, PhD
principal investigator · Boston Children's Hospital
David B Allison, PhD
principal investigator · Indiana University, Bloomington
Cara B Ebbeling, PhD
study director · Boston Children's Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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