Optimum Propionate Delivery to the Large IntestineNCT02229500
Investigating Optimal Propionate Delivery to the Colon Using Stable Isotope Labeling
A study testing Inulin, 2.5 g of propionate and 5 g of propionate in people with Optimum Propionate Delivery to the Large Intestine, run by Scottish Universities Environmental Research Centre at 1 site in United Kingdom.
Trial summary
Obesity, with its associated co-morbidities, is a major public health challenge. It is estimated that by 2050, 60% of men and 50% of women will be clinically obese. Obesity is associated with increased risk of developing diabetes, cardiovascular disease, and certain cancers. Read more about this study
- Who is it for?
- Ages 21 to 65 years, men onlyHealthy volunteers can take part
- Conditions the study is for
- Optimum Propionate Delivery to the Large Intestine
- What is being tested?
- Inulin, 2.5 g of propionate and 5 g of propionate
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- Aug 2014to Dec 2015
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 65 years
- Men only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- overweight males (BMI 25-35 kg/m2) aged between 21 - 65
Who cannot join
- Weight change of > 3kg in the preceding 2 months
- Current smokers
- Substance abuse
- Excess alcohol intake
- Pregnancy
- Diabetes
Show all 13Show fewer
- Cardiovascular disease
- Cancer
- Gastrointestinal disease
- Kidney disease
- Liver disease
- Pancreatitis
- Use of any medication
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
Glasgow Clinical Research Facility
Glasgow, Lanarkshire, G4 0SF
About this study
Official title: Regulating Appetite by Targeting Nutrient Delivery in the Gut
Obesity, with its associated co-morbidities, is a major public health challenge. It is estimated that by 2050, 60% of men and 50% of women will be clinically obese. Obesity is associated with increased risk of developing diabetes, cardiovascular disease, and certain cancers. The increasing epidemic of obesity has necessitated the study of the complex mechanisms underlying energy homeostasis. Food intake, energy balance and body weight are tightly regulated by the hypothalamus, brainstem and reward circuits, on the basis both of cognitive inputs and of diverse humoral and neuronal signals of nutritional status. Several gut hormones, including glucagon-like peptide-1 (GLP-1) and peptide YY3-36 (PYY), have been shown to play an important role in regulating short-term food intake. Peripheral administration of PYY or GLP-1 enhances satiety and reduces food intake in animals and man. PYY, GLP-1 along with a host of other hormones are produced by the gut in response to nutrient availability in different regions of the gut and provide an exquisite mechanism of nutrient sensing in response to dietary intake. These hormones therefore represent potential targets in the development of novel anti-obesity treatments. A novel and attractive strategy to induce appetite regulation is the enrichment of foods with components that stimulate the release of GLP-1 and PYY. The short chain fatty acids (SCFA) produced by microbial fermentation of dietary fibre in the colon have been shown to stimulate the release of PYY and GLP-1 from rodent enteroendocrine L cells, via stimulation of the G-protein coupled free fatty acid receptors (FFAR) on colonic L cells. Of the SCFAs produced by colonic fermentation of dietary fibre, propionate has the highest affinity for FFAR 2. Furthermore, propionate is an end product of bacterial metabolism, and thus, unlike acetate, does not undergo conversion to other SCFAs. Increasing colonic propionate is therefore an attractive target for appetite modulation.
We have developed a novel delivery system for delivering propionate to the right site in the colon and we now wish to optimise the delivery of propionate to the colon in man using stable isotope labelling methods.
Read the detailed description
The role of SCFA in appetite regulation: SCFA have been shown to stimulate PYY and GLP-1 production in animal models and dietary fibre, of which SCFA are the major end products, induce appetite regulation in humans. However the evidence underpinning which dietary fibres induce appetite regulation in humans is very weak because of the difficulty in controlling studies with very high fibre intake. In a recent project funded under the BBSRC DRINC initiative (BB/H004815/1), we have the first direct evidence that SCFA can directly regulate appetite in humans. Prior to this study, in order to achieve production of SCFA to a level, which is high enough to induce appetite-regulating effects, very large amounts of dietary fibre (>25 g/d and up to 40 g/d) are required, and compliance with high fibre diets is poor due to gastrointestinal side effects. Furthermore, supplementing diets with mixed high fibre does not predictably or reliably increase colonic SCFA production or circulating levels of SCFA in all human populations because of the variability in gut microbial activity. Finally, orally administered SCFAs are not palatable and are rapidly absorbed in the small intestine where L cells are sparse. In our studies to date we have focussed on the SCFA propionate because it has the highest affinity for the receptors and is an end product of metabolism in the microbiota and therefore seems the obvious target to manipulate to investigate the effects of SCFA on appetite regulation. To overcome the unpalatably high levels of fermentable dietary fibre needed to significantly increase colonic propionate levels, and the unpredictability in the production of the resulting SCFAs, we have developed and tested a novel delivery system targeting the release of gram quantities of propionate in the proximal colon. We estimate that our delivery system may lead to a 2-8 fold increase in colonic propionate, a level very difficult to achieve through feeding a mixed fermentable fibre diet. This level of propionate production might have been observed in ancestral diets and in parts of rural Africa where dietary fibre intake is very high. We have also demonstrated that delivery system increases plasma propionate levels, reduces food intake in acute studies of appetite, and in a longer term study (24 weeks), positive effects on food intake, body composition, glucose homeostasis, circulating lipids, cholesterol and liver function, liver and visceral fat and weight management were observed. However, in these studies we pragmatically chose an preparation that could be produced at scale. The amount of propionate released can be varied which in itself may affect the rate and amount of propionate released. For an ingredient, with the potential to be incorporated into a wide variety of foodstuffs, we now wish to investigate the optimum delivery system preparation that delivers the maximal propionate dose in the least amount of material.
We plan to use non-invasive, stable isotope labelling methodologies to determine propionate bioavailability from a range of delivery system preparations, in order to determine the optimum preparation for delivering maximal propionate to the proximal colon.
- Being tested
- Inulin, 2.5 g of propionate, 5 g of propionate
- Keywords
- Propionate, Microbiome, Dietary Fibre, Short chain fatty acids
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
InulinDietary supplement
Also called Beneo-Orafti HP
2.5 g of propionateDietary supplement
This system delivers approximately 2.5 g of propionate to the colon in a 10g dose.
5 g of propionateDietary supplement
This delivers approximately 5g of propionate to the colon per 10g dose
| Study group | Role | What they receive |
|---|---|---|
| Control | Active comparator | Inulin control, 10g/d for 7 days. Isotope and appetite measurements on day 7 Receives: Dietary Supplement: Inulin |
| Delivery system 1 | Experimental | Delivery system, 28.5% w/w propionate, 10g/d for 7 days. Isotope and appetite measurements on day 7. Receives: Dietary Supplement: 2.5 g of propionate |
| Delivery system 2 | Experimental | Delivery system, 54% w/w propionate, 10g/d for 7 days. Isotope and appetite measurements on day 7. Receives: Dietary Supplement: 5 g of propionate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to maximal 13C appearance in breath
The time to peak maximal excretion in breath 13C (measured in breath 13CO2) will be the primary outcome criterion
Measured: over 24 hrs
Secondary outcomes (1)
Area under curve of breath 13C excretion
The area under the curve of breath 13C excretion (measured in 13CO2) will be determined to assess amount of propionate released.
Measured: over 24hrs
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Sep 2014 (estimated)
- Study startAug 2014
- Primary completionAug 2015
- Study completionDec 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Optimum Propionate Delivery to the Large IntestineStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 10 participants (actual)
Sponsor and investigators
- Lead sponsor
- Scottish Universities Environmental Research Centre
- Sponsor type
- University, hospital or other
- Collaborators
- Biotechnology and Biological Sciences Research Council, University of Glasgow
- Responsible party
- Sponsor
- Investigators
- Douglas Morrison, PhD, Principal investigator, University of Glasgow
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02229500
- Sponsor's protocol ID
- BB/L004259/1_SUERC_1
- Status last verified
- Apr 2016
- First submitted
- 28 Aug 2014
- Last updated
- 28 Apr 2016
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Apr 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Regulating Appetite by Targeting Nutrient Delivery in the Gut
- ClinicalTrials.gov ID
- NCT02229500
- Acronym / sponsor ID
- BB/L004259/1_SUERC_1
- Keywords
- Propionate, Microbiome, Dietary Fibre, Short chain fatty acids
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 10 participants (actual)
- Lead sponsor
- Scottish Universities Environmental Research CentreUniversity, hospital or other
- Collaborators
- Biotechnology and Biological Sciences Research Council, University of Glasgow
- Study start
- Aug 2014
- Primary completion
- Aug 2015 (actual)
- Study completion
- Dec 2015 (actual)
- First posted
- 1 Sep 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Obesity, with its associated co-morbidities, is a major public health challenge. It is estimated that by 2050, 60% of men and 50% of women will be clinically obese. Obesity is associated with increased risk of developing diabetes, cardiovascular disease, and certain cancers. The increasing epidemic of obesity has necessitated the study of the complex mechanisms underlying energy homeostasis. Food intake, energy balance and body weight are tightly regulated by the hypothalamus, brainstem and reward circuits, on the basis both of cognitive inputs and of diverse humoral and neuronal signals of nutritional status. Several gut hormones, including glucagon-like peptide-1 (GLP-1) and peptide YY3-36 (PYY), have been shown to play an important role in regulating short-term food intake. Peripheral administration of PYY or GLP-1 enhances satiety and reduces food intake in animals and man. PYY, GLP-1 along with a host of other hormones are produced by the gut in response to nutrient availability in different regions of the gut and provide an exquisite mechanism of nutrient sensing in response to dietary intake. These hormones therefore represent potential targets in the development of novel anti-obesity treatments. A novel and attractive strategy to induce appetite regulation is the enrichment of foods with components that stimulate the release of GLP-1 and PYY. The short chain fatty acids (SCFA) produced by microbial fermentation of dietary fibre in the colon have been shown to stimulate the release of PYY and GLP-1 from rodent enteroendocrine L cells, via stimulation of the G-protein coupled free fatty acid receptors (FFAR) on colonic L cells. Of the SCFAs produced by colonic fermentation of dietary fibre, propionate has the highest affinity for FFAR 2. Furthermore, propionate is an end product of bacterial metabolism, and thus, unlike acetate, does not undergo conversion to other SCFAs. Increasing colonic propionate is therefore an attractive target for appetite modulation.
We have developed a novel delivery system for delivering propionate to the right site in the colon and we now wish to optimise the delivery of propionate to the colon in man using stable isotope labelling methods.
Detailed description
The role of SCFA in appetite regulation: SCFA have been shown to stimulate PYY and GLP-1 production in animal models and dietary fibre, of which SCFA are the major end products, induce appetite regulation in humans. However the evidence underpinning which dietary fibres induce appetite regulation in humans is very weak because of the difficulty in controlling studies with very high fibre intake. In a recent project funded under the BBSRC DRINC initiative (BB/H004815/1), we have the first direct evidence that SCFA can directly regulate appetite in humans. Prior to this study, in order to achieve production of SCFA to a level, which is high enough to induce appetite-regulating effects, very large amounts of dietary fibre (>25 g/d and up to 40 g/d) are required, and compliance with high fibre diets is poor due to gastrointestinal side effects. Furthermore, supplementing diets with mixed high fibre does not predictably or reliably increase colonic SCFA production or circulating levels of SCFA in all human populations because of the variability in gut microbial activity. Finally, orally administered SCFAs are not palatable and are rapidly absorbed in the small intestine where L cells are sparse. In our studies to date we have focussed on the SCFA propionate because it has the highest affinity for the receptors and is an end product of metabolism in the microbiota and therefore seems the obvious target to manipulate to investigate the effects of SCFA on appetite regulation. To overcome the unpalatably high levels of fermentable dietary fibre needed to significantly increase colonic propionate levels, and the unpredictability in the production of the resulting SCFAs, we have developed and tested a novel delivery system targeting the release of gram quantities of propionate in the proximal colon. We estimate that our delivery system may lead to a 2-8 fold increase in colonic propionate, a level very difficult to achieve through feeding a mixed fermentable fibre diet. This level of propionate production might have been observed in ancestral diets and in parts of rural Africa where dietary fibre intake is very high. We have also demonstrated that delivery system increases plasma propionate levels, reduces food intake in acute studies of appetite, and in a longer term study (24 weeks), positive effects on food intake, body composition, glucose homeostasis, circulating lipids, cholesterol and liver function, liver and visceral fat and weight management were observed. However, in these studies we pragmatically chose an preparation that could be produced at scale. The amount of propionate released can be varied which in itself may affect the rate and amount of propionate released. For an ingredient, with the potential to be incorporated into a wide variety of foodstuffs, we now wish to investigate the optimum delivery system preparation that delivers the maximal propionate dose in the least amount of material.
We plan to use non-invasive, stable isotope labelling methodologies to determine propionate bioavailability from a range of delivery system preparations, in order to determine the optimum preparation for delivering maximal propionate to the proximal colon.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Control | Active comparator | Dietary Supplement: InulinInulin control, 10g/d for 7 days. Isotope and appetite measurements on day 7 |
| Delivery system 1 | Experimental | Dietary Supplement: 2.5 g of propionateDelivery system, 28.5% w/w propionate, 10g/d for 7 days. Isotope and appetite measurements on day 7. |
| Delivery system 2 | Experimental | Dietary Supplement: 5 g of propionateDelivery system, 54% w/w propionate, 10g/d for 7 days. Isotope and appetite measurements on day 7. |
Who may qualify
- Ages
- 21 to 65 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- overweight males (BMI 25-35 kg/m2) aged between 21 - 65
Key exclusion criteria (13 listed)
- Weight change of > 3kg in the preceding 2 months
- Current smokers
- Substance abuse
- Excess alcohol intake
- Pregnancy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| InulinAlso: Beneo-Orafti HP | Dietary supplement | Control |
| 2.5 g of propionateThis system delivers approximately 2.5 g of propionate to the colon in a 10g dose. | Dietary supplement | Delivery system 1 |
| 5 g of propionateThis delivers approximately 5g of propionate to the colon per 10g dose | Dietary supplement | Delivery system 2 |
Primary outcome
Time to maximal 13C appearance in breath
Time frame: over 24 hrs
The time to peak maximal excretion in breath 13C (measured in breath 13CO2) will be the primary outcome criterion
1 secondary outcome
Area under curve of breath 13C excretion
Time frame: over 24hrs
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Apr 2016.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Douglas Morrison, PhD principal investigator
University of Glasgow
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Inulin, 2.5 g of propionate and 5 g of propionate in people with Optimum Propionate Delivery to the Large Intestine, run by Scottish Universities Environmental Research Centre at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Apr 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to maximal 13C appearance in breath (time frame: over 24 hrs). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Apr 2016.