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Dietary ModificationNCT03194334

Creatine, Carnitine and Carnosine in Vegetarians

A study testing Vegetarian diet, creatine and Beta-alanine in people with Dietary Modification, run by University Ghent.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Balanced vegetarian diets are popular and contain health-promoting characteristics. A balanced lacto-ovo-vegetarian diet differs in nutrient intake from an omnivorous diet, e.g. by increased intake of fibre, magnesium and antioxidants, but lower intake of omega-3 fatty acids and vitamin B12. Read more about this study

Who is it for?
Ages 18 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Dietary Modification
What is being tested?
Vegetarian diet, creatine and Beta-alanine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
No sites listed yet
Study dates
Dec 2012to Jun 2013
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 18 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • women

Who cannot join

  • smoking, chronic use of medication or taking supplements, athletes participating in competitions, vegetarianism or eating meat or fish less than 5 times a week

About this study

Official title: Effect of a 6-month Vegetarian Diet in Omnivorous Women on Body Creatine, Carnitine and Carnosine Stores

Balanced vegetarian diets are popular and contain health-promoting characteristics. A balanced lacto-ovo-vegetarian diet differs in nutrient intake from an omnivorous diet, e.g. by increased intake of fibre, magnesium and antioxidants, but lower intake of omega-3 fatty acids and vitamin B12. However, the impact of reduced to near absent intake of carnitine, carnosine and creatine in a vegetarian diet is less well established and could be relevant in relation to muscle function, exercise capacity and sports performance. Few longitudinal intervention studies investigating the effect of a vegetarian diet on the availability of these compounds currently exist.

This study aimed therefore to investigate the effect of of transiently switching omnivores onto a vegetarian diet for 6 months on muscle and plasma creatine, carnitine and carnosine homeostasis.

We hypothesized that homeostasis of creatine and carnosine would be disrupted when their dietary intake was missing. For carnitine, however, we hypothesized that homeostasis can be maintained given its slow turnover rate and its presence in some non-meat nutrients. A second aim was to investigate whether supplementation of creatine and beta-alanine (the rate-limiting precursor of carnosine synthesis), concurrently with a lacto-ovo-vegetarian diet, was able to correct for potentially emerging deficiencies.

Read the detailed description

Forty healthy female omnivores will be included in this 6-month intervention study. Exclusion criteria are smoking, chronic use of medication, athletes participating in competitions, vegetarianism or eating meat or fish less than 5 times a week. The study is scheduled over a period of 6 months and measurements will be performed 1 week prior to the intervention (0M), after 3 months (3M) and within the last week (6M). Ten women will continue their omnivorous diet throughout the entire study (controls) and the other 30 subjects will switch to a lacto-ovo-vegetarian diet for 6 months. The vegetarian group will be split in 2 groups, matched for age, weight, height and baseline carnosine concentrations in soleus and gastrocnemius medialis muscles. Fifteen of them will be supplemented with beta-alanine and creatine (Veg+Suppl) and the other 15 women will receive a placebo (Veg+Pla). A co-worker, not involved in the study design and analysis, will perform the randomisation and will prepare the containers with supplements. With regard to supplementation, the study is double-blind placebo-controlled. The lacto-ovo-vegetarian diet consists of vegetables, fruits, seeds, grains, meat substitutes, eggs and dairy products and the exclusion of meat, poultry and fish. Subjects will complete a 3 day food diary at the start and after 3 months and will receive nutritional advice by a dietician during the study to prevent deficiencies in macronutrients and micronutrients. Furthermore, vegetarian recipes will be provided by email to support the subjects in their vegetarian diet.

The supplementation protocol includes simultaneously daily oral administration of creatine monohydrate (Creapure®, AlzChem AG, Germany) and slow-release beta-alanine (Carnosyn®, Natural Alternatives International, San Marcos, USA) or a placebo (maltodextrin, Natural spices, France). The supplements are considered as safe and efficacious. The Veg+Suppl group ingests 1 g of creatine monohydrate (2 capsules of 500 mg) and 0.8 g of beta-alanine (1 Carnosyn® tablet) each day during the intervention period. The Veg+Pla group will be supplemented with an identical number of capsules and tablets of maltodextrin. All subjects are asked not to take any other supplements than those provided by the current study. Compliance will be checked by asking the subjects to return the containers and counting the pills that are left. The control group, who will remain on an omnivorous diet, will not receive any supplements.

Before (0M), after 3 (3M) and 6 months (6M), subjects will perform an incremental cycling test, a fasted venous blood sample and 24hr urine will be collected, a muscle biopsy of the vastus lateralis muscle will be taken and muscle carnosine content will be determined by 1H-MRS.

A two-way analysis of variance (ANOVA) will be used to evaluate plasma and urinary metabolite concentrations, muscle carnosine, muscle biopsy metabolite concentrations, time to exhaustion (TTE) and VO2max with 'group' (Veg+Suppl; Veg+Pla; control) as between-subject factor and 'time' (0M; 3M; 6M) as within-subject factor (SPSS statistical software, SPSS Inc, Chicago, USA). For the analysis of capillary lactate and pH, measurements before and after the incremental cycling test were included as another within factor (start; end). In case of significance, analyses were repeated for each group separately and pairwise comparisons were used to compare the different time points. Values will be presented as mean ± SD and statistical significance threshold will be set at p ≤0.05.

Being tested
Vegetarian diet, creatine, Placebo, Beta-alanine
Keywords
vegetarianism, creatine, carnosine, carnitine

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Vegetarian dietBehavioural

    Also called lacto-ovo-vegetarian diet

  • creatineDietary supplement

    1g creatine/day

  • PlaceboDietary supplement

    pills

  • Beta-alanineDietary supplement

    0.8g beta-alanine per day

Study groups in NCT03194334
Study groupRoleWhat they receive
ControlNo interventioncontinued their omnivorous diet throughout the entire study
Veg+PlaExperimentalvegetarian + placebo: switch to a lacto-ovo-vegetarian diet for 6 months and are supplemented with placebo pills instead of beta-alanine and creatine
Receives: Behavioral: Vegetarian diet; Dietary Supplement: Placebo
Veg+ creatine and beta-alanineExperimentalswitch to a lacto-ovo-vegetarian diet for 6 months and are supplemented with 1 g of creatine monohydrate (2 capsules of 500 mg) and 0.8 g of beta-alanine (1 Carnosyn® tablet) each day
Receives: Behavioral: Vegetarian diet; Dietary Supplement: creatine; Dietary Supplement: Beta-alanine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Fasted Plasma Beta-alanine Concentration

    Fasted venous plasma beta-alanine concentration (precursor for carnosine) at 0, 3 and 6 months of the intervention

    Measured: 6 months

  2. Gastrocnemius Carnosine Concentration

    Gastrocnemius carnosine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  3. Soleus Carnosine Concentration

    Soleus carnosine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  4. Plasma Creatine Concentration

    Plasma creatine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  5. Plasma Creatinine Concentration

    Plasma creatinine at 0, 3 and 6 months of the intervention

    Measured: 6 months

  6. Plasma Guanidinoacetate Concentration

    Plasma guanidinoacetate at 0, 3 and 6 months of the intervention

    Measured: 6 months

  7. Urinary Creatinine Concentration

    Urinary creatinine at 0, 3 and 6 months of the intervention

    Measured: 6 months

  8. Muscle Creatine Concentration

    Muscle total creatine concentration in vastus lateralis muscle at 0 and 3 months of the intervention

    Measured: 3 months

  9. Plasma Carnitine Concentration

    plasma free carnitine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  10. Plasma Acetylcarnitine Concentration

    plasma acetylcarnitine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  11. Plasma Total Carnitine Concentration

    plasma total carnitine concentration (free + acetyl) at 0, 3 and 6 months of the intervention

    Measured: 6 months

  12. Muscle Carnitine Concentration

    muscle free carnitine concentration in vastus lateralis muscle at 0 and 3 months of the intervention

    Measured: 3 months

  13. Muscle Acetylcarnitine Concentration

    muscle acetylcarnitine concentration in vastus lateralis muscle at 0 and 3 months of the intervention

    Measured: 3 months

  14. Muscle Total Carnitine Concentration

    muscle total carnitine concentration (free + acetylcarnitine) in vastus lateralis muscle at 0 and 3 months of the intervention

    Measured: 3 months

Secondary outcomes (8)
  1. Vitamin D Status

    Serum 25-Hydroxyvitamin D concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  2. Urinary Biomarker for Meat Intake: Pi-methyl-histidine

    urinary pi-methyl-histidine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  3. Urinary Biomarker for Meat Intake: Tau-methyl-histidine

    urinary tau-methyl-histidine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  4. Urinary Biomarker for Meat Intake: Anserine

    urinary anserine concentration at 0, 3 and 6 months of the intervention

    Measured: 6 months

  5. VO2max

    VO2max during incremental cycling test performed at 0, 3 and 6 months

    Measured: 6 months

  6. Time to Exhaustion

    Time to exhaustion during incremental cycling test performed at 0, 3 and 6 months

    Measured: 6 months

  7. Capillary Lactate

    capillary lactate at the start and at the end of the incremental cycling test performed at 0, 3 and 6 months

    Measured: 6 months

  8. Capillary pH

    capillary pH at the start and at the end of the incremental cycling test performed at 0, 3 and 6 months

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jun 2017
  2. Study startDec 2012
  3. Primary completionJun 2013
  4. Study completionJun 2013

Resources

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
Parallel groups
Model description
The study was scheduled over a period of 6 months. Of the 40 subjects, 10 women will continue their omnivorous diet throughout the entire study (controls) and the other 30 subjects will switch to a lacto-ovo-vegetarian diet for 6 months. The vegetarian group will be split in 2 groups, matched for age, weight, height and baseline carnosine concentrations in soleus and gastrocnemius medialis muscles. Fifteen of them will be supplemented with beta-alanine and creatine (Veg+Suppl) and the other 15 women will receive a placebo (Veg+Pla).
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03194334
Sponsor's protocol ID
EC/2012/666
Status last verified
Oct 2018
First submitted
15 Jun 2017
Last updated
28 Feb 2019
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: individual data will not be made available to other researchers

Publications

  • Van Dyck D, Herman K, Poppe L, Crombez G, De Bourdeaudhuij I, Gheysen F. Results of MyPlan 2.0 on Physical Activity in Older Belgian Adults: Randomized Controlled Trial. J Med Internet Res. 2019 Oct 7;21(10):e13219. doi: 10.2196/13219.

    PubMed 31593541
  • Blancquaert L, Baguet A, Bex T, Volkaert A, Everaert I, Delanghe J, Petrovic M, Vervaet C, De Henauw S, Constantin-Teodosiu D, Greenhaff P, Derave W. Changing to a vegetarian diet reduces the body creatine pool in omnivorous women, but appears not to affect carnitine and carnosine homeostasis: a randomised trial. Br J Nutr. 2018 Apr;119(7):759-770. doi: 10.1017/S000711451800017X.

    PubMed 29569535

Questions about this trial

What is this clinical trial studying?

A study testing Vegetarian diet, creatine and Beta-alanine in people with Dietary Modification, run by University Ghent.

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 1 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 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

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?

Yes. Results are posted in the registry (first posted 28 Feb 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Fasted Plasma Beta-alanine Concentration (time frame: 6 months). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03194334, which also lists 2 linked publications.

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 Feb 2019.

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