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ObesityNCT04555447

Gastrointestinal Tolerability to Agavins and Impact on Host-gut Microbiota-metabolism Interactions Modulation

A study testing Agavins (prebiotic fiber) in people with Obesity and Healthy, run by Centro De Investigación Y De Estudios Avanzados Del Instituto Politécnico Nacional-Unidad Irapuato at 2 sites in Mexico.

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

Agavins are branched neo-fructans and prebiotic fiber found in Agave plants. In preclinical studies, agavins have demonstrated an effect in reversing metabolic disorders associated to overweight and obesity through the modulation of gut microbiota activity and composition, showing their interesting potential in the… Read more about this study

Who is it for?
Ages 30 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Obesity, Healthy
What is being tested?
Agavins (prebiotic fiber)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
52 participants
Where
2 sitesMexico
Study dates
22 Mar 2019to 7 Sep 2019
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 30 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Males and females
  • Age 30 - 60 years
  • BMI ≥ 30 kg/m2
  • Stable body weight for at least 1 month prior to the study

Who cannot join

  • Type 1 and type 2 diabetes
  • Hypothyroidism
  • Currently following a weight loss diet or physical activity regime for the same purpose
  • Weight loss >3 kg within 3 months before enrollment
  • Use of prebiotics, probiotics, or dietary fiber supplements
  • Long-term (and within the preceding month) use of antioxidants, omega-3, and omega-6 fatty acids supplements
Show all 25Show fewer
  • Strenuous exercise (>3 hours/week)
  • Concomitant use of any medication influencing appetite, weight, metabolism
  • Use of metformin
  • Antibiotic use 1 week prior to the study
  • Alcohol or substance abuse
  • Diagnosis of neurological or psychiatric disorders, like anxiety, depression, Attention-Deficit/Hyperactivity Disorder (ADHD), schizophrenia
  • Active smoker
  • Alanine Transaminase (ALT) and Aspartate Aminotransferase (AST) enzymes concentration >2.5 times the highest limit value
  • Creatinine >1.2 mg/dL
  • Women: pregnancy or lactation
  • Previous intestinal or bariatric surgery
  • Heart, brain, or thyroid surgeries within the preceding 6 months
  • History of liver or pancreatic disease
  • History of renal failure
  • Intestinal absorption disorder
  • Inflammatory bowel disease
  • Established cardiovascular disease
  • Active or history of neoplasia within the preceding 5 years
  • Chronic use of bulk laxatives and antacids

Trial locations and contacts

2 sites in 1 country.

Mexico2 sites
  • Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional-Unidad Irapuato (CINVESTAV-UI)

    Irapuato, Guanajuato, 36824

  • Centro de Estudios Cardiometabólicos S.C. (CESCAM)

    Mexico City, 07760

Other trials in Mexico

About this study

Official title: Gastrointestinal Tolerability to Increasing Doses of Agavins and Impact on Gut Microbiota, Fecal Metabolites, and Metabolic Biomarkers in Healthy and Obese Subjects

Agavins are branched neo-fructans and prebiotic fiber found in Agave plants. In preclinical studies, agavins have demonstrated an effect in reversing metabolic disorders associated to overweight and obesity through the modulation of gut microbiota activity and composition, showing their interesting potential in the context of high obesity and cardiovascular diseases prevalence in Mexican population. However, current information about gastrointestinal adaptation and effects of agavins intake in humans is scarce. We hypothesized that increasing amounts of agavins up to 12 g/day, will be well tolerated by healthy and obese adult participants, but with differences between these groups, modulating gut microbiota activity and structure differentially, as well as the metabolic status after a 5-week dose-escalation intervention.

Read the detailed description

Diet has dramatically changed over the past decades with increased consumption of high-fat, high-sugar, high-sodium processed and refined foods, but with low or very low fiber-rich products. Microbiota-accessible carbohydrates (MACs) found for example in dietary fiber have been recognized as crucial for the microbial ecosystem in the gut; the lack of these available carbohydrates depletes the microbial community, causing alterations in its composition and performance. Perturbations in the gut microbiota have been related with several diseases, so as reduction in dietary fiber has been linked with an increased risk for developing chronic diseases, namely cardiovascular and metabolic ones, such as obesity and type 2 diabetes. Mexico is the second country with the highest obesity rates worldwide, which represents a major national public health challenge. Interestingly, national nutrition surveys have found that Mexican adults consume less than half the dietary intake recommendation for fiber, along with an alarming statistic of 7 in 10 adults being overweight or obese.

A change in dietary patterns intended to achieve adequate nutrient intake, dietary fiber included, is one strategy that could help modify this nutrition trend in the country, but another accessible alternative is the supplementation of prebiotic fiber, thus increasing fiber consumption and avoiding gut microbiota alterations simultaneously. Prebiotics, such as fructans, are substrates selectively used by gut microbes, modifying their activity and/or community composition, and conferring health benefits to the host. Clinical research has demonstrated their impact in reducing body weight, fat mass, hyperlipidemia, etc. Agave prebiotics, also known as agavins, are fructan-type carbohydrates that possess a unique molecular structure and are extracted as a complex multi-disperse mixture presenting different degrees of polymerization and/or branching. Previously, agavins have shown to induce weight loss, a significant reduction in glucose and total cholesterol levels, and promotion of satiety-related hormones in overweight mice through the increment in short-chain fatty acids (SCFA) and specific modulation of gut microbiota; more recently, fecal metabolomics have revealed interesting microbial-derived metabolites, detected after agavins supplementation in mouse models that could induce a beneficial effect on host health, but more research is needed.

Experts have stated that differences in dietary fiber structure guide its degradation: which microbes can metabolize these substrates, and the effects in the microbial community that overall, impact health. Additionally, structural differences in prebiotic fibers like agavins, may cause specific gastrointestinal (GI) adaptation and tolerance which is of great importance to promote their consumption and in determining an ideal amount or dose to further explore their impact.

In this study we propose a double-blind, placebo controlled, parallel groups, dose-escalation trial, where lean and obese subjects were assigned to either agavins or placebo group for a 5-week dose-escalation period. We aim to evaluate the evolution of GI tolerability and compared the records between lean and obese participants (Mexican adults), the impact in gut microbiota composition and activity through the determination of short-chain fatty acids and fecal metabolites, and metabolic status, all of this after a short period of time proposed to induce adaptation to agavins intake.

Conditions
Obesity, Healthy
Being tested
Agavins (prebiotic fiber), Placebo
Keywords
Prebiotics, Agavins, Gastrointestinal tolerability, Obesity, Gut microbiota, SCFA, Fecal metabolites, Agave dietary fiber
Medical subject headings
Obesity

What participants receive

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

  • Agavins (prebiotic fiber)Dietary supplement

    Also called Agave inulin (Preventy)

    Agavins contained in ready-to-use sachets were dissolved in water, and participants consumed the corresponding dose daily (2.5, 5.0, 7.0, 10 or 12 g) for 1 week, preferentially in the evening. Participants followed a 5-week dose-escalation intervention.

  • PlaceboDietary supplement

    Also called Maltodextrin (Globe 10 IP)

    Maltodextrin contained in ready-to-use sachets was dissolved in water, and participants consumed the corresponding dose daily (2.5, 5.0, 7.0, 10 or 12 g) for 1 week, preferentially in the evening. Participants followed a 5-week dose-escalation intervention.

Study groups in NCT04555447
Study groupRoleWhat they receive
Healthy-agavinsExperimentalAgavins are branched neo-fructans and were supplemented for a 5-week dose-escalation period in lean participants
Receives: Dietary Supplement: Agavins (prebiotic fiber)
Healthy-placeboPlacebo comparatorMaltodextrin was used as placebo and supplemented for a 5-week dose-escalation period in lean participants
Receives: Dietary Supplement: Placebo
Obese-agavinsExperimentalAgavins are branched neo-fructans that were supplemented for a 5-week dose-escalation period in obese participants
Receives: Dietary Supplement: Agavins (prebiotic fiber)
Obese-placeboPlacebo comparatorMaltodextrin was used as placebo and supplemented for a 5-week dose-escalation period in obese participants
Receives: Dietary Supplement: Placebo

What is being measured

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

  1. Gastrointestinal tolerability

    Five gastrointestinal symptoms related to tolerability (flatulence, bloating, borborygmi, diarrhea, and abdominal pain) were assessed by a 10-cm Visual Analog Scale (VAS), guided by "no effect" (0 cm) , "moderate effect" (5 cm), and "worst effect possible" (10 cm). Participants rated their feelings 12 hours after taking their daily dose of dietary supplement, at the same time every day. All VAS were provided as printed material, one scale for each gastrointestinal symptom.

    Measured: 0-5 weeks

Secondary outcomes (4)
  1. Appetite and satiety subjective assessment

    Appetite and satiety feelings were assessed by a 10-cm Visual Analog Scale (VAS). Appetite ratings were guided by "How hungry do you feel?" anchored by "I am not hungry at all" and "I have never been hungrier; I have to eat immediately". Satiety ratings were guided by "How satisfied do you feel?" anchored by "I feel my stomach completely empty" and "I cannot eat another bite". Participants rated their feelings 12 hours after taking their daily dose of dietary supplement, at the same time every day. Each VAS was provided as printed material.

    Measured: 0-5 weeks

  2. Gut microbiota composition

    Gut microbiota composition was assessed by 16S rRNA sequencing

    Measured: 5 weeks

  3. SCFA production

    Short-chain fatty acids (SCFA) production was determined in feces by Gas Chromatography-Flame Ionization Detector (GC-FID), and expressed as SCFA concentration (µmol/g)

    Measured: 5 weeks

  4. Fecal metabolomics

    Fecal metabolomics will be performed by Gas Chromatography-Mass Spectrometry (GC-MS) . Ordination methods and statistical dimension reduction techniques such as Principal Component Analysis (PCA), Partial Least Square-Discriminant Analysis (PLS-DA), as well as hierarchical clustering analysis will be implemented to explore and identify clusters of samples, groups.

    Measured: 5 weeks

Timeline

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

  1. First posted18 Sep 2020
  2. Study start22 Mar 2019
  3. Primary completion7 Sep 2019
  4. Study completion7 Sep 2019

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Healthy and obese participants randomized into agavins (prebiotic fiber) or placebo group received the corresponding dietary supplement simultaneously
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
52 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04555447
Sponsor's protocol ID
CINVESTAV-IRA-BYB-171018
Status last verified
Sep 2020
First submitted
28 Aug 2020
Last updated
18 Sep 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Results will be published in a peer-reviewed journal in the fields of dietetics and nutrition, with impact factor according to the Journal Citation Reports.

Publications

  • Huazano-Garcia A, Shin H, Lopez MG. Modulation of Gut Microbiota of Overweight Mice by Agavins and Their Association with Body Weight Loss. Nutrients. 2017 Aug 23;9(9):821. doi: 10.3390/nu9090821.

    PubMed 28832493
  • Franco-Robles E, Lopez MG. Agavins Increase Neurotrophic Factors and Decrease Oxidative Stress in the Brains of High-Fat Diet-Induced Obese Mice. Molecules. 2016 Aug 2;21(8):998. doi: 10.3390/molecules21080998.

    PubMed 27490526
  • Huazano-Garcia A, Lopez MG. Agavins reverse the metabolic disorders in overweight mice through the increment of short chain fatty acids and hormones. Food Funct. 2015 Dec;6(12):3720-7. doi: 10.1039/c5fo00830a. Epub 2015 Sep 3.

    PubMed 26333285
  • Santiago-Garcia PA, Lopez MG. Agavins from Agave angustifolia and Agave potatorum affect food intake, body weight gain and satiety-related hormones (GLP-1 and ghrelin) in mice. Food Funct. 2014 Dec;5(12):3311-9. doi: 10.1039/c4fo00561a.

    PubMed 25367106
  • Garcia-Vieyra MI, Del Real A, Lopez MG. Agave fructans: their effect on mineral absorption and bone mineral content. J Med Food. 2014 Nov;17(11):1247-55. doi: 10.1089/jmf.2013.0137. Epub 2014 Jul 28.

    PubMed 25069021
  • Urias-Silvas JE, Cani PD, Delmee E, Neyrinck A, Lopez MG, Delzenne NM. Physiological effects of dietary fructans extracted from Agave tequilana Gto. and Dasylirion spp. Br J Nutr. 2008 Feb;99(2):254-61. doi: 10.1017/S0007114507795338. Epub 2007 Aug 22.

    PubMed 17711612

Questions about this trial

What is this clinical trial studying?

A study testing Agavins (prebiotic fiber) in people with Obesity and Healthy, run by Centro De Investigación Y De Estudios Avanzados Del Instituto Politécnico Nacional-Unidad Irapuato at 2 sites in Mexico.

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 4 inclusion and 25 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 18 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Mexico. 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. Some participants in this study may receive a placebo. 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?

Gastrointestinal tolerability (time frame: 0-5 weeks). 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 NCT04555447, which also lists 6 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 18 Sep 2020.

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