CClinicalTrials.gg
CompletedNCT03466047MicrocapsuleUpdated Oct 20, 2020Results posted

The Effect of Macronutrients on Satiety and Gut Hormone Responses

An interventional study of Protein stomach and Protein distal small intestine in Eating Behavior, sponsored by Imperial College London. Completed at 1 site in Ireland. Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-10-20.

Sponsored by Imperial College London · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
8
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study is part of a research theme aiming at elucidating the physiological mechanisms of action of weight loss after gastric bypass surgery. The Roux-en-Y Gastric Bypass procedure induces pronounced and sustained weight loss, but the physiological mechanisms of action are not completely clear. Neither mechanical restriction of food intake nor malabsorption, are the main contributing factors. The enhanced postprandial responses of gut hormones (e.g. GLP-1 and PYY) which increase satiety as well as energy expenditure after surgery suggest a changed physiological set point for appetite and metabolism.

Our hypothesis is that the intake of high quantity of protein in a microcapsule form would be able to reach the distal parts of the intestinal mucosa and stimulate maximum stimulation of the anorectic gut hormones. The higher functions of the brain will respond to these strong neuroendocrine signals by ensuing satiety and fullness.

Read the detailed description

Ten healthy volunteers, aged 18 to 65 years will be recruited. Each subject will be studied on six occasions one week apart. On each visit, a baseline serum sample will be drawn from each subject. In a randomized way all subjects will receive the following meals in their successive weekly visits: Option 1 High protein mixed meal in capsules that break down in the stomach, Option 2 High protein mixed meal in capsules that break down in the distal small bowel, Option 3 High fat mixed meal in capsules that break down in the stomach, Option 4 High fat mixed meal in capsules that break down in the distal small bowel, Option 5 High CHD mixed meal in capsules that break down in the stomach, Option 6 High CHD mixed meal in capsules that break down in the distal small bowel. On the same day, all subjects will be offered standard ad libitum meal to measure their food consumption. After 3 hours (i.e. at 12:00) another blood sample will be drawn. All subjects will be asked to rate their appetite on a Visual Analogue Scale (VAS). Upon VAS completion the subjects will be allowed to go home.

02

Conditions studied

  • Eating Behavior
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • 18-65 years
  • Normal fasting glucose
  • Stable body weight for at least last three months
  • BMI \< 30 Kg/m2
  • Capacity to consent to participate
  • Independently mobile

Exclusion criteria

Exclusion Criteria:

  • Patients who meet any of the following criteria will be excluded:
  • Pre-diabetes Diabetes
  • Obesity
  • Smoking
  • Substance abuse
  • Pregnancy
  • Use of medications (except for oral contraceptives)
  • Chronic medical or psychiatric illness
  • Any significant abnormalities detected on physical examination, electrocardiography, or screening blood tests (measurement of complete blood count, electrolytes, fasting glucose, and liver function)
04

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Investigator)
Enrollment
8 participants (actual)

Study arms

  • Experimental
    Protein stomach

    Encapsulated protein released in the stomach

    Dietary Supplement: Protein stomach

  • Experimental
    Protein distal small intestine

    Encapsulated protein released in the distal small intestine

    Dietary Supplement: Protein distal small intestine

  • Experimental
    CHO stomach

    Encapsulated CHO released in the stomach

    Dietary Supplement: CHO stomach

  • Experimental
    CHO distal small intestine

    Encapsulated CHO released in the distal small intestine

    Dietary Supplement: CHO distal small intestine

  • Experimental
    Fat stomach

    Encapsulated Fat released in the stomach

    Dietary Supplement: Fat stomach

  • Experimental
    Fat distal small intestine

    Encapsulated Fat released in the distal small intestine

    Dietary Supplement: Fat distal small intestine

Interventions

  • Dietary supplementProtein stomach

    encapsulated protein stomach

  • Dietary supplementProtein distal small intestine

    encapsulated protein distal small intestine

  • Dietary supplementCHO stomach

    encapsulated CHO stomach

  • Dietary supplementCHO distal small intestine

    encapsulated CHO distal small intestine

  • Dietary supplementFat stomach

    encapsulated Fat stomach

  • Dietary supplementFat distal small intestine

    encapsulated Fat distal small intestine

05

What researchers measure

Primary outcomes

  1. The Effect of Proteins on the Secretion of Gut Hormones From Different Parts of the Gastrointestinal Tract

    3 hours AUC for different gut hormones (PYY) to determine the response to macronutrients in different release (stomach vs small intestine) locations. AUC for timepoints 0, 30min, 60min, 120min, 180min.

    Time frame: 3 hours

Secondary outcomes

  1. Total Intake (kj) of ad Libitum Lunch Meals to Assess Food Intake

    Food intake as assessed with ad libitum lunch 3 hours after intervention

    Time frame: 3 hours

  2. Visual Analogue Scale Ratings of Hunger

    Visual Analogue Scale ratings of hunger at 180 min (before the meal). The scale is 10cm line with two anchors at each end. Scores are recorded by making a handwritten mark that represents a continuum between "not hungry at all" and "Extremly hungry." The score of 0 represents least hunger. The score of 10 represent extreme hunger.

    Time frame: 180min

06

Results

Posted Oct 20, 2020

Participant flow

Protein Stomach (1day)
Participant flow — Protein Stomach (1day)
MilestoneInterventions
Started8
Completed8
Not completed0
Protein Small Intestine (1 Day)
Participant flow — Protein Small Intestine (1 Day)
MilestoneInterventions
Started8
Completed8
Not completed0
CHO Stomach (1 Day)
Participant flow — CHO Stomach (1 Day)
MilestoneInterventions
Started8
Completed8
Not completed0
CHO Small Intestine (1 Day)
Participant flow — CHO Small Intestine (1 Day)
MilestoneInterventions
Started8
Completed8
Not completed0
Fat Stomach (1 Day)
Participant flow — Fat Stomach (1 Day)
MilestoneInterventions
Started8
Completed8
Not completed0
Fat Small Intestine (1 Day)
Participant flow — Fat Small Intestine (1 Day)
MilestoneInterventions
Started8
Completed8
Not completed0

Outcome measures

PrimaryThe Effect of Proteins on the Secretion of Gut Hormones From Different Parts of the Gastrointestinal Tract

3 hours AUC for different gut hormones (PYY) to determine the response to macronutrients in different release (stomach vs small intestine) locations. AUC for timepoints 0, 30min, 60min, 120min, 180min.

Time frame:
3 hours
Reported as:
Mean · pg*min/mL
The Effect of Proteins on the Secretion of Gut Hormones From Different Parts of the Gastrointestinal Tract
pg*min/mLProtein StomachFat StomachCHO StomachProtein Distal Small IntestineFat Distal Small IntestineCHO Distal Small Intestine
The Effect of Proteins on the Secretion of Gut Hormones From Different Parts of the Gastrointestinal Tract1310 ± 1021073 ± 1541118 ± 1501188 ± 1211725 ± 3511194 ± 221
SecondaryTotal Intake (kj) of ad Libitum Lunch Meals to Assess Food Intake

Food intake as assessed with ad libitum lunch 3 hours after intervention

Time frame:
3 hours
Reported as:
Mean · kj
Total Intake (kj) of ad Libitum Lunch Meals to Assess Food Intake
kjProtein StomachProtein Distal Small IntestineCHO StomachCHO Distal Small IntestineFat StomachFat Distal Small Intestine
Total Intake (kj) of ad Libitum Lunch Meals to Assess Food Intake3138 ± 1753389 ± 1613146 ± 1683008 ± 1923690 ± 1702305 ± 183
SecondaryVisual Analogue Scale Ratings of Hunger

Visual Analogue Scale ratings of hunger at 180 min (before the meal). The scale is 10cm line with two anchors at each end. Scores are recorded by making a handwritten mark that represents a continuum between "not hungry at all" and "Extremly hungry." The score of 0 represents least hunger. The score of 10 represent extreme hunger.

Time frame:
180min
Reported as:
Mean · cm
Visual Analogue Scale Ratings of Hunger
cmProtein StomachProtein Small IntestineCHO StomachCHO Small IntestineFat StomachFat Small Intestine
Visual Analogue Scale Ratings of Hunger5.4 ± 0.55.5 ± 0.53.8 ± 0.74.1 ± 0.64.1 ± 0.44.1 ± 0.5

Adverse events

Collected over 1 month. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Protein Stomach0/8 (0%)0/8 (0%)0/8 (0%)
Fat Stomach0/8 (0%)0/8 (0%)0/8 (0%)
CHO Stomach0/8 (0%)0/8 (0%)0/8 (0%)
Protein Distal Small Intestine0/8 (0%)0/8 (0%)0/8 (0%)
Fat Distal Small Intestine0/8 (0%)0/8 (0%)0/8 (0%)
CHO Distal Small Intestine0/8 (0%)0/8 (0%)4/8 (50%)
Most frequent other events
Most frequent other events
EventProtein StomachFat StomachCHO StomachProtein Distal Small IntestineFat Distal Small IntestineCHO Distal Small Intestine
NauseaGastrointestinal disorders0/80/80/80/80/84/8
Loose StoolGastrointestinal disorders0/80/80/80/80/84/8

Baseline characteristics

Age, Continuous
Age, Continuous(years)Interventions
Mean28.8 ± 3.5
Sex/Gender, Customized
Sex/Gender, Customized(Participants)Interventions
Women3
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Interventions
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White8
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Interventions
Ireland8
Weight
Weight(kg)Interventions
Mean81.8 ± 7.2
07

Study locations

1 site
  • Clinical Research Centre
    Dublin, Dublin 4, Ireland
08

References and documents

Study documents

  • Protocol and statistical analysis plan · May 10, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03466047
Lead sponsor
Imperial College London
Responsible party
Carel Le Roux (Professor, Imperial College London) — Principal investigator
First posted
Mar 15, 2018
Start date
Mar 15, 2018
Primary completion
Jan 1, 2019
Completion
Jan 1, 2019
Results posted
Oct 20, 2020
Last update
Oct 20, 2020

Study contacts

Carel le Roux
principal investigator · Imperial College London

Oversight

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

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