Dietary Polyphenols and Insulin Sensitivity in Overweight and Obese Humans

Long-term Supplementation of Dietary Polyphenols as Modulators of Lipid Oxidation and Mitochondrial Function in Overweight Volunteers

In this double-blind, randomized, placebo-controlled study, we aim to investigate the effects of a long-term supplementation on insulin sensitivity, mitochondrial function and substrate metabolism in healthy overweight men and women.

In each group, 21 subjects consume 100mg Resveratrol (RSV) and 150mg Epigallocatechin-gallate (EGCG), respectively Placebo capsules, twice daily over a period of 12 weeks. The subjects receive the capsules after the last pre-measurement and continue to take them throughout the post-measurements.

Before and after the supplementation period, we perform a hyperinsulinemic-euglycemic clamp with a glucose-tracer infusion to assess hepatic and systemic insulin sensitivity. Simultaneously, substrate oxidation is measured throughout the clamp by indirect calorimetry. Furthermore, we perform a high-fat mixed meal test, in which we collect blood and measure substrate oxidation during fasted and postprandial conditions. During the meal tests, extra plasma is collected at the start (t=-30) and the end (t=240), of which the supernatant is stored in light-protected tubes (EGCG is mixed 1:1 with an EGCG buffer) for analyzing polyphenol concentrations in the blood.

In the male subgroup (21 men), we additionally place each 2 microdialysis probes in the subcutaneous adipose tissue and the gastrocnemius in order to assess local lipolysis and blood flow by means of ethanol infusion.

Furthermore, a dexa-scan is performed to assess body composition and biopsies are taken under fasted conditions from the subcutaneous adipose tissue and the quadriceps femoralis muscle. These samples are stored at -80C. Part of the adipose tissue samples is collected to measure adipocyte size. Of the skeletal muscle biopsy, one part is directly buffered and used for the oxygraph to measure mitochondrial function.

At last, feces samples are collected before and after the intervention in order to assess energy content, microbial composition and short-chain fatty acid content.

Based on previous human studies in our and other departments, we hypothesize that after 12 weeks of the combined polyphenol supplementation, insulin sensitivity and mitochondrial function improve. Furthermore, based on results of a short-term study performed by our group, that demonstrated an increase in energy expenditure, a positive effect on the regulation of body composition might be expected.

Study Overview

• Status: Completed
• Conditions: Healthy
• Intervention / Treatment: Dietary supplement: Placebo; Dietary supplement: EGCG+RSV-supplementation

• Study Type: Interventional
• Enrollment (Actual): 42
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Maastricht, Netherlands, 6229 ER
    • Maastricht University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Overweight men and women (BMI≥25kg/m2-39.9kg/m2),
• Aged 20-35 and 35-50 years
• Caucasian
• Normal fasting glucose (< 6.1 mmol/L) and normal postprandial glucose (2h-glucose <7.8 mm)
• Normal blood pressure (systolic blood pressure 100-140 mmHg, diastolic blood pressure 60-90 mmHg)
• Weight stable in last 3 months (± 2kg)

Exclusion Criteria:

• Women lactating, pregnant or (post) menopausal
• Regular smokers
• People with intensive fitness training, eg. athletes (≥ 3 per week ≥ 1 hour training)
• Habitual consumption of green tea (more than 1 cup per day) or products containing green tea extract
• Total caffeine consumption > 300 mg/day (1 can of cola or 2 cups of regular coffee or 2 cups of black tea or 1 cup of coffee and 1 cup of black tea or other combinations)
• Alcohol intake >20 g/day (2 glasses of beer or wine)
• Any dietary vitamins or dietary supplements
• Diabetes mellitus (defined as FPG ≥ 7.0 mmol/l and/or 2hPG ≥ 11.1 mmol/l)
• Serious pulmonary, cardiovascular, hepatic or renal disease
• History of cardiovascular disease
• All other relevant medical disorders that potentially interfere with this trial (e.g. history of gastro-intestinal, liver or thyroid disorders)
• Current use of medication interfering with study intervention or interfering with study endpoints/hypotheses (e.g. medication containing caffeine like analgesics, anorectics and analeptics)
• Not to be able to understand the study information
• Subjects on a special diet or vegetarian
• Blood donation 2 months prior to the study and during the study
• Participation in other studies
• Drug use
• Coagulation disorders (i.e. hemophilia (type A, B and C), von Willebrand disease, vitamin K deficiency, afibrinogenemia, disseminated intravascular coagulation and thrombosis)
• Use of anti-coagulant medication
• Acute or history of gastrointestinal diseases (Morbus Crohn, Colitis Ulcerosa)
• Intake of Antibiotics for the last 3 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo; micro-cellulose-filled Placebo	Dietary supplement: Placebo
Active Comparator: EGCG+RSV-supplementation; EGCG+RSV: 300mg/d + 80mg/d	Dietary supplement: EGCG+RSV-supplementation; Teavigo (~300mg/d) Resveratrol (~80mg/d); Other Names: Teavigo, Pure Encapsulations Inc. (Massachusetts, USA); Resveratrol, Pure Encapsulations Inc. (Massachusetts, USA)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Systemic insulin sensitivity	hyperinsulinemic euglycemic clamp with glucose-tracer	change from week 0 to week 12 after supplementation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
skeletal muscle mitochondrial function	ex vivo skeletal muscle respiratory capacity	change from week 0 to week 12 after supplementation

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
lipid oxidation	fasting and 4-h postprandial (high-fat mixed-meal) by indirect calorimetry	change from week 0 to week 12 after supplementation
skeletal muscle and adipose tissue lipolysis	microdialysate sample fasting and postprandial (after high-fat mixed-meal)	change from week 0 to week 12 after supplementation

Collaborators and Investigators

• Sponsor: Maastricht University Medical Center
• Investigators: Principal Investigator: Ellen E Blaak, Prof., Maastricht University Medical Center

Publications and helpful links

General Publications

• Fazelzadeh P, Hoefsloot HCJ, Hankemeier T, Most J, Kersten S, Blaak EE, Boekschoten M, van Duynhoven J. Global testing of shifts in metabolic phenotype. Metabolomics. 2018 Oct 4;14(10):139. doi: 10.1007/s11306-018-1435-8.
• Most J, Goossens GH, Reijnders D, Canfora EE, Penders J, Blaak EE. Gut microbiota composition strongly correlates to peripheral insulin sensitivity in obese men but not in women. Benef Microbes. 2017 Aug 24;8(4):557-562. doi: 10.3920/BM2016.0189. Epub 2017 Jun 16.
• Most J, Timmers S, Warnke I, Jocken JW, van Boekschoten M, de Groot P, Bendik I, Schrauwen P, Goossens GH, Blaak EE. Combined epigallocatechin-3-gallate and resveratrol supplementation for 12 wk increases mitochondrial capacity and fat oxidation, but not insulin sensitivity, in obese humans: a randomized controlled trial. Am J Clin Nutr. 2016 Jul;104(1):215-27. doi: 10.3945/ajcn.115.122937. Epub 2016 May 18.

Study record dates

Study Major Dates

• Study Start: August 1, 2012
• Primary Completion (Actual): May 1, 2014
• Study Completion (Actual): September 1, 2014

Study Registration Dates

• First Submitted: August 20, 2013
• First Submitted That Met QC Criteria: March 2, 2015
• First Posted (Estimate): March 6, 2015

Study Record Updates

• Last Update Posted (Actual): September 5, 2018
• Last Update Submitted That Met QC Criteria: September 3, 2018
• Last Verified: September 1, 2018

More Information

Terms related to this study

• Keywords: Insulin sensitivity; Resveratrol; Polyphenols; mitochondrial function; lipid oxidation; Epigallocatechin-gallate; tissue lipolysis
• Additional Relevant MeSH Terms: Body Weight; Overweight; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Platelet Aggregation Inhibitors; Protective Agents; Antioxidants; Resveratrol
• Other Study ID Numbers: NL31421.068.10