The SIMBA Project - The Effect of a Prebiotic Supplement on Glucose Metabolism and Gut Microbiota in Obese Adults (SIMBA)

The SIMBA Project - The Effect of a Prebiotic Supplement on Glucose Metabolism and Gut Microbiota

Modulation of the gut microbiota via administration of pro- and prebiotics have been proposed to contribute to weight loss and reduce plasma glucose and serum lipid levels, improving the inflammatory state and decreasing the incidence of type 2 diabetes and cardiovascular disease. This study will test a fermented canola-seaweed (FCS) product, high in glucosinolates and putatively prebiotic oligosaccharides, in human subjects with obesity.

Study Overview

• Status: Unknown
• Conditions: Metabolic Syndrome; Glucose Metabolism; Gut Microbiota
• Intervention / Treatment: Dietary supplement: Fermented canola-seaweed; Other: Placebo

Detailed Description

The overall objective of this study is to investigate a fermented canola-seaweed (FCS) product in obese human subjects with increased risk of metabolic syndrome (MS). We will study the effects of the FCS on glucose handling and related cardiometabolic traits such as dyslipidemia and low-grade systemic inflammation. Finally, we will examine the gut microbiota and the metabolic phenotype of the subjects to explore molecular mechanisms related to the potential improvements.

It is hypothesized that the FCS product will improve postprandial glucose handling, blood lipids and low-grade inflammation in obese subjects with increased risk of MS. Furthermore, it is hypothesized that this effect is modified through gut microbiota compositional and functionality changes

Methods:

This study will be conducted as a randomized, controlled, investigator and participant blinded intervention trial. The participants will be randomized to the FCS supplement or control and are expected to consume one sachet of either every day for 6 weeks.

Randomization, blinding and allocation concealment:

After having given oral and written consent, randomization will be performed separately for each participant in blocks of variable size to ensure equal randomization throughout the enrolment phase of the study. The randomization sequence will be done by an investigator without contact to the participants. The personnel conducting the study will allocate participants to the sequence of intervention using a list of participant identification numbers matched with allocated sequences. The participants will be blinded to the intervention and blinding of the allocation sequence will be present for investigators during sample analysis and initial data analysis.

Examinations:

Participants will arrive for clinical examination after an overnight fast of at least 8 hours. Lifestyle questionnaires and questionnaires about medication use will be performed for baseline characterization of the participants. Blood pressure and anthropometric measurements are performed including measurements of body weight, height, waist and hip circumference, and bio-impedance measurements for assessing body fat mass. A fasting blood sample is obtained and an oral glucose tolerance test (OGTT) is performed with collection of blood samples after 0, 30 and 120 min. Samples will be analyzed with standard clinical procedures for glycaemic variability markers, including glucose, insulin, c-peptide, and HbA1c, as well as plasma lipids. Furthermore, fecal samples will be collected at both examination visits and kept stored for future microbiota analyses, using untargeted shotgun sequencing.

Samples in biobank will be stored for further analyses, which could include gastrointestinal hormones, gut microbiota metabolites, blood, and fecal metabolome and low-grade inflammation markers. In addition, a subgroup of participants (10 in each group) will be equipped with a 24-h continuous glucose monitoring device for 14 days at the start of the intervention period. Both examination days consists of similar examinations and data collections and are estimated to last approximately 2½ hours.

• Study Type: Interventional
• Enrollment (Anticipated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Mads V Lind, PhD; Phone Number: +45 35 33 10 91; Email: madslind@nexs.ku.dk
• Study Contact Backup: Name: Dennis S Nielsen, PhD; Phone Number: +45 35 33 32 87; Email: dn@food.ku.dk

Study Locations

• Denmark
  • Danmark
    • Frederiksberg, Danmark, Denmark, 2000
      • Recruiting
      • University of Copenhagen
      • Contact: Mads Lind, PhD; Phone Number: 004535331091; Email: madslind@nexs.ku.dk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 30 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participants who have provided written informed consent
• Age between 30 and 65 years
• Body mass index ≥31 kg/m^2

Exclusion Criteria:

• Body mass index <31 kg/m^2
• Diagnosis of diabetes (HbA1c ≥ 6,5% (48 mmol/mol)) or pharmacological treatment of diabetes
• Use of peroral glucocorticoids
• Lack of compliance with the procedures (ingestion of sachets) in the study protocol, judged by Investigator
• Ingestion of pre- or probiotic supplements during the study and 14 days prior to study start
• Use of systemic antibiotics 1 month prior to study start
• Use of cholesterol lowering drugs
• Have had an obesity or abdominal surgery
• Chronic inflammation disorders (excluding obesity)
• Diagnosed psychiatric disorder including depression requiring treatment
• Gastro intestinal and liver disorders
• Gluten intolerance
• Maltodextrin intolerance
• Intensive physical training/ elite athlete (>10 hours of strenuous physical activity per week)
• Pregnant or lactating
• High intake of alcohol (>14 drinks/week for women and >21 drinks/week for men)
• Simultaneous blood donation for other purpose than this study
• Simultaneous participation in other clinical intervention studies
• Inability, physically or mentally, to comply with the procedures required by the study protocol as evaluated by the principal investigator or clinical responsible.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: OTHER
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: QUADRUPLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Fermented canola-seaweed supplement; Ingredients: Canola meal, seaweed, wheat, glucose, Vitamin D and lactic acid bacteria	Dietary supplement: Fermented canola-seaweed; A daily sachet with 5 gram FCS-granulate for 6 weeks
PLACEBO_COMPARATOR: Placebo; Ingredients: Rye flour, water, iodized salt, brown sugar	Other: Placebo; A daily sachet with 5 gram rye cereal for 6 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
changes in 2-h post-OGTT glucose in blood between baseline and endpoint	2 hour post oral glucose tolerance test glucose measurement in blood (mmol/L)	Week 0 and Week 6

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in Hba1c between baseline and endpoint	fasting measurement of blood glycated hemoglobin (%)	Week 0 and Week 6
Changes in fasting blood glucose between baseline and endpoint	Fasting measurement of blood glucose (mmol/L)	Week 0 and Week 6
Changes in 30 min post OGTT between baseline and endpoint	Measurement of blood glucose 30 min after OGTT (mmol/L)	Week 0 and Week 6
Insulin sensitivity and secretion	Measured as part of the OGTT. Plasma glucose (mmol/l). Plasma insulin - fasting (pmol/l)	Week 0 and Week 6
Changes in blood lipids between baseline and endpoint	Measurements of total and HDL cholesterol (mmol/L) and triglycerides (mmol/L)	Week 0 and Week 6
Changes in C-Reactive Protein between baseline and endpoint	Blood measurements of C-Reactive Protein (mg/L)	Week 0 and Week 6
Changes in Interleukin-6 between baseline and endpoint	Blood measurements of Interleukin-6 (pg/mL)	Week 0 and Week 6
Changes in small metabolites between baseline and endpoint	Measured using blood metabolomic measurements of amino acids, lipids, and other small metabolites (umol/L)	Week 0 and Week 6
Changes in weight between baseline and endpoint	Measured using a Tanita body composition analyser. Body weight in kilograms	Week 0 and Week 6
Changes in waist circumference between baseline and endpoint	Measured using measurement tape	Week 0 and Week 6
Changes in body composition between baseline and endpoint	Measured using a Tanita body composition analyser. Fat free mass and Body fat mass in kilograms used to calculate body fat percentage.	Week 0 and Week 6
Changes in blood pressure (BP) between baseline and endpoint	Systolic BP (mmHG) Diastolic BP (mmHG)	Week 0 and Week 6
Continuous glucose monitoring	Continuous glucose monitor from Abbott is worn for 14 days in each period providing glucose measurements continuously (mmol/L)	Week 0
Changes in Liver function markers	Alanine transaminase (ALAT) (U/L), Aspartate transaminase (ASAT) (U/L)	Week 0 and week 6
Changes in circulating endotoxin/lipopolysaccharide (LPS) concentrations	LPS (pg/ml)	Week 0 and Week 6
Changes in gut microbiota composition	Measured on fecal samples	Week 0 and Week 6

Collaborators and Investigators

• Sponsor: University of Copenhagen
• Collaborators: FermBiotics ApS
• Investigators: Principal Investigator: Mads V Lind, PhD, University of Copenhagen, Department of Nutrition, Exercise and Sports

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 28, 2019
• Primary Completion (ANTICIPATED): March 31, 2020
• Study Completion (ANTICIPATED): March 31, 2020

Study Registration Dates

• First Submitted: October 7, 2019
• First Submitted That Met QC Criteria: October 7, 2019
• First Posted (ACTUAL): October 9, 2019

Study Record Updates

• Last Update Posted (ACTUAL): November 5, 2019
• Last Update Submitted That Met QC Criteria: November 4, 2019
• Last Verified: November 1, 2019

More Information

Terms related to this study

• Keywords: Obesity; Metabolic syndrome; Gut Microbiota; Supplement
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Insulin Resistance; Hyperinsulinism; Metabolic Syndrome
• Other Study ID Numbers: H-19041432

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No