- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05545501
Ketone Ester and Acute Salt (KEAS) in Young Adults (KEAS)
Ketone Ester and Acute Salt: Can Ketone Supplementation Prevent the Adverse Negative Effects of High Salt on Blood Vessel Health in Young Adults?
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Austin T Robinson, PhD
- Phone Number: 15745141034
- Email: atr0026@auburn.edu
Study Contact Backup
- Name: Braxton A Linder, MS
Study Locations
-
-
Alabama
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Auburn, Alabama, United States, 36849
- Recruiting
- Auburn University
-
Contact:
- Austin T Robinson, PhD
- Phone Number: 574-514-1034
- Email: atr0026@auburn.edu
-
Principal Investigator:
- Austin T Robinson, PhD
-
Contact:
- Braxton A Linder, MS
- Phone Number: 2568567599
- Email: bal0039@auburn.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Between the ages of 18-39
- Resting blood pressure no higher than 150/90
- BMI below 35 kg/m2 (or otherwise healthy)
- Free of any metabolic disease (diabetes or renal), pulmonary disorders (COPD or cystic fibrosis), cardiovascular disease (peripheral vascular, cardiac, or cerebrovascular), no autoimmune diseases, and no history of cancer
- Do not have any precluding medical conditions (i.e. hemophilia) or medication (Pradaxa, Eliquis, etc.) that prevent participants from giving blood
- Participants must be able to cycle on an exercise bike for up to one hour at a time.
Exclusion Criteria:
- High blood pressure - greater the 150/90 mmHg
- Low blood pressure - less than 90/50 mmHg
- History of cardiovascular disease
- History of cancer
- History of diabetes
- History of kidney disease
- Obesity (BMI > 30 kg/m2)
- Smoking or tobacco use
- Current pregnancy
- Nursing mothers
- Communication barriers
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: No Salt, No β-OHB
Participants will consume the supplemental intervention for 10 days.
On day 10 participants will arrive at the laboratory where the investigators will assess resting blood pressure, arterial stiffness, endothelial function, renal blood flow, and submaximal exercise blood pressure reactivity.
Blood will be collected to investigate inflammatory and immune responses to the dietary conditions.
Starting on day 9, participants will undergo ambulatory blood pressure monitoring and 24-hour urine collection.
|
Participants will consume the following for ten days.
Enteric capsules will be filled with a dextrose placebo.
The placebo supplement will be a β-OHB-free, taste and viscosity-matched, beverage produced by KetoneAid.
|
Active Comparator: High Salt, No β-OHB
Participants will consume the supplemental intervention for 10 days.
On day 10 participants will arrive at the laboratory where the investigators will assess resting blood pressure, arterial stiffness, endothelial function, renal blood flow, and submaximal exercise blood pressure reactivity.
Blood will be collected to investigate inflammatory and immune responses to the dietary conditions.
Starting on day 9, participants will undergo ambulatory blood pressure monitoring and 24-hour urine collection.
|
Participants will consume the following for ten days.
Enteric capsules will be filled with Morton's table salt.
Sodium consumption will be normalized to caloric intake (2 mg Sodium/Calorie).
The placebo supplement will be a β-OHB-free, taste and viscosity-matched, beverage produced by KetoneAid.
|
Experimental: High Salt, High β-OHB
Participants will consume the supplemental intervention for 10 days.
On day 10 participants will arrive at the laboratory where the investigators will assess resting blood pressure, arterial stiffness, endothelial function, renal blood flow, and submaximal exercise blood pressure reactivity.
Blood will be collected to investigate inflammatory and immune responses to the dietary conditions.
Starting on day 9, participants will undergo ambulatory blood pressure monitoring and 24-hour urine collection.
|
Participants will consume the following for ten days.
Enteric capsules will be filled with Morton's table salt.
Sodium consumption will be normalized to caloric intake (2 mg Sodium/Calorie).
Ketone beverage will be the β-OHB supplement produced by KetoneAid.
Participants will consume 24 mL (12 grams β-OHB) of the ketone beverage three times a day (total 36 grams β-OHB).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Flow mediated dilation (FMD)
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
|
Flow-mediated vasodilation will be assessed using continuous measures of brachial artery diameter and velocity via duplex Doppler ultrasound (Hitachi Arietta 70).
The brachial artery will be imaged in the longitudinal plane proximal to the medial epicondyle using a high-frequency (10-12 MHz) linear-array probe.
The ultrasound probe will be stabilized using a custom-built clamp.
Shear rate (sec-1) will be calculated as [(blood flow velocity (cm*s-1) *4)/blood vessel diameter (mm)] The image will be recorded throughout a 60-s baseline, a 300-s ischemic stimulus (250 mmHg), and 180 seconds post deflation.
FMD will be expressed as % dilation (final diameter-baseline diameter/baseline diameter x 100) and also normalized to the shear stimulus.
Allometric scaling will be used if appropriate, including if there are baseline differences in artery diameter by race or condition.
|
Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Pulse wave velocity
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
|
The investigators will use the SphygmoCor XCEL system to assess pulse wave velocity (PWV).
A high-fidelity transducer is used to obtain the pressure waveform at the carotid pulse.
Distances from the carotid artery sampling site to the femoral artery (upper leg instrumented with a thigh cuff for oscillometric sphygmomanometry), and from the carotid artery to the suprasternal notch will be recorded.
PWV will be expressed as cm/s
|
Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Pulse wave analysis
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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The investigators will use the SphygmoCor XCEL system to assess pulse wave analysis (PWA) The sampling site is the brachial artery (upper alarm instrumented with a cuff for oscillometric sphygmomanometer).
PWA will be expressed as % (calculated as augmentation pressure divided by the pulse pressure).
|
Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
|
Passive Leg movement
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
|
Passive leg movement will be used assessed blood flow responses to movement. The investigators will usie continuous measures of femoral artery diameter and velocity via duplex Doppler ultrasound (Hitachi Arietta 70) to calculate blood flow at rest and with the passive lelg movement. The femoral artery will be imaged in the longitudinal plane distal to the inguinal crease using a high-frequency (10-12 MHz) linear-array probe. Participants will be in a seated, reclined position with the lower leg free hanging. The ultrasound probe will be positioned by a lab member and the image will be recorded throughout triplicate 60-s measurements. Another lab member will independently move the lower leg through 90º range of motion at a rate of 1 Hz. |
Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
|
Blood pressure reactivity responses
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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The investigators will measure systolic and diastolic pressure using photoplethysmography at the finger and manually measure brachial pressures.
Systolic and diastolic blood pressure will be assessed at rest and during submaximal cycling exercise.
Blood pressure reactivity will be expressed as a change in pressure (mmHg) from baseline to a predetermined time during the stressor.
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Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Inflammatory cell responses to Conditions
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Participants' blood will be used to isolate peripheral blood mononuclear cells (PBMCs) for quantification of immune cell subsets specifically counts of monocytes and t cells.
|
Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Inflammatory cytokine responses to Conditions
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Plasma will be used for a multiplex to measure inflammatory cytokines
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Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Changes in circulating reactive oxygen species
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Investigators will use electron paramagnetic resonance to measure reactive oxygen species (spectra units) in whole blood samples treated with a spin probe.
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Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Changes in blood biomarkers of nitric oxide bioavailability
Time Frame: Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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The investigators will measure nitric oxide metabolites (nitrate and nitrite nanomolar concentration).
|
Change from low salt to high salt to high salt + ketone (once per visit after each 10-day intervention periods)
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Objective sleep duration
Time Frame: Pre-intervention (14 days)
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Philips actiwatch spectrum will be used to quantify sleep duration.
Participants will wear the watch units for 14 days.
The investigators will assess sleep duration and cross-check actigraphy wear times with a sleep diary.
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Pre-intervention (14 days)
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Objective sleep efficiency
Time Frame: Pre-intervention (14 days)
|
Philips actiwatch spectrum will be used to quantify % of time in bed actually spent sleeping to calculate sleep efficiency.
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Pre-intervention (14 days)
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Subjective sleep duration
Time Frame: Pre-intervention
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The investigators will use the Pittsburgh Sleep Quality Index to asses sleep duration reflective of the one month period leading into the study.
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Pre-intervention
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Subjective sleep quality
Time Frame: Pre-intervention
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The investigators will use the Pittsburgh Sleep Quality Index to asses perceived sleep quality reflective of the one month period leading into the study.
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Pre-intervention
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Physical activity
Time Frame: Pre-intervention (14 days)
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Participants will wear an ActiGraph GT3X accelerometer for 14 days to objectively quantify steps taken per day.
|
Pre-intervention (14 days)
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Cardiorespiratory fitness
Time Frame: Pre-intervention
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The investigators will use indirect calorimetry to measure the participant's maximal oxygen consumption (VO2max) during incremental exercise on a treadmill.
The investigators will use a Parvo TrueOne metabolic cart and Monarch stationary bike.
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Pre-intervention
|
Mental health - social anxiety
Time Frame: Pre-intervention
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The investigators will administer the Liebowitz Social Anxiety Scale.
The scale starts at 0 (none) and ends at 3 (severe) for 24 questions related to anxiety and avoidance, and a cumulative score is calculated.
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Pre-intervention
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Mental health - depression
Time Frame: Pre-intervention
|
The investigators will administer the Beck's Depression Inventory.
The scale starts at 0 and ends at 3 for 21 questions related to depression.
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Pre-intervention
|
Habitual dietary intake
Time Frame: Pre-intervention
|
The investigators will instruct participants to complete a diet log for 6 days which will be operationalized with Nutrition Data System for Research (NDSR).
|
Pre-intervention
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Austin T Robinson, PhD, Auburn University
Publications and helpful links
General Publications
- Babcock MC, Robinson AT, Migdal KU, Watso JC, Martens CR, Edwards DG, Pescatello LS, Farquhar WB. High Salt Intake Augments Blood Pressure Responses During Submaximal Aerobic Exercise. J Am Heart Assoc. 2020 May 18;9(10):e015633. doi: 10.1161/JAHA.120.015633. Epub 2020 May 14.
- Costa TJ, Linder BA, Hester S, Fontes M, Pernomian L, Wenceslau CF, Robinson AT, McCarthy CG. The janus face of ketone bodies in hypertension. J Hypertens. 2022 Nov 1;40(11):2111-2119. doi: 10.1097/HJH.0000000000003243. Epub 2022 Aug 8.
- Barnett AM, Babcock MC, Watso JC, Migdal KU, Gutierrez OM, Farquhar WB, Robinson AT. High dietary salt intake increases urinary NGAL excretion and creatinine clearance in healthy young adults. Am J Physiol Renal Physiol. 2022 Apr 1;322(4):F392-F402. doi: 10.1152/ajprenal.00240.2021. Epub 2022 Feb 14.
- Chakraborty S, Galla S, Cheng X, Yeo JY, Mell B, Singh V, Yeoh B, Saha P, Mathew AV, Vijay-Kumar M, Joe B. Salt-Responsive Metabolite, beta-Hydroxybutyrate, Attenuates Hypertension. Cell Rep. 2018 Oct 16;25(3):677-689.e4. doi: 10.1016/j.celrep.2018.09.058.
- McCarthy CG, Chakraborty S, Singh G, Yeoh BS, Schreckenberger ZJ, Singh A, Mell B, Bearss NR, Yang T, Cheng X, Vijay-Kumar M, Wenceslau CF, Joe B. Ketone body beta-hydroxybutyrate is an autophagy-dependent vasodilator. JCI Insight. 2021 Oct 22;6(20):e149037. doi: 10.1172/jci.insight.149037.
- Wenstedt EF, Verberk SG, Kroon J, Neele AE, Baardman J, Claessen N, Pasaoglu OT, Rademaker E, Schrooten EM, Wouda RD, de Winther MP, Aten J, Vogt L, Van den Bossche J. Salt increases monocyte CCR2 expression and inflammatory responses in humans. JCI Insight. 2019 Nov 1;4(21):e130508. doi: 10.1172/jci.insight.130508.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- AU IRB #22-025
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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