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Exercise and Prolonged Fasting to Improve Brown Adipose Tissue Function in Postmenopausal Women (EMPOWER-BAT)

17 settembre 2026 aggiornato da: Borja Martínez Tellez, Universidad de Almeria

Exercise and Prolonged Fasting to Improve Interscapular Brown Fat Mitochondrial Function and Enhance Metabolic Flexibility in Postmenopausal Women (EMPOWER-BAT)

Type of Study: Clinical Trial

Goal: The goal of this clinical trial is to investigate mitochondrial function in interscapular brown adipose tissue (iBAT) in postmenopausal women and determine whether aerobic exercise, prolonged fasting, or their combination can improve iBAT mitochondrial function and whole-body metabolic flexibility.

Participant Population/Health Conditions: The study will involve 60 postmenopausal women aged 45-65 years living with overweight or obesity.

Main Questions: The main questions this study aims to answer are:

  • What are the mitochondrial function and cellular characteristics of iBAT in postmenopausal women?
  • Can aerobic exercise or five-day prolonged fasting improve mitochondrial function in iBAT and whole-body metabolic flexibility?
  • Does combining aerobic exercise with prolonged fasting produce greater metabolic adaptations than either intervention alone?
  • Are improvements in metabolic flexibility maintained four weeks after the intervention?

Participants Will:

Be randomized into one of four groups: control, aerobic exercise, prolonged fasting, or combined aerobic exercise plus prolonged fasting.

Follow their assigned intervention for five consecutive days. Undergo metabolic and physiological assessments before and after the intervention and again four weeks later.

Provide dorsocervical adipose tissue biopsies and biological samples to investigate mitochondrial function, adipocyte characteristics, and metabolic adaptations.

Comparison Group: Researchers will compare the effects of aerobic exercise, prolonged fasting, and their combination with a control condition to determine their effects on iBAT mitochondrial function and whole-body metabolic flexibility.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Postmenopause is associated with a substantial increase in cardiometabolic risk, partly driven by the decline in estrogen levels and alterations in cellular energy metabolism. Mitochondrial dysfunction has been documented in skeletal muscle of postmenopausal women and is associated with metabolic inflexibility, reduced fat oxidation, ectopic fat accumulation, and insulin resistance. However, whether mitochondrial dysfunction is also present in adipose tissue of postmenopausal women, and whether it can be reversed through lifestyle interventions, remains largely unknown.

Brown adipose tissue (BAT) is a mitochondria-rich and metabolically active tissue involved in thermogenesis and substrate utilization. Although human BAT has traditionally been studied in the supraclavicular region, emerging evidence from our research group suggests the presence of a metabolically active adipose tissue depot in the dorsocervical region, referred to as interscapular brown adipose tissue (iBAT). Preliminary observations indicate that this depot may have distinct metabolic characteristics. However, iBAT has not yet been characterized in postmenopausal women.

Aerobic exercise is a potent non-pharmacological stimulus for mitochondrial remodeling and improves mitochondrial biogenesis and oxidative capacity. Exercise-derived lactate may also promote adipose tissue browning and mitochondrial remodeling. Prolonged fasting induces profound metabolic adaptations characterized by increased fat mobilization and changes in substrate utilization. Preliminary data from our group suggest that five days of prolonged fasting substantially increase fat oxidation during exercise, providing a rationale for investigating whether fasting and exercise may have complementary effects on mitochondrial function and metabolic flexibility.

Based on this rationale, the main hypothesis of EMPOWER-BAT is that iBAT in postmenopausal women presents mitochondrial dysfunction and that aerobic exercise, five-day prolonged fasting, and their combination can improve mitochondrial function through lactate-related signaling pathways, leading to enhanced whole-body metabolic flexibility. The main objective is to characterize mitochondrial function in iBAT and determine the effects of these interventions on iBAT mitochondrial function and metabolic flexibility.

EMPOWER-BAT is a randomized controlled trial involving 60 postmenopausal women aged 45-65 years with a body mass index ≥25 kg/m². Participants will be randomized (1:1:1:1) into four groups: a control group maintaining its usual lifestyle; an aerobic exercise group performing supervised exercise for 60-90 minutes at 65% of heart rate reserve; a prolonged fasting group following a medically supervised fasting protocol providing approximately 600 kcal/day; or a combined group completing both exercise and fasting. All interventions will last five consecutive days.

Before and after the intervention, iBAT biopsies will be collected from the dorsocervical region to assess mitochondrial function and adipocyte characteristics. Metabolic and physiological assessments will include indirect calorimetry at rest and during exercise, body composition, cardiorespiratory fitness, and blood and urine biomarkers. Continuous glucose and ketone monitoring will also be performed during the intervention. Four weeks later, metabolic and physiological assessments will be repeated to determine whether changes in metabolic flexibility are maintained after participants return to their usual lifestyle.

Tipo di studio

Interventistico

Iscrizione (Stimato)

60

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: Borja Martínez Téllez, PhD
  • Numero di telefono: +34 950215334
  • Email: borjammt@ual.es

Luoghi di studio

    • Almería
      • Almería, Almería, Spagna, 04131
        • Universidad de Almería

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 45 anni a 65 anni (Adulto, Adulto più anziano)

Accetta volontari sani

Sì

Sessi ammissibili allo studio

Femmina

Descrizione

Inclusion Criteria:

  • Women aged 45 to 65 years.
  • Postmenopausal status, defined as ≥ 12 consecutive months without menstruation.
  • Women with amenorrhea shorter than 12 months will be included if their follicle-stimulating hormone levels are >30IU/liter.
  • BMI between ≥25 kg/m2.
  • Sedentary or low-active (not meeting physical activity guidelines).
  • Willing to be randomized to any of the four groups.
  • Able and willing to adhere to all study procedures and show availabity in their schedule.
  • Must be willing to have biological samples stored for future research.

Exclusion Criteria:

  • Diabetes mellitus (determined based on fasting glucose levels defined by ADA criteria).
  • Any other active endocrine disease (thyroid disease, any signs of Cushing's syndrome, adrenal disease and lipid-associated disorders such as familial hypercholesterolemia).
  • Any cardiac disease (i.e., ischemic cardiac disease, arrhythmias, severe heart failure).
  • Use of medication known to influence glucose and/or lipid metabolism or brown fat activity (e.g., beta-blockers, antidepressants, corticosteroids).
  • Current or recent (past 6 months) use of hormone replacement therapy, including systemic estrogen therapy (oral or transdermal), combined estrogen-progestin therapy, tibolone, or selective estrogen receptor modulators.
  • Clinically relevant abnormalities in clinical chemistry or electrocardiogram at screening (to be judged by the study physician).
  • A first-degree family member with sudden cardiac death.
  • Any chronic renal or hepatic disease.
  • Abuse of alcohol or other substances.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Scienza basilare
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Nessun intervento: Control

n=15; maintaining their usual lifestyle without changes to diet or physical activity; Total 5 days

Sperimentale: Aerobic exercise

n=15; receiving supervised aerobic exercise for 60-90 minutes/day at 65% of heart rate reserve; Total 5 days

Participants will perform supervised aerobic exercise for 60-90 minutes per day at 65% of heart rate reserve on 5 consecutive days.

Sperimentale: Prolonged fasting

n=15; following a prolonged fasting protocol providing approximately 600 kcal/day; Total 5 days

Participants will follow a medically supervised prolonged fasting protocol providing approximately 600 kcal/day for five consecutive days.

Sperimentale: Aerobic exercise + prolonged fasting

n=15; receiving supervised aerobic exercise for 60-90 minutes/day at 65% of heart rate reserve and prolonged fasting providing approximately 600 kcal/day; Total 5 days

Participants will perform supervised aerobic exercise for 60-90 minutes per day at 65% of heart rate reserve on 5 consecutive days.

Participants will follow a medically supervised prolonged fasting protocol providing approximately 600 kcal/day for five consecutive days.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
iBAT adipocyte composition and gene expression (snRNA-seq)
Lasso di tempo: 1 week

Change in adipocyte subpopulations and gene expression in dorsocervical iBAT assessed by single-nucleus RNA sequencing (snRNA-seq)

1 week

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
iBAT mitochondrial respiration (Oroboros O2k).
Lasso di tempo: 1 week

Change in mitochondrial respiration in dorsocervical iBAT assessed by high-resolution respirometry.

1 week
iBAT protein expression (Western blot)
Lasso di tempo: 1 week

Change in protein expression in dorsocervical iBAT assessed by Western blot, including markers related to thermogenesis and mitochondrial function.

1 week
Total Body Fat Mass
Lasso di tempo: 5 weeks

Change in total body fat mass (kg) from baseline, assessed by dual-energy X-ray absorptiometry (DXA).

5 weeks
Body Fat Percentage
Lasso di tempo: 5 weeks

Change in total body fat percentage (%) from baseline, assessed by dual-energy X-ray absorptiometry (DXA).

5 weeks
Resting Metabolic Rate
Lasso di tempo: 5 weeks

Change in resting metabolic rate (kcal/day) from baseline, assessed by indirect calorimetry.

5 weeks
Cardiorespiratory Fitness - Peak Oxygen Uptake (VO₂peak)
Lasso di tempo: 5 weeks

Change from baseline in peak oxygen uptake (VO₂peak; mL/kg/min), assessed during exercise testing with breath-by-breath gas exchange analysis.

5 weeks
LDL Cholesterol
Lasso di tempo: 5 weeks

Change in fasting LDL cholesterol (mg/dL) from baseline, assessed in blood samples.

5 weeks
Urinary Urea Nitrogen
Lasso di tempo: 5 weeks

Change from baseline in urinary urea nitrogen (UUN) concentration (mg/dL), assessed in urine samples as a marker of protein metabolism.

5 weeks
Gut microbiota
Lasso di tempo: 5 weeks

Change in gut microbiota composition assessed in fecal samples.

5 weeks
Fat-Free Mass
Lasso di tempo: 5 weeks

Change in total fat-free mass (kg) from baseline, assessed by dual-energy X-ray absorptiometry (DXA).

5 weeks
Visceral Adipose Tissue (VAT) Fat Mass
Lasso di tempo: 5 weeks

Change in visceral adipose tissue (VAT) fat mass (g) from baseline, assessed by dual-energy X-ray absorptiometry (DXA).

5 weeks
Subcutaneous Adipose Tissue (SAT) Fat Mass
Lasso di tempo: 5 weeks

Change in subcutaneous adipose tissue (SAT) fat mass (g) from baseline, assessed by dual-energy X-ray absorptiometry (DXA).

5 weeks
Fat Oxidation Rate at Rest
Lasso di tempo: 5 weeks

Change in resting fat oxidation rate (g/min) from baseline, calculated from oxygen consumption (VO₂) and carbon dioxide production (VCO₂) measured by indirect calorimetry.

5 weeks
Carbohydrate Oxidation Rate at Rest
Lasso di tempo: 5 weeks

Change in resting carbohydrate oxidation rate (g/min) from baseline, calculated from oxygen consumption (VO₂) and carbon dioxide production (VCO₂) measured by indirect calorimetry.

5 weeks
HDL Cholesterol
Lasso di tempo: 5 weeks

Change in fasting HDL cholesterol (mg/dL) from baseline, assessed in blood samples.

5 weeks
Fasting Glucose
Lasso di tempo: 5 weeks

Change in fasting blood glucose (mg/dL) from baseline.

5 weeks
Fasting Insulin
Lasso di tempo: 5 weeks

Change in fasting insulin concentration (µIU/mL) from baseline, assessed in blood samples.

5 weeks
Triglycerides
Lasso di tempo: 5 weeks

Change in fasting triglyceride concentration (mg/dL) from baseline, assessed in blood samples.

5 weeks
C-Reactive Protein (CRP)
Lasso di tempo: 5 weeks

Change in C-reactive protein concentration (mg/L) from baseline, assessed in blood samples.

5 weeks
Fat Oxidation During Exercise
Lasso di tempo: 5 weeks

Change from baseline in fat oxidation rate (g/min) during exercise, estimated by indirect calorimetry using a COSMED Quark metabolic cart.

5 weeks
Carbohydrate Oxidation During Exercise
Lasso di tempo: 5 weeks

Change from baseline in carbohydrate oxidation rate (g/min) during exercise, estimated by indirect calorimetry using a COSMED Quark metabolic cart.

5 weeks

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 settembre 2027

Completamento primario (Stimato)

1 settembre 2029

Completamento dello studio (Stimato)

1 settembre 2029

Date di iscrizione allo studio

Primo inviato

9 settembre 2026

Primo inviato che soddisfa i criteri di controllo qualità

17 settembre 2026

Primo Inserito (Effettivo)

23 settembre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

23 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

17 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • PID2025-173649OB-I00

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Periodo di condivisione IPD

5 years after publishing the data

Criteri di accesso alla condivisione IPD

Everybody

Tipo di informazioni di supporto alla condivisione IPD

  • STUDIO_PROTOCOLLO
  • ICF
  • RSI

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .