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Endurance Trial: Ketone and Carbohydrate Supplementation

2026년 8월 25일 업데이트: Adelino Sanchez Ramos da Silva, University of Sao Paulo

Double-Blind Randomized Crossover Trial Examining the Effects of Ketone and Carbohydrate Supplementation on Molecular Biomarkers, Cognitive Function, and Physical Performance in Healthy Endurance Athletes

This randomized, double-blind, crossover study investigates the effects of exogenous ketone supplementation on physical and cognitive performance in amateur endurance athletes during exhaustive exercise. Participants will complete three 3-hour cycling sessions under different nutritional conditions: carbohydrate alone (CHO), carbohydrate plus ketone (CHO-KET), and placebo (PLA). The study will assess cognitive function through validated computerized tests, physical performance via distance covered, and metabolic responses through blood biomarkers. Additionally, peripheral blood mononuclear cells (PBMCs) will be collected and cultured with LPS or not. Other PBMCs co-cultured with neuronal cells (SH-SY5Y) to investigate neuro-immune interactions. The primary hypothesis is that ketone supplementation will preserve cognitive function and enhance physical performance during prolonged exhaustive exercise compared to carbohydrate supplementation alone, potentially through anti-inflammatory mechanisms and alternative energy substrate provision.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

Design rationale

Published trials of exogenous ketosis in prolonged cycling have used intermittent load, which oscillates intensity and, with it, substrate preference. That format does not favour expression of the proposed mechanism, whereby ketosis suppresses glycolysis, raises fat oxidation and spares glycogen for a decisive final block. Constant prolonged load was therefore chosen as the more adequate format to test it.

Those trials also compare two arms against a carbohydrate background present in every condition, without a carbohydrate-free control, which does not separate the contribution of carbohydrate from that of added ketone. The three arms used here resolve this: the placebo-to-carbohydrate contrast measures the contribution of carbohydrate, and the carbohydrate to carbohydrate-plus-ketone contrast measures the contribution of ketone added on a matched background, added rather than substituted on an isocaloric basis.

The three-hour window was chosen because it is where cortisol and the inflammatory response intensify, allowing examination of whether ketosis acts beyond energy provision, as a signalling metabolite on the kynurenine pathway.

Pre-experimental visit

Body composition is assessed by dual-energy X-ray absorptiometry on a Lunar GE Medical Systems Prodigy Advance scanner with Encore software version 13.6, calibrated by the same technician according to manufacturer recommendations. Lean mass, fat mass, body fat percentage and bone mineral density are recorded. This assessment is performed once and characterizes the sample rather than serving as a study outcome, since it precedes any supplementation and is not repeated within conditions.

The maximal incremental test follows, on a cycle ergometer, with a three-minute warm-up at 100 W and increments of 25 W every three minutes until exhaustion. Maximal oxygen uptake is determined by indirect calorimetry on a COSMED Quark CPET analyser, maximal power output by a Saris power meter with Golden Cheetah software, and heart rate by a Polar chest strap. Perceived exertion is rated on the Borg 0 to 10 scale. At each increment, 25 microlitres of capillary blood are sampled from the earlobe for lactate determination on a Yellow Springs YSI analyser, from which the anaerobic threshold is derived. Together with maximal power output and maximal oxygen uptake, the threshold informs individual load prescription for the experimental sessions.

Standardization before each experimental session

Participants maintain their habitual dietary pattern and their habitual training volume, intensity and frequency throughout the experimental period. In the three days preceding each visit, caffeine, non-steroidal anti-inflammatory drugs and any medication affecting intestinal transit are suspended. In the week preceding each experimental session, intense effort and systematic training are prohibited, to avoid residual fatigue or muscle inflammation; adherence is verified by direct contact and by inspection of individual training records.

Gut training is prescribed in that same week, with progressive carbohydrate volume and dose taken during the participant's own training rides, adapted from the protocol of Costa et al. (2017), to increase gastrointestinal tolerance to the carbohydrate load of the experimental session. Supplements for the following week of gut training are handed to the participant before discharge from each session.

Hydration follows 5 mL/kg of cold water on arrival at the laboratory, with ad libitum replacement throughout the session.

Experimental session logistics

Each session runs on a fixed schedule of approximately seven and a half hours from arrival to discharge.

Venous blood is drawn from the antecubital vein into serum and EDTA tubes. Peripheral blood mononuclear cells are isolated from the EDTA tubes by Ficoll-Hypaque gradient at 400 g for 40 minutes. Serum is obtained after 60 minutes at room temperature followed by centrifugation at 1300 g for 10 minutes, and stored at minus 80 degrees Celsius.

Capillary blood is sampled from the earlobe at defined intervals before, during and after exercise for on-site determination of lactate, glucose and beta-hydroxybutyrate on a Freestyle Optium meter, which also serves to verify that the target ketosis was reached in the CHO-KET condition. Perceived exertion is rated on the Borg 0 to 10 scale at predefined moments. Four five-minute gas exchange windows are recorded during the fixed-intensity phase, with the mask fitted continuously during the maximal effort block.

Before exercise, the cycle ergometer is adjusted to the participant's measurements and the heart rate monitor is fitted. Gas exchange is recorded across four fixed windows per session: 15 minutes covering rest, warm-up and exercise onset; 5 minutes at two points during the fixed-intensity phase; and 30 minutes from 5 minutes before the end of the fixed-intensity phase through the maximal effort block and the cool-down. After the cool-down, the participant completes the post-exercise cognitive battery, showers, and is weighed. The final venous draw follows the same protocol as baseline.

연구 유형

중재적

등록 (추정된)

12

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

  • 이름: João P. Floriano, Bachelor of Nutrition
  • 전화번호: +551699772-5355
  • 이메일: jp_floriano@usp.br

연구 장소

    • São Paulo
      • Ribeirão Preto, São Paulo, 브라질, 14040-900
        • 모병
        • School of Physical Education and Sport of Ribeirão Preto - University of São Paulo
        • 연락하다:
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인

건강한 자원 봉사자를 받아들입니다

예

설명

Inclusion Criteria:

  • Amateur male cyclists;
  • At least 2 years of cycling experience;
  • At least 5 hours of endurance cycling training per week;
  • VO2max of at least 50 mL/kg/min.

Exclusion Criteria:

  • Confirmed diagnosis of COVID-19 by PCR or rapid antigen test within the last 12 months;
  • Symptoms compatible with COVID-19 within the last six months;
  • Smokers;
  • Alcoholics;
  • Presence of neurological, immune, or muscular diseases;
  • Use of psychoactive medications in the last year;
  • Use of any acute medication prior three days each visit that possible could affect the experiment such as stool-altering medications and non-steroidal anti-inflammatory drugs;
  • Confirmed gastrointestinal infections, diseases, or disorders (e.g., coeliac disease, inflammatory bowel disease, irritable bowel syndrome, diverticular disease, gastroesophageal reflux disease);
  • Medical history of gastrointestinal surgery, or any other self-reported gastrointestinal issues;
  • Within the previous three months, if they had consumed substances that could affect gastrointestinal integrity or followed gastrointestinal-targeted dietary regimes;
  • Participants with any food allergy should be excluded of this study.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 기초 과학
  • 할당: 무작위
  • 중재 모델: 크로스오버 할당
  • 마스킹: 네 배로

무기와 개입

참가자 그룹 / 팔
개입 / 치료
활성 비교기: Carbohydrate (CHO)
Participants receive a non-caloric, flavour-matched placebo before exercise, at 45 and 5 minutes before the start of the cycling protocol, and a carbohydrate beverage during exercise. Interventions administered in this arm: standardized evening meal, standardized breakfast, pre-exercise non-caloric placebo, and carbohydrate beverage.
Participants ingest 210 mL of a ~15% carbohydrate solution, providing 30 g of carbohydrate per dose, every 20 minutes from the start of the 155-minute fixed-intensity phase, with the final dose taken immediately before the start of the 20-minute maximal effort block. No beverage is provided during the maximal effort. The solution combines sucrose and dextrose so that glucose and fructose are absorbed through separate intestinal transporters. All doses are supplied in opaque, coded bottles prepared by a researcher not involved in the assessments, so that treatments cannot be identified visually.
다른 이름들:
  • 조
Participants ingest a non-caloric placebo beverage at 45 and 5 minutes before the start of the cycling protocol, at the same time points at which the (R)-1,3-butanediol is administered in the CHO-KET arm. The placebo is matched to the ketone beverage for volume, appearance and flavour, and provides no energy. Doses are supplied in opaque, coded bottles prepared by a researcher not involved in the assessments.
다른 이름들:
  • Ketone placebo
On the evening before each experimental session, participants consume a standardized meal providing 1.5 g of carbohydrate per kg of body mass. The same meal is provided before all three experimental sessions and is followed by an overnight fast of 8 to 12 hours.
Each experimental session comprises 5 minutes of warm-up at 100 W, 155 minutes at 55% of maximal power output (Wmax) with the cycle ergometer set in hyperbolic mode, and a final 20 minutes of maximal self-paced effort in linear mode, followed by 5 minutes of low-load cool-down. The same protocol is applied in all three conditions, with load individually prescribed from the maximal incremental test performed at the pre-experimental visit.
On the morning of each experimental session, after the baseline venous blood draw and following an overnight fast of 8 to 12 hours, participants consume a standardized breakfast providing 1.5 g of carbohydrate per kg of body mass, 40 g of protein and 7 g of fat. Participants are instructed to consume the entire meal. The same breakfast is provided before all three experimental sessions.
위약 비교기: Placebo (PLA)
Participants receive a non-caloric, flavour-matched placebo before exercise, at 45 and 5 minutes before the start of the cycling protocol, and a non-caloric placebo beverage during exercise. No carbohydrate and no ketone precursor are provided after the standardized breakfast. Interventions administered in this arm: standardized evening meal, standardized breakfast, pre-exercise non-caloric placebo, and during-exercise non-caloric placebo.
Participants ingest a non-caloric placebo beverage at 45 and 5 minutes before the start of the cycling protocol, at the same time points at which the (R)-1,3-butanediol is administered in the CHO-KET arm. The placebo is matched to the ketone beverage for volume, appearance and flavour, and provides no energy. Doses are supplied in opaque, coded bottles prepared by a researcher not involved in the assessments.
다른 이름들:
  • Ketone placebo
On the evening before each experimental session, participants consume a standardized meal providing 1.5 g of carbohydrate per kg of body mass. The same meal is provided before all three experimental sessions and is followed by an overnight fast of 8 to 12 hours.
Each experimental session comprises 5 minutes of warm-up at 100 W, 155 minutes at 55% of maximal power output (Wmax) with the cycle ergometer set in hyperbolic mode, and a final 20 minutes of maximal self-paced effort in linear mode, followed by 5 minutes of low-load cool-down. The same protocol is applied in all three conditions, with load individually prescribed from the maximal incremental test performed at the pre-experimental visit.
On the morning of each experimental session, after the baseline venous blood draw and following an overnight fast of 8 to 12 hours, participants consume a standardized breakfast providing 1.5 g of carbohydrate per kg of body mass, 40 g of protein and 7 g of fat. Participants are instructed to consume the entire meal. The same breakfast is provided before all three experimental sessions.
Participants ingest 210 mL of a non-caloric placebo beverage every 20 minutes from the start of the 155-minute fixed-intensity phase, with the final dose taken immediately before the start of the 20-minute maximal effort block. No beverage is provided during the maximal effort. The placebo is water with the same flavouring used in the carbohydrate beverage, matched for volume, appearance and ingestion schedule, and provides no energy. Doses are supplied in opaque, coded bottles prepared by a researcher not involved in the assessments.
다른 이름들:
  • PLA
실험적: Carbohydrate plus ketone (CHO-KET)
Participants receive (R)-1,3-butanediol before exercise, at 1.0 g/kg body mass 45 minutes before the start of the cycling protocol and a further 0.5 g/kg 5 minutes before the start, and the same carbohydrate beverage as the CHO arm during exercise. Interventions administered in this arm: standardized evening meal, standardized breakfast, (R)-1,3-butanediol, and carbohydrate beverage.
Participants ingest 210 mL of a ~15% carbohydrate solution, providing 30 g of carbohydrate per dose, every 20 minutes from the start of the 155-minute fixed-intensity phase, with the final dose taken immediately before the start of the 20-minute maximal effort block. No beverage is provided during the maximal effort. The solution combines sucrose and dextrose so that glucose and fructose are absorbed through separate intestinal transporters. All doses are supplied in opaque, coded bottles prepared by a researcher not involved in the assessments, so that treatments cannot be identified visually.
다른 이름들:
  • 조
On the evening before each experimental session, participants consume a standardized meal providing 1.5 g of carbohydrate per kg of body mass. The same meal is provided before all three experimental sessions and is followed by an overnight fast of 8 to 12 hours.
Each experimental session comprises 5 minutes of warm-up at 100 W, 155 minutes at 55% of maximal power output (Wmax) with the cycle ergometer set in hyperbolic mode, and a final 20 minutes of maximal self-paced effort in linear mode, followed by 5 minutes of low-load cool-down. The same protocol is applied in all three conditions, with load individually prescribed from the maximal incremental test performed at the pre-experimental visit.
On the morning of each experimental session, after the baseline venous blood draw and following an overnight fast of 8 to 12 hours, participants consume a standardized breakfast providing 1.5 g of carbohydrate per kg of body mass, 40 g of protein and 7 g of fat. Participants are instructed to consume the entire meal. The same breakfast is provided before all three experimental sessions.
Participants ingest (R)-1,3-butanediol at 1.0 g/kg body mass 45 minutes before the start of the cycling protocol and a further 0.5 g/kg 5 minutes before the start, for a total dose of 1.5 g/kg body mass. The dose was selected to sustain blood beta-hydroxybutyrate at approximately 2 mmol/L throughout the session, a range compatible with nutritional ketosis and without risk to participants. Doses are supplied in opaque, coded bottles prepared by a researcher not involved in the assessments.
다른 이름들:
  • CHO + KET
  • Ketone precursor
  • Ketone-IQ

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Distance covered during the final 20 minutes of maximal effort
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): final 20 minutes of exercise.

Physical performance is assessed as the distance covered during the final 20-minute maximal effort block of each experimental session. Each session begins with 5 minutes of warm-up at 100 W, followed by 155 minutes at 55% of maximal power output (Wmax) with the cycle ergometer set in hyperbolic mode, and ends with 20 minutes of maximal self-paced effort in linear mode. Load is individually prescribed from the maximal incremental test performed at Visit 1. Participants ride the bicycle they are accustomed to, mounted on an electromagnetically braked cycle ergometer, and distance is recorded by the ergometer software.

Unit: kilometres

Visits 2, 3 and 4 (weeks 3, 4 and 5): final 20 minutes of exercise.
Visuospatial working memory: Corsi block-tapping span
기간: Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.

Visuospatial working memory is assessed with the Corsi block-tapping task from the Psychology Experiment Building Language (PEBL) battery. Sequences of illuminated squares are presented, starting with two blocks and increasing by one every two attempts, until two consecutive errors occur. The span is the length of the longest sequence correctly reproduced; higher values indicate better working memory. Participants are familiarized with the task at Visit 1, and a brief rehearsal is performed immediately before testing at each experimental session.

Unit: number of blocks

Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.
Inhibitory control: accuracy on No-Go trials
기간: Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.

Inhibitory control is assessed with the Go/No-Go task from the PEBL battery. The letters P or R replace a blue star on screen, with 10 practice trials followed by 160 stimuli per block in an 80:20 Go to No-Go ratio, a 500-millisecond stimulus duration and a 1500-millisecond inter-stimulus interval. Accuracy on No-Go trials is reported as the proportion of correctly withheld responses, ranging from 0 to 1, with higher values indicating better inhibitory control.

Unit: proportion of correct responses

Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.
Processing speed: reaction time on Go trials
기간: Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.
Reaction time on correct Go trials of the Go/No-Go task described above is recorded automatically by the PEBL software and reported as the mean latency in milliseconds. Lower values indicate faster processing speed.
Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.
Cognitive flexibility: Trail Making Test B minus A completion time
기간: Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.

Cognitive flexibility is assessed with the Trail Making Test, parts A and B, from the PEBL battery. In part A the participant selects numbered circles from 1 to 26 in ascending order as fast as possible; in part B the participant alternates between numbers and letters. The difference between the completion times of part B and part A is reported, with lower values indicating greater cognitive flexibility.

Unit: milliseconds

Visit 1 (week 0), familiarization session. Visits 2, 3 and 4 (weeks 3, 4 and 5): 15 minutes after the standardized breakfast, before the first supplement dose; and 5 minutes after the end of exercise.

2차 결과 측정

결과 측정
측정값 설명
기간
Gastrointestinal symptom severity
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): immediately before breakfast; immediately before exercise; 40, 100 and 160 minutes after exercise onset; immediately after exercise; and 60 minutes after exercise.

A 10-point Likert-type scale, adapted into a 20 cm visual analogue scale, is used, where 0 indicates absence of symptoms and 10 indicates extreme symptoms, so that higher scores indicate worse tolerance. The questionnaire comprises three sections: upper abdominal symptoms (reflux, abdominal distension, nausea, vomiting); lower abdominal symptoms (cramps, flatulence, abdominal pain, diarrhoea); and systemic symptoms (dizziness, headache, muscle cramps).

Unit: score on a 0 to 10 scale

Visits 2, 3 and 4 (weeks 3, 4 and 5): immediately before breakfast; immediately before exercise; 40, 100 and 160 minutes after exercise onset; immediately after exercise; and 60 minutes after exercise.
Serum intestinal fatty acid-binding protein concentration
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.

Serum concentration of intestinal fatty acid-binding protein (I-FABP) is quantified by enzyme-linked immunosorbent assay (HK406, Hycult Biotech, Uden, Netherlands). Samples are analysed in duplicate according to the manufacturer's instructions on the same day, with standards and controls on each plate, and all samples from a given participant are assayed on the same plate to minimize inter-assay variability.

Unit: picograms per millilitre

Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Protein expression of kynurenine pathway, endoplasmic reticulum stress, autophagy and oxidative stress markers in PBMCs
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fasting, and 60 minutes after the end of exercise.

Peripheral blood mononuclear cells are isolated from whole blood by Ficoll-Hypaque density-gradient centrifugation. Total protein is extracted with RIPA buffer containing protease inhibitors and quantified by the bicinchoninic acid assay. Protein expression of enzymes of the kynurenine pathway and of markers of endoplasmic reticulum stress, autophagic flux and oxidative stress is determined by Western blot after SDS-PAGE separation, transfer to nitrocellulose membrane, overnight incubation with specific primary antibodies, incubation with a peroxidase-conjugated secondary antibody, chemiluminescent detection and densitometric analysis.

Unit: arbitrary units, normalized to loading control

Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fasting, and 60 minutes after the end of exercise.
Sleep difficulty score on the Athlete Sleep Screening Questionnaire
기간: Sleep during the 7 days preceding each assessment. Assessed at Visit 1 (week 0) and at Visits 2, 3 and 4 (weeks 3, 4 and 5). At the experimental sessions the questionnaire is administered immediately after the standardized breakfast.
Sleep is assessed with the Athlete Sleep Screening Questionnaire (ASSQ), validated for Brazilian athletes. The instrument comprises 15 items covering sleep quantity, sleep quality, insomnia and chronotype; only the first seven items are used, as these generate the sleep difficulty score (SDS). The SDS ranges from 0 to 17, with higher scores indicating greater sleep difficulty, and classifies athletes into four categories of clinical sleep problems: none (0 to 4), mild (5 to 7), moderate (8 to 10) and severe (11 to 17). The questionnaire refers to the 7 days preceding its administration. Because the three experimental sessions are separated by a one-week washout, each administration characterizes sleep during the week that precedes the corresponding condition. Unit: score on a scale
Sleep during the 7 days preceding each assessment. Assessed at Visit 1 (week 0) and at Visits 2, 3 and 4 (weeks 3, 4 and 5). At the experimental sessions the questionnaire is administered immediately after the standardized breakfast.
Fatigue and vigour subscale scores on the Brunel Mood Scale
기간: Visit 1 (week 0). Visits 2, 3 and 4 (weeks 3, 4 and 5): immediately after the baseline cognitive battery, 45 minutes before exercise; and immediately after the post-exercise cognitive battery, 40 minutes after exercise.
Mood is assessed with the Brunel Mood Scale (BRUMS), the Brazilian version of a shortened Profile of Mood States. The instrument comprises 24 single-word mood descriptors distributed across six subscales of four items each: tension, depression, anger, vigour, fatigue and confusion. Each item is rated on a 5-point Likert scale from 0 (not at all) to 4 (extremely), so that each subscale score ranges from 0 to 16, with higher scores indicating greater intensity of that mood dimension. The fatigue and vigour subscales are the variables of interest. Unit: score on a scale
Visit 1 (week 0). Visits 2, 3 and 4 (weeks 3, 4 and 5): immediately after the baseline cognitive battery, 45 minutes before exercise; and immediately after the post-exercise cognitive battery, 40 minutes after exercise.
Daily energy intake
기간: Visit 1 (week 0): after DEXA. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Dietary intake is assessed by a 24-hour dietary recall conducted in person by a nutritionist using the five-step multiple-pass method, referring to the day preceding each visit. Participants are instructed to maintain their habitual diet and physical activity throughout the experimental period, and protein, carbohydrate and micronutrient supplements are quantified together with food. Records are analysed using the Brazilian food composition tables TBCA-USP and TACO-UNICAMP and, when an item is not listed, the United States Department of Agriculture National Nutrient Database for Standard Reference. Total daily energy intake is reported. Unit: kilocalories per day.
Visit 1 (week 0): after DEXA. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Gene expression of kynurenine pathway, endoplasmic reticulum stress, autophagy and oxidative stress targets in PBMCs
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.

Total RNA is extracted from peripheral blood mononuclear cells and reverse transcribed. Gene expression of targets related to the kynurenine pathway, endoplasmic reticulum stress, autophagy and oxidative stress is quantified by real-time quantitative PCR using SYBR Green chemistry, and reported as relative expression by the 2^-ddCt method against a reference gene.

Unit: relative expression, 2^-ddCt

Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Serum concentration of kynurenine pathway metabolites
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.

Serum concentrations of kynurenine pathway metabolites, including kynurenine, kynurenic acid, 3-hydroxykynurenine and quinolinic acid, are quantified by high-performance liquid chromatography coupled to tandem mass spectrometry.

Unit: micromoles per litre

Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Serum endotoxin concentration
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.

Circulating concentration of Gram-negative bacterial endotoxin is measured using a chromogenic Limulus amebocyte lysate assay (HIT302, Hycult Biotech, Uden, Netherlands), in duplicate, with all samples from a given participant assayed on the same plate.

Unit: endotoxin units per millilitre

Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Serum endotoxin core antibody concentration
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.

Serum concentration of endotoxin core antibody is quantified by enzyme-linked immunosorbent assay (HK504, Hycult Biotech, Uden, Netherlands), in duplicate, with all samples from a given participant assayed on the same plate.

Unit: median metric units per millilitre

Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Serum cortisol concentration
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Serum cortisol concentration is quantified by enzyme-linked immunosorbent assay, in duplicate, with all samples from a given participant assayed on the same plate. Unit: micrograms per decilitre
Visits 2, 3 and 4 (weeks 3, 4 and 5): baseline on arrival after an 8 to 12 hour overnight fast, and 60 minutes after the end of exercise.
Concentration of inflammatory cytokines in serum and cell culture medium
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5). Serum: baseline after an overnight fast and 60 minutes after exercise. Culture medium: before and after 24 hours of incubation of cells isolated at those two time points.
Concentrations of interleukin-6, interleukin-4, nuclear factor kappa-B, tumour necrosis factor, interleukin-1 beta and interleukin-10 are quantified in serum, in the culture medium of peripheral blood mononuclear, and cells co-cultured with SH-SY5Y neuronal cells. Unit: picograms per millilitre.
Visits 2, 3 and 4 (weeks 3, 4 and 5). Serum: baseline after an overnight fast and 60 minutes after exercise. Culture medium: before and after 24 hours of incubation of cells isolated at those two time points.
skinfold thicknesses
기간: Visit 1 (week 0): after DEXA, before maximum incremental exercise. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Subcutaneous fat is estimated from skinfold thickness measured with a Lange skinfold caliper by the same trained assessor at every visit. At the experimental sessions the measurement is performed between the first and second supplement doses, together with the 24-hour dietary recall. The sum of skinfolds is reported. Unit: millimetres
Visit 1 (week 0): after DEXA, before maximum incremental exercise. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Body circumferences
기간: Visit 1 (week 0): after DEXA, before maximum incremental exercise. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Body circumferences are measured with an inelastic anthropometric tape by the same trained assessor, following the same schedule as the skinfold measurements. Unlike skinfold thickness, which estimates subcutaneous adiposity, circumferences characterize regional body dimensions and are reported individually by site. Unit: centimetres
Visit 1 (week 0): after DEXA, before maximum incremental exercise. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Body mass
기간: Visit 1 (week 0). Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, and 45 minutes after the end of exercise.
Body mass is measured on a calibrated digital scale with the participant wearing minimal clothing. Unlike the skinfold and circumference measurements, which are recorded once per visit, body mass is recorded twice at each experimental session: before exercise, between the first and second supplement doses, and again after exercise, following a shower and before the final venous blood draw. The difference between the two measurements is used to estimate fluid loss during exercise. Unit: kilograms
Visit 1 (week 0). Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, and 45 minutes after the end of exercise.
Daily nutrient intake
기간: Visit 1 (week 0): after DEXA. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Carbohydrate, protein and fat intake as well as micronutrient intake are derived from the same 24-hour dietary recall and analysed with the same food composition tables described for daily energy intake, and are reported in grams per day. Unit: grams per day.
Visit 1 (week 0): after DEXA. Visits 2, 3 and 4 (weeks 3, 4 and 5): 45 to 5 minutes before the start of exercise, between the first and second supplement doses.
Respiratory exchange ratio during exercise
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): 15-minute window covering rest, warm-up and exercise onset; 5-minute windows at minutes 60 and 120; and a 30-minute window from minute 155, covering the last 5 minutes of fixed load, maximal effort and cool-down.
Pulmonary gas exchange is measured breath-by-breath on a COSMED Quark CPET analyser with Omnia software, across four fixed windows per session: a 15-minute window covering seated rest, warm-up and the onset of exercise; two 5-minute windows during the fixed-intensity phase; and a 30-minute window beginning 5 minutes before the end of the fixed-intensity phase and running through the 20-minute maximal effort block and the 5-minute cool-down. The respiratory exchange ratio is calculated as carbon dioxide production divided by oxygen uptake and reported as the mean of each window. A lower ratio indicates a greater contribution of fat oxidation to energy provision. Unit: ratio.
Visits 2, 3 and 4 (weeks 3, 4 and 5): 15-minute window covering rest, warm-up and exercise onset; 5-minute windows at minutes 60 and 120; and a 30-minute window from minute 155, covering the last 5 minutes of fixed load, maximal effort and cool-down.
Substrate oxidation rate during exercise
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): 15-minute window covering rest, warm-up and exercise onset; 5-minute windows at minutes 60 and 120; and a 30-minute window from minute 155, covering the last 5 minutes of fixed load, maximal effort and cool-down.
Fat and carbohydrate oxidation rates are derived from oxygen uptake and carbon dioxide production measured breath-by-breath on a COSMED Quark CPET analyser, using stoichiometric equations, and are reported separately in the same unit as the mean of each of the four measurement windows described for the respiratory exchange ratio. This outcome tests whether exogenous ketosis shifts substrate preference toward fat oxidation during prolonged constant-load exercise, and characterizes the substrate mix sustaining the effort in each condition. Unit: grams per minute.
Visits 2, 3 and 4 (weeks 3, 4 and 5): 15-minute window covering rest, warm-up and exercise onset; 5-minute windows at minutes 60 and 120; and a 30-minute window from minute 155, covering the last 5 minutes of fixed load, maximal effort and cool-down.
Oxygen uptake during exercise
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): 15-minute window covering rest, warm-up and exercise onset; 5-minute windows at minutes 60 and 120; and a 30-minute window from minute 155, covering the last 5 minutes of fixed load, maximal effort and cool-down.
Oxygen uptake is measured breath-by-breath on a COSMED Quark CPET analyser, normalized to body mass and reported as the mean of each of the four measurement windows. Because external load during the fixed-intensity phase is individually prescribed and identical across conditions, differences in oxygen uptake between conditions reflect differences in exercise economy. Unit: millilitres per kilogram per minute.
Visits 2, 3 and 4 (weeks 3, 4 and 5): 15-minute window covering rest, warm-up and exercise onset; 5-minute windows at minutes 60 and 120; and a 30-minute window from minute 155, covering the last 5 minutes of fixed load, maximal effort and cool-down.

기타 결과 측정

결과 측정
측정값 설명
기간
Total work produced during the final 20 minutes of maximal effort
기간: Visits 2, 3 and 4 (weeks 3, 4 and 5): final 20 minutes of exercise.

Total mechanical work produced during the final 20-minute maximal effort block, calculated from power output recorded continuously by the cycle ergometer.

Unit: kilojoules

Visits 2, 3 and 4 (weeks 3, 4 and 5): final 20 minutes of exercise.

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

  • 수석 연구원: Joao P Floriano, University of Sao Paulo

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2025년 12월 18일

기본 완료 (추정된)

2028년 1월 1일

연구 완료 (추정된)

2029년 1월 1일

연구 등록 날짜

최초 제출

2026년 5월 6일

QC 기준을 충족하는 최초 제출

2026년 8월 25일

처음 게시됨 (실제)

2026년 8월 28일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 8월 28일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 8월 25일

마지막으로 확인됨

2026년 8월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • 76661423.6.0000.5659
  • 001 (Marta Eliza Miller Foundation)
  • 2023 (미국 NIH 보조금/계약: GRAMMY Museum Foundation)
  • 2023/11419-4 (기타 보조금/기금 번호: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP))

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

예

IPD 계획 설명

De-identified individual participant data (IPD) underlying the results reported in this study will be shared. This includes metabolic variables (e.g., blood lactate, glucose, ketone concentrations), physiological responses (e.g., VO₂, VCO₂, heart rate), performance outcomes, perceptual measures (RPE and gastrointestinal symptoms), and cognitive test results. All data will be fully anonymized, with removal of direct and indirect identifiers, ensuring that participants cannot be re-identified. Data dictionaries and variable descriptions will be provided to facilitate interpretation and reuse.

IPD 공유 기간

Data will be available beginning 6 months after publication of the primary results and will remain available for a period of 5 years. Supporting documents will be available within the same timeframe.

IPD 공유 액세스 기준

Access will be granted to qualified researchers who provide a methodologically sound research proposal. Requests must include study objectives, analysis plan, and evidence of institutional affiliation. Data will be shared under a data use agreement that prohibits re-identification of participants and limits use to the approved research purposes. Requests should be directed to the principal investigator. Data will be provided in a de-identified format via secure data transfer

IPD 공유 지원 정보 유형

  • 연구_프로토콜
  • 수액
  • ICF
  • CSR

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .