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Nitrate Supplementation and Cerebrovascular and Cognitive Function in Metabolic Syndrome

Primary Purpose

Metabolic Syndrome

Status
Recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Beetroot Juice - Active
beetroot juice - Placebo
Sponsored by
Penn State University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Metabolic Syndrome focused on measuring Cognition

Eligibility Criteria

55 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

MetS classification according to NCEP III definition - MetS group only … at least 3 of the 5 components Individuals with a waist circumference >102 cm (40 in) for men > 88 cm for women Triglycerides ≥150 mg/dL HDL cholesterol ≤ 50 mg/dL for women and ≤ 40 mg/dL for men Blood pressure ≥130/85 mmHg Fasting blood glucose ≥100 mg/dL Age 55-75 Men and women All races and ethnicities

Exclusion Criteria:

  1. Individuals with any overt cardiovascular, hematologic, pulmonary, renal, musculoskeletal, and/or neurological disease(s).
  2. Premenopausal women - indicated by mention of last menstrual cycle
  3. Individuals with active cancer
  4. Individuals with moderate/severe depressive disorder as indicated by BDI-II scores (BDI-II score >14)
  5. Individuals with cognitive impairment as indicated by the MMSE (score on the MMSE < 24)
  6. Individuals with visual impairment
  7. Users of any tobacco and/or nicotine products (smokers, chewing tobacco, nicotine-containing patches/gum, smokeless cigarettes)
  8. Individuals taking hormone replacement
  9. Taking following an of the following medications:

    1. nitrates (e.g. nitroglycerin) for angina
    2. phosphodiesterase inhibitors (e.g., Viagra)
    3. anti-Inflammatory drugs

Sites / Locations

  • Penn State University, Noll LabRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Metabolic Syndrome Older Adult

Metabolic Syndrome Older Adult - Placebo juice condition

Arm Description

Participants with metabolic syndrome will be drinking nitrate rich beetroot juice from the James White Beet It company. Participants will drink one dose of 140mL beetroot juice for two visits of either a nitrate rich juice or a nitrate depleted placebo drink. Both drinks taste and smell the same, just with the active component removed. Following these visits, participants will drink 70ml of nitrate rich beetroot juice daily for 4 weeks to investigate long term effects of the juice on study outcomes.

Participants with metabolic syndrome will be drinking nitrate rich beetroot juice from the James White Beet It company. Participants will drink one dose of 140mL beetroot juice for two visits of either a nitrate rich juice or a nitrate depleted placebo drink. Both drinks taste and smell the same, just with the active component removed. Following these visits, participants will drink 70ml of nitrate rich beetroot juice daily for 4 weeks to investigate long term effects of the juice on study outcomes.

Outcomes

Primary Outcome Measures

Cognitive Functioning - Change in N-back test performance
Reaction time of responses for each trial type (0-back, 1-back, 2-back, and 3-back)
Cognitive Functioning - Change in N-back test performance
Percent accuracy of correct responses for each trial type (0-back, 1-back, 2-back, and 3-back)
Changes in Cerebral Autoregulation - NIRx (fNIRS/cerebral oxygenation) and finapres (blood pressure) derived waveforms for transfer function analysis
This outcome will be measured using non-invasive methodology utilizing fNIRS and will involve rhythmic breathing to determine the relation between blood pressure and an index of blood flow. The variable of interest is the phase derived from transfer function analysis of the blood pressure and fNIRS waveforms.
Changes in Neurovascular Coupling - changes in fNIRS signals during the N-back cognitive test
This outcome will also be measured using fNIRS and will involve measurement of brain oxygenation during cognitive assessment. The variable of interest will be changes in fNIRS oxyhemoglobin and deoxyhemoglobin signals (% change from baseline) during the cognitive assessment (n-back test).

Secondary Outcome Measures

Changes in Pulse Wave Velocity - Colin Cardiovascular Profiling System 2000
Participants will have arterial stiffness (cm/s) assessed at certain time points to determine if beetroot juice impacts this outcome
Taste Profile of Juice (Sweetness, Bitterness, and Sourness) - Questionnaire developed in our lab
A survey questionnaire will be used to characterize participants perception and thoughts on the beetroot juice which will help determine the potential clinical translation of beetroot juice in this population. This scale will be 1-10 and a higher score indicates more of that taste.

Full Information

First Posted
August 26, 2022
Last Updated
January 13, 2023
Sponsor
Penn State University
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1. Study Identification

Unique Protocol Identification Number
NCT05532423
Brief Title
Nitrate Supplementation and Cerebrovascular and Cognitive Function in Metabolic Syndrome
Official Title
Effect of Nitrate Supplementation on Cerebrovascular Function and Cognitive Function in Older Adults With Metabolic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 1, 2022 (Actual)
Primary Completion Date
April 2024 (Anticipated)
Study Completion Date
April 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Penn State University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if beetroot juice consumption can improve cognitive performance and brain vascular function in individuals with metabolic syndrome
Detailed Description
Metabolic syndrome is a preclinical state that is related to increased risk of cardiovascular and metabolic disease. The purpose of this study is to determine if beetroot juice consumption can improve cognitive performance and brain vascular function in individuals with metabolic syndrome. The first part of this study will aim to determine if people with metabolic syndrome present with poorer brain vascular function and cognitive performance relative to older adults without metabolic syndrome. The second part of this study aims to determine whether brain vascular functions and cognitive function can be improved with beetroot juice. Cognitive function is highly related to the ability of the brain to deliver blood to specific regions of the brain. The brain has many blood vessels and relies on a healthy and intact vascular system to optimally perform. With aging and disease risk factors that relate to metabolic syndrome, cognition and brain function and structure decline at a more rapid pace. These changes may directly impact quality of life, financial burden, and independence. Therefore, determining the cognitive and brain functional changes that occur due to metabolic syndrome is an important clinical and scientific question. This research study will assess whether dietary nitrate, in the form of beetroot juice, can improve brain blood vessel function and cognition in adults with metabolic syndrome. Beetroot juice has a high content of dietary nitrate, which has known beneficial effects on blood vessel function and blood pressure. With aging and disease risk factors, you lose the ability to dilate the blood vessels, reducing how much blood can get to the brain. Providing dietary nitrate in the form of beetroot juice may help improve blood vessel dilation and cognitive function in individuals with metabolic disease risk factors. Additionally, intervening during metabolic syndrome, before disease progresses to cardiovascular disease and diabetes, is optimal to minimize the long-term effects on cognition and brain health.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome
Keywords
Cognition

7. Study Design

Primary Purpose
Prevention
Study Phase
Early Phase 1
Interventional Study Model
Crossover Assignment
Model Description
The design is a single group randomized crossover trial, with individuals with metabolic syndrome receiving both the active nitrate rich juice and the placebo juice, randomized in order.
Masking
ParticipantInvestigator
Masking Description
As it is a double blind study, participants and investigators for this study will be blinded to the intervention they are receiving.
Allocation
Randomized
Enrollment
25 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Metabolic Syndrome Older Adult
Arm Type
Experimental
Arm Description
Participants with metabolic syndrome will be drinking nitrate rich beetroot juice from the James White Beet It company. Participants will drink one dose of 140mL beetroot juice for two visits of either a nitrate rich juice or a nitrate depleted placebo drink. Both drinks taste and smell the same, just with the active component removed. Following these visits, participants will drink 70ml of nitrate rich beetroot juice daily for 4 weeks to investigate long term effects of the juice on study outcomes.
Arm Title
Metabolic Syndrome Older Adult - Placebo juice condition
Arm Type
Experimental
Arm Description
Participants with metabolic syndrome will be drinking nitrate rich beetroot juice from the James White Beet It company. Participants will drink one dose of 140mL beetroot juice for two visits of either a nitrate rich juice or a nitrate depleted placebo drink. Both drinks taste and smell the same, just with the active component removed. Following these visits, participants will drink 70ml of nitrate rich beetroot juice daily for 4 weeks to investigate long term effects of the juice on study outcomes.
Intervention Type
Drug
Intervention Name(s)
Beetroot Juice - Active
Other Intervention Name(s)
Experimental
Intervention Description
Participants with Metabolic syndrome will drink 140mL of organic nitrate rich beetroot juice from the James White Beet It Company. This juice will be the active juice, meaning it has the high nitrate content that is of interest. This drink will be given two 70 mL bottles of the juice that will be blinded to them and investigators.
Intervention Type
Drug
Intervention Name(s)
beetroot juice - Placebo
Other Intervention Name(s)
Placebo
Intervention Description
Participants with Metabolic syndrome will drink 140mL of organic nitrate rich beetroot juice from the James White Beet It Company. This drink will be the placebo drink, which means all of the nitrate has been extracted, however it tastes and smells the same as the active drink. This drink will be given two 70 mL bottles of the juice that will be blinded to them and investigators.
Primary Outcome Measure Information:
Title
Cognitive Functioning - Change in N-back test performance
Description
Reaction time of responses for each trial type (0-back, 1-back, 2-back, and 3-back)
Time Frame
At Baseline, 90 minutes following drinking the beetroot juice (single 140mL acute dose), 90 minutes following drinking the placebo drink (single 140mL acute dose), and after 4 weeks of daily (70mL) beetroot juice consumption
Title
Cognitive Functioning - Change in N-back test performance
Description
Percent accuracy of correct responses for each trial type (0-back, 1-back, 2-back, and 3-back)
Time Frame
At Baseline, 90 minutes following drinking the beetroot juice (single 140mL acute dose), 90 minutes following drinking the placebo drink (single 140mL acute dose), and after 4 weeks of daily (70mL) beetroot juice consumption
Title
Changes in Cerebral Autoregulation - NIRx (fNIRS/cerebral oxygenation) and finapres (blood pressure) derived waveforms for transfer function analysis
Description
This outcome will be measured using non-invasive methodology utilizing fNIRS and will involve rhythmic breathing to determine the relation between blood pressure and an index of blood flow. The variable of interest is the phase derived from transfer function analysis of the blood pressure and fNIRS waveforms.
Time Frame
At Baseline, 90 minutes following drinking the beetroot juice (single 140mL acute dose), 90 minutes following drinking the placebo drink (single 140mL acute dose), and after 4 weeks of daily (70mL) beetroot juice consumption
Title
Changes in Neurovascular Coupling - changes in fNIRS signals during the N-back cognitive test
Description
This outcome will also be measured using fNIRS and will involve measurement of brain oxygenation during cognitive assessment. The variable of interest will be changes in fNIRS oxyhemoglobin and deoxyhemoglobin signals (% change from baseline) during the cognitive assessment (n-back test).
Time Frame
At Baseline, 90 minutes following drinking the beetroot juice (single 140mL acute dose), 90 minutes following drinking the placebo drink (single 140mL acute dose), and after 4 weeks of daily (70mL) beetroot juice consumption
Secondary Outcome Measure Information:
Title
Changes in Pulse Wave Velocity - Colin Cardiovascular Profiling System 2000
Description
Participants will have arterial stiffness (cm/s) assessed at certain time points to determine if beetroot juice impacts this outcome
Time Frame
At Baseline, 90 minutes following drinking the beetroot juice (single 140mL acute dose), 90 minutes following drinking the placebo drink (single 140mL acute dose), and after 4 weeks of daily (70mL) beetroot juice consumption
Title
Taste Profile of Juice (Sweetness, Bitterness, and Sourness) - Questionnaire developed in our lab
Description
A survey questionnaire will be used to characterize participants perception and thoughts on the beetroot juice which will help determine the potential clinical translation of beetroot juice in this population. This scale will be 1-10 and a higher score indicates more of that taste.
Time Frame
This will be taken one time, at the last study visit after 4 weeks of juice consumption

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: MetS classification according to NCEP III definition - MetS group only … at least 3 of the 5 components Individuals with a waist circumference >102 cm (40 in) for men > 88 cm for women Triglycerides ≥150 mg/dL HDL cholesterol ≤ 50 mg/dL for women and ≤ 40 mg/dL for men Blood pressure ≥130/85 mmHg Fasting blood glucose ≥100 mg/dL Age 55-75 Men and women All races and ethnicities Exclusion Criteria: Individuals with any overt cardiovascular, hematologic, pulmonary, renal, musculoskeletal, and/or neurological disease(s). Premenopausal women - indicated by mention of last menstrual cycle Individuals with active cancer Individuals with moderate/severe depressive disorder as indicated by BDI-II scores (BDI-II score >14) Individuals with cognitive impairment as indicated by the MMSE (score on the MMSE < 24) Individuals with visual impairment Users of any tobacco and/or nicotine products (smokers, chewing tobacco, nicotine-containing patches/gum, smokeless cigarettes) Individuals taking hormone replacement Taking following an of the following medications: nitrates (e.g. nitroglycerin) for angina phosphodiesterase inhibitors (e.g., Viagra) anti-Inflammatory drugs
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jigar Gosalia, M.S.
Phone
5168161654
Email
jzg691@psu.edu
First Name & Middle Initial & Last Name or Official Title & Degree
David Proctor, Ph.D.
Phone
814-863-0724
Email
dnp3@psu.edu
Facility Information:
Facility Name
Penn State University, Noll Lab
City
University Park
State/Province
Pennsylvania
ZIP/Postal Code
16802
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jigar Gosalia
Phone
516-816-1654
Email
jzg691@psu.edu

12. IPD Sharing Statement

Learn more about this trial

Nitrate Supplementation and Cerebrovascular and Cognitive Function in Metabolic Syndrome

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