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A Pilot Study to Determine the Effect of a Cobiotic Formulation on the Gastrointestinal Microbiome

Primary Purpose

Pre Diabetic

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Placebo
NM504:
Sponsored by
NuMe Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Pre Diabetic focused on measuring microbiome, prebiotic, cobiotic, NM504, GI microbiome

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy male or female.
  • Stable body weight.
  • Stable body weight (+ 11 pounds) in the 3 months prior to the study. Between 18 and 70 years of age, inclusive.
  • BMI between 25 and 45 Kg/m2, inclusive. BMI is a measure of your height to weight ratio. (Body Mass Index).
  • Fasting blood glucose between 100 and 200 mg/dL, inclusive.

Exclusion Criteria:

  • Pregnant or nursing.
  • Diabetes or diseases of the liver, pancreas or gastrointestinal tract (except surgery like cholecystectomy, appendectomy or hiatus hernia repair).
  • Taking a medication for diabetes, or a medication like systemic glucocorticoids that can affect blood insulin, or a mediation like atypical antipsychotics that alters affect blood sugar or blood insulin, or a medication like atypical antipsychotics that alters body weight, or a medication like antibiotics that can change intestinal bacterial flora, or a medication that alters blood lipids.
  • Past history of Bariatric surgery.
  • Chronic use of proton pump inhibitors or bulk laxatives.
  • Active dependence on alcohol (>14 drinks/week) or illegal drugs.
  • following a weight loss regimen.
  • Body weight over 350 pounds (.160 kg).
  • Any chronic medication [for example: for treatment of conditions like hypothyroidism (like thyroxine), gout (like allopurinol) or hypertension (like propranolol)] that has not had a stable dose for 1 month or longer.

Sites / Locations

  • Pennington Biomedical Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Placebo Comparator:

NM504:

Arm Description

Celluose 10g - Matches the total dietary fiber content of NM504 as well as the color and taste. Subjects take 1 dose within 1h prior to either breakfast or lunch and a 2nd dose within 1h prior to the evening meal for 4 weeks.

Cobiotic formula of GRAS ingredients with a total dietary fiber content of 10g. Subjects take 1 dose within 1h prior to either breakfast or lunch and a 2nd dose within 1h prior to the evening meal for 4 weeks.

Outcomes

Primary Outcome Measures

Change in the ratio of Bacteroidetes to Firmicuites ratio in the stool comparing the baseline value to the completion of study value.
Abundance of 11 different genera that are characterized in lean and obese individuals will be quantitated and the ratio of abundance of those in the Bacteriodetes phylum to Firmicutes phylum will calculated.

Secondary Outcome Measures

Insulin sensitivity based on homeostasis model assessment (HOMA)
Fasting blood glucose and insulin levels will be used to calculate HOMA-IR (insulin resistance) and to estimate insulin sensitivity at baseline and at the completion of the study.
Fasting blood glucose
Weekly measurements of fasting blood glucose and serum insulin will be performed.
Body weight
Body weight will be monitored weekly.
Hunger perception
Visual analog scales to assess appetite and satiety will be used at weekly visits.
Meal tolerance test
A fixed meal will be consumed at 3 weeks. Visual analog scales (VAS) for appetite will be used to measure hunger before the meal. A VAS to assess satiety will be used at completion of the meal. Plasma ghrelin, PYY, GLP-1, glucose and insulin will be measured both before the meal and at 1 hour after consumption.
Clinical Chemistry
Blood will be obtained at baseline and after 4-weeks of treatment to measure lipids, high-sensitivity C-reactive protein (hsCRP) and glycosylated hemoglobin (HgbA1c).
Fecal profiling
Feces will be collected at baseline and after 4 weeks to measure pH, short chain fatty acids, pathogens, branched chain fatty acids and triglycerides to assess changes in the GI microbiome.
Insulin sensitivity based on Oral Glucose Tolerance Testing
An oral glucose tolerance test will be performed at baseline and at the completion of the study to estimate insulin sensitivity.
Mood
A standardized mood instrument will be used at baseline and at 4 weeks.
Gastrointestinal Symptoms
A survey to measure GI symptoms, changes in bowel habits and changes in stool characteristics will be performed on weekly visits for 4 weeks.

Full Information

First Posted
November 6, 2012
Last Updated
July 23, 2014
Sponsor
NuMe Health
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1. Study Identification

Unique Protocol Identification Number
NCT01724736
Brief Title
A Pilot Study to Determine the Effect of a Cobiotic Formulation on the Gastrointestinal Microbiome
Official Title
A Pilot Study to Determine the Effect of a Cobiotic Formulation on the Fecal Bacteroidetes: Firmicutes Ratio in Pre-Diabetic Subjects.
Study Type
Interventional

2. Study Status

Record Verification Date
July 2014
Overall Recruitment Status
Completed
Study Start Date
November 2012 (undefined)
Primary Completion Date
February 2014 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NuMe Health

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study aims to investigate the effect of a cobiotic formulation, prepared as a smoothie beverage, on the ratio of intestinal microbiota of the Bacteroidetes phylum to those of the Firmicutes phylum in the stool as well as the effect on insulin resistance, gut hormones (PYY) Peptide YY and (GLP-1) Glucagon-like Peptide, ghrelin with perceptions of appetite and satiety.
Detailed Description
Human gut microbiome appears to be involved in the regulation of metabolic processes, including digested food components, absorption of fat, metabolism of drugs, and conversion of indigestible foods or partially digested food ingredients to molecules that may signal physiological host mechanisms. The gut microbiome is a complex ecosystem of liquor or chime and microbiota. A change in that habitat may result in microbiota community shifts and consequential changes in brain-gut regulatory interactions. NM504 is a cobiotic formulation composed of 3 (generally recognized as safe; GRAS) food ingredients. One ingredient is a conventional prebiotic fiber. A second ingredient can be fermented but it also is included to change the viscosity of the biome while protecting the mucosal barrier. The 3rd ingredient is an antioxidant with poor bioavailability that alters the redox potential of the biome, selecting for some and against other microbiota growth. In a placebo-controlled double-blinded intervention this trial will investigate the effect of NM504 on the intestinal microbiota as well as markers of glucose regulation in 20 prediabetic adults. The intervention periods last 28 days. Examination of participants will happen at the beginning, weekly and at the end of intervention and will contain anthropometry; blood samples; fecal samples; oral glucose tolerance test; meal tolerance test; and scales to assess appetite, hunger, mood, and bowel habits.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pre Diabetic
Keywords
microbiome, prebiotic, cobiotic, NM504, GI microbiome

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo Comparator:
Arm Type
Placebo Comparator
Arm Description
Celluose 10g - Matches the total dietary fiber content of NM504 as well as the color and taste. Subjects take 1 dose within 1h prior to either breakfast or lunch and a 2nd dose within 1h prior to the evening meal for 4 weeks.
Arm Title
NM504:
Arm Type
Active Comparator
Arm Description
Cobiotic formula of GRAS ingredients with a total dietary fiber content of 10g. Subjects take 1 dose within 1h prior to either breakfast or lunch and a 2nd dose within 1h prior to the evening meal for 4 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Celluose 10g - Matches the total dietary fiber content of NM504 as well as the color and taste. Subjects take 1 dose within 1h prior to either breakfast or lunch and a 2nd dose within 1h prior to the evening meal for 4 weeks.
Intervention Type
Drug
Intervention Name(s)
NM504:
Intervention Description
Cobiotic formula of GRAS ingredients with a total dietary fiber content of 10g. Subjects take 1 dose within 1h prior to either breakfast or lunch and a 2nd dose within 1h prior to the evening meal for 4 weeks.
Primary Outcome Measure Information:
Title
Change in the ratio of Bacteroidetes to Firmicuites ratio in the stool comparing the baseline value to the completion of study value.
Description
Abundance of 11 different genera that are characterized in lean and obese individuals will be quantitated and the ratio of abundance of those in the Bacteriodetes phylum to Firmicutes phylum will calculated.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Insulin sensitivity based on homeostasis model assessment (HOMA)
Description
Fasting blood glucose and insulin levels will be used to calculate HOMA-IR (insulin resistance) and to estimate insulin sensitivity at baseline and at the completion of the study.
Time Frame
4 weeks
Title
Fasting blood glucose
Description
Weekly measurements of fasting blood glucose and serum insulin will be performed.
Time Frame
Weekly for 4 weeks
Title
Body weight
Description
Body weight will be monitored weekly.
Time Frame
Weekly for 4 weeks
Title
Hunger perception
Description
Visual analog scales to assess appetite and satiety will be used at weekly visits.
Time Frame
Weekly for 4 weeks
Title
Meal tolerance test
Description
A fixed meal will be consumed at 3 weeks. Visual analog scales (VAS) for appetite will be used to measure hunger before the meal. A VAS to assess satiety will be used at completion of the meal. Plasma ghrelin, PYY, GLP-1, glucose and insulin will be measured both before the meal and at 1 hour after consumption.
Time Frame
3 weeks
Title
Clinical Chemistry
Description
Blood will be obtained at baseline and after 4-weeks of treatment to measure lipids, high-sensitivity C-reactive protein (hsCRP) and glycosylated hemoglobin (HgbA1c).
Time Frame
4 weeks
Title
Fecal profiling
Description
Feces will be collected at baseline and after 4 weeks to measure pH, short chain fatty acids, pathogens, branched chain fatty acids and triglycerides to assess changes in the GI microbiome.
Time Frame
4 weeks
Title
Insulin sensitivity based on Oral Glucose Tolerance Testing
Description
An oral glucose tolerance test will be performed at baseline and at the completion of the study to estimate insulin sensitivity.
Time Frame
4 weeks
Title
Mood
Description
A standardized mood instrument will be used at baseline and at 4 weeks.
Time Frame
4 weeks
Title
Gastrointestinal Symptoms
Description
A survey to measure GI symptoms, changes in bowel habits and changes in stool characteristics will be performed on weekly visits for 4 weeks.
Time Frame
4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy male or female. Stable body weight. Stable body weight (+ 11 pounds) in the 3 months prior to the study. Between 18 and 70 years of age, inclusive. BMI between 25 and 45 Kg/m2, inclusive. BMI is a measure of your height to weight ratio. (Body Mass Index). Fasting blood glucose between 100 and 200 mg/dL, inclusive. Exclusion Criteria: Pregnant or nursing. Diabetes or diseases of the liver, pancreas or gastrointestinal tract (except surgery like cholecystectomy, appendectomy or hiatus hernia repair). Taking a medication for diabetes, or a medication like systemic glucocorticoids that can affect blood insulin, or a mediation like atypical antipsychotics that alters affect blood sugar or blood insulin, or a medication like atypical antipsychotics that alters body weight, or a medication like antibiotics that can change intestinal bacterial flora, or a medication that alters blood lipids. Past history of Bariatric surgery. Chronic use of proton pump inhibitors or bulk laxatives. Active dependence on alcohol (>14 drinks/week) or illegal drugs. following a weight loss regimen. Body weight over 350 pounds (.160 kg). Any chronic medication [for example: for treatment of conditions like hypothyroidism (like thyroxine), gout (like allopurinol) or hypertension (like propranolol)] that has not had a stable dose for 1 month or longer.
Facility Information:
Facility Name
Pennington Biomedical Research Center
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70808
Country
United States

12. IPD Sharing Statement

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A Pilot Study to Determine the Effect of a Cobiotic Formulation on the Gastrointestinal Microbiome

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