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Investigation of the Gut Microbiota in Regulating Nutrient Absorption in Humans

Phase 2
Completed
Conditions
Obesity
Interventions
Drug: Placebo oral tablet
Other: Overfeeding diet (OF)
Other: Underfeeding diet (UF)
Registration Number
NCT02037295
Lead Sponsor
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Brief Summary

We propose to study both stool and urine energy loss in 24 individuals on two experimental diets (50% increased and 50% reduced nutrient load relative to body size) in a random cross-over design. Following this over/underfeeding, volunteers will also be randomly assigned to a placebo versus oral antibiotic medication arm. This study will extend our previous findings by investigating whether 1) nutrient absorption changes upon similar increases/decreases in relative nutrient load and 2) whether manipulation of gut microbial communities with antibiotics alters nutrient absorption and 3) how these changes may affect glucose tolerance and fat storage.

Detailed Description

The prevalence of obesity has risen to epidemic proportions in the world, resulting from both excessive energy intake and low levels of energy expenditure. The effect of nutrient absorption on energy balance, that is, the relative amount of nutrients consumed vs. the amount excreted in stool, has been reported only in small studies in which energy waste in feces and urine between lean and obese individuals was not found to be different. New studies have shown that bacteria in the gut may play an important role in calorie absorption. We have recently shown that leaner individuals absorbed more calories when overfed compared to when they were given a diet with just enough calories to maintain their own weight. Our studies have also found that overfeeding also changes the kinds of bacteria found in the gut. In lean individuals, these changes in gut bacterial communities with overfeeding were associated with changes in how many calories were absorbed. Our results are similar to those seen in other studies in animals and humans that suggest a role for gut bacteria in weight gain and obesity. To try to better understand the role of gut bacteria in absorbing food, we propose to investigate 1) whether energy loss (as measured in stool and urine) changes following over- and underfeeding relative to body size and 2) whether changes in the gut bacteria, induced by an antibiotic medication, affect nutrient absorption and glucose tolerance. We plan to study 24 healthy non-smoking volunteers age 18 45 years old, not taking any medications (including medications for weight loss, antibiotics or probiotics) for the examination. All participants will be admitted to the Clinical Research Unit for 31 days. During their stay, subjects will be fed a weight maintaining diet for 3 days, followed by two experimental diets (150% and 50% of weight maintaining calories) in a random order. After this, volunteers will be randomly assigned to one of two groups: group 1 will take oral antibiotic medication; group 2 will receive pills that look the same but will not contain any active medication (placebos). Feces (stool) will be collected throughout the study. Additionally, twenty four-hour urine collections will take place each day of the experimental diet period and when stool is collected on the antibiotics. The energy content of these waste products as well as that of the diet (using duplicate plate analysis) will be measured by bomb calorimetry. Bacterial components in feces will be extracted by repeated fractional centrifugation to obtain bacterial mass and by using 16S rDNA-based oligonucleotide probes to obtain data on gut bacteria. Primary results will examine how many calories remain in stool during relative over- and underfeeding and whether changes in gut bacteria, induced by an antibiotic medication, affect nutrient absorption and glucose tolerance.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
27
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
OF_UF VancomycinOverfeeding diet (OF)Healthy volunteers assigned overfeeding diet, underfeeding diet, and then vancomycin
OF_UF VancomycinUnderfeeding diet (UF)Healthy volunteers assigned overfeeding diet, underfeeding diet, and then vancomycin
OF_UF PlaceboPlacebo oral tabletHealthy volunteers assigned overfeeding diet, underfeeding diet, and then placebo
OF_UF PlaceboOverfeeding diet (OF)Healthy volunteers assigned overfeeding diet, underfeeding diet, and then placebo
OF_UF PlaceboUnderfeeding diet (UF)Healthy volunteers assigned overfeeding diet, underfeeding diet, and then placebo
UF_OF VancomycinVancomycinHealthy volunteers assigned underfeeding diet, overfeeding diet, and then vancomycin
UF_OF VancomycinOverfeeding diet (OF)Healthy volunteers assigned underfeeding diet, overfeeding diet, and then vancomycin
UF_OF VancomycinUnderfeeding diet (UF)Healthy volunteers assigned underfeeding diet, overfeeding diet, and then vancomycin
UF_OF PlaceboPlacebo oral tabletHealthy volunteers assigned underfeeding diet, overfeeding diet, and then placebo
UF_OF PlaceboOverfeeding diet (OF)Healthy volunteers assigned underfeeding diet, overfeeding diet, and then placebo
UF_OF PlaceboUnderfeeding diet (UF)Healthy volunteers assigned underfeeding diet, overfeeding diet, and then placebo
OF_UF VancomycinVancomycinHealthy volunteers assigned overfeeding diet, underfeeding diet, and then vancomycin
Primary Outcome Measures
NameTimeMethod
Stool Calories During OF and UFDays 5-7 and 11-13

Calculated as stool calories (kcal/day) x 100/ingested calories (kcal/day)

Stool Calories During Vancomycin and PlaceboDays 23-25

Calculated as stool calories (kcal/day) x 100/ingested calories (kcal/day), vancomycin compared to placebo

Secondary Outcome Measures
NameTimeMethod
Urine Calories During OF and UFDays 5-7 and 11-13

Calculated as urine calories (kcal/day) x 100/ingested calories (kcal/day)

Urine Calories During Vancomycin and PlaceboDays 23-25

Calculated as urine calories (kcal/day) x 100/ingested calories (kcal/day), vancomycin compared to placebo

Change in 2 Hour Glucose Tolerance From Day 16 to Day 28 During Vancomycin and PlaceboDay 16 and day 28

A 75-g 2 hour oral glucose tolerance test (OGTT) was performed on days 16 and 28, before and after treatment with vancomycin or placebo.

Overall Gut Microbial Colonization During OF and UFDays 5-7 and 11-13

qPCR-based quantification of 16S rRNA gene copies per gram wet weight (log10)

Overall Gut Microbial Colonization During Vancomycin and PlaceboDays 23-25

qPCR-based quantification of 16S rRNA gene copies per gram wet weight (log10)

Trial Locations

Locations (1)

NIDDK, Phoenix

🇺🇸

Phoenix, Arizona, United States

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