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Assessing Gut Microbiota Mediated Health Outcomes of Whole Wheat and Its Major Bioactive Components

Not Applicable
Active, not recruiting
Conditions
PreDiabetes
Dysbiosis
Endotoxemia
Inflammation
Interventions
Other: Whole Wheat Bread
Other: White Bread (control)
Registration Number
NCT05318183
Lead Sponsor
Ohio State University
Brief Summary

This study will investigate the gut microbiota-mediated effects of whole wheat consumption on human health in adults with pre-diabetes. Participants will complete two phases of intervention in random order in which they will consume either whole wheat bread (4 servings) or white bread a day for two weeks prior to collecting specimens (stool, urine, and plasma/serum).

Detailed Description

Accumulating clinical evidence suggests positive effects of whole grain on cardiometabolic risk. However, outcomes of controlled trials indicate that substantial interpersonal variation occurs in these studies with regard to glucose homeostasis, with some persons being unaffected and others experiencing glucose-lowering effects due to whole wheat bread consumption. Whole grain (whole wheat) contains bioactive phytochemicals in addition to its well-recognized fiber content, and these constituents have not received adequate study to inform dietary recommendations. The objective of this study is to investigate the glucose-lowering effects of whole wheat bread in persons with prediabetes using multi-omics platforms that can provide an understanding of the complex interactions among the gut microbiome, gut metabolome, host metabolome, and gut barrier function. The hypothesis is that gut microbial metabolism of whole wheat and its major bioactive components is a determining factor of human health benefits. This will be tested by conducting a randomized, controlled crossover trial in persons with pre-diabetes who follow a controlled diet containing whole wheat bread or white bread for 2-weeks. Outcomes are expected to significantly advance an understanding of personalized, gut microbiome-mediated approaches in individuals with pre-diabetes to help guide dietary recommendations of whole wheat intake. In addition, novel evidence that maps out the differential functions of diverse genus/species of microbiota to biotransform whole wheat nutrients into more bioactive metabolites are expected.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Fasting blood glucose between 100-125 mg/dL
  • BMI of 30-35 kg/m2
Exclusion Criteria
  • History of liver disease, cardiovascular disease, overt diabetes, or cancer
  • Prescribed medications for hyperglycemia or dyslipidemia
  • Use of dietary supplements, prebiotics, or probiotics
  • Usage of antibiotics or anti-fungals within 3 months prior to enrollment
  • Smoker
  • Alcohol consumption greater than 2 drinks per day
  • Aerobic exercise greater than 5 hours per week
  • Pregnancy or fertility treatments
  • History of chronically active inflammatory or neoplastic disease in 3 years prior to enrollment
  • History of chronic gastrointestinal disorder including diarrhea, inflammatory bowel disease, celiac disease; coagulation disorders, chronic immunosuppressive medication usage
  • History of myocardial infarction or cerebrovascular accident within 6 months prior to participation

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Whole Wheat BreadWhole Wheat BreadParticipants consuming 128 g of whole wheat bread (4 slices of bread) daily for two weeks
White Bread (control)White Bread (control)Participants consuming 128 g of white bread (4 slices of bread) daily for two weeks
Primary Outcome Measures
NameTimeMethod
Change in fasting plasma glucoseDay 0, Day 14

Fasting plasma glucose concentrations (mg/dL) will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Secondary Outcome Measures
NameTimeMethod
Change in insulin sensitivityDay 14

Evaluated through an oral glucose tolerance test and quantified using the area under the curve (AUC) of the temporal changes in blood glucose and insulin conducted at the end of each intervention arm to assess between-treatment effects.

Level of myeloid differentiation factor 88 gene expressionDay 0, Day 14

Expression of pro-inflammatory myeloid differentiation factor 88 gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Change in plasma insulinDay 0, Day 14

Plasma concentration (μIU/mL) of insulin will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Small gastrointestinal permeabilityDay 14

Lactulose/mannitol ratio will be measured in urine collected 0-5 h following the digestion of non-digestible sugar probes to assess small intestinal permeability. Excretion ratios will be measured at the end of each intervention arm to assess between-treatment effects.

Metabolic EndotoxemiaDay 0, Day 14

Serum endotoxin concentration (EU/mL) will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Level of tumor necrosis factor alpha gene expressionDay 0, Day 14

Expression of pro-inflammatory tumor necrosis factor alpha gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Level of interleukin-8 gene expressionDay 0, Day 14

Expression of pro-inflammatory interleukin-8 gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Colonic gastrointestinal permeabilityDay 14

Sucralose/erythritol ratio will be measured in urine collected 6-24 h following digestion of non-digestible sugar probes to access colonic permeability. Excretion ratios will be measured at the end of each intervention arm to assess between-treatment effects.

Level of toll-like receptor 4 gene expressionDay 0, Day 14

Expression of pro-inflammatory toll-like receptor 4 gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Serum myeloperoxidaseDay 0, Day 14

Serum concentration (ng/mL) of myeloperoxidase will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Level of p65 subunit of nuclear factor kappa B gene expressionDay 0, Day 14

Expression of pro-inflammatory p65 subunit of nuclear factor kappa B gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Level of interleukin-6 gene expressionDay 0, Day 14

Expression of pro-inflammatory interleukin-6 gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Level of myeloperoxidase gene expressionDay 0, Day 14

Expression of pro-inflammatory myeloperoxidase gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Fecal short-chain fatty acid: isovaleric acidDay 0, Day 14

Fecal concentrations (mmol/kg) of isovaleric acid will be measured in samples collected at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Level of monocyte chemoattractant protein-1 gene expressionDay 0, Day 14

Expression of pro-inflammatory monocyte chemoattractant protein-1 gene from peripheral blood mononuclear cells will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Serum whole wheat bread phytochemical: phenolic compoundsDay 0, Day 14

Serum concentrations of (nmol/L) phenolic compounds and phenolic derivatives will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Intestinal whole wheat phytochemical: benoxazinoidsDay 0, Day 14

Fecal concentrations of (μmol/L) benoxazinoids and benoxazinoids derivatives will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Intestinal whole wheat phytochemical: phenolic compoundsDay 0, Day 14

Fecal concentrations of (μmol/L) phenolic compounds and phenolic derivatives will be measured at the beginning and end of each intervention arm to assess within-treatment and between treatment effects.

Fecal calprotectinDay 0, Day 14

Fecal concentration (μg/g) of calprotectin will be measured in samples collected and the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Fecal myeloperoxidaseDay 0, Day 14

Fecal concentration (ng/g) of myeloperoxidase will be measured in samples collected at the beginning and end of each study arm to assess within-treatment and between-treatment effects.

Fecal short-chain fatty acid: butyrateDay 0, Day 14

Fecal concentrations (mmol/kg) of butyrate will be measured in samples collected at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Fecal short-chain fatty acid: acetateDay 0, Day 14

Fecal concentrations (mmol/kg) of acetate will be measured in samples collected at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Fecal short-chain fatty acid: propionateDay 0, Day 14

Fecal concentrations (mmol/kg) of propionate will be measured individually in samples collected at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Fecal short-chain fatty acid: isobutyric acidDay 0, Day 14

Fecal concentrations (mmol/kg) of isobutyric acid will be measured in samples collected at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Serum whole wheat bread phytochemical: alkylersorcinolsDay 0, Day 14

Serum concentrations of (nmol/L) alkylresorcinol and alkylresorcinol derivatives will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Serum whole wheat bread phytochemical: benoxazinodsDay 0, Day 14

Serum concentrations of (nmol/L) benoxazinoids and benoxazinoids derivatives will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Intestinal whole wheat phytochemical: alkylresorcinolsDay 0, Day 14

Fecal concentrations of (μmol/L) alkylresorcinols and alkylresorcinol derivatives will be measured at the beginning and end of each intervention arm to assess within-treatment and between-treatment effects.

Trial Locations

Locations (1)

The Ohio State University

🇺🇸

Columbus, Ohio, United States

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