Saturated Fat Versus Monounsaturated Fat and Insulin Action

This study is currently recruiting participants. (see Contacts and Locations)
Verified May 2014 by University of Vermont
Sponsor:
Information provided by (Responsible Party):
Craig Lawrence Kien, University of Vermont
ClinicalTrials.gov Identifier:
NCT01612234
First received: May 29, 2012
Last updated: May 19, 2014
Last verified: May 2014
  Purpose

High intakes of saturated fat are associated with diabetes. Our work has shown that the two most common fatty acids in the North American diet, palmitic acid (saturated fat) and oleic acid (monounsaturated fat) are metabolized differently and have opposite effects on fat burning. The proposed study will examine biochemical and molecular mechanisms for how a high saturated fat diet versus a low saturated fat/high monounsaturated fat diet alters the action of the hormone, insulin, in skeletal muscle.


Condition Intervention
Obesity
Dietary Supplement: High palmitate or high oleate diet.

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Palmitate Metabolism and Insulin Resistance

Resource links provided by NLM:


Further study details as provided by University of Vermont:

Primary Outcome Measures:
  • Whether increased palmitate balance (as measured by intake and the rate of [1-13C]-PA oxidation) causes increased insulin resistance and increased inflammatory signaling by peripheral blood mononuclear cells [ Time Frame: up to 4 yr ] [ Designated as safety issue: No ]
    Insulin sensitivity, inflammatory signaling, palmitate balance, and incomplete oxidation of palmitate in lean and obese young adults.


Secondary Outcome Measures:
  • We will examine the link between palmitate intake and balance and oxidative stress measured using muscle and peripheral blood markers of oxidative stress and antioxidant responses. [ Time Frame: up to 4 yr ] [ Designated as safety issue: No ]
    activation of c-Jun N-terminal kinase (JNK) and heme oxygenase 1 in skeletal muscle in response to the diets.


Estimated Enrollment: 32
Study Start Date: April 2010
Estimated Study Completion Date: December 2015
Estimated Primary Completion Date: December 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: High palmitate or high oleate diet.
This is a solid food diet in which vegetable oils are used to create a dietary fat composition similar to the average American/Western diet in which palmitic and oleic acid are ingested in approximately equal amounts (high palmitate diet) or a composition similar to the Mediterranean Diet (low palmitate, high oleate, using hazelnut oil as the source of fat). There are no interventions other than the diet itself.
Dietary Supplement: High palmitate or high oleate diet.
High palmitate diet composition: Fat, 40.4% kcal; palmitic acid, 16.0% kcal; oleic acid,16.2% kcal. High oleate diet composition: Fat, 40.1% kcal; palmitic acid, 2.4% kcal; oleic acid, 28.8% kcal
Experimental: high palmitate or high oleate diet
This is a solid food diet in which vegetable oils are used to create a dietary fat composition similar to the average American/Western diet in which palmitic and oleic acid are ingested in approximately equal amounts (high palmitate diet) or a composition similar to the Mediterranean Diet (low palmitate, high oleate, using hazelnut oil as the source of fat). There are no interventions other than the diet itself.
Dietary Supplement: High palmitate or high oleate diet.
High palmitate diet composition: Fat, 40.4% kcal; palmitic acid, 16.0% kcal; oleic acid,16.2% kcal. High oleate diet composition: Fat, 40.1% kcal; palmitic acid, 2.4% kcal; oleic acid, 28.8% kcal

Detailed Description:

Palmitic acid (PA), impairs insulin sensitivity in skeletal muscle, and replacing PA in the diet with oleic acid (OA), a monounsaturated fatty acid (FA), may be beneficial. The first objective of this project is to understand the effects on lipid metabolism and skeletal muscle lipid composition, insulin signaling, and inflammatory signaling of two common variations in FA composition of the diet: (1) The typical intake of North America where PA and OA are present in equal proportions (HI PA diet). (2) The Mediterranean FA composition in which PA is much lower and OA much higher (HI OA diet). PA may induce insulin resistance in skeletal muscle cells via its accumulation in lipids within muscle cells and via activation of inflammatory signaling. The second objective of this project is to assess the hypothesis that a high intake of PA will down-regulate its own one-carbon (initial) oxidation, leading to increased inflammatory signaling and decreased insulin signaling. However, there is literature evidence that FA may induce defects in insulin signaling, if FA are not completely oxidized; therefore, the third objective is to assess the hypotheses that a high PA diet may decrease complete oxidation of FA and possibly accelerate initial FA oxidation. A double-masked, cross-over trial of the effects of a high PA diet versus a high OA/low PA diet in 16 overweight or obese subjects and 16 lean subjects (aged 18 - 40 yr) will be conducted to investigate the following Specific Aims:

  1. To test the hypothesis that increased intake of PA will cause a decreased rate of [1-13C]-PA oxidation and will be associated with: (a) increased inflammatory signaling, within the muscle and by peripheral blood mononuclear cells; (b) Decreased insulin signaling as characterized by decreased, whole body, peripheral insulin sensitivity (euglycemic/hyperinsulinemic clamp) and, in skeletal muscle, decreased phospho-AKT (Ser473), increased phospho-IRS-1 (Ser636/Ser639), decreased tyrosine phosphorylation of IRS-1, and decreased membrane content of GLUT4.
  2. To test the hypothesis that increased intake of PA will cause less complete mitochondrial fatty acid oxidation, perhaps associated with dysfunction of the TCA cycle and increased reactive oxygen species formation. This hypothesis will be tested by measuring whole body and muscle (upper limb) relative rates of oxidation of [13-13C]-PA and [1-13C]-PA and by determining the serum profile of acylcarnitines, the urine concentrations of organic acids, and muscle concentrations of protein carbonyls.
  3. To test the hypothesis that a high PA diet will lead to less complete oxidation of FA, less insulin signaling in skeletal muscle in response to a test meal, less whole body insulin sensitivity, increased dysfunction of the TCA cycle, and greater reactive oxygen species formation compared to the results obtained in obese versus lean humans.
  Eligibility

Ages Eligible for Study:   18 Years to 40 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • healthy young adults,
  • 18 - 40 years of age

Exclusion Criteria:

  • regular aerobic exercise training,
  • dyslipidemia, and
  • type 2 diabetes or insulin resistance
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01612234

Contacts
Contact: David Ebenstein, B.A, M.S. 802-656-9093 David.Ebenstein@uvm.edu
Contact: Karen I. Crain, B.A. 802-656-9093 Karen.Crain@uvm.edu

Locations
United States, Vermont
The Unversity of Vermont Clinical Research Center at Fletcher Allen Health Care Recruiting
Burlington, Vermont, United States, 05401
Contact: David Ebenstein, B.A., M.S.    802-656-9093    David.Ebenstein@uvm.edu   
Contact: Karen I. Crain, B.A.    (802) 656-9093    Karen.Crain@uvm.edu   
Principal Investigator: Craig L. Kien, M.D., Ph.D.         
Sponsors and Collaborators
University of Vermont
Investigators
Principal Investigator: Craig L. Kien, M.D, Ph.D. The University of Vermont
  More Information

Additional Information:
Publications:
Responsible Party: Craig Lawrence Kien, The Mary Kay Davignon Green and Gold Professor, Depts. of Pediatrics and Medicine, University of Vermont
ClinicalTrials.gov Identifier: NCT01612234     History of Changes
Other Study ID Numbers: R01DK082803
Study First Received: May 29, 2012
Last Updated: May 19, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by University of Vermont:
humans
lean
obese
saturated fat
monounsaturated fat
insulin sensitivity
inflammation
oxidant stress

Additional relevant MeSH terms:
Insulin
Hypoglycemic Agents
Pharmacologic Actions
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on October 30, 2014