Effect of High Caloric Diet on Brain Insulin Sensitivity and Inflammation

• ClinicalTrials.gov Identifier: NCT03590561
• Recruitment Status: Completed
• First Posted: July 18, 2018
• Last Update Posted: May 20, 2020
• Sponsor: University Hospital Tuebingen
• Information provided by (Responsible Party): University Hospital Tuebingen

Study Description

Brief Summary:

Obesity if known to be associated with brain insulin resistance in humans and evidence is rapidly accumulating that brain insulin resistance influences peripheral metabolism, eating behavior and cognition. A reduced insulin response in the brain is found mainly in people with a metabolically unfavorable fat distribution - high visceral fat. Visceral fat produces inflammatory mediators and elevated inflammatory levels are closely linked to insulin resistance. Inflammation of the brain (i.e., neuroinflammation) has been proposed as a possible cause of brain insulin resistance. Interestingly, rodent models of a high calorie diet show that these inflammatory mechanisms occur rapidly in the brain, even prior to weight gain of the animals. Among other things, it has been shown in humans that a short-term increase in calories, especially carbohydrates and fats, reduces insulin sensitivity in the body and increases inflammatory parameters in the blood. Whether a high-calorie diet triggers insulin resistance or inflammation in the human brain is currently unknown.

Aim of study:

The aim of the study is to investigate the effects of a five-day high calorie diet in healthy young male volunteers on peripheral and brain insulin sensitivity as well as on eating behavior, mood and cognition. Brain insulin sensitivity, peripheral metabolism and different behavioral assessments will be evaluated before, 1 week and 2 weeks after high caloric diet.

Condition or disease	Intervention/treatment	Phase
Obesity; Diabetes Mellitus, Type 2	Other: High caloric diet	Not Applicable

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 32 participants
• Allocation: Non-Randomized
• Intervention Model: Sequential Assignment
• Masking: None (Open Label)
• Primary Purpose: Basic Science
• Official Title: Einfluss Von Hochkalorischer Nahrungsaufnahme Auf Die Insulinsensitivität Des Menschlichen Zentralnervensystems
• Actual Study Start Date: June 13, 2018
• Actual Primary Completion Date: March 10, 2020
• Actual Study Completion Date: March 10, 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: High caloric diet; Participants will eat 1500 kcal more than their usual diet for five days.	Other: High caloric diet; After dietary counseling, subjects will receive high caloric snacks for five days.
No Intervention: Control diet; Participants will eat regular diet.

Outcome Measures

Primary Outcome Measures :

1. Change in brain insulin sensitivity [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control dietwill start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   fMRI measurement will be performed before and after administration of 160 U of human insulin as nasal spray. Changes in regional activity will be quantified to assess regional brain insulin sensitivity.
2. Change in quantitative proton density [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control dietwill start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   The inflammatory processes in the brain will be measured through the quantification of the water content by means of proton density imaging.
3. Change in brain metabolites [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control dietwill start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   The inflammatory processes in the brain will be measured through the determination of brain metabolites by MR spectroscopy

Secondary Outcome Measures :

1. Change in whole-body insulin sensitivity [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control diet will start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   Insulin sensitivity will be estimated from a frequent-sampling 75 g oral glucose tolerance test using the Matsuda formula.
2. Change in body fat distribution [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control dietwill start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   Body composition will be addressed by whole-body MRI and liver MRS.
3. Behavioral assessment [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control dietwill start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   Memory function, food reward behavior and mood will be assessed by questionnaires, neuropsychological testing and a snack test.
4. Change in insulin secretion [ Time Frame: Outcome measurements will be assessed at baseline (t0). Then, the 5-day high caloric diet or control dietwill start 5 to 30 days after t0. Outcome measurements will again be assessed on the 6th-7th day and on the 10th-15th day after start of diet. ]
   Insulin secretion will be estimated from a frequent-sampling 75 g oral glucose tolerance test.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 29 Years (Adult)
• Sexes Eligible for Study: Male
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• BMI 19-24 kg/m2

  • Non smoking
  • normal glucose tolerance during 75g oral glucose tolerance test (OGTT)
  • Exercise less than 2h per week

Exclusion Criteria:

• Vegetarians and Vegans
• Food allergies
• Working at night
• Professional Athletes
• Not removable metal parts in or on the body
• manifest cardiovascular disease
• claustrophobia
• recent surgery (less than 3 months)
• Simultaneous participation in other studies
• Acute disease or infection within the last 4 weeks
• neurological and psychiatric disorders
• treatment with centrally acting drugs
• hemoglobin Hb <13g / dl
• Hypersensitivity to any of the substances used

Contacts and Locations

Locations

Germany

University of Tuebingen, Department of Internal Medicine IV

Tübingen, Germany, 72076

Sponsors and Collaborators

University Hospital Tuebingen

More Information

• Responsible Party: University Hospital Tuebingen
• ClinicalTrials.gov Identifier: NCT03590561
• Other Study ID Numbers: 813/2017BO2
• First Posted: July 18, 2018
• Last Update Posted: May 20, 2020
• Last Verified: May 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No
• Plan Description: We will not able to share individual participant data due to data protection restraints.

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Diabetes Mellitus, Type 2; Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases