Obesity Clinical Trial
Official title:
Effect of Polyphenols on Glucoregulatory Biomarkers, Blood Pressure and Lipid Profile in Overweight and Obese Subjects
This study aims to investigate the effect of polyphenol-rich dark chocolate (DC) on insulin
resistance, adiponectin , blood pressure (BP), lipid profile in obese subjects and determine
possible associations between all assessed parameters.
It hypothesizes that consumption of polyphenol-rich Dc could lower fasting glucose levels,
insulin resistance and improve BP, total cholesterol, low-density lipoprotein (LDL) and
triglycerides while increasing adiponectin and high-density lipoprotein (HDL) in overweight
or obese individuals.
It is well acknowledged that the main mechanism by which cocoa and DC polyphenols improve
fasting glucose levels, insulin sensitivity, BP and lipid profile in healthy individuals and
those with hypertension and/or impaired glucose-tolerance, involves increased nitric oxide
(NO) bioavailability. NO is essential for the regulation of blood pressure, glucose and
lipid balance. This is evident in that e-NOsynthase knockout mice exhibit insulin
resistance, hypertension and hyperlipidemia, a cluster of diseases that is also observed in
the metabolic syndrome. Recently, it was shown that adiponectin regulates eNOsynthase
activity through the phosphatidylinositol 3-kinase-dependent pathway wherein eNOsynthase is
phosphorylated by 5'-AMP-activated protein kinase at Ser1179 and that plasma adiponectin
levels are inversely correlated with BMI, waist-to-hip ratio, fasting plasma glucose,
insulin, triglyceride, hyperinsulinemia, and glucose intolerance and positively with
HDL-cholesterol, but not BP. This suggests a strong link between impaired NO
bioavailability, adiponectin levels and obesity. Indeed, apart from exhibiting impaired NO
bioavailability, obese individuals also have decreased plasma adiponectin levels. Since
cocoa and DC are known to modulate NO activity, investigating the impact of cocoa or DC
polyphenols on adiponectin levels and observing a correlation between its levels and
improved fasting glucose levels, insulin resistance, BP and lipid profile is essential in
improving our understanding of the relationship between diet and health, particularly that
polyphenols in apples, oolong and green tea polyphenols have been previously shown to
influence adiponectin levels.
This study uses a randomised single-blind, placebo-controlled design. Following a 1-week
run-in phase, each group will be randomised to one of the two groups:
placebo-polyphenol-rich DC, polyphenol-rich DC-placebo. Subjects will follow each diet for
4weeks, after which they will cross-over to the next diet separated by a 2-week washout
period and until each subject completes both interventions.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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