Obesity Clinical Trial
Official title:
Study to Evaluate Botanicals for Mechanisms Related to Appetite and Fat Metabolism in Healthy, Overweight and Obese Individuals
Excess caloric consumption, particularly from inexpensive, energy dense foods that are high
in fat and refined carbohydrates, is a major driver of the global obesity epidemic. Dietary
supplements that promote reduced intake of energy dense foods and/or impact the absorption
and metabolism of fat and carbohydrates in the body can be used to help consumers control
their weight. We identified two separate mechanistic approaches to target these effects.
Diacylglycerol acyltransferase-1 (DGAT-1) is an enzyme involved in the formation of dietary
fat into circulating triglycerides within the body. Once dietary fat is digested and
absorbed, the resulting fatty acids are re-esterified into triglycerides. Inhibition of
DGAT-1 results in delayed and decreased re-esterification of dietary fats into circulating
triglycerides. It is hypothesized that this effect may lead to decreased deposition of
excess dietary fat as adipose tissue, possibly due to increased fatty acid oxidation in the
enterocytes.
Ghrelin is a hormone that is known to stimulate appetite in humans. When calorie dense fatty
foods are sensed in the stomach, ghrelin is acylated and activated via ghrelin
O-acyltransferase (GOAT). The activation step attaches a medium chain fatty acid to the
ghrelin molecule that enables it to transmit a signal in the brain that triggers eating and
fat storage in adipose tissue. Interfering with the GOAT pathway will inhibit ghrelin
activation and possibly diminish food intake and lipid storage. This concept is supported by
animal studies in which weight gain in a high fat diet model is prevented when GOAT is
inhibited.
Our objective was to determine whether botanicals demonstrating in vitro DGAT-1 and GOAT
inhibition have similar mechanistic effects in the human body. Based on the results of this
study, prototype formulas may be developed and clinically- tested for outcomes related to
weight management.
Excess caloric consumption, particularly from inexpensive, energy dense foods that are high
in fat and refined carbohydrates, is a major driver of the global obesity epidemic. Dietary
supplements that promote reduced intake of energy dense foods and/or impact the absorption
and metabolism of fat and carbohydrates in the body can be used to help consumers control
their weight. We identified two separate mechanistic approaches to target these effects.
Diacylglycerol acyltransferase-1 (DGAT-1) is an enzyme involved in the formation of dietary
fat into circulating triglycerides within the body. Once dietary fat is digested and
absorbed, the resulting fatty acids are re-esterified into triglycerides. Inhibition of
DGAT-1 results in delayed and decreased re-esterification of dietary fats into circulating
triglycerides. It is hypothesized that this effect may lead to decreased deposition of
excess dietary fat as adipose tissue, possibly due to increased fatty acid oxidation in the
enterocytes.
Ghrelin is a hormone that is known to stimulate appetite in humans. When calorie dense fatty
foods are sensed in the stomach, ghrelin is acylated and activated via ghrelin
O-acyltransferase (GOAT). The activation step attaches a medium chain fatty acid to the
ghrelin molecule that enables it to transmit a signal in the brain that triggers eating and
fat storage in adipose tissue. Interfering with the GOAT pathway will inhibit ghrelin
activation and possibly diminish food intake and lipid storage. This concept is supported by
animal studies in which weight gain in a high fat diet model is prevented when GOAT is
inhibited.
Ghrelin levels are positively associated with stress, sleep deprivation, and caloric
restriction. Weight loss induced by exercise does not have the same positive association
with ghrelin levels that caloric restriction alone has. Ghrelin levels are influenced by
diet composition, however, the results vary considerably between trials.
Over 160 botanical extracts from our internal ingredient library were screened at a single
concentration for inhibition of both DGAT-1 and GOAT. Botanicals that were identified as
having at least 75% activity were then titrated to identify those with IC50 values < 25 g/ml
or less. We narrowed our list of viable ingredients by looking at those with activity in
both the DGAT-1 and GOAT in vitro enzyme bioassay models. The top performing botanicals were
then evaluated in a cellular model for DGAT-1 inhibition. Those with the highest inhibition
activity in this model were considered lead candidates. A preliminary literature search was
conducted and the final filter included factors such as cost and regulatory acceptability
which results in the four ingredients being tested in the current clinical protocol.Our
objective was to determine whether these four ingredients have similar mechanistic effects
in the human body.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT04243317 -
Feasibility of a Sleep Improvement Intervention for Weight Loss and Its Maintenance in Sleep Impaired Obese Adults
|
N/A | |
| Recruiting |
NCT04101669 -
EndoBarrier System Pivotal Trial(Rev E v2)
|
N/A | |
| Terminated |
NCT03772886 -
Reducing Cesarean Delivery Rate in Obese Patients Using the Peanut Ball
|
N/A | |
| Completed |
NCT03640442 -
Modified Ramped Position for Intubation of Obese Females.
|
N/A | |
| Completed |
NCT04506996 -
Monday-Focused Tailored Rapid Interactive Mobile Messaging for Weight Management 2
|
N/A | |
| Recruiting |
NCT06019832 -
Analysis of Stem and Non-Stem Tibial Component
|
N/A | |
| Active, not recruiting |
NCT05891834 -
Study of INV-202 in Patients With Obesity and Metabolic Syndrome
|
Phase 2 | |
| Active, not recruiting |
NCT05275959 -
Beijing (Peking)---Myopia and Obesity Comorbidity Intervention (BMOCI)
|
N/A | |
| Recruiting |
NCT04575194 -
Study of the Cardiometabolic Effects of Obesity Pharmacotherapy
|
Phase 4 | |
| Completed |
NCT04513769 -
Nutritious Eating With Soul at Rare Variety Cafe
|
N/A | |
| Withdrawn |
NCT03042897 -
Exercise and Diet Intervention in Promoting Weight Loss in Obese Patients With Stage I Endometrial Cancer
|
N/A | |
| Completed |
NCT03644524 -
Heat Therapy and Cardiometabolic Health in Obese Women
|
N/A | |
| Recruiting |
NCT05917873 -
Metabolic Effects of Four-week Lactate-ketone Ester Supplementation
|
N/A | |
| Active, not recruiting |
NCT04353258 -
Research Intervention to Support Healthy Eating and Exercise
|
N/A | |
| Completed |
NCT04507867 -
Effect of a NSS to Reduce Complications in Patients With Covid-19 and Comorbidities in Stage III
|
N/A | |
| Recruiting |
NCT03227575 -
Effects of Brisk Walking and Regular Intensity Exercise Interventions on Glycemic Control
|
N/A | |
| Completed |
NCT01870947 -
Assisted Exercise in Obese Endometrial Cancer Patients
|
N/A | |
| Recruiting |
NCT05972564 -
The Effect of SGLT2 Inhibition on Adipose Inflammation and Endothelial Function
|
Phase 1/Phase 2 | |
| Recruiting |
NCT06007404 -
Understanding Metabolism and Inflammation Risks for Diabetes in Adolescents
|
||
| Recruiting |
NCT05371496 -
Cardiac and Metabolic Effects of Semaglutide in Heart Failure With Preserved Ejection Fraction
|
Phase 2 |