Osteoporosis Clinical Trial
Official title:
Systemic and Intestinal Therapeutic Target Bioactivity of a Functional Beverage Containing β-cryptoxanthin (β-Cx), Plant Sterols (PS) and Galactooligosaccharides (GOS): "in Vivo" and "in Vitro" Studies.
Regular consumption of a beverage containing β-cryptoxanthin (β-Cx) and plant sterols (PS)
has been shown to exert a synergic effect in reducing some markers of cardiovascular risk and
bone-remodeling (formation and resorption). The present project aims to:
- Evaluate (by in vivo and in vitro studies) the bioavailability of added β-Cx, PS and
galactooligosaccharides (GOS) and its stability in the beverage employed in the proposed
study.
- Study the biological effect (bioefficacy) associated with the regular consumption of
modified milk-based fruit beverages containing β-Cx, PS and GOS in post-menopausal women
(target group) by assessing changes in inflammation, cardiovascular and bone turnover
biochemical markers.
- Characterize genetic variability (polymorphisms), genetic expression and DNA oxidative
damage in the target group as determinants of bioavailability and biological effects of
β-Cx, PS and GOS.
- Evaluate the potential prebiotic effect associated to regular consumption of a beverage
supplemented with β-Cx, PS and GOS: including "in vitro" studies and characterization of
subjects' microbiota and possible microbiota changes associated to the beverage
consumption.
A previous Clinical Trial (AGL2012-39503-C02) evidenced the beneficial synergic effects upon
bone remodeling and cardiovascular risk of a beverage, based on juice and milk, and enriched
with PS and β-Cx. "In vitro" and "in vivo" (clinical) studies have confirmed low absorption
of PS and β-Cx in this beverage, with possible slight modification of the sterols and
metabolites by the intestinal microbiota. PS and β-Cx can reach the colon and be transformed
by the intestinal microbiota with resulting beneficial effects.
The new Clinical Trial aims to determine whether the presence of galactooligosaccharides
(GOS) in a beverage containing PS and β-Cx might modulate the biological effects of these
latter components at either intestinal level (modification of microbiota and inflammatory
markers) or systemically (blood cholesterol-lowering effect and bone turnover).
In the present clinical interventional study we will evaluate the systemic biological effects
of a beverage containing GOS, PS and β-Cx, as well as its intestinal effects and its
influence on the microbiota in postmenopausal women. Furthermore, we will study the stability
and bioavailability of PS and β-Cx in the beverage.
The clinical study will help to confirm whether the new GOS-containing beverage has effects
upon cardiovascular risk markers, bone remodeling and inflammation at least equivalent to
those observed with the beverage studied in the previous Clinical Trial.
The results obtained will generate interesting information for improving beverage formulation
with bioactive components that might be relevant for food industry. Furthermore, clarifying
the beneficial effects of the studied beverages is relevant not only for healthy subjects but
also for those with certain disease conditions (i.e., intestinal inflammation diseases), and
may contribute to improve their wellbeing and health, with the consequent social and economic
benefits.
DESIGN OF THE CLINICAL STUDY:
Single and combined randomized, double-blind, crossover multiple-dose supplementation trial
will be carried out with two beverages (250 ml/day): PS-enriched skimmed milk based fruit
beverage rich in β-Cx (sham beverage) and a similar skimmed milk based fruit beverage rich in
PS and β-Cx supplemented with GOS (active beverage),as diet supplementation in healthy
post-menopausal women.
The Clinical study will take place at the Vitamins Unit of the Clinical Biochemistry Service
of the Hospital Universitario Puerta de Hierro-Majadahonda (Madrid, Spain).
Sample size assessment:
The sample size was calculated taking into account the results of total PS and cholesterol
obtained in a previous clinical trial (no. NCT01074723). From previous assumption we choose
the more conservative option to assure detection of a 7% reduction of cholesterol levels in a
mild hypercholesterolemic subjects (e.g. 15 mg/dl) with a type I error of 0.05 and a
statistical power of 80%. Furthermore, taking into account that 45% of western population
might presented some polymorphisms implicated in the cholesterol absorption process, and
assuming a drop-out of 10%, the final sample size should included 40 subjects.
Standard Operating procedures:
Two periods of intervention of 6 weeks separated by a wash-out period of 4 weeks.
During the first trial period, 20 subjects daily will consume the active beverage and 20
subjects will consume the sham beverage for 6 weeks, and after a what-out period of 4 weeks,
the type of beverage to be consume during other 6 weeks period will be change (two-by-two
cross over assignment). All participants receive sham beverage and active beverage B at some
point during the trial but in a different order, depending on the group to which they are
assigned.
Sample collection (serum and faeces) will be performed before and after each 6 weeks
treatment periods.
All subjects should give written consent to participate in the trial.
The participants will be provided with a list of foods and beverage rich in β-Cx to be
avoided during the trial period and will be asked not to change its usual diet and physical
activity, to record any side effects during the study, and to complete a semi-quantitative
Food Frequency Questionnaire (FFQ) at the end of each intervention period. Question on the
organoleptic properties of the beverages will also be included.
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