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HealthyCRNitrateMRINCT06151015

The Combined Effect of Dietary Nitrate and Caloric Restriction on Cognitive and Vascular Function.

A study testing Nitrate-rich beetroot juice plus calorie-restricted diet and Nitrate-rich beetroot juice plus weight-maintenance diet in people with Healthy and Older Adults, run by Moira Taylor at 1 site in United Kingdom.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This pilot study will compare the effect of combining dietary nitrate and caloric restriction versus dietary nitrate alone. The participant will be contacted, having responded to an advertisement on social media and posters, to attend the screening visit. Read more about this study

Who is it for?
Ages 60 to 75 yearsHealthy volunteers can take part
Conditions the study is for
Healthy, Older Adults, Overweight and Obesity
What is being tested?
Nitrate-rich beetroot juice plus calorie-restricted diet and Nitrate-rich beetroot juice plus weight-maintenance diet
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited Kingdom
Study dates
6 May 2024to Sep 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 to 75 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Participant is able to give written informed consent for their participation in the study.
  • Healthy.
  • Non-smoking adults.
  • Male or female.
  • Aged 60 to 75 years.
  • BMI between 25 and 40 kg/m2.

Who cannot join

  • Systolic BP > 180mmHg and/or diastolic BP >110mmHg at the Clinic Screening Visit.
  • Contraindication for MRI.
  • Does not have adequate understanding of verbal and written information in English, sufficient to complete an MRI safety screening and to give informed consent.
  • Any existing or previous medical condition that may affect the study outcomes (i.e., diabetes, kidney dysfunction, malignant cancer, brain surgery, stroke).
  • Any medical treatment that may affect the study outcomes (i.e., diuretics, anti-acids, organic nitrates, anti-pyschotics or neuro-stimulants).
  • Evidence of an eating disorder as indicated by the Three-factor eating questionnaire (Eating Attitudes Tests-26).
Show all 11Show fewer
  • Blood donation within the last 3 months of the anticipated intervention beginnings.
  • Having taken part in a research study in the last 3 months involving invasive procedures or an inconvenience allowance.
  • High-alcohol consumers (≥ 14 units/week for females, and ≥ 22 units/week for males).
  • Vegetarianism (likely to have very high nitrate intake and food provided during the dietary intervention unsuitable).
  • Weight change over 3.0kg in the last 2 months (important influence on vascular function).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United Kingdom1 site, 1 recruiting
  • The University of Nottingham

    Nottingham, Nottinghamshire, NG7 2RD

    Mushari Alharbi, MBBS, MSc, +44 (0)115 823 0141, Mushari.Alharbi@nottingham.ac.uk

    Moira A Taylor, PhD RD, +44 (0)115 823 0141, Moira.Taylor@nottingham.ac.uk

    Recruiting

Other trials in United Kingdom

About this study

Official title: Testing the Combined Effect of Dietary Nitrate and Caloric Restriction on Cognitive and Vascular Function in Older Adults Living with Overweight or Obesity: a 28-Day Pilot Randomised Trial

This pilot study will compare the effect of combining dietary nitrate and caloric restriction versus dietary nitrate alone. The participant will be contacted, having responded to an advertisement on social media and posters, to attend the screening visit. They will be asked about their health status, suitability for MRI and availability. The investigators will use physical activity and eating attitude questionnaires. The investigators will also measure their height, weight, body mass index (BMI), and blood pressure (BP) and undertake blood tests. If they are eligible, they will be randomised to one of the two arms. The first group will consume nitrate-rich beetroot juice with a calorie-restricted diet for 28 days. The second group will drink the same juice with a weight-maintenance diet for the same period. The food and drinks will be provided. The outcome measures will be measured twice (at the baseline and end visits) to evaluate the change. The primary outcome is the cognitive function. The secondary outcomes are peripheral vascular health (BP and microvascular perfusion), cerebral vascular health (brain blood flow), anthropometry, body composition, and exhaled NO and nitrate concentrations. Also, the feasibility and accessibility of the study will be assessed.

Read the detailed description

Twenty healthy males and females, aged 60-70 years, non-smokers, and living with overweight or obesity (BMI 25-40 kg/m2) will be recruited to a 28-day pilot, randomised, parallel trial to follow one of the interventions (dietary nitrate with calorie-restricted diet or dietary nitrate with weight-maintenance diet) if they are eligible. Their energy requirement will be calculated using the Mifflin-St Jeor Equation, and the participant will be instructed to follow a healthy diet ( pre-diet standardisation) for three days before the intervention to minimise the effect of the sudden change of their habitual diet (during which their energy requirement will be met). At the Baseline Visit (Day 0), they will be randomised to one of the two arms, and the outcome measurements will be taken. Cognitive function will be measured via a pen-and-paper test (TMT) and a cognitive battery of tests (COMPASS). Clinic and home resting blood pressure (BP) will be measured using an automated BP monitor. Microvascular perfusion will be measured by a Laser Doppler monitor. Cerebral blood flow will be measured using a brain MRI scan. Height, weight, BMI, skinfold thickness, and waist circumference will be measured via a wall-mounted stadiometer, calibrated scale, BMI equation, calipers, and a tape measure, respectively. Body composition will be measured by a bioelectrical impedance analysis (BIA). Exhaled NO will be measured using a fractional exhaled nitric oxide analyser (FeNO). Blood samples will be taken to measure plasma nitrate concentrations. Physical activity will be monitored through a wearable smartwatch with an integrated accelerometer. The participants will be provided with 14 bottles of nitrate-rich beetroot juice (70 ml, which provides 6.5mmol of nitrate/day) with their allocated diet to be consumed in the next 14 days, starting from the next day (Day 1), and the remaining 14 days' supply will be delivered on Day 13. There will be an energy deficit of 1,000 kcal/day if they are allocated to the caloric restriction group. Otherwise, the energy requirement will be met. After completing the 28-day intervention, the participant will attend the End Visit (Day 29), to repeat the same study measurements they have done in the Baseline Visit. An exit feedback questionnaire will be given to collect information on the acceptability and compliance with the measurement protocols and intervention.

Being tested
Nitrate-rich beetroot juice plus calorie-restricted diet, Nitrate-rich beetroot juice plus weight-maintenance diet
Medical subject headings
Overweight, Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nitrate-rich beetroot juice plus calorie-restricted dietOther

    One daily bottle (70ml) of nitrate-rich beetroot juice with a calorie-restricted diet (1,000kcal deficit).

  • Nitrate-rich beetroot juice plus weight-maintenance dietOther

    One daily bottle (70ml) of nitrate-rich beetroot juice with a weight-maintenance diet (energy will be met).

Study groups in NCT06151015
Study groupRoleWhat they receive
Dietary nitrate plus caloric restrictionExperimentalParticipants will drink beetroot juice with a calorie-restricted diet for 28 days.
Receives: Other: Nitrate-rich beetroot juice plus calorie-restricted diet
Dietary nitrate aloneActive comparatorParticipants will drink beetroot juice with a weight-maintenance diet for 28 days.
Receives: Other: Nitrate-rich beetroot juice plus weight-maintenance diet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Cognitive function (TMT-B)

    Change in cognitive function from the baseline after 28 days intervention using a pen-and-paper cognitive test (TMT-B) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

Secondary outcomes (20)
  1. Composite score of cognitive function

    Change in the composite score of cognitive function from the baseline after 28 days intervention using a computerised cognitive battery (COMPASS) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  2. Cognitive function individual tasks (alphabetic working memory)

    Change in the cognitive function of individual task (alphabetic working memory) from the baseline after 28 days of intervention using a computerised cognitive battery (COMPASS) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  3. Cognitive function individual task (serial subtraction)

    Change in the cognitive function of individual task (serial subtraction) from the baseline after 28 days of intervention using a computerised cognitive battery (COMPASS) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  4. Cognitive function individual task (stroop)

    Change in the cognitive function of individual task (stroop) from the baseline after 28 days of intervention using a computerised cognitive battery (COMPASS) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  5. Cognitive function individual task (peg and ball)

    Change in the cognitive function of individual task (peg and ball) from the baseline after 28 days of intervention using a computerised cognitive battery (COMPASS) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  6. Cognitive function individual task (simple reaction time)

    Change in the cognitive function of individual task (simple reaction time) from the baseline after 28 days of intervention using a computerised cognitive battery (COMPASS) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  7. Cognitive function (TMT-A)

    Change in cognitive function from the baseline after 28 days intervention using a pen-and-paper cognitive test (TMT-A) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  8. Clinic blood pressure for systolic and diastolic pressure

    Change in clinic blood pressure (systolic and diastolic pressure) from the baseline after 28 days intervention using automated blood pressure device compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  9. Continuous home blood pressure for systolic and diastolic pressure

    Changes in home blood pressure (systolic and diastolic pressure) from the first day of the intervention until last day using an automated blood pressure device compared to the comparator.

    Measured: Every three days starting from Day 1 until Day 28 of the intervention.

  10. Microvascular perfusion

    Change in microvascular perfusion from the baseline after 28 days intervention using a Laser Doppler monitor compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  11. Cerebral blood flow

    Change in cerebral blood flow from the baseline after 28 days intervention using a brain MRI scan compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  12. Anthropometry (weight)

    Change in weight in kilograms from the baseline after 28 days intervention using a calibrated scale compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  13. Anthropometry (BMI)

    Change in BMI in kg/m^2 from the baseline after 28 days intervention using the BMI equation (weight and height will be combined to report BMI in kg/m^2) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  14. Anthropometry (skinfold thickness)

    Change in skinfold thickness in millimetre from the baseline after 28 days intervention using a skinfold calipers, compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  15. Anthropometry (waist circumference)

    Change in waist circumference from the baseline after 28 days intervention using a tape measure compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  16. Body composition (fat mass)

    Change in body composition (fat mass in kg) from the baseline after 28 days intervention using a bioelectrical impedance analysis (BIA) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  17. Body composition (fat-free mass)

    Change in body composition (fat-free mass in kg) from the baseline after 28 days intervention using a bioelectrical impedance analysis (BIA) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  18. Exhaled nitric oxide

    Change in nitric oxide from the baseline after 28 days intervention using a fractional exhaled nitric oxide analyser (FeNO) compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  19. Nitrate concentrations

    Change in plasma nitrate concentrations from the baseline after 28 days intervention using an Ozone-based chemiluminescence compared to the comparator.

    Measured: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.

  20. Feasibility and accessibility

    A paper exit feedback questionnaire will be administered at the end of the study to collect information on the acceptability and compliance with the measurement protocols and intervention.

    Measured: End Visit (Day 29).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Nov 2023
  2. Study start6 May 2024
  3. Primary completionSep 2025 (estimated)
  4. Study completionSep 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Pilot, randomised, parallel trial
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06151015
Sponsor's protocol ID
323-0723
Acronym
CRNitrateMRI
Status last verified
Dec 2024
First submitted
6 Nov 2023
Last updated
24 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Only anonymised individual personal data will be shared, upon specific request from other researchers, for example, in order to undertake a meta analysis.

Publications

  • Alharbi M, Stephan BC, Shannon OM, Siervo M. Does dietary nitrate boost the effects of caloric restriction on brain health? Potential physiological mechanisms and implications for future research. Nutr Metab (Lond). 2023 Oct 25;20(1):45. doi: 10.1186/s12986-023-00766-9.

    PubMed 37880786
  • Alharbi M, Chiurazzi M, Nasti G, Muscariello E, Mastantuono T, Koechl C, Stephan BC, Shannon OM, Colantuoni A, Siervo M. Caloric Restriction (CR) Plus High-Nitrate Beetroot Juice Does Not Amplify CR-Induced Metabolic Adaptation and Improves Vascular and Cognitive Functions in Overweight Adults: A 14-Day Pilot Randomised Trial. Nutrients. 2023 Feb 10;15(4):890. doi: 10.3390/nu15040890.

    PubMed 36839248
  • Babateen AM, Shannon OM, O'Brien GM, Olgacer D, Koehl C, Fostier W, Mathers JC, Siervo M. Moderate doses of dietary nitrate elicit greater effects on blood pressure and endothelial function than a high dose: A 13-week pilot study. Nutr Metab Cardiovasc Dis. 2023 Jun;33(6):1263-1267. doi: 10.1016/j.numecd.2023.02.024. Epub 2023 Mar 2.

    PubMed 36958967
  • Shannon OM, Gregory S, Siervo M. Dietary nitrate, aging and brain health: the latest evidence. Curr Opin Clin Nutr Metab Care. 2022 Nov 1;25(6):393-400. doi: 10.1097/MCO.0000000000000866. Epub 2022 Aug 9.

    PubMed 35943128
  • Siervo M, Babateen A, Alharbi M, Stephan B, Shannon O. Dietary nitrate and brain health. Too much ado about nothing or a solution for dementia prevention? Br J Nutr. 2022 Sep 28;128(6):1130-1136. doi: 10.1017/S0007114522002434.

    PubMed 36688430
  • Babateen AM, Shannon OM, O'Brien GM, Okello E, Smith E, Olgacer D, Koehl C, Fostier W, Wightman E, Kennedy D, Mathers JC, Siervo M. Incremental Doses of Nitrate-Rich Beetroot Juice Do Not Modify Cognitive Function and Cerebral Blood Flow in Overweight and Obese Older Adults: A 13-Week Pilot Randomised Clinical Trial. Nutrients. 2022 Mar 2;14(5):1052. doi: 10.3390/nu14051052.

    PubMed 35268027
  • Siervo M, Arnold R, Wells JC, Tagliabue A, Colantuoni A, Albanese E, Brayne C, Stephan BC. Intentional weight loss in overweight and obese individuals and cognitive function: a systematic review and meta-analysis. Obes Rev. 2011 Nov;12(11):968-83. doi: 10.1111/j.1467-789X.2011.00903.x. Epub 2011 Jul 18.

    PubMed 21762426

Questions about this trial

What is this clinical trial studying?

A study testing Nitrate-rich beetroot juice plus calorie-restricted diet and Nitrate-rich beetroot juice plus weight-maintenance diet in people with Healthy and Older Adults, run by Moira Taylor at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 24 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Moira A Taylor, PhD RD (+44 (0)115 823 0141, Moira.Taylor@nottingham.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Cognitive function (TMT-B) (time frame: Baseline Visit (Day 0)-one day before intervention, and End Visit (Day 29)-one day after intervention.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06151015, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Dec 2024.

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