Clinical trial NCT05742373: Role of Fasted Exercise on Improving Cardiometabolic Health
Official title: Investigating the Role of Fasted Exercise on Improving Cardiometabolic Health; a Potential Mediatory Role of Sirtuins
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Cardiovascular Diseases
Diabetes Mellitus, Type 2
Obesity
Keywords: Cardiovascular disease
Diabetes Mellitus
Obesity
Cardiometabolic health
Exercise
Fasted
Sirtuins
Lead sponsor: Manchester Metropolitan University
Sponsor class: OTHER
Collaborators: name: European Society for Clinical Nutrition and Metabolism
First posted: 2023-02-24
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Randomised control
Primary purpose: BASIC_SCIENCE

Brief summary: The aim of this randomised control trial is to investigate the role of fasted exercise on cardiometabolic health. Participants will be assigned to one of three conditions, fasted exercise, fed exercise and control (no exercise). Participants in the exercise groups will complete four weeks of moderate intensity cycling exercise, three times per week, either in the fasted or fed state according to their group assignment. Experimental trials involving anthropometric and cardiometabolic disease risk factor measurements as well as metabolic responses to a subsequent meal ingestion following exercise will be compared pre-intervention and post intervention.

Detailed description: The aim of this study is to investigate the effect of fasted exercise on cardiometabolic health and the potential mediatory role of sirtuins.

The objectives are to investigate:

1. The effect of a single bout of fasted exercise on acute metabolic responses following a high fat meal.
2. The effect of four weeks of fasted exercise training on cardiovascular and metabolic disease risk factors.
3. The effect of four weeks of fasted exercise training on circulating levels and subcutaneous adipose tissue gene expression of SIRT1, SIRT3 and SIRT6.

A randomised control trial will be conducted with volunteers allocated under the conditions of a) no exercise (control), b) fasted exercise training (FASTEX) and c) fed exercise training (FEDEX). The pre- and post-intervention visits will consist of 50 minutes of cycling at a moderate exercise intensity for both the FASTEX and FEDEX groups. The control group would not perform any exercise. The FASTEX group will perform the exercise in the fasted state, whilst the FEDEX and control groups will be fed a standardised breakfast meal one hour in advance of the exercise period. Following the exercise period, the participants will be fed a high fat meal and metabolic responses to the meal will be measured for four hours. Multiple blood samples will be obtained as well as a sample of subcutaneous adipose (fat) tissue. The FASTEX and FEDEX groups will then complete four weeks of moderate intensity continuous exercise training, either fasted or fed according to their group, on three days per week whilst the control group will maintain their normal sedentary lifestyle. All participants will return to the laboratory for post-intervention testing at the end of the four weeks with the same protocols and measurements as the pre-intervention testing.

Eligibility criteria: Inclusion Criteria:

* Male or female
* Non-smokers
* Physically inactive (partake in no more than one exercise session per week on average)
* Body mass index \>18.5 kg/m2
* Healthy as assessed by medical screening questionnaire
* Prior recipient of local anaesthetic with no known adverse effects, no known hypersensitivity or no other health issue that may constrain the administration of lidocaine hydrochloride
* Free from musculoskeletal injury and able to perform cycling exercise
* Capacity to give informed consent

Exclusion Criteria:

* Regular exerciser
* BMI \< 18.5 kg/m2
* Pregnant
* Allergy or intolerances to test meal products/ingredients (such as wheat or dairy products).
* Recent major body weight change (+/- 3 kg in the past month)
* Known hypersensitivity to Lidocaine Hydrochloride
* Cardiovascular disease - complete heart block or hypovolaemia
* Adam's-Stokes Syndrome
* Wolff-Parkinson-White Syndrome
* Porphyria
* Epilepsy
* Myasthenia Gravis
* Other chronic medical condition or diagnosis including respiratory (eg asthma), endocrine, cardiovascular, neuromuscular disorders.
* Taking medications or receiving treatment that may constrain the administration of lidocaine or local anaesthesia.

Primary outcomes:
measure: Changes in circulating concentrations of key metabolic markers following a high fat lunch meal
timeFrame: 9 blood samples collected at pre-meal ingestion then every 30 min after ingestion for four hours
measure: Changes in circulating concentrations of key metabolic markers during the experimental trial day
timeFrame: 12 blood samples collected at 0 (baseline), 75 (pre-exercise), 125 (immediately post-exercise), 155 min (pre-meal ingestion) then every 30 min after ingestion for four hours
measure: Area under the circulating concentration versus time curve (AUC) of key metabolic markers following a high fat lunch meal
timeFrame: 4.5 hours
measure: Changes in cardiovascular and metabolic disease biochemistry risk factors
timeFrame: 4 weeks (pre and post intervention)
measure: Changes in cardiovascular disease physiological risk factors
timeFrame: 4 weeks (pre and post intervention)
measure: Changes in concentration of sirtuin molecules
timeFrame: 4 weeks (pre and post intervention)
measure: Changes in sirtuin molecule gene expression
timeFrame: 4 weeks (pre and post intervention)
measure: Changes in sirtuin molecule tissue expression
timeFrame: 4 weeks (pre and post intervention)
Secondary outcomes:
measure: Changes in cardiovascular and metabolic disease anthropometric risk factors
timeFrame: 4 weeks (pre and post intervention)
measure: Change in body composition
timeFrame: 4 weeks (pre and post intervention)
measure: Change in body mass
timeFrame: 4 weeks (pre and post intervention)
measure: Change in substrate oxidation during the experimental trial day
timeFrame: 17 measurements at 0 (baseline), 15 (post-breakfast meal period), 45 (30 min post-breakfast meal period), 75 (pre-exercise), every 10 min during exercise, 155 (pre-meal ingestion), then every 30 min for four hours.
measure: Heart rate response to exercise
timeFrame: At rest before exercise then every 5 min during 50 min cycle exercise
measure: Perceived exertion
timeFrame: Every 5 min during 50 min cycle exercise
measure: Change in physical activity levels
timeFrame: Daily for 4 weeks
measure: Change in physical activity duration
timeFrame: Daily for 4 weeks
measure: Change in energy intake
timeFrame: Daily for 4 weeks
measure: Change in dietary nutritional intake
timeFrame: Daily for 4 weeks
Other outcomes:
Locations:
city: Manchester
country: United Kingdom
facility: Manchester Metropolitan University
state: Greater Manchester
Study officials:
affiliation: Manchester Metropolitan University
name: Adora Yau, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Manchester Metropolitan University
name: Gethin Evans, PhD
role: STUDY_DIRECTOR
References: