Clinical trial NCT04138654: Natural Compounds to Reduce Nitrite in Meat Products
Official title: Natural Compounds to Reduce Nitrite in Meat Products: PHYTOME
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Colon Cancer
Lead sponsor: Maastricht University
Sponsor class: OTHER
First posted: 2019-10-24
Enrollment: 78
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The PHYTOME project (Phytochemicals to reduce nitrite in meat products) is a major European Union (EU) co-funded research project that aims to develop innovative meat products in which the food additive nitrite has been replaced by natural compounds originating from fruits and vegetables. These biologically active compounds, also referred to as phytochemicals, are known to contribute to improved gut health and are added to the meat as natural extracts.

In a number of meat products, carefully selected combinations of natural antioxidants and other biologically active compounds occurring in vegetables, fruits and natural extracts such as coffee and tea, will be added during meat processing. Some of these compounds possess an antimicrobial activity allowing them to replace nitrite, whereas others possess a natural red colour that may contribute to the desired appearance of the products. Also, some of these compounds are known to protect colonic cells against damaging effects of cancer causing agents that may be formed in the large intestine after meat consumption.

The PHYTOME project will develop new technologies to introduce the natural extracts during processing to different types of meat products. These techniques will guarantee good sensory quality of the product as well as microbiological safety. Once these techniques have been developed and optimized at laboratory scale, the new type of products will be produced on an industrial scale. The health promoting effects of these products will be evaluated in a human dietary intervention study with healthy volunteers. After consumption of a fully controlled diet with either relatively high amounts of the traditional meat products or products produced following the new concept, faeces and colonic material will be collected and investigated for markers of colorectal cancer risk. These investigations will be performed in close collaboration with Research Institutes in the United Kingdom, Belgium, Italy and Greece, and will make use of the newest genomics techniques that are available.

Detailed description: Rationale:

The aim of this project is to develop new meat processing technologies, resulting in innovative meat products that have low or no nitrite and that have been shown to contribute to improved human health. This will be achieved by introducing carefully selected mixtures of biologically compounds originating from natural plant extracts. The new meat products will be evaluated in a human dietary intervention study to establish their positive effect on cancer risk markers in colonic tissues using the newest genomics techniques available.

Objective:

This project aims to evaluate the health impact of newly developed low nitrite containing meat products using genomics markers in a human dietary intervention study.

Study design:

This study has a cross-over design with only healthy volunteers. Each participant will be asked to donate a urinal, faecal and blood sample and undergo endoscopy after each intervention period. All analyses will be done for each study group separately to examine the overall effects of nitrite levels in meat.

Study population:

All subjects will be recruited by the University of Maastricht (UM) in the province of Limburg, the Netherlands, using advertisements in local newspapers as well as other media. Healthy subjects of both sexes will be selected based on predefined inclusion criteria (BMI: 18-25; \> 18 years) and randomly assigned to one of the different experimental groups.

Intervention (if applicable):

Subjects will receive a completely controlled diet with 3 different types of meat products according to the study design, with either normal levels, low or no added nitrite. After each of the three intervention periods of 15 days (300 grams meat per day) blood, urine, saliva, mouth wash and faeces will be sampled and stored appropriately at UM for later analysis. Additionally, colonic biopsies will be taken by the department of internal medicine (UM) or at the hospital of Sittard during an endoscopic examination. To evaluate the impact of nitrate in drinking water on the endogenous nitrosation processes in combination with processed red meat intake, there will be and extra intervention period of 7 days were volunteers will be asked to consume drinking water with high nitrate levels according to the Acceptable Daily Intake level (ADI: 3.7mg/kg bodyweight) in combination with 300 grams processed red meat per day. Also after this intervention period volunteers will be asked to collect a blood and saliva sample and 24h urine and faeces samples. Also, colonic biopsies will be taken by the department of internal medicine (UM) or at the hospital of Sittard during an endoscopic examination.

Main study parameters/endpoints:

* Formation of N-nitrosocompounds in human faecal and urine samples
* Reveal differences in transcriptomic and epigenomic markers after consumption of meat products enriched with natural compounds. These markers can be interpreted as an indicator of reduced cancer risk.
* Correlating gene expression changes to changes in genotoxic endpoints (DNA damage, reduction in N-Nitroso compounds (NOC)) to reveal the molecular processes involved in cancer risk reduction. The identification of molecular pathways that are crucial in the carcinogenic process will demonstrate a causal association between dietary changes and markers of carcinogenic risk.

Eligibility criteria: Inclusion Criteria:

* Healthy with a Body Mass Index (BMI) between 18-25, male or female
* Between 18-70 years old

Exclusion Criteria:

* Alcohol abuse up to 6 months before participation in this research
* Current aberrations or insufficiency of kidney, liver, gut, heart or lungs
* Current presence of persistent inflammation in the gut or liver
* Current endocrine or metabolic aberrations
* Current anaemia or infection
* HIV infection or hepatitis
* Use of antibiotics and other medication over the last 3 months
* Current smokers
* Vegetarians
* Pregnant women
* Participants of other intervention studies during this intervention period.

Primary outcomes:
measure: Change in N-nitroso compound (NOC) levels in faeces and urine measured as apparent total nitroso compounds (ATNC) between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks, and at 7 weeks
measure: Change in whole genome gene expression analyses in colonic biopsies and blood between baseline levels and each intervention period (transcriptomics)
timeFrame: At baseline, at 2 weeks, at 4 weeks, and at 6 weeks
Secondary outcomes:
measure: Change in urinary nitrate and creatine levels between baseline levels at the start of the intervention and each intervention period.
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks, and at 7 weeks
measure: Genotyping of DNA
timeFrame: At baseline
measure: Change in DNA methylation analyses of DNA isolated from colonic biopsies and blood (epigenetics) between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks
measure: Change in enzyme activity of nitrate reductase in saliva between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks, and at 7 weeks
measure: Change in the microbiome in feacal samples and in saliva between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks, and at 7 weeks
Other outcomes:
measure: Change in faecal water genotoxicity between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks
measure: Change in O6-CMG in colonic biopsies between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks
measure: Change in O6-MeG in colonic biopsies between baseline levels at the start of the intervention and each intervention period
timeFrame: At baseline, at 2 weeks, at 4 weeks, at 6 weeks
Locations:
city: Maastricht
country: Netherlands
facility: Toxicogenomics
state: (Click To Select US State)
Study officials:
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