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Completed

NCT Number: NCT06395051

Effects of Ketone Monoesters on Brain Function

Disturbances in brain insulin-sensitivity are not only observed in obesity and type 2 diabetes (T2D), but also during brain aging and in dementia. Ketone monoester supplements may improve brain insulin-sensitivity, which can be quantified by measuring the gray-matter cerebral blood flow (CBF) response to intranasally administered insulin. We hypothesize that acute ketone monoester supplementation increases (regional) brain vascular function and insulin-sensitivity thereby improving cognitive performance and appetite control. The primary objective is to evaluate in older men the acute effect of ketone monoester supplementation on (regional) brain vascular function and insulin-sensitivity, as quantified by the non-invasive gold standard magnetic resonance imaging (MRI)-perfusion method Arterial Spin Labelling (ASL). The CBF response to intranasal insulin is a robust and sensitive physiological marker of brain insulin-sensitivity. Secondary objectives are to investigate effects on cognitive performance as assessed with a neuropsychological test battery, and appetite control as quantified by functional MRI (fMRI) with visual food cues.

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Key information

Age range

60 year–75 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Maastricht University Medical Center

Maastricht, Limburg, Netherlands

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Men, aged between 60-75 years
  • BMI between 25-30 kg/m2
  • Fasting plasma glucose < 7.0 mmol/L
  • Fasting serum TC < 8.0 mmol/L
  • Fasting serum TAG < 4.5 mmol/L
  • Systolic blood pressure < 160 mmHg and diastolic blood pressure < 100 mmHg
  • Stable body weight (weight gain or loss < 3 kg in the past three months)
  • Willingness to give up being a blood donor from 8 weeks before the start of the study, during the study and for 4 weeks after completion of the study
  • No difficult venipuncture as evidenced during the screening visit

Exclusion criteria

  • Women
  • Left-handedness
  • Following a low-carbohydrate diet or consuming nutritional ketone supplements
  • Current smoker, or smoking cessation < 12 months
  • Diabetic patients
  • Familial hypercholesterolemia
  • Abuse of drugs
  • More than 3 alcoholic consumptions per day
  • Use of products or dietary supplements known to interfere with the main outcomes as judged by the principal investigators
  • Use medication to treat blood pressure, lipid or glucose metabolism, or neurological or mental disorders.
  • Use of an investigational product within another biomedical intervention trial within the previous 1-month
  • Severe medical conditions that might interfere with the study, such as epilepsy, asthma, kidney failure or renal insufficiency, chronic obstructive pulmonary disease, inflammatory bowel diseases, auto inflammatory diseases and rheumatoid arthritis
  • Active cardiovascular disease like congestive heart failure or cardiovascular event, such as an acute myocardial infarction or cerebrovascular accident
  • Contra-indications for MRI imaging (e.g. pacemaker, surgical clips/material in body, metal splinter in eye, claustrophobia).

Treatment and study plan

Ketone monoester

Dietary Supplement

Ketone monoester supplement (395 mg/kg body mass)

Placebo

Dietary Supplement

The placebo will be taste-matched to the active supplement for bitterness using denatonium benzoate and volume-matched with water

Primary outcomes

  1. Brain Vascular Function

    Time frame: Change from placebo intervention at 30 minutes after supplement intake

    Cerebral blood flow as quantified non-invasively by the MRI perfusion method Arterial Spin Labeling (ASL)

  2. Brain Insulin Sensitivity

    Time frame: Change from placebo intervention at 60 minutes after supplement intake

    Cerebral blood flow measurements before and after a nasal insulin spray as quantified non-invasively by the MRI perfusion method Arterial Spin Labeling (ASL)

Secondary outcomes

  1. Appetite-related brain reward activity

    Time frame: Change from placebo intervention at 40 minutes after supplement intake

    Blood oxygenation level-dependent (BOLD)-functional MRI (fMRI) response to food cues

  2. Cognitive Performance

    Time frame: Change from placebo intervention at 120 minutes after supplement intake

    Cambridge Neuropsychological Test Automated Battery (CANTAB)

  3. Brain Perfusion

    Time frame: Change from placebo intervention at 120 minutes after supplement intake

    Transcranial Doppler (TCD) ultrasound will be used to assess the velocity of blood flow through the middle cerebral artery (MCA)

  4. Blood pressure

    Time frame: Change from placebo intervention at 90 minutes after supplement intake

    Office blood pressure and heart rate

  5. Ketone metabolism

    Time frame: During 120 minutes following supplement intake

    Circulating beta-hydroxybutyrate concentrations

  6. Glucose metabolism

    Time frame: During 120 minutes following supplement intake

    Circulating glucose and insulin concentrations

  7. Markers related to low-grade systemic inflammation

    Time frame: During 120 minutes following supplement intake

    Circulating high-sensitive C-reactive protein concentrations

  8. Appetite hormones

    Time frame: During 120 minutes following supplement intake

    Circulating ghrelin concentrations

  9. Perceived hunger and satiety

    Time frame: During 120 minutes following supplement intake

    Visual analogue scale (VAS) questionnaires

  10. Anthropometric measurements

    Time frame: Before supplement intake

    Weight, length, waist and hip circumference

  11. Food intake

    Time frame: Once 120 minutes following supplement intake

    Food Frequency Questionnaire to assess food intake over the past month

Sponsors and collaborators

Lead sponsor

Maastricht University Medical Center

Other

Registry information

Official study title

Acute Effects of Ketone Monoester Supplementation on Brain Function in Older Men with Overweight

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
May 1, 2024
Registry last updated
Feb 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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