Skip to main content
OpenTrials
Completed

NCT Number: NCT05518214

'Oral Microbiome -Dietary Nitrate' Interactions and Cognitive Health in Older Age

Vegetable rich diets contain natural inorganic nitrate. These diets are linked to good heart and brain health. Human cells cannot 'activate' nitrate. Humans must rely on specific bacteria living in the mouth to digest nitrate to an active form called 'nitric oxide' that we can use in the body. We have found that nitrate makes the oral microbiome healthier and improves nitric oxide production. This study will investigate whether changes in oral bacteria caused by dietary nitrate are linked to any changes in brain performance.We will ask 60 healthy men and women of over 50 years of age to take part. We will ask them to drink either nitrate-rich beetroot juice or placebo juice daily for 12 weeks. We will do this investigation entirely remotely by using online tools and by posting of supplements and samples. We will sample the volunteers' oral microbiome and assess their cognitive performance before and after dietary supplementation. We will analyse the nitric oxide content in the samples that the volunteers post us. We will try to findgroups of bacteria linked with goodbrainfunction.The results will help us better understand how oral bacteria may influence cognitive function in older age.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Dietary Supplementations

Age range

50 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Exeter Sport and Health Sciences

Exeter, Devon, EX12LU, United Kingdom

About this study

Oral dysbiosis and poor dental health have been associated with impaired cardiovascular and cognitive health, but it is not known which characteristics of bacterial communities specifically might mediate such relationships. One mechanism by which the oral microbiota may influence health is its contribution to production of the signalling molecule, nitric oxide (NO), which, among many other functions, regulates vascular tone and neurotransmission . The capacity for endogenous NO production via the enzymatic NOS synthase pathway declines in older age, contributing to development of arterial hypertension, reduced physical and cognitive functional capacity, and increased morbidity. Therefore, the composition of the oral microbiota may be particularly important to enable older people to benefit from a nitrate-rich diets, such as the Mediterranean diet, which has been associated with reduced risk of developing dementia in older age. A key genetic risk factor for dementia is a form of apolipoprotein E gene called APOE4, which may also modulate responsiveness to dietary interventions.The purpose of this research is to investigate whether specific groups of oral bacteria, that are sensitive to change with dietary nitrate supplementation, are correlated with indices of cognitive function (primary objective) as well as APOE genotype, diet, physical activity, and markers of vascular health (secondary objectives), in people over 50 years of age.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Participant is willing and able to give informed consent.
  • Male or Female.
  • Over 50 years of age.
  • Access to a postal service (Royal Mail)
  • Access to the Internet.
  • Mainland UK resident.
  • APOE genotype available in PROTECT database.

Exclusion criteria

  • Diagnosis of dementia, because the participant may be unable to provide informed consent.
  • Current or previous smoker (within the last year).
  • Regular drinkers of alcoholic beverages which are over 14% ABV undiluted.
  • Current or recent use of antibiotics (within the past 3 months).
  • Self-reported substantial use of mouthwash or tongue scrapers within the past month.
  • Self-reported periodontitis, gingivitis or other oral disease.
  • No available APOE genotyping in PROTECT database.

Treatment and study plan

Beetroot

Dietary Supplement

Participants receive a 12-week supply of beetroot juice.

Placebo

Dietary Supplement

Participants receive a 12-week supply of placebo beetroot juice.

Primary outcomes

  1. Change from baseline oral bacteria co-occurrence at 12 weeks using oral microbiome abundance data and WGCNA analysis.

    Time frame: Change measured between baseline and 12-weeks post-intervention.

    Identify co-occurring clusters of oral bacteria which are consistently related to indices of cognitive status across dietary interventions with nitrate and placebo. Using oral microbiome abundance data from sequenced oral microbiome DNA in the mouth rinse samples, the change from baseline to post-12 week intervention is measured. WGCNA analysis is used to cluster co-occurring bacteria and detect patterns of grouping.

Secondary outcomes

  1. Change from baseline oral nitric oxide bioavailability at 12 weeks using ozone-based chemiluminescence.

    Time frame: Change measured between baseline and 12-weeks post-intervention.

    The change from baseline to post-12 week intervention nitrate and nitrite concentrations in mouth rinse samples is measured using ozone-based chemiluminescence.

  2. Change from baseline composition of the oral microbiome at 12 weeks using oral microbiome abundance data from sequencing oral microbiome DNA in mouth rinse samples.

    Time frame: Change measured between baseline and 12-weeks post-intervention.

    Oral microbiome sequencing of bacterial DNA isolated from mouth rinse samples. The change in the composition of the oral microbiome is measured from baseline to post-12 week intervention using oral microbiome abundance data.

  3. Change from baseline cognitive status at 12 weeks.

    Time frame: Change measured between baseline and 12-weeks post-intervention.

    'Factors of Longitudinal Attention, Memory and Executive Function' (FLAME) composite score. Online FLAME cognitive assessment battery completed at home by the participants via the online PROTECT study. The FLAME cognitive assessment is a validated battery of online cognitive tests where correct/incorrect responses and response time are measured.

  4. Correlation between oral microbiome and existing descriptive data.

    Time frame: Correlation measured after 12-weeks post-intervention.

    Correlation of oral microbiome with existing PROTECT cohort variables (APOE genotype, diet, physical activity). The oral microbiome abundance data is correlated with APOE genotype and dietary and physical questionnaire data.

Sponsors and collaborators

Lead sponsor

University of Exeter

Other

Registry information

Acronym: COGNIT

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Aug 26, 2022
Registry last updated
Jan 11, 2024

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.

Related clinical trials

Published trials that share one or more normalized conditions with this study.