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Completed

NCT Number: NCT03679533

The Impact of Cranberries On the Microbiome and the Brain in Healthy Ageing sTudy (COMBAT)

Tremendous progress has been made in characterizing the interactions between the central nervous system and the gastrointestinal tract. This concept of a gut-brain axis suggests that influencing bacteria in the gut is a promising approach for developing new ways of benefiting brain function. This is particularly relevant for an ageing population for which cognitive decline is a common symptom and can be an indicator for the development of neurodegenerative conditions such as dementia. There is good evidence already that nutrition can delay the development of cognitive decline in ageing, in particular for ageing-sensitive brain regions such as the medial temporal lobe, however this has been little explored for cranberry intake. Cranberries are high in plant-derived nutrients called polyphenols, which have been suggested to promote brain function and protect against disease-causing mechanisms. In the proposed project we will pioneer work to investigate the impact of cranberry intake on gut bacteria and how it relates to cognitive performance in ageing and associated regions in the brain.

This study is being conducted by Chief Investigators Dr David Vauzour and Prof Michael Hornberger at the University of East Anglia. Sixty participants (i.e. n=30 control and treatment groups) aged 50-80 years old, with no memory complaints will be recruited for this 12-week double-blind placebo-controlled parallel intervention of cranberry flavonoids. Freeze-dried cranberry or a matched placebo will be taken twice daily for the duration of the trial. Blood, urine and faecal samples will be collected for microbiome, DNA, biochemical and nutritional analysis. Participants will also undergo cognitive testing, as well as MRI scanning to detect changes in brain physiology.

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Key information

Conditions

Aging Cognition Disorders Cognitive Decline Cognitive Dysfunction Mental Disorders Neurocognitive Disorders

Age range

50 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of East Anglia

Norwich, Norfolk, NR4 7UQ, United Kingdom

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Aged between 50 and 80 years old.
  • Willing and able to provide written informed consent.
  • Fluent in written and spoken English.
  • Normal or corrected to normal vision and hearing.
  • Understands and is willing and able to comply with all study procedures.

Exclusion criteria

  • Diagnosis of any form of dementia or significant neurological condition.
  • Significant memory complaints.
  • Past history or MRI evidence of brain damage, including significant trauma, stroke, learning difficulties or serious neurological disorder, including a loss of consciousness for more than 24 hours.
  • Currently smoking or ceased smoking less than 6 months ago.
  • Chronic fatigue syndrome, liver disease, diabetes mellitus, or gall bladder abnormalities.
  • History of alcohol or drug dependency.
  • Clinically diagnosed psychiatric disorder.
  • Existing diagnosed gastrointestinal disorders likely to impact on absorption of flavonoids.
  • Known allergy to the intervention supplement.
  • Any significant medical condition likely to affect participation.
  • Currently a participant or have been a participant in any other study involving an investigational product within the last 4 weeks.
  • Uncontrolled hypertension (systolic blood pressure >140mmHg, diastolic blood pressure >90mmHg).
  • Major cardiovascular event, such as myocardial infarction, within the last 12 months.
  • On a stable prescription of blood pressure lowering medication or non-steroidal anti-inflammatory drugs. for fewer than 2 months.
  • Prescribed anti-coagulant/blood thinning medication (eg. warfarin).
  • Taking flavonoid containing supplements (and unwilling to cease intake during, and 1 month preceding the trial) or unwilling to maintain existing intake of other supplements.
  • High flavonoid intake defined as > 15 portions of flavonoid rich foods per day
  • Are currently taking medication or supplements which have a significant impact on the outcome measures.

In addition, any participants with claustrophobia will not be invited to participate in the neuroimaging component of the study. Likewise for metal implants, e.g. pacemaker that precludes MRI.

Treatment and study plan

Freeze-Dried Cranberry Powder

Dietary Supplement

Freeze-dried cranberry powder (or matched placebo), approximating 500mg active flavonoids per day, taken twice daily for 12 weeks.

Placebo

Dietary Supplement

Placebo food powder matched for taste, colour, energy and macronutrient content to the active cranberry powder.

Primary outcomes

  1. Gut microflora speciation and metabolism

    Time frame: 12 weeks

    Measured in faecal and serum samples.

  2. Change in volumes of hippocampus and other key brain structures

    Time frame: 12 weeks

    Structural magnetic resonance imaging

  3. Change in cerebrovascular blood flow

    Time frame: 12 weeks

    Measured using spectroscopy

  4. Change in global cognition

    Time frame: 12 weeks

    Global cognition to be measured using the Addenbrooke's Cognitive Examination - III, from 0-100, with higher scores indicating better global cognitive performance.

  5. Change in spatial navigation abilities

    Time frame: 12 weeks

    The Supermarket Test, with outcomes including accurate reporting of starting direction, and accurate indication of end position and direction.

  6. Change in executive function and attention

    Time frame: 12 weeks

    Trail Making Test, with scores including time taken to complete and number of errors made.

  7. Change in memory performance

    Time frame: 12 weeks

    The Rey Complex Figure Test, with outcomes including time taken to complete copy, accuracy out of a possible 36 of copy and accuracy out of 36 of 3-minute recall.

  8. Change in spatial navigation abilities

    Time frame: 12 weeks

    SeaHero Quest Test, with outcomes including time taken to complete, accuracy of path taken and number of errors made.

  9. Change in executive function and attention

    Time frame: 12 Weeks

    Digit Span Backwards, scored out of a possible 14 for numbers recited backwards in the correct order.

  10. Change in presence of circulating inflammatory biomarkers (hs-CRP)

    Time frame: 12 weeks

    Blood samples analysed for presence of inflammatory cytokines

  11. Change in circulating biomarkers of neuronal functioning and cognitive decline (BDNF)

    Time frame: 12 weeks

    Blood samples analysed for presence of circulating biomarkers of neural function

  12. Change in circulating biomarkers of lipid metabolism (total-, HDL-, LDL-cholesterol)

    Time frame: 12 weeks

    Blood samples analysed for presence of circulating biomarkers of lipid metabolism

  13. Change in circulating biomarkers of lipid metabolism (triglycerides)

    Time frame: 12 weeks

    Blood samples analysed for presence of circulating biomarkers of lipid metabolism

Secondary outcomes

  1. Changes in energy expenditure and sleep

    Time frame: 12 weeks

    Actigraphs to be used to measure changes in activity and sleep patterns of participants.

  2. Genetics related to neurodegenerative disease

    Time frame: Baseline

    Blood samples to be analysed for genes associated with neurodegenerative disease and dementia (eg. C9ORF72, APOE-4)

  3. Biomarkers of gut permability and endotoxemia (LPS)

    Time frame: 12 weeks

    Blood serum/plasma samples to be analysed for presence of lipopolysaccharide (LPS) as a biomarker of gut permability and possible endotoxemia

  4. Levels of sunlight exposure

    Time frame: Baseline, Follow-up

    Self-reported levels of daily sunlight exposure to be measured using a brief questionnaire

Sponsors and collaborators

Lead sponsor

University of East Anglia

Other

Collaborators

  • Clinical Research and Trials Unit (Norfolk & Norwich University Hospital, UK)

Registry information

Official study title

The Impact of Cranberries on the Microbiome and the Brain in Healthy Ageing: A Feasibility Intervention

Acronym: COMBAT

Important dates

Study start
2018
Primary completion
2020
Study completion
2020
First posted
Sep 20, 2018
Registry last updated
Sep 30, 2020

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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