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OpenTrials
Completed

NCT Number: NCT06932666

Why Calories Are Not the Same - a Gut Explanation?

The aim of this study is to understand how the gut microbiome influences how much dietary energy humans excrete via feces. This study is based on the hypothesis that levels of methane in exhaled breath represent two different gut microbiome community structures, and therefore influence fecal energy excretion differently. Moreover, this study is assessed in the context of two different diets, both isocaloric and equal in macronutrient composition, but differing in contents of fiber, resistant starch, and large particles; which are hypothesized to impact the gut microbiome differently.

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Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Copenhagen, Department of Nutrition, Exercise and Sports

Frederiksberg, Capital Region, 1958, Denmark

About this study

The trial is a cross-over trial including two controlled isocaloric dietary interventions of three days duration. The two diets are isocaloric but with different contents of fiber, resistant starch, and food particle sizes. Each intervention is separated by a wash-out period of at least 10 days where participants adhere to their habitual diet. The trial includes a total of five visits (one screening visit and four regular visits).

Before the trial, participants undergo a screening period of 4 days. During the 4-day screening period, participants measure the levels of methane in their exhaled breath. Based on median breath methane levels, participants are allocated to one of the two arms: (HMP: high methane producers; LMP: low methane producers). Enrollment in the intervention trial will be conducted so there are similar numbers of participants in both arms.

At the beginning and at the end of each 3-day intervention period, participants consume a blue muffin, containing a royal blue dye that changes the stool color. The appearance of the color in stool following the first muffin will mark the beginning of the stool collection period, which will continue until the stool color change is no longer noticeable following consumption of the second muffin. Therefore, the duration of the stool collection period, which is estimated to be on average 3 days, will ultimately depend on the participants' passage time of food (i.e., intestinal transit time).

During the screening period, participants are asked to:

  • measure their methane and hydrogen levels in exhaled breath using a portable device
  • report defecation patterns (including stool frequency and Bristol Stool Scale)

Before each intervention period, participants are asked to:

  • collect a fecal and urine sample
  • register three days of habitual diet

At the visits before each intervention period, the following samples are collected:

  • a blood sample
  • methane and hydrogen measurements in exhaled breath
  • anthropometrics
  • data on physical activity

During the intervention periods, participants are asked to:

  • exclusively eat all the foods provided
  • collect all their stool samples, as specified above
  • collect three morning urine samples (one daily for the following three days)
  • measure their methane and hydrogen levels in their exhaled breath using a portable device
  • report their defecation patterns and gastrointestinal symptoms

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • 18-65 years old
  • BMI:18.5-29.9 kg/m2
  • Self-reported regular defecations defined as at least every second day
  • Willing to collect urine and stool samples at home and able to temporarily store them in their own freezer in a provided container
  • Willing to exclusively eat the food provided
  • Owning a smartphone (iOS 11.0 and onwards, or Android 5.0 and onwards) with access to the internet
  • Speak and understand Danish or English

Exclusion criteria

  • Current pregnancy or lactation
  • Following a specific dietary program or diet (e.g., vegetarian, vegan, gluten-free) or unable to consume the food provided
  • Diagnosis of small intestinal bacterial overgrowth (SIBO), inflammatory bowel diseases (IBD), gastrointestinal obstruction, or ischemic colitis
  • Diagnosed chronic constipation
  • Regular use of diarrhea inhibitors or laxatives
  • Any chronic disease that can affect the outcomes of the study
  • Use of medications potentially altering gastric pH (proton pump inhibitors, histamine receptor antagonists, antacids)
  • Use of medications potentially altering the gastro-intestinal motility (prokinetics, antiemetic agents, anticholinergic agents, narcotic analgesics, nonsteroidal anti-inflammatory drugs, peroral glucocorticoids, and GLP-1 related medications such as semaglutide and liraglutide)
  • Use of antibiotics, or any medication that can affect any outcomes of the study, within the previous three months
  • Concurrent participation in another trial
  • Any condition that makes the project responsible and/or the clinical responsible doubt the feasibility of the volunteer's participation

Treatment and study plan

Diet A group

Other

Diet high in fiber (> 40g/10MJ), high in resistant starch (> 10g/10MJ), and containing large food particles. Diet is provided for 3 full days, consists of three meals per day (breakfast, lunch, and dinner) and in-between meals, and covers 100% of the participants' energy requirements.

Diet B group

Other

Diet low in fiber (< 10g/10MJ), low in resistant starch (< 3g/10MJ) and containing small food particles. Diet is provided for 3 full days, consists of three meals per day (breakfast, lunch, and dinner) and in-between meals, and covers 100% of the participants' energy requirements.

Primary outcomes

  1. Total fecal energy excretion (between high- and low-methane producers)

    Time frame: During each stool collection period (following each 3-day intervention period)

    Differences in total fecal energy excretion, determined as total kilocalories excreted via feces, between low and high methane producers following intake of the two controlled, isocaloric diets.

Secondary outcomes

  1. Total fecal energy excretion (between diet A and diet B)

    Time frame: During each stool collection period (following each 3-day intervention period)

    Differences in total fecal energy excretion, determined as total kilocalories excreted via feces, between the two isocaloric diets (that differ in fiber, resistant starch, and particle size).

  2. Fecal energy density

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal energy density, determined as fecal energy (kcal) relative to fecal weight, between high- and low-methane producers.

  3. Total fecal weight excreted

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in total fecal weight excreted, determined as dry weight (grams), between high- and low-methane producers.

  4. Breath hydrogen and methane levels

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in breath methane and hydrogen concentration in exhaled breath, measured in parts per million (PPM), between high- and low-methane producers.

  5. Whole-gut transit time

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in whole-gut transit time, determined by the passage time of muffins with blue dye, between high- and low-methane producers.

  6. Stool consistency

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in stool consistency, determined by Bristol Stool Scale, between high- and low-methane producers.

  7. Stool frequency

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in stool frequency, determined by defecation records registered by the participants, between high- and low-methane producers.

  8. Stool moisture

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in stool moisture, determined as fecal water content relative to fecal weight, between high- and low-methane producers.

  9. Fecal pH

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal pH between high- and low-methane producers.

  10. Fecal microbial load

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal microbial load, determined as total microbial DNA reads in feces, between high- and low-methane producers.

  11. Fecal host DNA concentration

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal host DNA concentration, determined as total human DNA reads in feces, between high- and low-methane producers.

  12. Fecal short-chain fatty acids

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal short-chain fatty acid concentrations between high- and low-methane producers.

  13. Gut microbiome composition (16S)

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in gut microbiome composition, determined by 16S amplicon sequencing of fecal DNA, between high- and low-methane producers.

  14. Gut microbiome composition and functions (shotgun sequencing)

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in gut microbiome taxonomic composition and functions, determined by shotgun sequencing of fecal DNA, between high- and low-methane producers.

Other outcomes

  1. Gut microbiome-derived metabolites (fecal samples)

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in gut microbiome-derived metabolites, such as short-chain fatty acids, bile acids, amino acid-derived metabolites, and other metabolites derived from microbial proteolytic and saccharolytic fermentation measured from fecal samples, between high- and low-methane producers.

  2. Gut microbiome-derived metabolites (urine samples)

    Time frame: Before and during each 3-day intervention period

    Differences in gut microbiome-derived metabolites, such as short-chain fatty acids, bile acids, amino acid-derived metabolites, and other metabolites derived from microbial proteolytic and saccharolytic fermentation measured from urine samples, between high- and low-methane producers.

  3. Gut microbiome-derived metabolites (blood samples)

    Time frame: Right before each 3-day intervention period

    Differences in gut microbiome-derived metabolites, such as short-chain fatty acids, bile acids, amino acid-derived metabolites, and other metabolites derived from microbial proteolytic and saccharolytic fermentation measured from blood samples, between high- and low-methane producers.

  4. Fecal metabolome (untargeted metabolomics)

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in the fecal metabolome, measured by LC-MS/MS untargeted metabolomics, between high- and low-methane producers.

  5. Urine metabolome (untargeted metabolomics)

    Time frame: Before and during each 3-day intervention period

    Differences in the urine metabolome, measured by LC-MS/MS untargeted metabolomics, between high- and low-methane producers.

  6. Blood metabolome (untargeted metabolomics)

    Time frame: Right before each 3-day intervention period

    Differences in the blood metabolome, measured by LC-MS/MS untargeted metabolomics, between high- and low-methane producers.

  7. Gastrointestinal symptoms

    Time frame: During each 3-day intervention period

    Differences in the gastrointestinal symptoms during the 3-day intervention period, measured using a visual analog scale, between high- and low-methane producers.

  8. Habitual diet records

    Time frame: Right before each 3-day intervention period

    Differences in habitual diet records registered by participants, between high- and low-methane producers.

  9. Habitual physical activity records

    Time frame: Baseline (before the first 3-day intervention period)

    Differences in habitual physical activity records registered by participants, between high- and low-methane producers.

  10. Body weight

    Time frame: Right before each 3-day intervention period

    Differences in body weight before intervention, between high- and low-methane producers.

  11. Body fat composition

    Time frame: Baseline (before the first 3-day intervention period)

    Differences in body fat composition, measured through Dual-Energy X-ray Absorptiometry (DXA scan), between high- and low-methane producers.

  12. Muscle composition

    Time frame: Baseline (before the first 3-day intervention period)

    Differences in muscle composition, measured through Dual-Energy X-ray Absorptiometry (DXA scan), between high- and low-methane producers.

  13. Bone composition

    Time frame: Baseline (before the first 3-day intervention period)

    Differences in bone composition, measured through Dual-Energy X-ray Absorptiometry (DXA scan), between high- and low-methane producers.

  14. Biomarkers of food intake (fecal samples)

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in biomarkers of food intake, measured by untargeted metabolomics and food DNA in fecal samples, between high- and low-methane producers.

  15. Biomarkers of food intake (urine samples)

    Time frame: Before and during each 3-day intervention period

    Differences in biomarkers of food intake, measured by untargeted metabolomics in urine samples, between high- and low-methane producers.

  16. Biomarkers of food intake (blood samples)

    Time frame: Right before each 3-day intervention period

    Differences in biomarkers of food intake, measured by untargeted metabolomics in blood samples, between high- and low-methane producers.

  17. Fecal particle size

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal particle size between high- and low-methane producers.

  18. Fecal carbon-to-nitrogen ratio

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal carbon-to-nitrogen ratio between high- and low-methane producers.

  19. Fecal redox potential

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal redox potential, measured in millivolts (mV), between high- and low-methane producers.

  20. Fecal biomarkers of inflammation: calprotectin

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal biomarkers of inflammation, determined by fecal calprotectin, between high- and low-methane producers.

  21. Fecal biomarkers of intestinal permeability: zonulin

    Time frame: During each 3-day intervention period and its following stool collection period

    Differences in fecal biomarkers of intestinal permeability, determined by fecal zonulin, between high- and low-methane producers.

  22. Blood markers of glucose metabolism

    Time frame: Right before each 3-day intervention period

    Differences in blood markers of glucose metabolism, such as glucose, insulin and HbA1C, between high- and low-methane producers.

  23. Blood markers of lipid metabolism

    Time frame: Right before each 3-day intervention period

    Differences in blood markers of lipid metabolism, such as total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides, between high- and low-methane producers.

  24. Blood markers of inflammation

    Time frame: Right before each 3-day intervention period

    Differences in blood markers of inflammation, such as CRP, IL-6, TNF-α, and other cytokines, between high- and low-methane producers.

  25. Blood markers of appetite

    Time frame: Right before each 3-day intervention period

    Differences in blood markers of appetite, such as glucagon, GLP-1, GLP-2, PYY, leptin, ghrelin, GIP, and CCK, between high- and low-methane producers.

  26. Blood markers of intestinal permeability: LBP

    Time frame: Right before each 3-day intervention period

    Differences in blood markers of intestinal permeability, such as lipopolysaccharide-binding protein (LBP), between high- and low-methane producers.

Sponsors and collaborators

Lead sponsor

University of Copenhagen

Other

Collaborators

  • Wageningen University and Research

Registry information

Official study title

Why Calories Are Not the Same - a Gut Explanation

Acronym: GutEnergy

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Apr 17, 2025
Registry last updated
Jun 2, 2026

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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