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Childhood and adolescence are crucial periods for prevention of obesity, as obese children are five times more likely to be obese at adulthood than lean children. To this purpose, sugar consumption should be reduced. The sugar alcohol erythritol is increasingly popular as sugar substitute in the food industry and is also recommended to diabetic patients. The substance is freely available. Recent acute studies show that erythritol has a positive influence on satiation and gastric emptying without affecting insulin and plasma glucose. In this trial, the investigators aim to assess the effect of a chronic intake of erythritol versus sucrose on insulin resistance in healthy adolescents.
EryClot-Pilot:
Erythritol is also produced by the human body and possibly elevated erythritol levels in the blood are an indication of an increased risk of cardiovascular disease, obesity or diabetes in the future.
In a recently published study, a possible effect of erythritol on blood clotting function was described. In this in vitro experiment, increased blood clotting was observed when erythritol was added to clotting cells (platelets) in the test tube. Studies in humans on blood coagulation after administration of erythritol are missing so far.
With a pilot study, the investigators study whether erythritol is detectable in the blood after administration of glucose and fructose. Furthermore, the erythritol level in the blood and a possible effect on the blood coagulation function after administration of erythritol will be investigated.
These preliminary tests serve to clarify the data situation so that further studies can be based on them.
The preliminary results of the EryClot_Pilot study indicate that there appears to be no measurable effect of erythritol on thrombocyte aggregation. This implicates that there is a discrepancy between our results and the results reported in a recent published study. This is why we need to assess the effects of erythritol administration on more parameters of blood coagulation as well as in more subjects.
Due to a study published in June 2024, there appears the need to investigate the effects of xylitol on blood clotting function as well.
EryClot in vitro:
In addition to the human EryClot study, we will conduct in vitro experiments (aggregometry assay after addition of erythritol or xylitol in human platelet rich plasma).
This trial aims to assess the effects of the daily intake of an erythritol-sweetened beverage over 5 weeks on insulin resistance, glucose tolerance and metabolism as well as on gut microbiota. Moreover, this study will also assess the effect of the above-mentioned intervention on food intake, body composition and gastrointestinal tolerance in this population.
EryClot-Pilot:
The aim of this pilot study is to investigate whether erythritol is detectable in the blood after administration of glucose and fructose. Furthermore, the erythritol level in the blood and a possible effect on the blood clotting function after administration of erythritol will be investigated.
EryClot:
The aim of this study is to investigate the erythritol level in blood after administration of erythritol and a possible effect on blood clotting function. Additionally, a possible effect of xylitol on blood clotting function will be investigated.
EryClot in vitro:
The aim of this study is to investigate the platelet responsiveness in vitro in human plasma after addition of erythritol and xylitol.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sucrose | Active Comparator | 15 participants receive 25g sucrose per day during 5 weeks |
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| Erythritol | Experimental | 15 participants receive 36g eryhtritol per day during 5 weeks |
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| EryClot-Pilot Erythritol | Experimental | 3 participants receive 50g erythritol dissolved in 300mL water once during the visit |
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| EryClot-Pilot Glucose | Active Comparator | 3 participants receive 75g glucose dissolved in 300mL water once during the visit |
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| EryClot-Pilot Fructose | Active Comparator | 3 participants receive 25g fructose dissolved in 300mL water once during the visit |
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| EryClot Erythritol | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Eryhtritol | Dietary Supplement | Eryhtritol-sweetened beverages twice a day (36g erythritol/day) with main meals during 5 weeks EryClot-Pilot: Erythritol 50g dissolved in 300mL water administered once per visit EryClot: Erythritol 50g dissolved in 300mL water administered once per visit |
| Measure | Description | Time Frame |
|---|---|---|
| Insulin resistance | Insulin resistance as measured by the HOMA Index. | Change from baseline to 5 weeks after polyol/sucrose intake |
| EryClot-Pilot Thrombocyte aggregation | Thrombocyte aggregation after consumption of test solution measured with a blood sample | Blood samples at timepoint t= 0, 30, 60, 120, 180 minutes |
| EryClot Thrombocyte aggregation | Thrombocyte aggregation after consumption of test solution measured with a blood sample | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes |
| EryClot in vitro: Platelet responsiveness in human platelet rich plasma | Aggregometry assay after addition of erythritol or xylitol in human platelet rich plasma | One single fasting blood sample at timepoint t = -10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Glucose tolerance: Insulin | Insulin levels during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: Glucose | Glucose levels during OGTT |
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EryAdo:
Inclusion Criteria:
Exclusion Criteria:
EryClot-Pilot:
3 participants
Inclusion criteria:
Exclusion criteria:
EryClot:
Inclusion criteria:
Exclusion criteria:
EryClot in vitro
Inclusion criteria:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Bettina K. Wölnerhanssen, PD. MD | St. Clara Research Ltd. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Claraspital | Basel | Canton of Basel-City | 4002 | Switzerland |
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EryClot-Pilot:
This trial is a randomized, double-blind, crossover trial. The project set-up is single-center, national. In total, 3 volunteers will be enrolled. There will be 3 study arms.
EryClot This trial is a randomized single-blind, crossover trial. The project setup is single-center national. In total 10 volunteers will be enrolled. There will be 3 study arms.
EryClot in vitro This trial is an in vitro trial using human blood samples. The project setup is single-center national. In total blood samples from 12 volunteers will be collected.
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10 participants receive 50g erythritol dissolved in 300mL water once during the visit
|
| EryClot Xylitol | Experimental | 10 participants receive 33.5g xylitol dissolved in 300mL water once during the visit |
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| EryClot Water | Placebo Comparator | 10 participants receive 300mL water once during the visit |
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| Sucrose | Dietary Supplement | Sucrose-sweetened beverages twice a day (25g sucrose/day) with main meals during 5 weeks |
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| Glucose | Dietary Supplement | Glucose 75g dissolved in 300mL water administered once per visit |
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| Fructose | Dietary Supplement | Fructose 25g dissolved in 300mL water administered once per visit |
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| Xylitol | Dietary Supplement | Xylitol 33.5g dissolved in 300mL water administered once per visit |
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| Water | Dietary Supplement | 300mL water administered once per visit |
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| Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: C-Peptide | C-peptide levels during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: Glucagon | Glucagon levels during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: Fructosamin | Fructosamin levels | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: HbA1C | HbA1C levels | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: Continuous glucose monitoring average | Continuous glucose monitoring for average glucose levels | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: Continuous glucose monitoring glucose variability | Continuous glucose monitoring for glucose variability | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose tolerance: Continuous glucose monitoring time within range | Continuous glucose monitoring for time within range | Change from baseline to 5 weeks after polyol/sucrose intake |
| Glucose absorption | Glucose absorption measured by 3-OMG concetrations during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Metabolomics | Metabolomics in plasma, urine and stool samples, measured by 1H-NMR and Liquid Chromatography-Mass Spectrometry (LC-MS). | Change from baseline to 5 weeks after polyol/sucrose intake |
| Gut microbiota composition | The taxonomic and functional profiles of the gut microbiota (stool samples) assessed by metagenomic shotgun sequencing. | Change from baseline to 5 weeks after polyol/sucrose intake |
| Gastrointestinal hormones secretion: GLP-1 | Secretion of GLP-1 during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Gastrointestinal hormones secretion: PYY | Secretion of PYY during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Gastrointestinal hormones secretion: Ghrelin | Secretion of Ghrelin during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Gastrointestinal hormones secretion: CCK | Secretion of CCK during OGTT | Change from baseline to 5 weeks after polyol/sucrose intake |
| Food intake | Food intake assessed with self-reported food records | Change from baseline to 5 weeks after polyol/sucrose intake |
| Gastrointestinal tolerance | Gastrointestinal tolerance recorded by the "Gastrointestinal Symptoms Rating Scale" (GSRS), 15 items rated on 7 Point Likert-Scale, a higher score means a worse outcome. Maximum score: 90, Minimum score: 0 | Change from baseline to 3 and 5 weeks after polyol/sucrose intake |
| Body composition: fat mass | Body composition assessed by mean of bioimpedance analysis: fat mass in kg | Change from baseline to 5 weeks after polyol/sucrose intake |
| Body composition: fat free mass | Body composition assessed by mean of bioimpedance analysis: fat free mass in kg | Change from baseline to 5 weeks after polyol/sucrose intake |
| EryClot-Pilot Blood p-Selectin concentrations | Blood p-Selectin concentrations after consumption of test solution | Blood samples at timepoint t= 0, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot-Pilot Blood Erythritol concentrations | Blood Erythritol concentrations after consumption of test solution | Blood samples at timepoint t= 0, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot blood p-selectin concentrations | Blood p-Selectin concentrations after consumption of test solution | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot blood sVCAM1 concentrations | Blood sVCAM1 concentrations after consumption of test solution | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot blood PF4 concentrations | Blood PF4 concentrations after consumption of test solution | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot blood D-Dimers concentrations | Blood D-Dimers concentrations after consumption of test solution | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot blood Erythritol concentrations | Blood erythritol concentrations after consumption of test solution | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes and 24, 48 hours |
| EryClot blood Xylitol concentrations | Blood xylitol concentrations after consumption of test solution | Blood samples at timepoint t= -60, -1, 30, 60, 120, 180 minutes and 24, 48 hours |
| ID | Term |
|---|---|
| D007333 | Insulin Resistance |
| ID | Term |
|---|---|
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D013395 | Sucrose |
| D005947 | Glucose |
| D005632 | Fructose |
| D014993 | Xylitol |
| D014867 | Water |
| ID | Term |
|---|---|
| D004187 | Disaccharides |
| D009844 | Oligosaccharides |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
| D000073893 | Sugars |
| D006601 | Hexoses |
| D009005 | Monosaccharides |
| D007661 | Ketoses |
| D013402 | Sugar Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D006878 | Hydroxides |
| D000468 | Alkalies |
| D007287 | Inorganic Chemicals |
| D000838 | Anions |
| D007477 | Ions |
| D004573 | Electrolytes |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |
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