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The mechanism of neural communication between the brain and gut in the regulation of food intake is complex and not fully understood. Magnetic Resonance Imaging (MRI) is a powerful non-invasive imaging tool that allows studying the function of the brain and gut. The aim of this study is to develop MRI methods to combine brain and gut imaging in a single MRI scan session. The developed techniques will then be used to assess the brain-gut axis to a high fat drink compared with iso-caloric/iso-viscous/iso-volumetric carbohydrate drink in people with obesity and healthy weight participants. The findings could provide a possible explanation for why some people are heavier than others.
20 healthy weight participant (18 Kg/m2>BMI<30Kg/m2) and 20 age- and sex- matched peoples with obesity (BMI >30 Kg/m2) will be invited to a double-blinded two-way crossover MRI study, approximately 1 week apart, to assess the interplay between brain and gut to food intake.
Brain and gut MRI scans will be collected at fasted/baseline and at different time points postprandial for 120 mins using the 3T Ingenia Philips scanner. Brain measurements including resting state-fMRI, cerebral blood flow (CBF), and task-fMRI scans will be collected. During the task fMRI scan, images of high and low energy food pictures, and non-food control pictures will be presented. Food images are extensively used in fMRI studies to characterise the neural systems involved in processing the hedonic value of food as well as satiety and hunger signals. In addition to brain scans, sequences of gut scans will be collected to assess gastric volume, small bowel water content, and superior mesenteric artery (SMA) responses pre- and post-prandial. Blood samples will be collected to assess gut hormones (CCK, GLP1- PYY, ghrelin) insulin and glucose, triglycerides, free fatty acid levels at different timepoints. In addition, satiety and appetite scores will be collected using visual analogue scales. The total scan time including the fed and break times is around 3 hours.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | Active Comparator | Healthy weight group ( same age and sex) |
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| Obese group | Active Comparator | Obese group |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nutritional Drink A | Other | 300 mL of a 22% high fat emulsion (Rapeseed oil, water, emulsifier) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Changes in appetite- and satiety-related brain responses between drinks ( Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS obese) | Blood oxygen level-dependent (BOLD) responses to high-calorie, low-calorie and non-food images | From baseline to up to 2 hours after ingesting the drinks |
| Changes in Cerebral blood flow between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) | Cerebral blood flow differences | From baseline to up to 2 hours after ingesting the drinks |
| Changes resting state brain networks between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) | Alterations in functional brain connectivity/networks in brain regions involved in homeostatic and hedonic brain circuits. | From baseline to up to 2 hours after ingesting the drinks |
| Changes in gastric volume between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) | Area Under the Curve of post-prandial gastric volumes, measured by MRI | From baseline to up to 2 hours after ingesting the drinks |
| Correlations between gut and brain responses to assess alterations in brain-gut axis between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) | Exploratory correlations between brain and gut responses | From baseline to up to 2 hours after ingesting the drinks |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in small bowel water content between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) | Area Under the Curve of post-prandial small bowel water content, measured by MRI, up to 2h (AUC2h) postprandially | From baseline to up to 2 hours after ingesting the drinks |
| Changes in satiety and appetite regulators between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sally Eldeghaidy, PhD | University of Nottingham | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Nottingham | Nottingham | NG7 2RD | United Kingdom |
will be available upon reasonable request
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| ID | Term |
|---|---|
| D009765 | Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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Randomised parallel trial in human volunteers. Control (normal weight) group VS Obese group and High fat drink VS iso-caloric, iso-viscous Carbohydrate drink
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This is a double-blinded study, and the study participant and assessor will be unaware of the nature of the drink. Subjects will be invited into 2 MRI scan visits to investigate the brain and gut responses (brain-gut axis) to a high fat drink and a carbohydrate drink. Drinks will be randomised across participants using research randomizer software (https://www.randomizer.org/).
| Nutritional Drink B | Other | 300 mL of isocaloric, iso-volumetric and iso-viscous carbohydrate drink (maltodextrin) |
|
Area Under the Curve of post-prandial serum gut hormone (CCK, GLP-1, PYY, Ghrelin), insulin, free fatty acid, glucose, and triglyceride concentrations |
| From baseline to up to 2 hours after ingesting the drinks |
| Changes in satiety and appetite score (VAS) between drinks (Fat drink VS Carbohydrate drink) and across groups (Healthy weight VS Obese) | Area Under the Curve for appetite (Fullness, Hunger, Prospective food consumption) post prandial 100 mm VAS scores AUC2h | From baseline to up to 2 hours after ingesting the drinks |
| Correlations between blood, brain and gut and satiety date | Exploratory correlations between blood, brain and gut responses and satiety data | From baseline to up to 2 hours after ingesting the drinks |
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |