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The interaction between the gut microbiome, the intestinal barrier, and the host plays an important role in human health. The integrity of the intestinal barrier is essential to protect against translocation of food antigens and immunostimulatory microbial metabolites from the gut lumen. Accumulating studies show that stress may negatively affect the intestinal barrier function. In a previous study, the investigators developed the Leuven Prolonged Acute Stress Test (L-PAST), which combines physical (cold water), mental (arithmetic), and social (negative feedback) aspects of stress for a prolonged (2h) time. In the current study the investigators would like, as a first aim, to investigate whether the L-PAST 1) increases intestinal permeability compared to baseline intestinal permeability, and 2) whether a nutritional intervention can improve baseline intestinal permeability as well as intestinal permeability after exposure to the L-PAST in both healthy females and men. As a second aim of the present study, the investigators would like to investigate whether prebiotics and/or L-tryptophan can attenuate the cortisol response to stress. Lastly, as acute psychosocial stress impairs cognitive functions, the investigators would like as a third aim to investigate whether prebiotics and/or L-tryptophan supplementation may prevent these impairments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prebiotic | Experimental |
| |
| L-Tryptophan | Experimental |
| |
| Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prebiotic | Dietary Supplement | Group 1 (prebiotic and placebo L-tryptophan): prebiotic (oligofructose, Orafti®P95, 20g/day) and placebo L-tryptophan (microcrystalline cellulose, 3g/day) |
| Measure | Description | Time Frame |
|---|---|---|
| Executive functions during a prolonged stress task (the Leuven Prolonged Stress Test) | Working memory, cognitive flexibility, and response inhibition. Working memory will be assessed using the forward digit span. Cognitive flexibility will be assessed using the Wisconsin Card Sorting Test. Response inhibition will be assessed using the Stop Signal Task. | Measured during the stress induction task during both the pre-intervention visit and immediately after the 4 week intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Intestinal permeability after a prolonged stress task (the Leuven Prolonged Stress Test) | Intestinal permeability will be measured using the lactulose-mannitol test. The lactulose-mannitol ratio will be calculated and used as a measure for small intestinal permeability. Fractional excretion of lactulose and mannitol will also be assessed. | Measured at the pre-intervention and immediately after the 4 week intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Intestinal permeability baseline | Intestinal permeability will be measured using the lactulose-mannitol test. The lactulose-mannitol ratio will be calculated and used as a measure for small intestinal permeability. Fractional excretion of lactulose and mannitol will also be assessed. | Measured 2 days before the pre-intervention and immediately after the 4 week intervention. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Danique La Torre, MSc | Contact | +3216373499 | danique.latorre@kuleuven.be | |
| Kristin Verbeke, PhD | Contact | +3216330150 | kristin.verbeke@kuleuven.be |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| KU Leuven/ UZ Leuven | Recruiting | Leuven | Vlaams-Brabant | 3000 | Belgium |
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D056692 | Prebiotics |
| D014364 | Tryptophan |
| ID | Term |
|---|---|
| D004043 | Dietary Fiber |
| D004040 | Dietary Carbohydrates |
| D002241 | Carbohydrates |
| D011135 | Polysaccharides, Bacterial |
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The present study is a parallel group randomized controlled trial (RCT) aiming to investigate whether two nutritional interventions (prebiotics and L-tryptophan) can improve intestinal barrier function, attenuate the stress response, affect cognitive processes, and prevent stress-induced hyperpermeability. Participants will perform 2 study visits of 3h each and with 28 days in between, in which participants will be subjected to the L-PAST. During the L-PAST, 3 cognitive tasks will be administered. Moreover, participants will be asked to take a basal intestinal permeability test at home 2 days before the test days.
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Participants, investigators, and personnel involved in data analyses are blinded to the intervention. Unblinding occurs after all data has been collected AND analysed.
| L-Tryptophan | Dietary Supplement | Group 2 (placebo prebiotic and L-tryptophan): L-tryptophan (3g/day) and placebo prebiotic (microcrystalline cellulose, 20g/day) |
|
| Placebo | Dietary Supplement | Group 3 (placebo prebiotic and placebo L-tryptophan): placebo prebiotic (microcrystalline cellulose, 20g/day) and placebo L-tryptophan (microcrystalline cellulose, 3g/day). |
|
| Stress response to a prolonged stress test (the Leuven Prolonged Stress Test) | Cortisol, blood pressure, and subjective stress. Cortisol will be measured in saliva. Subjective stress will be measured using a Visual Analogue Scale (VAS) | During the stress task (at multiple time points during 120 min), measured at the pre-intervention and immediately after the 4 week intervention. |
| Short chain fatty acids | Short chain fatty acids will be measured both in feces and serum. | Measured for 3h during the pre-intervention and immediately after the 4 week intervention. |
| Tryptophan metabolites | Tryptophan metabolites (kynurenine and indole pathway) will be measured in urine and blood. | Measured in blood for 3h during the pre-intervention and immediately after the 4 week intervention. Urine will be collected 3 days prior to the pre-intervention and immediately after the 4 week intervention. |
| Inflammatory cytokines | Including interleukin (IL)-1β, IL-6, IL-10, IL-13, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α | Measured at the pre-intervention and immediately after the 4 week intervention. |
| Subjective pain response to the prolonged stress test | The subjective pain response to the prolonged stress task (Leuven Prolonged Stress Test) will be measured using a Visual Analogue Scale (VAS) (1-100) | Measured during the stress induction task during both the pre-intervention visit and immediately after the 4 week intervention. |
| Cognitive reactivity to failure response to the prolonged stress test | Cognitive reactivity to failure response to the prolonged stress task (Leuven Prolonged Stress Test) will be assessed using two rating scales on a scale of 0 to 100. On one scale, 0 means 'I feel much less self-assured than before, 50 means 'I feel as self-assured as before, and 100 means 'I feel much more self-assured than before'. On the other scale, 0 means 'I think I'm not good at anything at all, 50 means 'I still think the same about myself', and 100 means 'I think I can achieve anything'. | Measured during the stress induction task during both the pre-intervention visit and immediately after the 4 week intervention. |
| Perceived Stress Scale (PSS) | The Perceived Stress Scale (PSS) is a 14-item instrument designed to measure the degree to which situations in one's life are appraised as stressful. It provides a tool for examining issues about the role of appraised stress levels in the etiology of disease and behavioral disorders. The scale is designed such that it asks the respondent to rate the frequency of his/her feelings and thoughts related to events and situations that occurred over a selected time-frame. Notably, high PSS scores have been correlated with higher biomarkers of stress, such as cortisol. | Measured at the pre-intervention and immediately after the 4 week intervention. |
| Gastrointestinal symptom rating scale (GSRS) | The Gastrointestinal Symptom Rating Scale (GSRS) is a disease-specific instrument of 15 items combined into five symptom clusters depicting Reflux, Abdominal pain, Indigestion, Diarrhea and Constipation. The GSRS has a seven-point graded Likert-type scale where 1 represents absence of troublesome symptoms and 7 represents very troublesome symptoms. The reliability and validity of the GSRS are well-documented, and norm values for a general population are available. | Measured at the pre-intervention and immediately after the 4 week intervention. |
| Patient Health Questionnaire 9 (PHQ-9) | The Patient Health Questionnaire - 9 (PHQ-9) is a 9-item questionnaire based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). This self-report measure determines the severity of depression symptoms and is frequently used to monitor changes in symptom severity over time in non-psychiatric settings. Subjects are asked to rate each of the items on a scale of 0 to 3 on the basis of how much a symptom has bothered them over the last 2 weeks (0=not at all, 1=several days, 2=more than half the days, and 3=nearly every day). | Measured at the pre-intervention and immediately after the 4 week intervention. |
| Generalized Anxiety Questionnaire 7 (GAD-7) | The Generalized Anxiety Questionnaire (GAD-7) is a 7-item questionnaire based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). This self-report measure reflects the frequency of anxiety symptoms over the past 2 weeks. Subjects are asked to rate each of the items on a scale of 0 to 3 on the basis of how much a symptom has bothered them over the last 2 weeks (0=not at all, 1=several days, 2=more than half the days, and 3=nearly every day). | Measured at the pre-intervention and immediately after the 4 week intervention. |
| D011134 |
| Polysaccharides |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019587 | Dietary Supplements |
| D019602 | Food and Beverages |
| D024322 | Amino Acids, Aromatic |
| D000598 | Amino Acids, Cyclic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000601 | Amino Acids, Essential |