Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This study is testing whether taking vitamin C every day can help improve gut health and reduce inflammation in adults with obesity. Poor gut health-sometimes called "leaky gut"-can allow harmful substances from bacteria to enter the bloodstream, which may lead to inflammation and increase the risk of heart disease and liver problems.
Participants will complete two study periods, each lasting two weeks, with a two-week break in between. In one period, they will take vitamin C; in the other, a placebo. During each period, researchers will collect blood, urine, and stool samples, ask participants to track their diet and activity, and perform a test to measure gut permeability.
There are minimal risks, such as discomfort from blood draws or temporary stomach upset from a sugar drink. While participants may not directly benefit, their involvement will help researchers learn whether vitamin C is a safe and effective way to improve gut health in people with obesity.
This clinical study aims to evaluate the impact of vitamin C supplementation on gut barrier function and systemic inflammation in adults with obesity. The research builds on preclinical findings that suggest vitamin C plays a critical role in maintaining gut integrity and reducing inflammation. Approximately 40% of Americans have suboptimal vitamin C status, with even higher prevalence among individuals with obesity.
The primary hypothesis is that improving vitamin C status through dietary supplementation will reduce intestinal permeability and metabolic endotoxemia. A secondary hypothesis is that vitamin C will also reduce biomarkers of intestinal inflammation and promote favorable changes in gut microbiota composition, including increased production of short-chain fatty acids (SCFAs), which are essential for intestinal health.
This randomized, double-blind, placebo-controlled crossover trial will enroll 34 obese adults (BMI 30-40 kg/m², aged 18-50 years). Participants will complete two 2-week intervention periods separated by a 2-week washout. In one period, they will receive vitamin C (500 mg capsules taken twice daily); in the other, a placebo. During both periods, participants will follow a low-vitamin C diet to minimize variability in circulating vitamin C levels.
Assessments will occur on Days 0, 7, and 14 of each intervention period and include: Anthropometric measurements; Resting blood pressure; Fasting blood samples; and 3-day food records. On Day 14 of each period, participants will: Provide a stool sample and Complete a gut permeability test using a non-digestible sugar probe solution followed by a 24-hour urine collection. After the first intervention period, participants will undergo a 2-week washout before repeating the procedures with the alternate supplement.
Primary Outcome: Intestinal permeability
Secondary Outcomes: Biomarkers of endotoxemia; Gut microbiota composition; Intestinal and circulating inflammation biomarkers; Plasma vitamin C concentrations; Fecal short-chain fatty acids.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inadequate Vitamin C Status | Placebo Comparator | Placebo + Low Vitamin C Diet |
|
| Adequate Vitamin C Status | Experimental | Vitamin C Supplement + Low Vitamin C Diet |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vitamin C Supplement + Low Vitamin C Diet | Dietary Supplement | Participants will receive a vitamin C supplement (1000 mg/d) while following a low vitamin C diet to achieve adequate vitamin C status in a blinded manner. This will be compared to participants receiving a placebo while following a low vitamin C diet that is expected to maintain inadequate vitamin C status. |
| Measure | Description | Time Frame |
|---|---|---|
| Small Intestinal Permeability | Urinary excretion ratio of lactulose/mannitol following oral ingestion of these sugar probes. | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Large Intestinal Permeability | Urinary excretion ratio of sucralose/erythritol following oral ingestion of these sugar probes. | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma Vitamin C |
| Measure | Description | Time Frame |
|---|---|---|
| alpha-Diversity (Chao1) | Gut microbiota alpha-diversity will be determined from 16S rRNA sequencing | Between-treatment arm comparison on day 14 following 2-week intervention |
| alpha-Diversity (Shannon Index) |
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Study Coordinator | Contact | 614-292-4751 | NutritionClinicalTrials@osu.edu |
| Name | Affiliation | Role |
|---|---|---|
| Richard Bruno, PhD, RD | Ohio State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Ohio State University | Recruiting | Columbus | Ohio | 43210 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30640128 | Background | Traber MG, Buettner GR, Bruno RS. The relationship between vitamin C status, the gut-liver axis, and metabolic syndrome. Redox Biol. 2019 Feb;21:101091. doi: 10.1016/j.redox.2018.101091. Epub 2018 Dec 26. |
Not provided
Not provided
Although no formal plan for sharing is established, data will be shared upon reasonable request and when in accordance with regulatory compliance considerations.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Placebo + Low Vitamin C Diet | Dietary Supplement | Participants will receive a placebo while following a low vitamin C diet to achieve inadequate vitamin C status in a blinded manner. This will be compared to participants receiving a vitamin C supplement while following a low vitamin C diet that is expected to maintain adequate vitamin C status. |
|
Biochemical measures of Vitamin C
| Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma Vitamin C | Biochemical measures of Vitamin C | Within-treatment arm comparison from day 0 to day 14 following 2-week intervention. |
| Fecal Calprotectin | Biochemical measures of Calprotectin | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Fecal Myeloperoxidase | Biochemical measures of Myeloperoxidase | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Fecal Butyrate | Biochemical measures of Butyrate | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Fecal Proprionate | Biochemical measures of Proprionate | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Fecal Acetate | Biochemical measures of Acetate | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Serum Endotoxin Concentration | Biochemical measure of circulating endotoxin concentration at fasting | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma Lipopolysaccharide Binding Protein/Soluble Cluster of Differentiation-14 | Biochemical measures of Lipopolysaccharide Binding Protein/Soluble Cluster of Differentiation-14 at fasting, reported as a ratio of protein concentrations | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma C-Reactive Protein | Biochemical measures of C-Reactive Protein | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma Myeloperoxidase | Biochemical measures of Myeloperoxidase | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma Tumor Necrosis Factor-α | Biochemical measures of Tumor Necrosis Factor-α | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Plasma Trimethylamine N-oxide | Biochemical measures of Trimethylamine N-oxide | Between-treatment arm comparison on day 14 following 2-week intervention. |
Gut microbiota alpha-diversity will be determined from 16S rRNA sequencing
| Between-treatment arm comparison on day 14 following 2-week intervention |
| beta-Diversity (Bray-Curtis Dissimilarity) | Gut microbiota beta-diversity will be determined from 16S rRNA sequencing | Between-treatment arm comparison on day 14 following 2-week intervention |
| beta-Diversity (UniFrac) | Gut microbiota beta-diversity will be determined from 16S rRNA sequencing | Between-treatment arm comparison on day 14 following 2-week intervention |
| Toll-like Receptor-4 mRNA expression | qPCR measure of gene expression from Peripheral Blood Mononuclear Cells isolated from whole blood | Between-treatment arm comparison on day 14 following 2-week intervention. |
| TNF-alpha mRNA expression | qPCR measure of gene expression from Peripheral Blood Mononuclear Cells isolated from whole blood | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Monocyte Chemoattract Protein-1 mRNA expression | qPCR measure of gene expression from Peripheral Blood Mononuclear Cells isolated from whole blood | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Interleukin-6 mRNA expression | qPCR measure of gene expression from Peripheral Blood Mononuclear Cells isolated from whole blood | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Interleukin-8 mRNA expression | qPCR measure of gene expression from Peripheral Blood Mononuclear Cells isolated from whole blood | Between-treatment arm comparison on day 14 following 2-week intervention. |
| Myeloid differentiation primary response 88 mRNA expression | qPCR measure of gene expression from Peripheral Blood Mononuclear Cells isolated from whole blood | Between-treatment arm comparison on day 14 following 2-week intervention. |