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| Name | Class |
|---|---|
| National Dairy Council | OTHER |
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Disturbances in brain insulin sensitivity are associated not only with obesity and type 2 diabetes, but also with brain aging and cognitive decline. Longitudinal studies suggest that dietary patterns, particularly those high in dairy intake, may impact brain function via the gut-brain axis. Indeed, dairy foods are known to modulate gut microbiota and may, through this pathway, not only improve brain insulin sensitivity and cognitive performance, but also mental health and appetite regulation. However, underlying mechanisms remain largely unexplored. The primary objective of this study is to evaluate, in older adults with overweight or obesity, the effects of a high-dairy food pattern (4-5 daily servings of (butter)milk, cheese, yogurt, or cottage cheese) compared to a low-dairy food pattern (≤1 serving daily) on (regional) brain vascular function and insulin sensitivity. These outcomes will be quantified using the non-invasive MRI perfusion technique Arterial Spin Labeling (ASL), which assesses cerebral blood flow (CBF) in response to intranasal insulin, a validated physiological marker of brain insulin sensitivity. Secondary objectives include changes in cognitive performance (via the CANTAB neuropsychological test battery), gut microbiota composition (via shotgun metagenomic analysis of fecal samples), and appetite-related brain reward activity (via BOLD-fMRI with food cues). Exploratory analyses include conventional cardiometabolic risk markers (blood pressure, lipid and glucose metabolism), and perceivable (consumer) benefits.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | High-Dairy Food Pattern |
|
| Control | Placebo Comparator | Low-Dairy Food Pattern |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High-dairy food pattern | Dietary Supplement | During the high-dairy period, participants will be instructed to consume 4-5 daily servings of dairy products, including: 1-2 servings of yogurt or cottage cheese (200 mL per serving, ≤1.5% fat), 1-2 servings of milk or buttermilk (250 mL per serving, ≤1.5% fat), and 1-2 servings of cheese (20 g per serving, 20+ or 30+ reduced-fat options). |
| Measure | Description | Time Frame |
|---|---|---|
| Brain Insulin Sensitivity | Cerebral blood flow measurements before and after a nasal insulin spray as quantified non-invasively by the MRI perfusion method Arterial Spin Labeling (ASL) | Change in brain insulin sensitivity (difference in CBF [mL/100 g tissue/min] before and after intranasal insulin) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Brain vascular function | Cerebral blood flow as quantified non-invasively by the MRI perfusion method Arterial Spin Labeling (ASL) | Change in brain vascular function (CBF in mL/100 g tissue/min) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive Performance | Cambridge Neuropsychological Test Automated Battery (CANTAB) | Change in cognitive performance (test-specific standardized scores) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Gut microbial composition |
| Measure | Description | Time Frame |
|---|---|---|
| Office blood pressure | Office blood pressure | Change in blood pressure (in mmHg) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Heart rate | Heart rate |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kevin MR Nijssen, PhD | Contact | +31433881305 | k.nijssen@maastrichtuniversity.nl |
| Name | Affiliation | Role |
|---|---|---|
| Ronald P Mensink, PhD | Maastricht University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maastricht University | Maastricht | Limburg | 6229ER | Netherlands |
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This study is a randomized, controlled, crossover intervention trial. Each participant will complete two 8-week intervention periods (high-dairy and low-dairy food patterns) separated by a washout period of at least 8 weeks, resulting in a total study duration of approximately 24 weeks.
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| Low-dairy food pattern | Dietary Supplement | During the low-dairy control period, participants will restrict dairy intake to a maximum of one serving per day |
|
Shotgun metagenomics of fecal samples |
| Change in gut microbial composition (shannon index indicating α-diversity) using gene relative abundance profiles at the start and end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Appetite-related brain reward activity | Appetite-related brain reward activity will be assessed by blood oxygenation level-dependent (BOLD) functional MRI responses to standardized food cues | Change in appetite-related brain reward activity (functional connectivity [BOLD signal changes]) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Change in heart rate (in beats/min) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Glucose concentrations | Circulating glucose concentrations | Change in circulating glucose concentrations (in mmol/L) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Insulin concentrations | Circulating insulin concentrations | Change in insulin concentrations (in mIU/L) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Lipid metabolism | Circulating lipid concentrations | Change in circulating lipid concentrations (in mmol/L) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Markers related to low-grade systemic inflammation | Circulating high-sensitive C-reactive protein concentrations | Change in circulating high-sensitive C-reactive protein concentrations (in mg/dl) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived hunger | Visual analogue scale (VAS) questionnaires for hunger | Change in perceived hunger (in mm) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived satiety | Visual analogue scale (VAS) questionnaires for satiety | Change in perceived satiety (in mm) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived desire to eat | Visual analogue scale (VAS) questionnaires for desire to eat | Change in perceived desire to eat (in mm) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived fullness | Visual analogue scale (VAS) questionnaires for fullness | Change in perceived fullness (in mm) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived quality of life | 32-item quality of life questionnaire to assess perceived quality of life | Change in perceived quality of life (average score) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived mood | Affect Grid Questionnaire to assess perceived mood | Change in perceived mood (average score) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived depression and anxiety symptoms | Beck Depression and Anxiety Inventories to assess perceived depression and anxiety symptoms | Change in perceived depression and anxiety symptoms (average scores) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived stress | Perceived Stress Scale questionnaire to assess perceived stress | Change in perceived stress (average score) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Perceived sleep quality | Pittsburgh Sleep Quality Index to assess perceived sleep quality | Change in perceived sleep quality (average score) at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Food intake | Food Frequency Questionnaire to assess food intake over the past month | Change in food intake at the end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Urinary calcium | 24-hour urine samples for analysis of calcium concentrations | Change in urinary calcium (mmol/24 hours) at the start and end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |
| Urinary urea | 24-hour urine samples for analysis of urea concentrations | Change in urinary urea (mmol/24 hours) at the start and end of an 8-week high-dairy food pattern and an 8-week low-dairy food pattern |