Effect of Butter & MCT Oil on Lipoproteins - A RCT

Walter Reed National Military Medical Center80 enrolled

Overview

Determine the effects on lipoprotein profiles of high dose concentrated dietary SFA (saturated fatty acids) (from MCT (medium-chain triglyceride) oil + butter) in combination added to coffee. The study will be conducted as a RCT in healthy adults without cardiometabolic disease or conditions that influence lipoprotein metabolism or other specific dietary recommendations.

Research Design A prospective randomized controlled interventional study Methodology /Technical Approach A total of up to 60 subjects will be recruited to allow for completion of the study by a minimum of 17 subjects per arm. Subjects will be randomized to one of two groups in a 1:1 ratio. Recruited subjects will be adult coffee drinkers between the ages of 18-45 without hyperlipidemia and without criteria for diabetes or pre-diabetes. Subjects will have baseline weight, waist circumference (WC), and blood-pressure (BP) measurements obtained. Subjects will have baseline fasting lipids,, CMP,HbA1c,TSH,and hsCRP. The subjects will be stratified by gender and randomized to receive one of two dietary regimens: 1) coffee (\< 50 kcal of added creamer/sweetener) or 2) coffee with butter + medium-chain triglyceride (MCT) oil combination (2 tbsp. MCT containing 230kcal and 28gm fat+ 2 tbsp butter containing 200kcal and 22gm fat). The drink will be consumed daily over a 4 week period. Dietary history will be evaluated by via the ASA24website (http://appliedresearch.cancer.gov/asa24/). At 6 and 12 weeks post-consent, baseline labs will be repeated. The primary outcome is change in apolipoprotein B between groups. Secondary outcomes include changes in lipids, WC, BP, HbA1c, and FBG. Exploratory analysis will include changes in dietary macronutrient load and subgroup analysis of effects related to dietary patterns. Primary objective: 1\. Evaluate clinically and statistically significant changes of apoB number in healthy adults who consume coffee with butter and MCT oil. Secondary objectives: 1\. Evaluating change in: 1. non-HDL-c 2. LDL-c 3. triglycerides 4. BP 5. waist circumference 6. FBG 7. HbA1c Exploratory objective: 1\. Change in macronutrient profiles of dietary patterns. Our null hypothesis is that the addition of butter and medium-chain triglyceride oil at proposed doses has no clinically significant effects on atherogenic lipoproteins, namely apo lipoprotein B particles (apoB).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Hyperlipidemia

Interventions

MCT oil + Butter in CoffeeDIETARY_SUPPLEMENT

2 tablespoons medium-chain triglyceride oil + 2 tablespoons butter added to 2-4 cups of coffee similar to their usual intake prior to 1200 daily over a 4 week period after a 2 week run-in phase during which the doses of butter and MCT oil will be titrated up (1 Tbsp. of each butter + MCT x 5 days, 2 Tbsp. butter + 1 Tbsp. MCT x 5 days, then 2 Tbsp. of each x 4 days) followed by 6 weeks of washout without treatment.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 45 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. DoD healthcare beneficiaries 2. willing to drink 2 to 4 cups of coffee daily 3. between the ages of 18 to 45 4. serum LDL-c \< 160, 5. non-HDL-c \< 190 6. apoB \< 120 Exclusion Criteria: 1. BMI \> 30kg/m2 or \< 20kg/m2 or waist circumference \> 102cm (males) or 88cm (females) 2. Triglycerides \> 150 3. Hypertension defined as SBP \> 150, DBP \> 90 or on treatment for high blood pressure 4. Chronic liver disease defined by any clinical or a history of serum AST or ALT \> 3 times ULN 5. Kidney disease defined as a GFR \<90 ml/min or history of nephritic syndrome 6. Impaired glucose metabolism defined as HbA1c \> 5.6, FBG \> 99, or 2-hour OGTT \> 139 7. Any known malignancy 8. Known malabsorption disorder to include inflammatory bowel disease, celiac disease, cystic fibrosis, history of gastric bypass 9. Hypothyroidism per lab evaluation at baseline 10. Pregnancy 11. Polycystic Ovary Syndrome or irregular menstrual periods 12. Subjects taking certain medications such as glucocorticoids, immunosuppressants (cyclosporine, sirolimus, etc.), tamoxifen, androgens, antipsychotics, hydrochlorothiazide, retinoids, beta-blockers, statins, bile acid sequestrants, niacin, fibrates, ezetimibe, high dose fish oil (\>1gm/day epa + dha), or any other supplement or pharmacologic agent known to alter lipoproteins a. If on hormonal contraceptives, lipid panel must be stable over the past 12-24 months 13. Cushing's syndrome per medical history or clinical suspicion 14. HIV per medical history 15. Chronic Inflammatory Disorders such as, but not limited to, SLE, RA, IBD per medical history 16. History of tobacco use within the previous 12 months to include cigarettes, e-cigarettes, chewing tobacco, cigars, and pipes. 17. History of marijuana use within the previous 12 months 18. Active intentional weight loss of over 5% in the past 3 months

Locations (1)

Walter Reed National Military Medical Center

Bethesda, Maryland, United States

Outcomes

Primary Outcomes

Changes in apolipoprotein B

Evaluate clinically and statistically significant changes of apoB number in healthy adults who consume coffee with butter and MCT oil.

Time frame: Baseline and 6 weeks

Secondary Outcomes

non-HDL-c

Evaluating change in non-HDL\_c

Time frame: 6 weeks

LDL-c

Evaluating change in LDL-c

Time frame: 6 weeks

triglycerides

Evaluating change in triglycerides

Time frame: 6 weeks

Blood pressure

Evaluating change in blood pressure

Time frame: 6 weeks

waist circumference

Evaluating change in waist circumference

Time frame: 6 weeks

Fasting Blood Glucose

Evaluating change in fasting blood glucose

Time frame: 6 weeks

HbA1c

Evaluating change in HbA1c

Time frame: 6 weeks

Data from ClinicalTrials.gov

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