In a cross-over design, 15 participants, age 65-75, will be tested in six different arms in a randomised order. After a 12-hour fast participants will be served 2.5 dl coffee with 15 g cream + 30-50 g of different fatty acids, with or without 50 g glucose. Blood ketones and other biomarkers will be measured during 4 hours.
In the metabolic state ketosis, beta-hydroxybutyrate (BHB) and acetoacetate are synthesised from fatty acids in the liver, resulting in higher circulating levels. Ketosis can be induced by fasting or adherence to a low-carb-high-fat diet, but also by intake of-at least some-medium-chain-triglycerides (MCT). MCT are built from fatty acids with a chain of 6-12 carbon atoms. Caprylic acid (C8) is well known to be ketogenic, but the effect of lauric acid (C12)-constituting about 50% of coconut oil-is less clear. The aim of this study is to assess ketosis, as a combined effect of an extended overnight fast, and intake of coconut oil or C8, and to study how ketosis is affected by simultaneous glucose intake. Sunflower oil is used as control, expected to not break fasting ketosis, although not being ketogenic in itself. Some sunflower oil is also added to C8 to make that arm isocaloric with coconut oil, with a roughly similar proportion of MCT. Coffee with cream will be used as a vehicle, and although coffee has been reported to be mildly ketogenic, this effect is expected to be negligible and equally distributed between arms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
15
Coconut oil given in coffee with cream
Caprylic acid given in coffee with cream
Sunflower oil given in coffee with cream
Karolinska Institutet
Solna, Stockholm County, Sweden
Concentrations of BHB, area under the curve, 0-4 h
BHB, measured in venous whole blood with a point-of-care meter
Time frame: 0, 15, 30, 45, 60, 75, 90, 120, 150, 180, 210, 240 (minutes)
Concentrations of total ketones
BHB + acetoacetate, laboratory analyses from plasma
Time frame: 0, 30, 60, 120 (minutes)
Concentrations of BHB (capillary)
BHB, measured in capillary whole blood with a point-of-care meter, for exploratory comparisons. (not measured in arm 3 \& 5)
Time frame: 30, 60, 120 (minutes)
Concentrations of BDNF / pro-BDNF
Brain-derived neurotrophic factor (BDNF) \& pro-BDNF in serum (not measured in arm 2, 3 \& 5)
Time frame: 0, 60, 120, 240 (minutes)
Concentrations of glucose
Glucose, laboratory analysis
Time frame: 0, 60, 120, 180, 240 (minutes)
Self-rated satiety
Assessed by a 5-grade categorical hunger-scale in a questionnaire at the end of each testing session. Participants will be instructed to choose the most suitable description of their hunger: 1. Not hungry at all. 2. Modestly hungry. Lunch can wait. 3. It feels like the right time for lunch. Hunger appeared during the last hour. 4. Very hungry. Hunger appeared during the last hour. 5. Hungry or very hungry. Hunger has been palpable for more than one hour. Answers a, b \& c will be interpreted as sufficient satiety.
Time frame: 240 (minutes)
Self-rated tolerance of beverage
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Glucose dissolved in water
Assessed by a 4-grade categorical scale in a questionnaire at the end of each testing session: Did you experience any inconvenience (i.e. nausea, upset stomach), which you attribute to the beverage you were served today? 1. No 2. Yes, minor inconvenience. 3. Yes, moderate inconvenience. 4. Yes, major inconvenience. If the answer is b, c or d participants are asked to give a short description.
Time frame: 240 (minutes)