Omeprazole is a proton pump inhibitor commonly used to reduce stomach acid in the treatment of heartburn, gastroesophageal reflux disease, and gastric ulcers. By blocking the H⁺/K⁺-ATPase pumps in the gastric lining, it raises gastric pH and can alter the normal activation of pepsin, the enzyme responsible for beginning protein breakdown in the stomach. Under normal conditions, dietary proteins are denatured by gastric acid and cleaved by pepsin into smaller peptides. These peptides enter the small intestine, where pancreatic enzymes (trypsin, chymotrypsin) and brush-border peptidases (aminopeptidase, dipeptidase) further hydrolyze them into free amino acids that are absorbed into the bloodstream. Suppressing stomach acidity may allow larger peptides to pass into the intestine, potentially reducing the efficiency of amino acid liberation and absorption. In this randomized, crossover study, adults aged 50-60 years will attend two study visits at least one week apart. In one visit they will take a standard dose of omeprazole before consuming a mixed meal with a fixed protein content; in the other visit they will consume the same meal without medication. Blood samples will be collected before the meal and at multiple time points afterward to measure plasma amino acid concentrations and compare postprandial responses. Older adults experience anabolic resistance, meaning they require higher protein intakes to stimulate muscle protein synthesis effectively. If omeprazole reduces amino acid availability after a meal, individuals taking this medication may need adjusted dietary protein recommendations. Findings from this study will help refine nutrition guidelines for people on proton pump inhibitors and support optimal muscle health and recovery in middle-aged and older adults.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
TRIPLE
Enrollment
4
Omeprazole 20mg capsule 1 dose = 1 capsule Participants will consume one dose per day for 5 days prior to their study visit. They will also consume one dose the day of the study visit in the laboratory setting. They will also consume one dose with the standardized mixed meal containing chicken, peas, potatoes, and butter the day of the study treatment visit in the laboratory.
Placebo 1 dose of placebo = 1 capsule filled with maltodextrin Participants will consume 1 dose per day for 5 days prior to their study visit. They will then consume 1 dose the day of their study visit in the laboratory setting. They will also consume one dose with the standardized mixed meal containing chicken, peas, potatoes, and butter the day of the study treatment visit in the laboratory.
McGill University
Montreal, Quebec, Canada
RECRUITINGIncremental Area Under the Curve for Total Plasma Amino Acid Concentrations
Plasma total amino acid concentrations (µmol·L-¹) measured by LC-MS at each time point; iAUC calculated using the trapezoidal rule to quantify the postprandial rise in amino acids after a single mixed meal in the Omeprazole versus placebo condition.
Time frame: 0-300 minutes post-meal (blood draws at baseline (0), 30, 60, 90, 120, 180, 240, and 300 minutes)
Total (0-5 hours) postprandial plasma branched chain amino acid concentration incremental area-under-the-curve
Free leucine, isoleucine, valine (combined) (µmol·L\^(-1)·300 minutes)
Time frame: 5 hours
Total (0-5 hours) postprandial plasma leucine concentration incremental area-under-the-curve
Free leucine (µmol·L\^(-1)·300 minutes)
Time frame: 5 hours
Postprandial plasma amino acid maximum concentration
Total amino acids, essential amino acids, branched chain amino acids, leucine (µmol/L)
Time frame: 5 hours
Postprandial plasma amino acid time to peak concentration
Total amino acids, essential amino acids, branched chain amino acids, leucine (minutes)
Time frame: 5 hours
Postprandial plasma glucose concentration incremental area-under-the-curve
Plasma glucose (mmol·L\^(-1)·300 minutes)
Time frame: 5 hours
Postprandial plasma insulin concentration incremental area-under-the-curve
Plasma insulin (mmol·L\^(-1)·300 minutes)
Time frame: 5 hours
8-Item Modified Gastrointestinal Tolerance Questionnaire scores
Participants will be asked to complete an 8-item modified Gastrointestinal Tolerance Questionnaire at the conclusion of each aminoacidemia trial (t = 4 hours). Gastrointestinal symptoms including abdominal bloating/distension, burping, gas/flatulence, borborygmus/stomach rumbling, abdominal cramping, reflux (heartburn), nausea, and vomiting, will be ranked on a 4-point scale ranging from "none" to "severe".
Time frame: 5 hours
Accuracy of participant guesses for intervention order
At the end of the study, participants complete a brief survey indicating which intervention (Omeprazole or placebo) they believe they received in each arm. We will report the proportion of correct vs. incorrect guesses for visit 1 and visit 2 as a measure of blinding effectiveness.
Time frame: Immediately after the second study visit (exit survey)
Incidence of adverse events
Number of participants with adverse events
Time frame: 120 days
Incremental Area Under the Curve for Essential Plasma Amino Acid Concentrations
Plasma essential amino acid concentrations (µmol·L-¹) measured by LC-MS at each time point; iAUC calculated using the trapezoidal rule to quantify the postprandial rise in amino acids after a single mixed meal in the Omeprazole versus placebo condition.
Time frame: 0-300 minutes post-meal (blood draws at baseline, 30, 60, 90, 120, 180, 240, and 300 minutes)
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