The goal of this clinical trial is to determine whether tocotrienol works as a senolytic agent to delay age-related biological changes in middle-aged adults. The study will also evaluate the safety of tocotrienol supplementation. The main questions it aims to answer are: Does tocotrienol reduce markers of cellular senescence, inflammation, oxidative stress, and mitochondrial dysfunction? What health changes or medical issues occur in participants taking tocotrienol? Researchers will compare tocotrienol-rich fraction to a placebo (a look-alike capsule with no active ingredient) to determine whether tocotrienol is effective in modulating aging-related pathways. Participants will: Take tocotrienol (200 mg/day) or a placebo daily for 6 months Attend study visits at baseline, 3 months, and 6 months for clinical assessments and laboratory tests Undergo blood sampling and health evaluations, including measures of senescence-associated secretory phenotype (SASP), inflammation, oxidative stress, mitochondrial function, vascular health, skin status, cognitive function, body composition, and bone mineral density. Complete questionnaires related to diet throughout the study period This study aims to provide clinical evidence on the potential of tocotrienol as a senolytic intervention for promoting healthy aging and reducing the risk of age-related diseases.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
220
National University of Malaysia
Kuala Lumpur, Kuala Lumpur, Malaysia
RECRUITINGBlood pressure
Blood pressure in mmHg using Sphygmomanometer
Time frame: Baseline, Month 3 and Month 6
Changes in Advanced Glycation End Products (AGEs)
Changes in blood AGEs concentration measured by ELISA will be quantified as circulating glycoxidation markers and expressed in arbitrary units (AU) or µg/mL
Time frame: Baseline, Month 3, and Month 6
Changes in Protein Carbonyl
Change in blood protein carbonyl concentration measured by ELISA , will be quantified as nmol carbonyl/mg protein
Time frame: Baseline, Month 3, and Month 6
Change in Malondialdehyde (MDA)
Change in blood malondialdehyde concentration measured by high-performance liquid chromatography (HPLC)
Time frame: Baseline, Month 3, and Month 6
Change in DNA Damage
Change in blood DNA damage levels measured using validated laboratory assays
Time frame: Baseline, Month 3, and Month 6
Body Composition assessment
Measured using Inbody 770 Analyzer at Physiology Department; BMI (kg/m²) calculated from weight (kg) and height (m); Body fat percentage (%); visceral fate (cm²); basal metabolic rate (kcal); waist to hip ratio
Time frame: Baseline, Month 3, and Month 6
Food intake questionnaire
Food frequency questionnaires (FFQ) will be completed by the participants, and analyse through Diet Information Management System; Result reported for carbohydrate (g), Cholesterol (mg), Energy (kcal), Fat (g), Fibre (g), Protein (g), vitamin E (mg), water (g)
Time frame: Baseline, Month 3, and Month 6
Changes in SASP Gene expression
Change in senescence-associated secretory phenotype (SASP) gene expression levels in peripheral blood measured by quantitative real-time polymerase chain reaction (qRT-PCR)
Time frame: Baseline, Month 3, and Month 6
Change in SASP Protein expression
Change in senescence-associated secretory phenotype (SASP) protein expression levels in peripheral blood measured using protein array analysis
Time frame: Baseline, Month 3, and Month 6
Change in Tumor Necrosis Factor-Alpha (TNF-α)
Change in blood TNF-α concentration measured by enzyme-linked immunosorbent assay (ELISA), qill be quantified in picograms per millilitre (pg/mL).
Time frame: Baseline, Month 3, and Month 6
Change in Inteleukin-6 (IL-6)
Change in blood IL-6 concentration measured by enzyme-linked immunosorbent assay (ELISA)
Time frame: Baseline, Month 3, and Month 6
Change in ATP production
Change in mitochondrial ATP production in peripheral blood measured using Seahorse analysis
Time frame: Baseline, Month 3, and Month 6
Change in Mitochondrial Complex V Enzyme Activity
Change in mitochondrial Complex V enzyme activity measured in peripheral blood samples
Time frame: Baseline, Month 3, and Month 6
Change in Mitochondrial Membrane Potential
Changes in mitochondrial membrane potential measured in peripheral blood samples
Time frame: Baseline, Month 3, and Month 6
Change in Plasma Alpha-Tocotrienol Concentration
Change in plasma α-tocotrienol concentration measured by HPLC will be quantified in micromoles per litre (µmol/L) or micrograms per millilitre (µg/mL).
Time frame: Baseline, Month 3, and Month 6
Change in Plasma Gamma- Tocotrienol Concentration
Change in plasma γ-tocotrienol concentration measured by HPLC will be quantified in micromoles per litre (µmol/L) or micrograms per millilitre (µg/mL).
Time frame: Baseline, Month 3, and Month 6
Change in Total Plasma Tocotrienol Concentration
Change in total plasma tocotrienol concentration measured by HPLC will be quantified in micromoles per litre (µmol/L) or micrograms per millilitre (µg/mL).
Time frame: Baseline, Month 3, and Month 6
Muscle mass
Appendicular lean mass in kilograms, kg will be measured using Dual-Energy X-ray Absorptiometry, (DEXA)
Time frame: Baseline and Month 6
Fat mass
Fat mass in gram, g will be measured using Dual-Energy X-ray Absorptiometry, (DEXA)
Time frame: Baseline and Month 6
Bone mineral content (BMC)
Bone mineral content in gram, g will be measured using Dual-Energy X-ray Absorptiometry, (DEXA)
Time frame: Baseline and Month 6
Cognitive Function
The assessment instrument, the Montreal Cognitive Assessment (MoCA) test will be administered. The evaluation involves assessing participants through questions and instructions covering executive and spatial cognitive domains. The maximum score is 30. A score of 26 and above indicates no cognitive impairment.
Time frame: Baseline and Month 6
Recall memory function
The Rey Auditory Verbal Learning Test (RAVLT) will be utilized. the RAVLT includes two distinct word lists (A and B). Participants will recall the items from list A over five trials (Memory A1 to A5). Following this, an interference list (list B), comprising 15 unrelated nouns, will be introduced, and participants will attempt to recall as many words as possible from it. Subsequently, participants will be asked to recall the words from list A (Delayed recall/memory A6) without the examiner repeating the list. The number of correctly recalled words for each trial will be totaled to generate a score. Total Learning Score (Sum of Trials A1-A5) to indicate normal performance: 45-65, Mild Cognitive impairment: 30-45, dementia: below 30. For delayed recall score (M6), to indicate normal performance: ≥8-12 words recalled, Mild Cognitive Impairment: 4-7 words recalled, and dementia: ≤3 words recalled
Time frame: Baseline and Month 6
Working memory function
The Digit Span Test involves recalling numbers in the same order (forward), reverse order (backward), or ascending order (sequencing). The test starts with short sequences and increases in length to assess memory capacity. A higher score (20 - 30) indicates better cognitive function, while a lower score (0 - 19) may suggest attention or memory issues. The total score is 30.
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Time frame: Baseline and Month 6
Change in Pulse Wave Velocity (PWV)
Change in arterial stiffness assessed by pulse wave velocity using an Arteriograph device, will be recorded in metres per second (m/s)
Time frame: Baseline and Month 6
Change in Augmentation Index (Aix)
Change in arterial wave reflection assessed by augmentation index using an Arteriograph device will be expressed as a percentage (%).
Time frame: Baseline, and Month 6
Change in Central Blood Pressue
Change in central blood pressure measured using an Arteriograph device will be measured in millimetres of mercury (mmHg)
Time frame: Baseline, and month 6
Change in Skin Elasticity
Change in skin elasticity measured using a Cutometer, quantify in Arbitary unit
Time frame: Baseline and month 6
Change in Skin Hydration
Change in skin hydration measured using a Corneometer, quantify in Arbitary unit
Time frame: Baseline and month 6
Change in Transepidermal Water Loss
Change in skin barrier function measured as transepidermal water loss using a Tewameter quantify in Arbitary unit
Time frame: Baseline and Month 6
Change in Skin Pigmentation
Change in skin pigmentation measured using a mexameter quantify in Arbitary unit
Time frame: Baseline and Month 6
Change in sebum secretion
Change in skin sebum secretion measured using a Sebumeter quantify in Arbitary unit
Time frame: Baseline and Month 6
Change in Skin Wrinkle and Roughness
Change in wrinkle and skin roughness parameters measured using a visiocan quantify in Arbitary unit
Time frame: Baseline and Month 6