About this trial
The study aims to evaluate the safety, feasibility, and preliminary efficacy of six-month fasting-mimicking (FMD) relative to Dietary Guidance intervention in middle-aged adults at elevated risk for Alzheimer's disease due to the apolipoprotein (APOE) ε4 allele. Participants randomly assigned to the FMD intervention will consume a FMD for 5-days each month over a period of 6-months.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Provision of signed and dated informed consent form
Stated willingness to comply with all study procedures and availability for the duration of the study
Male or female, aged 45-65 years at screening
Carrier of at least one copy of the APOE e4 allele
Disqualifiers
Has any medical disease or condition that, in the opinion of the principal investigator (PI) or appropriate study personnel, precludes study participation* (*Including acute, subacute, intermittent or chronic medical disease or condition that would place the subject at an unacceptable risk of injury, render the subject unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the subject's successful completion of this trial);
Significant depression (PHQ-9>9) or generalized anxiety (GAD-7>9)
Diagnosis of a significant neurological condition such as multiple sclerosis, epilepsy, Parkinson's disease, major stroke
Contraindications to MRI such as claustrophobia, cardiac pacemaker, etc.
Trial design
Parallel
Treatments tested in this trial
FMD1 (LNT22-017-1)
Dietary supplementFMD is a plant-based ketogenic diet that provides essential nutrients while maintaining hypo-caloric content. FMD is administered cyclically with 3-5 consecutive days of the diet followed by resumption of normal eating.
Dietary Guidance
BehavioralParticipants will receive established dietary guidance based on the Harvard Healthy Eating Plate.
Treatment groups
Trial outcomes
Primary outcomes
Evaluate the safety of a six-month FMD intervention
Endpoint: Number of adverse events in the intervention group relative to the Dietary Guidance group
Secondary outcomes
Investigate the impact of the FMD intervention on cerebral blood flow relative to the Dietary Guidance Group
Endpoint: Cerebral blood flow - Cerebral blood flow will be assessed through brain magnetic resonance imaging arterial spin labeling sequence.
Investigate the impact of the FMD intervention on cognition relative to the Dietary Guidance group.
NIH Toolbox Flanker and Pattern Comparison Tests and the Mayo Preclinical Alzheimer's Cognitive Composite. The NIH Toolbox assessments are measured through scaled scores (T-scores), which range from 20-80 with higher scores indicating better outcomes. The Mayo Preclinical Alzheimer's Cognitive Composite is also measured using a standardized score (Z-score) with mean of 0 and a standard deviation of 1. Higher scores indicate better performance.
Other outcomes
Examine the impact of FMD relative to Dietary Guidance on ADRD blood-based biomarkers
Endpoint: Circulating levels of phosphorylated tau 217 (p-tau 217), neurofilament light (NFL), and glial fibrillary acidic protein (GFAP). The same unit of measurement applies for all - pg/ml.
Evaluate the efficacy of FMD relative to Dietary Guidance for modulating autophagic flux
Endpoint: Autophagic flux in PBMCs and tissue (optional) Autophagy related gene expression. Both have the same unit of measurement as arbitrary units.
Evaluate the efficacy of FMD relative to Dietary Guidance for modulating insulin growth factor-1
Endpoint: insulin growth factor 1 (unit of measure is ng/ml)
Examine the impact of FMD relative to Dietary Guidance on systemic markers of inflammation through physiological parameters.
Endpoint: Proteomic expression of pro-inflammatory markers Pro-inflammatory markers are IFN-γ, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α, which are all measured in pg/ml.
Sponsors and contacts
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