Tocotrienols for Obesity of Postmenopausal Women

Postmenopausal women are at a risk of excessive weight gain, bone loss, hypertension, and metabolic syndrome. Among these risk factors, obesity is now recognized as a worldwide epidemic disease. Obesity-induced chronic low-grade inflammation is initiated by excess nutrients in metabolic cells. Aging and decline of estrogen are factors that contribute to weight gain in postmenopausal women, and approaches, such as anti-inflammatory potential in dietary antioxidants to reduce inflammation may likely combat obesity. Recent studies have indicated tocotrienols (one kind of vitamin E, a potent antioxidant) supplement may be good for mitigating negative impacts of obesity in postmenopausal women. However, no study has ever been done the role of tocotrienols in obesity-associated outcome measures in postmenopausal women. The long-term goal is to develop a new strategy featuring a dietary supplement (i.e., tocotrienols) for mitigating obesity in postmenopausal women. The purpose of the study is to examine the effect of 24-week tocotrienols on obesity-associated outcome measurements in postmenopausal women. The investigators plan to recruit postmenopausal women using flyers, non-solicited e-mail system, campus announcement, local radio, newspapers, and TV scripts. The investigators plan to enroll approximately 150-200 women to obtain 60 qualified women at the start of the study. After screening, qualified participants will be matched by body weight and age, and then randomly assigned to no tocotrienols or tocotrienols group. The outcome measures will be assessed at baseline, after 12, and after 24 weeks. Obesity-associated measurements will be recorded using blood, urine, adipose tissue, and fecal samples. The investigators will monitor safety of subjects after 12 and after 24 weeks. Food intake and physical activity will be assessed at baseline, after 12, and after 24 weeks. All data will be analyzed statistically.

• placebo softgel (Drug), also known as olive oil: Each placebo softgel of 430 mg olive oil will contain no TT or tocopherols at detectable levels.
• DeltaGold® Tocotrienol 70% (Drug), also known as tocotrienols: DeltaGold® Tocotrienol 70% contains 430 mg tocotrienol (90% δ-tocotrienol + 10% γ-tocotrienol) with a 70% purity, representing 300 mg tocotrienol.

Primary outcomes

• Fat mass [24 weeks]: total and regional fat mass by DXA
• visceral adipose tissue [24 weeks]: VAT by BIA

Secondary outcomes

• total cholesterol [24 weeks]: total cholesterol in serum
• FASN [24 weeks]: Fatty acid synthase mRNA expression in fat tissue
• Oxylipins inflammation marker [24 weeks]: oxylipins levels in plasma and adipose tissue
• Gut microbiota [24 weeks]: abundance and composition of intestinal bacteria in feces
• hs-CRP [24 weeks]: high-sensitivity C-reactive protein in serum
• leptin [24 weeks]: serum leptin
• beta-oxidation [24 weeks]: carnitine palmitoyltransferase 1A (CPT1) mRNA expression in adipose tissue
• endocannabinoids inflammatory markers [24 weeks]: endocannabinoids levels in plasma and adipose tissue
• HDL [24 weeks]: high density lipoprotein in serum
• TG [24 weeks]: triglycerides in serum

Sex: Female, accepts healthy volunteers

Inclusion Criteria:

1. PMW with BMI ≥30 kg/m2.
2. Normal liver, kidney, and thyroid function (TSH)-sent to Quest Diagnostic Laboratory.
3. Sedentary using International Physical Activity Questionnaire (IPAQ-short form).

Exclusion criteria

1. Unstable body weight (more than 5% change in body weight) within 3 months before intervention begins.
2. Changes to medications or supplements (i.e., steroids, statins) within 3 months of the baseline study visit that could affect lipid metabolism. • If they change any medications/supplements after the baseline visit that will affect lipid metabolism, their study participation will end.
3. Taking anticoagulants that may interact with TT.
4. Serious chronic disease (e.g., unstable cardiovascular disease, uncontrolled diabetes and hypertension, and active cancer).

• Results publication: Aryaie A, Tinsley G, Lee J, Watkins BA, Moore L, Alhaj-Saleh A, Shankar K, Wood SR, Wang R, Shen CL. Actions of annatto-extracted tocotrienol supplementation on obese postmenopausal women: study protocol for a double-blinded, placebo-controlled, randomised trial. BMJ Open. 2020 Mar 8;10(3):e034338. doi: 10.1136/bmjopen-2019-034338. PMID 32152169

• Chwan-Li Shen, PhD, Principal investigator, Texas Tech University Health Sciences Center