NCT06682767

Brief Summary

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.

Trial Health

63
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
40

participants targeted

Target at P25-P50 for not_applicable

Timeline
10mo left

Started Mar 2026

Geographic Reach
1 country

1 active site

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress19%
Mar 2026Mar 2027

First Submitted

Initial submission to the registry

October 29, 2024

Completed
14 days until next milestone

First Posted

Study publicly available on registry

November 12, 2024

Completed
1.3 years until next milestone

Study Start

First participant enrolled

March 1, 2026

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2027

Last Updated

February 9, 2026

Status Verified

February 1, 2026

Enrollment Period

1 year

First QC Date

October 29, 2024

Last Update Submit

February 4, 2026

Conditions

Keywords

APOE 4preventionnutrititionfasting mimicking dietdietAlzheimer's disease

Outcome Measures

Primary Outcomes (1)

  • Evaluate the safety of a six-month FMD intervention

    Endpoint: Number of adverse events in the intervention group relative to the Dietary Guidance group

    From pre- to post-treatment (Day 165 +/-8 days)

Secondary Outcomes (2)

  • Investigate the impact of the FMD intervention on cerebral blood flow relative to the Dietary Guidance Group

    From pre- to post-treatment (Day 165 +/-8 days)

  • Investigate the impact of the FMD intervention on cognition relative to the Dietary Guidance group.

    From pre- to post-treatment (Day 165 +/-8 days)

Other Outcomes (7)

  • Examine the impact of FMD relative to Dietary Guidance on ADRD blood-based biomarkers

    From pre- to post-treatment (Day 165 +/-8 days)

  • Evaluate the efficacy of FMD relative to Dietary Guidance for modulating autophagic flux

    From pre- to post-treatment (Day 165 +/-8 days)

  • Evaluate the efficacy of FMD relative to Dietary Guidance for modulating insulin growth factor-1

    From pre- to post-treatment (Day 165 +/-8 days)

  • +4 more other outcomes

Study Arms (2)

FMD - Intervention

EXPERIMENTAL

Participants in the FMD group will be asked to refrain from consuming any calorie-containing foods or drinks other than the provided study foods/drinks during the designated intervention days each month.

Dietary Supplement: FMD1 (LNT22-017-1)

Dietary Guidance

ACTIVE COMPARATOR

The Dietary Guidance Group will receive nutrition recommendations based on the Harvard Healthy Eating Plate.

Behavioral: Dietary Guidance

Interventions

Participants will receive established dietary guidance based on the Harvard Healthy Eating Plate.

Dietary Guidance
FMD1 (LNT22-017-1)DIETARY_SUPPLEMENT

FMD 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.

FMD - Intervention

Eligibility Criteria

Age45 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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
  • BMI 20-39kg/m2 (inclusive) at screening
  • On a stable medication regimen for at least 3 months.

You may not qualify if:

  • 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.
  • Current adherence or adherence within the past 3 months to a specialized diet (e.g. ketogenic, paleo, intermittent fasting, raw food, vegan)
  • Food allergies (e.g. dairy, eggs, fish/shellfish, peanuts, tree nuts, soy, wheat, sesame, corn)
  • Diagnosis of mild cognitive impairment or dementia; use of an FDA-approved medication for Alzheimer's disease; MoCA\<23
  • Diabetes (hbA1c \>6.5%) or anti-diabetic medications
  • History of gastric bypass;
  • Inflammatory bowel disease
  • Small or large bowel resection
  • Subjects with recent weight loss (\>5%), use of weight loss medication, participated in a weight loss program in the past 3 months
  • Use of immune suppression drugs;
  • Contraindication for study foods (special food needs and allergy);
  • Women who are pregnant, lactating, or trying to conceive
  • +5 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Cedars Sinai Medical Center

Los Angeles, California, 90048, United States

Location

MeSH Terms

Conditions

Alzheimer Disease

Condition Hierarchy (Ancestors)

DementiaBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesTauopathiesNeurodegenerative DiseasesNeurocognitive DisordersMental Disorders

Study Officials

  • Mitzi Gonzales, PhD

    Cedars-Sinai Medical Center

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Mitzi Gonzales, PhD

CONTACT

Sara Espinoza, MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
As diet requires volitional activity, the study participants cannot be blinded. To minimize bias, the investigators evaluating cognitive, research labs, and MRI outcomes will be blinded to group assignments.
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

October 29, 2024

First Posted

November 12, 2024

Study Start

March 1, 2026

Primary Completion (Estimated)

March 1, 2027

Study Completion (Estimated)

March 1, 2027

Last Updated

February 9, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

Data collected for this study will be analyzed and stored at Cedars Sinai. After the study is completed, the de-identified, archived data will be stored at Cedars Sinai for use by other researchers including those outside of the study. As new relevant methodologies are developed, however, there is a conceivable future interest to process deidentified samples and data in a collaborating laboratory at Cedars-Sinai Medical Center or outside of Cedars-Sinai Medical Center including commercial entities. Participants are made aware of this possibility in the written informed consent form at the time of enrollment and are informed that to consent to this study is also to consent to permit coded data to be shared for the purposes of this research. The key to the code is not shared with collaborators but will remain in a HIPAA-compliant, secure, REDCap database at Cedars-Sinai Medical Center.

Shared Documents
STUDY PROTOCOL, ICF
Time Frame
De-identified data will be available within 6 months of release of the primary endpoint results and will be made available by request indefinitely
Access Criteria
Access to trial IPD can be requested by qualified researchers engaging in independent scientific research, and will be provided following review and approval of a research proposal and execution of a Data Sharing Agreement (DSA)

Locations