Link between gut microbiota and health outcomes in inulin -treated obese patients: Lessons from the Food4Gut multicenter randomized placebo-controlled trial.

BACKGROUND: The gut microbiota is altered in obesity and is strongly influenced by nutrients and xenobiotics. We have tested the impact of native inulin as prebiotic present in vegetables and added as a supplement on gut microbiota-related outcomes in obese patients. Metformin treatment was analyzed as a potential modulator of the response. METHODS: A randomized, single-blinded, multicentric, placebo-controlled trial was conducted in 150 obese patients who received 16 g/d native inulin versus maltodextrin, coupled to dietary advice to consume inulin-rich versus -poor vegetables for 3 months, respectively, in addition to dietary caloric restriction. Anthropometry, diagnostic imaging (abdominal CT-scan, fibroscan), food-behavior questionnaires, serum biology and fecal microbiome (primary outcome; 16S rDNA sequencing) were analyzed before and after the intervention. RESULTS: Both placebo and prebiotic interventions lowered energy intake, BMI, systolic blood pressure, and serum γ-GT. The prebiotic induced greater weight loss and additionally decreased diastolic blood pressure, AST and insulinemia. Metformin treatment compromised most of the gut microbiota changes and metabolic improvements linked to prebiotic intervention. The prebiotic modulated specific bacteria, associated with the improvement of anthropometry (i.e. a decrease in Desulfovibrio and Clostridium sensu stricto). A large increase in Bifidobacterium appears as a signature of inulin intake rather than a driver of prebiotic-linked biological outcomes. CONCLUSIONS: Inulin-enriched diet is able to promote weight loss in obese patients, the treatment efficiency being related to gut microbiota characteristics. This treatment is more efficacious in patients who did not receive metformin as anti-diabetic drugs prior the intervention, supporting that both drug treatment and microbiota might be taken into account in personalized nutrition interventions. Registered under ClinicalTrials.gov Identifier no NCT03852069.

In vitro approach to evaluate the fermentation pattern of inulin-rich food in obese individuals.

Alterations of the gut microbiome have been associated with obesity and metabolic disorders. The gut microbiota can be influenced by the intake of dietary fibres with prebiotic properties, such as inulin-type fructans. The present study tested the hypothesis that obese individuals subjected for 12 weeks to an inulin-enriched v. inulin-poor diet have differential faecal fermentation patterns. The fermentation of cellulose and inulin hydrolysates of six different inulin-rich and inulin-poor vegetables of both groups was analysed in vitro on faecal inocula. The results showed that the microbiota from obese patients who received a fructan-rich diet for 3 weeks produces more gas and total SCFA compared with the microbiota taken from the same individuals before the treatment. Obese individuals fed with a low-fructan diet produce less gas and less SCFA compared with the treated group. The present study highlighted profound changes in microbiota fermentation capacity obtained by prebiotic intervention in obese individuals, which favours the production of specific bioactive metabolites.

Effects of a diet based on inulin-rich vegetables on gut health and nutritional behavior in healthy humans.

BACKGROUND: Inulin-type fructans (ITFs) are a type of fermentable dietary fiber that can confer beneficial health effects through changes in the gut microbiota. However, their effect on gut sensitivity and nutritional behavior is a matter of debate. OBJECTIVE: We evaluated the impact of consuming ITF-rich vegetables daily on gut microbiota, gastro-intestinal symptoms, and food-related behavior in healthy individuals. METHODS: A single group-design trial was conducted in 26 healthy individuals. During 2 wk, the participants were instructed to adhere to a controlled diet based on ITF-rich vegetables (providing a mean intake of 15 g ITF/d). Three test days were organized: before and after the nutritional intervention and 3 wk after returning to their usual diet. We assessed nutrient intake, food-related behavior, fecal microbiota composition, microbial fermentation, and gastrointestinal symptoms. RESULTS: The major microbial modifications during the intervention were an increased proportion of the Bifidobacterium genus, a decreased level of unclassified Clostridiales, and a tendency to decrease Oxalobacteraceae. These changes were reversed 3 wk after the intervention. The volunteers showed greater satiety, a reduced desire to eat sweet, salty, and fatty food, and a trend to increase hedonic attitudes towards some inulin-rich vegetables. Only flatulence episodes were reported during the dietary intervention, whereas intestinal discomfort, inversely associated with Clostridium cluster IV and Ruminococcus callidus, was improved at the end of the intervention. CONCLUSIONS: A higher consumption of ITF-rich vegetables allows a substantial increase in well-tolerated dietary fiber, which may in turn improve food-related behavior. Moreover, it leads to beneficial modifications of the gut microbiota composition and function. This trial is registered at clinicaltrial.gov as NCT03540550.

Characterization of fructans and dietary fibre profiles in raw and steamed vegetables.

Dietary fibre (DF) has many positive effects on human health associated with its functionality in the gastrointestinal tract. These benefits vary according to the type of DF. Vegetables can be a natural source of DF in the diet. However, to provide adequate nutritional advice, the content and profile of their various DF types must be characterised. This study aimed to determine the DF profile of 29 vegetables cultivated in Wallonia (Belgium) and the impact of steaming on these profiles. Using a combination of enzymatic, gravimetric and chromatographic methods, fructans, total dietary fibre (TDF), low- and high-molecular-weight soluble dietary fibre (SDF), and insoluble dietary fibre (IDF) were analysed. Results show that the DF content varies considerably among the 29 investigated vegetable varieties and species, but the influence of steaming is limited to a shift from IDF to high-molecular-weight SDF for 18 of the 29 tested vegetables, while fructans are preserved with not actual reduction in the DP.

Nutritive value of three tropical forage legumes and their influence on growth performance, carcass traits and organ weights of pigs.

The effects of tropical forage legumes on feed intake, growth performance and carcass traits were investigated in 16 groups of two Large White × Duroc pigs. The diets consisted of a commercial corn-soybean meal diet as the basal diet and three forage-supplemented diets. Four groups of control pigs received daily 4 % of body weight of the basal diet, and 12 groups of experimental pigs were fed the basal diet at 3.2 % of body weight completed with fresh leaves of one of the three forage legumes (Psophocarpus scandens, Stylosanthes guianensis and Vigna unguiculata) ad libitum. The study lasted 90 days. The in vitro digestion and fermentation of the forage legumes were also determined. The in vitro digestible energy content of the legumes was between 0.72 and 0.77 that of the basal diet (14.4 MJ/kg dry matter (DM)). V . unguiculata was the most digestible forage legume expected for crude protein digestibility. Feeding forage legumes lowered the dry matter intake by 4.5 to 9.6 % (P < 0.05), final body weight (P = 0.013), slaughter weight, average daily gain and hot carcass weight (P < 0.05) without affecting the feed conversion ratio (FCR), dressing percentage and back fat thickness. In conclusion, using forage to feed pig could be interesting in pig smallholder production with limited access to concentrate, as FCR was not significantly affected.