Effect of oligofructose supplementation on body weight in overweight and obese children: a randomised, double-blind, placebo-controlled trial

Abstract

Limited evidence suggests that the dietary inclusion of oligofructose, an inulin-type fructan with prebiotic properties, may increase satiety and, thus, reduce energy intake and body weight in overweight and obese adults. The aim of the present study was to assess the effect of oligofructose supplementation for 12 weeks on the BMI of overweight and obese children. A total of ninety-seven children aged 7-18 years who were overweight and obese (BMI . 85th percentile) were randomly assigned to receive placebo (maltodextrin) or oligofructose (both at an age-dependent dose: 8 g/d for children aged 7 -11 years and 15 g/d for children aged 12-18 years) for 12 weeks. Before the intervention, all children received dietetic advice and they were encouraged to engage in physical activity. The primary outcome measure was the BMI-for-age z-score difference between the groups at the end of the intervention. Data from seventy-nine (81 %) children were available for analysis. At 12 weeks, the BMI-for-age z-score difference did not differ between the experimental (n 40) and control (n 39) groups (mean difference 0·002, 95 % CI 20·11, 0·1). There were also no significant differences between the groups with regard to any of the secondary outcomes, such as the mean BMI-for-age z-score, percentage of body weight reduction and the difference in total body fat. Adverse effects were similar in both groups. In conclusion, oligofructose supplementation for 12 weeks has no effect on body weight in overweight and obese children.

Prebiotics as a modulator of gut microbiota in paediatric obesity

“…Furthermore, they maintained their BMI Z‐score, whereas those in the placebo group had significant increases in BMI Z‐score after 12 months . In contrast, a clinical trial by Liber and Szajewska showed that 8 g/d of OFS consumption in otherwise‐healthy overweight or obese children 7–11 years old and 15 g/d in those 12–18 years old did not result in improvements in BMI Z‐score after 12 weeks compared with placebo control. There were also no improvements in the secondary outcomes of change in body weight and difference in absolute body fat or in other metabolic outcomes.…”

“…Tanner developmental staging was assessed by Abrams et al , and all subjects were a Tanner stage 2 or 3. In contrast, Liber and Szajewska did not include Tanner staging. Because subjects were between 7 and 18 years old, pubertal stage varied considerably within the study which could also account for differences.…”

Short-chain fatty acid production by gut microbiota from children with obesity is linked to bacterial community composition and prebiotic choice

“…In select cases, these treatments have been associated with smaller increases in BMI and fat mass (32), and reductions in body weight z-scores, body fat, and trunk fat (33). Still, other prebiotic trials in overweight children have reported no significant beneficial effects (34).…”

“…Interpreting the mixed outcomes of prior prebiotic clinical trials in pediatric obesity though is complicated by several challenges. First, in vivo studies in pediatric obesity to date have each used only one prebiotic supplement due to the logistical constraints of clinical trials (32–34). Trials employing testing only a single type of supplement hinder the ability to generalize conclusions regarding the efficacy of prebiotics and also make it challenging to determine whether some prebiotics are inherently more acidogenic than others.…”

“…Third, while SCFA concentrations have been shown to be altered in children with overweight or obesity (36), changes in fecal SCFA during dietary intervention have not been measured in past in vivo studies in pediatric populations. If prebiotics mediate their effects through SCFA (33, 34, 37), directly tracking SCFAs could help determine treatment success. Fourth, in vivo studies in adults, especially those with obesity, may be confounded by the concurrence of chronic disease and the medications a person may be taking to treat chronic disease.…”