Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, Brussels, Belgium.
Laboratory of Diabetology, Nutrition and Metabolic Disease, Université de Liège, Liège, Belgium.
BMC Med. 2022 Mar 30;20(1):110. doi: 10.1186/s12916-022-02299-z.
BACKGROUND: Dietary interventions targeting the gut microbiota have been proposed as innovative strategies to improve obesity-associated metabolic disorders. Increasing physical activity (PA) is considered as a key behavioral change for improving health. We have tested the hypothesis that changing the PA status during a nutritional intervention based on prebiotic supplementation can alter or even change the metabolic response to the prebiotic. We confirm in obese subjects and in high-fat diet fed mice that performing PA in parallel to a prebiotic supplementation is necessary to observe metabolic improvements upon inulin. METHODS: A randomized, single-blinded, multicentric, placebo-controlled trial was conducted in obese participants who received 16 g/day 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. Primary outcomes concern the changes on the gut microbiota composition, and secondary outcomes are related to the measures of anthropometric and metabolic parameters, as well as the evaluation of PA. Among the 106 patients who completed the study, 61 patients filled a questionnaire for PA before and after intervention (placebo: n = 31, prebiotic: n = 30). Except the dietitian (who provided dietary advices and recipes book), all participants and research staff were blinded to the treatments and no advices related to PA were given to participants in order to change their habits. In parallel, a preclinical study was designed combining both inulin supplementation and voluntary exercise in a model of diet-induced obesity in mice. RESULTS: Obese subjects who increased PA during a 3 months intervention with inulin-enriched diet exhibited several clinical improvements such as reduced BMI (- 1.6 kg/m), decreased liver enzymes and plasma cholesterol, and improved glucose tolerance. Interestingly, the regulations of Bifidobacterium, Dialister, and Catenibacterium genera by inulin were only significant when participants exercised more. In obese mice, we highlighted a greater gut fermentation of inulin and improved glucose homeostasis when PA is combined with prebiotics. CONCLUSION: We conclude that PA level is an important determinant of the success of a dietary intervention targeting the gut microbiota. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03852069 (February 22, 2019 retrospectively registered).
背景:针对肠道微生物群的饮食干预已被提议作为改善肥胖相关代谢紊乱的创新策略。增加身体活动 (PA) 被认为是改善健康的关键行为改变。我们已经测试了这样一个假设,即在基于益生元补充的营养干预期间改变 PA 状态可以改变甚至改变对益生元的代谢反应。我们在肥胖受试者和高脂肪饮食喂养的小鼠中证实,在补充益生元的同时进行 PA 是观察菊粉代谢改善所必需的。
方法:一项随机、单盲、多中心、安慰剂对照试验在肥胖参与者中进行,他们每天接受 16 克天然菊糖与麦芽糊精,分别辅以饮食建议,以摄入富含或缺乏菊粉的蔬菜,为期 3 个月,同时进行饮食热量限制。主要结果是肠道微生物群组成的变化,次要结果与人体测量和代谢参数的测量有关,以及对 PA 的评估。在完成研究的 106 名患者中,有 61 名患者在干预前后填写了 PA 问卷(安慰剂:n=31,益生元:n=30)。除营养师(提供饮食建议和食谱书)外,所有参与者和研究人员对治疗均不知情,并且没有向参与者提供与 PA 相关的建议,以改变他们的习惯。同时,在饮食诱导肥胖的小鼠模型中设计了一项结合菊粉补充和自愿运动的临床前研究。
结果:在富含菊糖的饮食干预期间增加 PA 的肥胖受试者表现出多种临床改善,例如 BMI 降低(-1.6kg/m)、肝酶和血浆胆固醇降低以及葡萄糖耐量改善。有趣的是,只有当参与者进行更多运动时,菊糖对双歧杆菌、 Dialister 和 Catenibacterium 属的调节才具有统计学意义。在肥胖小鼠中,当 PA 与益生元结合使用时,我们发现菊粉的肠道发酵增加,葡萄糖稳态得到改善。
结论:我们得出结论,PA 水平是针对肠道微生物群的饮食干预成功的重要决定因素。
试验注册:ClinicalTrials.gov,NCT03852069(2019 年 2 月 22 日回溯注册)。
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