Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, 4031 Basel, Switzerland.
Nutrients. 2022 Jun 24;14(13):2627. doi: 10.3390/nu14132627.
The prevalence of overweight and obesity is rising rapidly, currently affecting 1.9 billion adults worldwide. Prebiotic dietary fibre supplementation is a promising approach to improve weight loss and reduce metabolic complications in overweight and obese subjects due to modifications of the microbiota composition and function. Previous systematic reviews and meta-analyses addressing similar questions revealed discordant evidence and/or are outdated. We searched MEDLINE, Embase, Google Scholar, and forward and backward citations for randomised controlled trials (RCTs) with isolated soluble dietary fibre supplementation for at least 12 weeks in overweight and obese patients measuring body weight, published through April 2022. We expressed the results as mean differences (MDs) using the random-effects model of the metafor package in R and assessed risk of bias using the Cochrane RoB2 tool. We conducted the study according to the PRISMA guidelines and registered the protocol on PROSPERO (CRD42022295246). The participants with dietary fibre supplementation showed a significantly higher reduction in body weight (MD -1.25 kg, 95% CI -2.24, -0.25; 27 RCTs; 1428 participants) accompanied by a significant decrease in BMI, waist circumference, fasting blood insulin, and HOMA-IR compared to the control group. Certainty of evidence was high, paving the way for the implementation of isolated soluble dietary fibre supplementation into clinical practice.
超重和肥胖的患病率迅速上升，目前影响着全球 19 亿成年人。由于微生物群落组成和功能的改变，膳食纤维补充剂是一种很有前途的方法，可以改善超重和肥胖人群的体重减轻和减少代谢并发症。之前针对类似问题的系统评价和荟萃分析显示出不一致的证据和/或已经过时。我们检索了 MEDLINE、Embase、Google Scholar 以及随机对照试验（RCT）的参考文献，这些 RCT 对超重和肥胖患者进行了至少 12 周的孤立可溶性膳食纤维补充，测量了体重，文献发表时间截至 2022 年 4 月。我们使用 R 中的 metafor 包的随机效应模型将结果表示为均数差值（MD），并使用 Cochrane RoB2 工具评估偏倚风险。我们根据 PRISMA 指南进行了研究，并在 PROSPERO（CRD42022295246）上注册了方案。与对照组相比，膳食纤维补充组的体重明显减轻（MD -1.25 公斤，95%置信区间 -2.24，-0.25；27 项 RCT；1428 名参与者），体重指数、腰围、空腹胰岛素和 HOMA-IR 也显著降低。证据的确定性很高，为将孤立可溶性膳食纤维补充剂纳入临床实践铺平了道路。
