Effect of Prebiotic Supplementation on Health Status in Adults with Prediabetes: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Prediabetes with a considerable progression rate is a primary risk factor for type 2 diabetes if left untreated. Dietary interventions examining the health effects of prebiotic consumption on health status have been studied in subjects with prediabetes, but the results are controversial. This study aimed to investigate whether prebiotic consumption can favorably alter metabolic status as well as anthropometric features in subjects with prediabetes. Electronic databases were searched up to January 2024, and randomized clinical trials examining the effect of prebiotic consumption on glycemic status, lipid profile, and/or anthropometric features in adults with prediabetes were selected. Data from 11 selected studies were extracted. In total, 546 subjects were included in our analysis, of whom 258 were allocated to prebiotic supplemented group and 288 to control group. Our results demonstrated a significant reduction in body fat (BF) percentage (standardized mean difference: -1.27 %, 95% confidence interval: -2.33, -0.22) after prebiotic supplementation. We found no significant alterations in metabolic indices, including fasting plasma glucose, insulin, glycosylated hemoglobin A1c, homeostasis model assessment of insulin resistance, total cholesterol, triglyceride, and low- and high-density lipoprotein cholesterol concentrations. In addition, we did not notice a significant effect of prebiotic consumption on other anthropometrics, including body mass index and waist circumference. There was no fair evidence that prebiotic consumption could improve metabolic and anthropometric features in subjects with prediabetes. Yet, a significant reduction in BF might support the beneficial effect of prebiotics when aiming at preventing diabetes through lifestyle modifications and weight management. In addition, the reduction in BF can be of clinical significance, indicating the potential of prebiotics to increase insulin sensitivity, which can positively affect people with prediabetes. Nevertheless, current findings should be taken with caution due to the very low certainty in the pooled estimate for the majority of outcomes. Future studies are needed to investigate the effect of prebiotics on health status in people with prediabetes. This trial was registered at PROSPERO as CRD42023473082.