Dietary inulin supplementation promotes weight loss in obese individuals

This study aims to evaluate the effect of an innovative nutritional

approach combining the consumption of vegetables naturally rich in

inulin with daily supplementation in native inulin on obese individuals. Primary outcome includes the identification of microbiota driven

improvement of host health • Prevalence of Obesity in Europe has reached epidemic

proportions

• Novel nutritional approach such as inulin-enriched vegetables consumption are promising tools to control weight gain and

related metabolic disorders

Dietary inulin supplementation promotes weight loss

in obese individuals

• Randomized, simple-blind, placebo-controlled parallel study including 150 obese subjects (BMI > 30 kg.m-2 _{; 18-65 years, recruited in three university}

hospitals in Belgium). The preliminary data presented here concern 38 patients (end of recruitment January 2018).

• Subjects must present at least one of the following comorbidities : prediabetes, hypertension, dyslipidemia, liver steatosis.

• Treatment/Placebo consist of a daily consumption of meals (following given recipes) including vegetables naturally rich/poor in inulin. In addition, patients receive a daily supplement of 16 g of native Inulin/Maltodextrin (Cosucra).

• Ethical approval was registered under the number: BE403201422056 • Analysis performed before and after the treatment include :

 Anthropometric measurements  Blood tests

 Fibroscan (evaluates the level of liver fibrosis)  CT-scan (Measurement of abdominal fat area)  Dietary habit evaluation

 Behavior study

 Urine, saliva and feces collection

Sophie Hiel

1

, Julie Rodriguez

1

, Marco Gianfrancesco

2

, Daphné Portheault

3

, Gaetan Kalala

4

, Audrey M. Neyrinck

1

,

Barbara Pachikian

1

, Sarah Potgëns

1

, Laure Bindels

1

, Nicolas Lanthier

6

, Pierre Trefois

7

, Jérome Bindelle

4

, Nicolas

Paquot

2

, Miriam Cnop

3

, Jean-Paul Thissen

5

, Nathalie M. Delzenne

1*

1_{Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Université catholique de Louvain, Brussels, Belgium}

2_{Laboratoire de Diabétologie, Nutrition et Maladies métaboliques, Liège, Université de Liège, Belgium}

3_{ULB Center for Diabetes Research, Universite Libre de Bruxelles, and Division of Endocrinology, Erasmus Hospital, Brussels, Belgium}

4_{Precision Livestock and Nutrition Unit, Gembloux Agro-Bio Tech, Université de Liège, Liège, Belgium}

5_{Pole of Endocrinology, Diabetology and Nutrition, Université catholique de Louvain, Brussels, Belgium}

6_{Laboratory of Hepatogastroenterology, Institut de recherche expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium}

7_{Medical Imaging Department, Cliniques Universitaires St-Luc, Brussels, Belgium}

*contact: nathalie.delzenne@uclouvain.be

• Three months nutritional advices and prebiotic supplementation significantly reduce Body Mass Index in obese individuals.

• Glucose metabolism, liver fibrosis and visceral fat area tend to improve with the treatment. More patients are needed to confirm these trends. • Gut microbiota analysis will be performed at the end of the study and will be correlated to health parameters.

These preliminary data's highlight a promising way to prevent obesity and metabolic disorders. To our knowledge, this is the first study to propose nutritional advices favoring the consumption of vegetables rich in Inulin. To a larger scale, this approach will lead the patients to manage their

health with daily nutritional choices, favoring nutriments beneficial for gut health.

Main

Find

ings

R

esults

Stud

y

Design

Con

te

xt

Aim

Month 0 Medical test Sample collection

Dietary advice Medical test

Sample collection Month 3 Dietary advice Month 1 Month 2

Recruitment

• Included patients : 73 • Ended the study : 38 • Drop out : 12

Anthropometric Measurements

1 Waist/Hip ratio Placebo Prebiotic -0.03 -0.02 -0.01 0.00 0.01 0.02 p = 0.2198 W a is t/ Hi p Ra ti o D if fe re n tia l V a lu e

Diastolic Blood Pressure

Placebo Prebiotic -8 -6 -4 -2 0 Di a s to li c Bl o o d p re s s u re ( m m Hg ) D if fe re n ti a l v a lu e

Systolic Blood Pressure

Placebo Prebiotic -10 -8 -6 -4 -2 0 S y s to li c Bl o o d p re s s u re ( m m Hg ) D if fe re n ti a l v a lu e

Blood Parameters

1 Glucose Metabolism Lipid Profile HbA1c Placebo Prebiotic -0.15 -0.10 -0.05 0.00 p = 0.1964 Hb A 1 c ( % ) Di ff e re n ti a l v a lu e Liver Transaminases Aspartate Transaminase Placebo Prebiotic -2.5 -2.0 -1.5 -1.0 -0.5 0.0 p = 0.3441 A S T ( U/ l) D if fe re n ti a l v a lu e Alanine aminotransferase Placebo Prebiotic 0 1 2 3 4 A L T (U/ l) D if fe re n ti a l v a lu e

Liver Fibrosis

1

Abdominal Fat Area

1

Fibroscan Elasticity Median

Placebo Prebiotic -1.5 -1.0 -0.5 0.0 p = 0.3425 F ib ro s c a n E la s ti c it y ( k P a ) Di ff e re n ti a l v a lu e

Fibroscan elasticity IQR

Placebo Prebiotic -1.5 -1.0 -0.5 0.0 F ib ro s c a n E la s ti c it y I QR (k P a ) D if fe re n tia l V a lu e

Blood lipid parameters (mg/dl) Change (Final-Initial measurement) Between group p-value Placebo Prebiotic Triglycerides -27,71 ± 13,22 -38,95 ± 38,23 0,26 Total Cholesterol -4,50 ± 7,45 -4,43 ± 4,90 0,99 HDL-Cholesterol 2,143 ± 2,09 1,52 ± 1,00 0,62 Calculated LDL-Cholesterol -0,36 ± 6,20 -0,06 ± 3,274 0,96

Visceral Fat Area

Placebo Prebiotic -30 -20 -10 0 10 20 30 p = 0.2006 c m ² D if fe re n ti a l v a lu e

Subcutaneous Fat Area

Placebo Prebiotic -40 -30 -20 -10 0 c m ² D if fe re n ti a l v a lu e p-value <0,05

1_{Data are expressed as mean±SEM ; n=16 in placebo, n=22 in prebiotic ; Statistical analysis were performed on differential values, Mann-Withney non parametric t-test}

2

2 _{Mixed model ANOVA analysis performed}

Fasting Glycemia Placebo Prebiotic -5 0 5 10 p = 0,8621 F a s ti n g Gl y c e m ia ( m g /d l) D if fe re n tia l V a lu e -Glutamyl-Transpeptidase Placebo Prebiotic -8 -6 -4 -2 0 g GT ( U/ l) D if fe re n ti a l v a lu e