Childhood obesity is increasing worldwide and it has been reported that associations between appetite and adiposity are consistent with a behavioural susceptibility model of obesity. Prebiotics have been shown to decrease food intake and reduce body fat in overweight and obese adults. A previous study has shown that a diet rich in non-digestible carbohydrates may modulate gut microbiota and alleviate both genetic and simple obesity in children. However, little is known regarding the effect of prebiotics on appetite regulation in children.
A recent randomized, double-blind, placebo-controlled trial, led by Dr. Raylene A. Reimer from the Department of Biochemistry and Molecular Biology at Cumming School of Medicine at the University of Calgary (Canada), has found that prebiotic supplementation may influence appetite control and energy intake in children with overweight and obesity.
42 boys and girls, aged 7-12 years and with a body mass index (BMI) equal to or greater than the 85th percentile, were randomly assigned to 8 grams oligofructose-enriched inulin/day (n = 22) or placebo (maltodextrin) (n = 20) for 16 weeks. Objective measures of appetite included energy intake at an ad libitum breakfast buffet that took place at baseline and again at 16 weeks, 3-day weighed food and beverage records at baseline and at 8 and 16 weeks, and fasting gut hormones, adipokines and insulin serum concentrations at baseline and at the end of the study. Subjective sensations of appetite were obtained by using a visual analog scale at baseline and at the end of study immediately before and after the ad libitum breakfast buffet. Subjective appetite and eating behaviours were also assessed by using the Children’s Eating Behaviour Questionnaire completed by caregivers at baseline and at 8 and 16 weeks. Participants were allowed to maintain their dietary habits and their usual level of physical activity with no influence from the research team.
Prebiotic intake led to a significantly higher feeling of fullness after the breakfast buffet at week 16 compared with the placebo group. The prebiotic also reduced the amount of food that participants thought they could consume at the breakfast buffet. Also, prebiotic supplementation significantly reduced energy intake at the week 16 breakfast buffet in 11- and 12-year-old children but not in 7- to 10-year-old children.
Serum sample analysis showed that fasting adiponectin, a key regulator of insulin sensitivity and tissue inflammation, and ghrelin, a hormone that controls appetite, increased at week 16 in the prebiotic group compared with placebo. The authors explained in the paper discussion that ghrelin may be involved in “the physiologic mechanisms by which prebiotics improve satiety and regulate appetite” and how prebiotics affect adiponectin is unknown and may be independent of short-chain fatty acid production.
Prebiotic supplementation showed a trend toward reducing BMI z score, which is a measure of relative weight and height adjusted for age and sex applied to a reference standard, to a greater extent than placebo.
In conclusion, prebiotic intake for 16 weeks may help improve appetite control in children with overweight and obesity. Further research is needed in order to elucidate a clear picture regarding the role of postprandial satiety hormones in the physiologic effects of prebiotics.
Hume MP, Nicolucci AC, Reimer RA. Prebiotic supplementation improves appetite control in children with overweight and obesity: a randomized controlled trial. Am J Clin Nutr. 2017; doi: 10.3945/ajcn.116.140947.