Childhood Obesity Body Mass Index and Gut Microbiome: A Cluster Randomized Controlled Pilot Feasibility Study

<b><i>Background:</i></b> Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity. <b><i>Methods:</i></b> This cluster randomized controlled feasibility trial included an online program designed to improve diet and PA along with administration of prebiotic fiber for 12 weeks in 123 4th and 5th grade students where 98% were eligible for free or reduced fee lunch. Of these 56% were male; 71% Latinx; 15% African American; and 14% Other. <b><i>Results:</i></b> A decrease in body fat (BF) was associated with higher pre-test BF. Lower BMI was associated with a decrease in fecal <i>Tenericutes</i> and an increase in <i>Actinobacteria</i>. <b><i>Conclusion:</i></b> Prebiotic fiber was evaluated in additional studies. Determining those most responsive to prebiotic fiber can also permit individual recommendations for greater inclusion in usual diet choices.