Effects of synbiotic supplementation on metabolic profiles in children with obesity: a randomized double-blinded placebo-controlled trial

Childhood obesity is a global concern, associated with various metabolic complications. Gut microbiota dysbiosis has been implicated in its pathogenesis. Synbiotics may improve metabolic health by modulating gut microbiota. To evaluate the effects of synbiotic supplementation on lipid profiles, fasting blood glucose (FBG), insulin, and alanine aminotransferase (ALT) in children with obesity. This randomized, double-blind, placebo-controlled trial (April 2024-June 2025), children aged 7–18 years with obesity received either a new freeze-dried synbiotic (10 g inulin from Thai Jerusalem artichoke plus Bifidobacterium animalis and Lactobacillus paracasei, 10⁷ CFU each) or a placebo (isocaloric maltodextrin) daily for 3 months. Both groups received the same lifestyle modification counseling. Anthropometric measurements, dietary intake, physical activity, and metabolic parameters were assessed at baseline and month 3. Sixty children were enrolled; 57 completed the study. High-density lipoprotein cholesterol (HDL-C) significantly increased in the synbiotic group compared to controls [median change: 0.34 (-0.16, 1.35) vs. -0.84 (-1.35, -0.33) mg/dL, P = 0.001], after adjusting for baseline. No significant changes were observed in BMI z-score or other metabolic parameters. Furthermore, there were no significant differences in dietary intake or physical activity levels between groups at the 3-month follow-up. Synbiotic supplementation significantly improved HDL-C in children with obesity. These results suggest that synbiotics may serve as an adjunctive nutritional intervention for managing metabolic health in childhood obesity. https://www.thaiclinicaltrials.org/ (TCTR20240321005).