Journal Article

Effect of prebiotic fiber on physical function and gut microbiota in adults, mostly women, with knee osteoarthritis and obesity: a randomized controlled trial

Fortuna, Rafael, Sampsell, Kara, Tuplin, Erin W. Noye, Hart, David A., Wang, Weilan, Reimer, Raylene A., Mayengbam, Shyamchand, Sharkey, Keith A.

2024

Overview

Purpose Obesity is a primary risk factor for knee osteoarthritis (OA). Prebiotics enhance beneficial gut microbes and can reduce body fat and inflammation. Our objective was to examine if a 6-month prebiotic intervention improved physical function in adults with knee osteoarthritis and obesity. We also measured knee pain, body composition, quality of life, gut microbiota, inflammatory markers, and serum metabolomics. Methods Adults (n = 54, mostly women) with co-morbid obesity (BMI > 30 kg/m 2 ) and unilateral/bilateral knee OA were randomly assigned to prebiotic (oligofructose-enriched inulin; 16 g/day; n = 31) or isocaloric placebo (maltodextrin; n = 21) for 6 months. Performance based-tests, knee pain, quality of life, serum metabolomics and inflammatory markers, and fecal microbiota and short-chain fatty acids were assessed. Results Significant between group differences were detected for the change in timed-up-and-go test, 40 m fast paced walk test, and hand grip strength test from baseline that favored prebiotic over placebo. Prebiotic also reduced trunk fat mass (kg) at 6 months and trunk fat (%) at 3 months compared to placebo. There was a trend (p = 0.059) for reduced knee pain at 6 months with prebiotic versus placebo. In gut microbiota analysis, a total of 37 amplicon sequence variants differed between groups. Bifidobacterium abundance was positively correlated with distance walked in the 6-min walk test and hand grip strength. At 6 months, there was a significant separation of serum metabolites between groups with upregulation of phenylalanine and tyrosine metabolism with prebiotic. Conclusion Prebiotics may hold promise for conservative management of knee osteoarthritis in adults with obesity and larger trials are warranted. Clinical Trial Registration Clinicaltrials.gov/study/NCT04172688.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Aged / Arthritis / Bifidobacterium / blood serum / Body composition / Body fat / Chemistry / Chemistry and Materials Science / Clinical trials / Dietary Fiber - administration & dosage / Dietary Fiber - pharmacology / digestive system / Double-Blind Method / Fecal microflora / Female / Gastrointestinal Microbiome - drug effects / Gut microbiota / hand strength / Humans / Inflammation / Intestinal microflora / intestinal microorganisms / inulin / Knee / Male / Maltodextrin / maltodextrins / metabolism / metabolites / Metabolomics / Microbiota / Middle Aged / NCT / NCT04172688 / Nutrition / Obesity / Obesity - microbiology / Original Contribution / Osteoarthritis / Osteoarthritis, Knee / Pain / phenylalanine / Placebos / Prebiotics / Prebiotics - administration & dosage / Quality of Life / randomized clinical trials / Risk factors / tyrosine