Many chronic conditions typically have increased nutrient demands than healthy individuals. These are considered conditionally essential nutrients. There is either a disruption in metabolic processes, underlying inflammation, oxidative stress, or an inability to meet the metabolic demands with the current nutrient reserves.

According to a new study published earlier this month in JAMA Network, researchers investigated whether oral butyrate supplementation is effective in treating pediatric obesity.

This was a randomized, quadruple-blind, parallel-group, placebo-controlled trial including 54 patients with obesity between the ages of 5 and 17 years of age. These individuals had a body mass index (BMI) greater than the 95th percentile for sex and age. The patients in the butyrate group received sodium butyrate capsules at a dose of 20 mg/kg body weight up to a maximum dose of 800 mg per day for 6 months. The placebo group received cornstarch capsules. Children that were not able to swallow capsules, were allowed to open the capsules and dissolve them in liquid or food. Laboratory assessment included fasting glucose, insulin, and a lipid panel. HOMA-IR was calculated, and ghrelin, IL-6 levels, and gut microbiome analysis were also measured. This clinical trial took place from November 2020 through December 2021.

This was the first randomized clinical trial evaluating the effects of butyrate on pediatric obesity. As a results, the study demonstrated 6 months of supplementation with butyrate can reduce BMI and improve glucose metabolism and inflammation.

The beneficial effects of butyrate supplementation on glucose metabolism were consistent with previous data. The research team found that butyrate supplementation decreased HOMA-IR and fasting insulin levels in children with obesity. In addition, the gut microbiome analysis supported the role of butyrate in glucose metabolism, as suggested by a more positive response in children with a higher abundance of butyrate-producing bacteria at baseline.

Glutamine is also another nutrient to consider due to its benefits on modulating the microbiome and its impact on the intestinal barrier and its role in patients who are overweight or obese. Glutamine may also be altering the microbiome by decreasing the Firmicutes to Bacteroidetes ratio, which is associated with obesity.

Other nutrients that should be considered include vitamin C, fish oil, and tocotrienols.

Obesity is associated with chronic low grade inflammation, so there will be increased vitamin C and antioxidant requirements to mitigate oxidative stress.

Increasing dietary fiber or fiber supplementation should also be considered. Only about 10 percent of Americans meet their daily fiber requirements. Dietary fiber is crucial in supporting the proper microbial balance and optimizing gut health.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Coppola S, Nocerino R, et al. Therapeutic Effects of Butyrate on Pediatric Obesity: A Randomized Clinical Trial. JAMA Netw Open. 2022 Dec 1;5(12):e2244912.

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