By Tonya Curry. graduate student in nutrition coordinated program
The childhood obesity rate has been on the rise and with that comes concerns for negative long term health effects such as increased risk of chronic diseases. Obesity during childhood is associated with an increase in asthma, cardiovascular disease risk factors, and psychological problems. According to the Centers for Disease Control and Prevention (CDC), 14.4 million (19.3%) children and adolescents aged 2-19 years old in 2017-2018 were affected by obesity. Excess weight during childhood has a tendency to carry on into adulthood. With these staggering rates, many health professionals and researchers are looking for ways to stop the constant rise.
One recent approach has been to alter the intestinal microbiota with prebiotics to avoid or treat obesity. The intestinal microbiota is a collection of fungi, bacteria and viruses that live in the gut. Sounds a bit scary but these “bugs” are linked to health maintenance and immunity.
In an ideal world we want to have more good bugs than bad. When we have more bad bugs, the condition is called dysbiosis. Dysbiosis is linked with the advancement of chronic metabolic diseases, including obesity and type 2 diabetes. Prebiotics, which are non-digestible dietary fiber, feed the good bacteria in the gut. Prebiotics include oats, barley, garlic, onion, sweetcorn, chickpeas, lentils, and asparagus, just to name a few. Ultimately, fresh fruit and vegetables and whole grains are the way to go to increase prebiotic consumption.
A 2017 study that included children (7-12 years old) who were overweight or obese examined the effect of prebiotic consumption on body composition, inflammatory markers, and intestinal microbiota. The children were randomized into two groups. One group received a prebiotic (oligofructose-enriched inulin), and the second group received a placebo (maltodextrin) for a period of 16 weeks. The researchers reported that prebiotic consumption normalized weight gain, lowered whole body and trunk body fat, and modified selected gut microbiota strains.
Similar results were found in studies that included adults, where an increase in prebiotics lead to a decrease in percent trunk fat. During childhood, growth is expected and necessary, but the study found that children who consumed prebiotics did not exceed the expected growth trends. The estimated annual body weight increase for those who consumed prebiotics was 3 kg, while the projected yearly increase was 8 kg for those that did not consume prebiotics.
Several microbiota strains are affected with the consumption of prebiotics, but a recent study isolated three strains including Bifidobacterium spp., bacteroides vulgatus and clostridium clostridioforme. Data suggests that Bifidobacterium increases with prebiotic consumption and that adults who are obese have significantly lower levels of the bacteria compared to those with a healthy weight. Bacteroides vulgatus was found to decrease in children consuming prebiotics. This reduction in linked to a decrease in percent trunk fat over a 16-week intervention.
Research indicates that clostridium clostridioforme is seen in significantly higher amounts in those with type 2 diabetes compared with healthy controls and that clostridium clostridioforme decreased in the children that consumed prebiotics. Each of these “bugs” were affected in a way to bring positive results to the body. During a study intervention, those who consumed prebiotics saw a mild increase in flatulence and bloating, about 25%. This may occur when the body is adjusting to an increase in fiber. Overtime, the body will adapt, and the side effects will lessen. Drinking additional water as fiber intake increases is vital.
There isn’t a magic pill to eliminate obesity, but consuming prebiotics from a healthy diet rich in fruits, vegetables and whole grains with regular physical activity could be a game changer. More research is needed to solidify itself as a weight loss option, but prebiotics from food are relatively inexpensive and non-invasive, and have proven health benefits besides possible weight loss including normalizing bowel movements, controlling blood sugar, lowering cholesterol, and increasing satiety. So, adding some extra fiber to a child’s daily dietary routine with an extra vegetable or whole grain per day may be just what the doctor ordered.