Healthier gut, stronger kids: harnessing prebiotics for childhood obesity-a narrative review

Poornema Umasankar; Narayanasamy K.; Srinivas Govindarajalu; Jasmine S. Sundar; Valarmathi Srinivasan; Kalpana Ramachandran; Neela Chandran; Dharshini Prem

doi:10.18203/2394-6040.ijcmph20252498

Authors

Poornema Umasankar Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Narayanasamy K. The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Srinivas Govindarajalu Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Jasmine S. Sundar Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Valarmathi Srinivasan Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Kalpana Ramachandran Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Neela Chandran Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India
Dharshini Prem Department of Epidemiology, The Tamilnadu Dr. M. G. R Medical University, Guindy, Chennai, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20252498

Keywords:

Prebiotics, Childhood obesity, Gut microbiota

Abstract

Childhood obesity has become a significant global public health concern. The prevalence of obesity among children is rising, with over 390 million affected worldwide, including 160 million living with obesity. Obesity in childhood increases both immediate and long-term risks for various non-communicable diseases such as diabetes, cardiovascular disease, and non-alcoholic fatty liver disease (NAFLD). In recent years, attention has turned to the role of gut microbiota in obesity management. Prebiotics influence gut microbiota by selectively fermenting and modulating microbial activity, particularly through carbohydrates like oligosaccharides and fibers. This fermentation produces short-chain fatty acids (SCFAs) like acetate, propionate, and butyrate, which support gut health, reduce inflammation, and promote beneficial bacteria like Bifidobacterium and Lactobacillus. Clinical Studies suggest that prebiotics may reduce adiposity, improve metabolic makers, enhance satiety and reduce calorie intake. This review aims to provide an overview of the current evidence on the effectiveness of prebiotics in obesity management among children.

Metrics

Metrics Loading ...

References

Ogborogu VC, Oparaocha ET, Chukwuocha UM, Dozie U, Chiegboka N. Association between lifestyle trends and obesity among adults in Imo state. World Journal of Advanced Research and Reviews. 2025;26(1):269-76. DOI: https://doi.org/10.30574/wjarr.2025.26.1.0967

Saha J, Chouhan P, Ahmed F, Ghosh T, Mondal S, Shahid M, et al. Overweight/obesity prevalence among under-five children and risk factors in India: a cross-sectional study using the national family health survey (2015–2016). Nutrients. 2022;14(17):3621. DOI: https://doi.org/10.3390/nu14173621

Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, et al. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med. 2019;17(1):212. DOI: https://doi.org/10.1186/s12916-019-1449-8

Thomas DW, Greer FR. Committee on Nutrition; Section on Gastroenterology H and Nutrition. Probiotics and Prebiotics in Pediatrics. Pediatrics. 2010;126(6):1217–31. DOI: https://doi.org/10.1542/peds.2010-2548

Wang Y, Salonen A, Jian C. Can prebiotics help tackle the childhood obesity epidemic. Front Endocrinol. 2025;14:459. DOI: https://doi.org/10.3389/fendo.2023.1178155

Druart C, Alligier M, Salazar N, Neyrinck AM, Delzenne NM. Modulation of the Gut Microbiota by Nutrients with Prebiotic and Probiotic Properties. Adv Nutr. 2014;5(5):24-33. DOI: https://doi.org/10.3945/an.114.005835

Megur A, Daliri EBM, Baltriukienė D, Burokas A. Prebiotics as a Tool for the Prevention and Treatment of Obesity and Diabetes: Classification and Ability to Modulate the Gut Microbiota. Int J Mol Sci. 2022;23(11):6097. DOI: https://doi.org/10.3390/ijms23116097

Hume MP, Nicolucci AC, Reimer RA. Prebiotic supplementation improves appetite control in children with overweight and obesity: a randomized controlled trial. American J Clin Nutr. 2017;105(4):790-9. DOI: https://doi.org/10.3945/ajcn.116.140947

Yoo S, Jung SC, Kwak K, Kim JS. The role of prebiotics in modulating gut microbiota: implications for human health. International J Molec Sci. 2024;25(9):4834. DOI: https://doi.org/10.3390/ijms25094834

Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013;5(4):1417-35. DOI: https://doi.org/10.3390/nu5041417

Holmes ZC, Villa MM, Durand HK, Jiang S, Dallow EP, Petrone BL, et al. Microbiota responses to different prebiotics are conserved within individuals and associated with habitual fiber intake. Microbiome. 2022;10(1):114. DOI: https://doi.org/10.1186/s40168-022-01307-x

Shin Y, Han S, Kwon J, Ju S, Choi TG, Kang I, et al. Roles of short-chain fatty acids in inflammatory bowel disease. Nutrients. 2023;15(20):4466. DOI: https://doi.org/10.3390/nu15204466

Rupa P, Mine Y. Recent advances in the role of probiotics in human inflammation and gut health. J Agricul Food Chem. 2012;60(34):8249-56. DOI: https://doi.org/10.1021/jf301903t

Wilson E. Rupa Health. The Firmicutes/Bacteroidetes Ratio: What It Means for Gut Health, Hormones, and Overall Wellness. Available at: https://www.rupahealth.com/post/the-firmicutes-bacteroidetes-ratio-what-it-means-for-gut-health-hormones. Accessed on 21 February 2025.

Zheng L, Kelly CJ, Battista KD, Schaefer R, Lanis JM, Alexeev EE, et al. Microbial-Derived Butyrate Promotes Epithelial Barrier Function through IL-10 Receptor–Dependent Repression of Claudin-2. J Immunol. 2017;199(8):2976–84. DOI: https://doi.org/10.4049/jimmunol.1700105

Bortoluzzi C, de Souza Castro FL, Kogut M. Butyrate and intestinal homeostasis: Effects on the intestinal microbiota and epithelial hypoxia. InGut Microbiota, Immunity, and Health in Production Animals Cham: Springer International Publishing. 2022: 57-68. DOI: https://doi.org/10.1007/978-3-030-90303-9_4

Fuhren J, Schwalbe M, Boekhorst J, Rösch C, Schols HA, Kleerebezem M. Dietary calcium phosphate strongly impacts gut microbiome changes elicited by inulin and galacto-oligosaccharides consumption. Microbiome. 2021;9(1):218. DOI: https://doi.org/10.1186/s40168-021-01148-0

Walton GE, Swann JR, Gibson GR. Prebiotics. InThe prokaryotes. Spinger, Berlin, Heidelberg. 2013: 25-43. DOI: https://doi.org/10.1007/978-3-642-30144-5_88

Alsharairi NA. Therapeutic potential of gut microbiota and its metabolite short-chain fatty acids in neonatal necrotizing enterocolitis. Life. 2023;13(2):561. DOI: https://doi.org/10.3390/life13020561

Bottacini F, Ventura M, van Sinderen D, O’Connell Motherway M. Diversity, ecology and intestinal function of bifidobacteria. Microb Cell Factories. 2014;13(1):4. DOI: https://doi.org/10.1186/1475-2859-13-S1-S4

Kong C, Akkerman R, Klostermann C, Beukema M, Oerlemans MM, Schols H, et al. Distinct fermentation of human milk oligosaccharides 3-FL and LNT2 and GOS/inulin by infant gut microbiota and impact on adhesion of Lactobacillus plantarum WCFS1 to gut epithelial cells. Food Funct. 2021;12(24):12513–25. DOI: https://doi.org/10.1039/D1FO02563E

Liu Y, Nawazish H, Farid MS, Abdul Qadoos K, Habiba UE, Muzamil M, et al. Health-promoting effects of Lactobacillus acidophilus and its technological applications in fermented food products and beverages. Fermentation. 2024;10(8):380. DOI: https://doi.org/10.3390/fermentation10080380

Davani-Davari D, Negahdaripour M, Karimzadeh I, Seifan M, Mohkam M. Prebiotics: definition, types, sources, mechanisms, and clinical applications. Foods. 2019;8(3):92. DOI: https://doi.org/10.3390/foods8030092

Kong Q, Liu T, Xiao H. effects of probiotics and prebiotics on gut pathogens and toxins. Front Microbiol. 2022;13:856779. DOI: https://doi.org/10.3389/fmicb.2022.856779

Jenkins G, Mason P. The role of prebiotics and probiotics in human health: A systematic review with a focus on gut and immune health. Food Nutr. J. 2022;6:245.

Rodriguez J, Delzenne NM. Modulation of the gut microbiota-adipose tissue-muscle interactions by prebiotics. J Endocrinol. 2021;249(1):1–23. DOI: https://doi.org/10.1530/JOE-20-0499

Kleessen B, Hartmann L, Blaut M. Fructans in the diet cause alterations of intestinal mucosal architecture, released mucins and mucosa-associated bifidobacteria in gnotobiotic rats. Br J Nutr. 2003;89(5):597–606. DOI: https://doi.org/10.1079/BJN2002827

Paone P, Suriano F, Jian C, Korpela K, Delzenne NM, VanHul M, et al. Prebiotic oligofructose protects against high-fat diet-induced obesity by changing the gut microbiota, intestinal mucus production, glycosylation and secretion. Gut Microbes. 2022;14(1):2152307. DOI: https://doi.org/10.1080/19490976.2022.2152307

Paone P, Cani PD. Mucus barrier, mucins and gut microbiota: the expected slimy partners. Gut. 2020;69(12):2232–43. DOI: https://doi.org/10.1136/gutjnl-2020-322260

Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic. Nat Rev Gastroenterol Hepatol. 2019;16(10):605–16. DOI: https://doi.org/10.1038/s41575-019-0173-3

Cani PD, Possemiers S, Van de Wiele T, Guiot Y, Everard A, Rottier O, et al. Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut. 2009;58(8):1091–103. DOI: https://doi.org/10.1136/gut.2008.165886

Woting A, Pfeiffer N, Hanske L, Loh G, Klaus S, Blaut M. Alleviation of high fat diet-induced obesity by oligofructose in gnotobiotic mice is independent of presence of Bifidobacterium longum. Mol Nutr Food Res. 2015;59(11):2267–78. DOI: https://doi.org/10.1002/mnfr.201500249

Wilmanski T, Rappaport N, Diener C, Gibbons SM, Price ND. From taxonomy to metabolic output: what factors define gut microbiome health. Gut Microbes. 2021;13(1):1–20. DOI: https://doi.org/10.1080/19490976.2021.1907270

Gibson GR, Hutkins R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491–502. DOI: https://doi.org/10.1038/nrgastro.2017.75

Mollard RC, Sénéchal M, MacIntosh AC, Hay J, Wicklow BA, Wittmeier KDM, et al. Dietary determinants of hepatic steatosis and visceral adiposity in overweight and obese youth at risk of type 2 diabetes. Am J Clin Nutr. 2014;99(4):804–12. DOI: https://doi.org/10.3945/ajcn.113.079277

Arora T, Bäckhed F. The gut microbiota and metabolic disease: current understanding and future perspectives. J Intern Med. 2016;280(4):339–49. DOI: https://doi.org/10.1111/joim.12508

Nicolucci AC, Hume MP, Martínez I, Mayengbam S, Walter J, Reimer RA. Prebiotics reduce body fat and alter intestinal microbiota in children who are overweight or with obesity. Gastroenterology. 2017;153(3):711-22. DOI: https://doi.org/10.1053/j.gastro.2017.05.055

Costa Santos GG, Nunes Filho JCC, Oliveira Nunes MP. Effects of the use of prebiotics in the treatment of obesity. Adv Obes Weight Manag Control. 2022;12(2):38–43. DOI: https://doi.org/10.15406/aowmc.2022.12.00361

Rasaei N, Heidari M, Esmaeili F, Khosravi S, Baeeri M, Tabatabaei-Malazy O, Emamgholipour S. The effects of prebiotic, probiotic or synbiotic supplementation on overweight/obesity indicators: An umbrella review of the trials’ meta-analyses. Front Endocrinol. 2024;15:1277921. DOI: https://doi.org/10.3389/fendo.2024.1277921

Zhang P, Dong X, Zeng Y, Chen J, Yang S, Yu P, et al. Synbiotic Effects of Lacticaseibacillus paracasei K56 and Prebiotics on the Intestinal Microecology of Children with Obesity. Probiotics Antimicrob Proteins. 2024;3:79-81. DOI: https://doi.org/10.1007/s12602-024-10395-0

Visuthranukul C, Chamni S, Kwanbunbumpen T, Saengpanit P, Chongpison Y, Tepaamorndech S, et al. Effects of inulin supplementation on body composition and metabolic outcomes in children with obesity. Sci Rep. 2022;12(1):13014. DOI: https://doi.org/10.1038/s41598-022-17220-0

Visuthranukul C, Sriswasdi S, Tepaamorndech S, Chamni S, Leelahavanichkul A, Joyjinda Y, et al. Enhancing gut microbiota and microbial function with inulin supplementation in children with obesity. Int J Obes. 2005;48(12):1696–704. DOI: https://doi.org/10.1038/s41366-024-01590-8

Czarnowski P, Bałabas A, Kułaga Z, Kulecka M, Goryca K, Pyśniak K, et al. Effects of soluble dextrin fiber from potato starch on body weight and associated gut dysbiosis are evident in western diet-fed mice but not in overweight/obese children. Nutrients. 2024;16(7):917. DOI: https://doi.org/10.3390/nu16070917

Atazadegan MA, Heidari-Beni M, Entezari MH, Sharifianjazi F, Kelishadi R. Effects of synbiotic supplementation on anthropometric indices and body composition in overweight or obese children and adolescents: a randomized, double-blind, placebo-controlled clinical trial. World J Pediatr WJP. 2023;19(4):356–65. DOI: https://doi.org/10.1007/s12519-022-00664-9

Liber A, Szajewska H. Effect of oligofructose supplementation on body weight in overweight and obese children: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2014;112(12):2068–74. DOI: https://doi.org/10.1017/S0007114514003110

Zhang C, Yin A, Li H, Wang R, Wu G, Shen J, et al. Dietary Modulation of Gut Microbiota Contributes to Alleviation of Both Genetic and Simple Obesity in Children. E bio Medicine. 2015;2(8):968–84. DOI: https://doi.org/10.1016/j.ebiom.2015.07.007

Zalewski BM, Szajewska H. No Effect of glucomannan on body weight reduction in children and adolescents with overweight and obesity: a randomized controlled trial. J Pediatr. 2019;211:85-91. DOI: https://doi.org/10.1016/j.jpeds.2019.03.044