Prebiotic Diet Changes Neural Correlates of Food Decision-making in Overweight Adults: a Randomised Controlled Within-subject Cross-over Trial

Objective: Animal studies suggest that prebiotic, plant-derived nutrients could improve homoeostatic and hedonic brain functions through improvements in microbiome-gut-brain communication. However, little is known if these results are applicable to humans. Therefore, we tested the effects of high-dosed prebiotic fibre on reward-related food decision-making in a randomised controlled within-subject cross-over study and assayed potential microbial and metabolic markers.

Design: 59 overweight young adults (19 females, 18-42 years, body mass index 25-30 kg/m) underwent functional task MRI before and after 14 days of supplementary intake of 30 g/day of inulin (prebiotics) and equicaloric placebo, respectively. Short chain fatty acids (SCFA), gastrointestinal hormones, glucose/lipid and inflammatory markers were assayed in fasting blood. Gut microbiota and SCFA were measured in stool.

Results: Compared with placebo, participants showed decreased brain activation towards high-caloric wanted food stimuli in the ventral tegmental area and right orbitofrontal cortex after prebiotics (preregistered, family wise error-corrected p <0.05). While fasting blood levels remained largely unchanged, 16S-rRNA sequencing showed significant shifts in the microbiome towards increased occurrence of, among others, SCFA-producing , and changes in >60 predicted functional signalling pathways after prebiotic intake. Changes in brain activation correlated with changes in microbial abundance and associated activity previously linked with SCFA production, such as ABC transporter metabolism.

Conclusions: In this proof-of-concept study, a prebiotic intervention attenuated reward-related brain activation during food decision-making, paralleled by shifts in gut microbiota.

Trial Registration Number: NCT03829189.