What question did this study set out to answer?

The trial aims to assess how a polysaccharide complex combined with dietary changes affects gut microbiota in children with metabolically unhealthy obesity.

March 16, 2026Open Access

Synergic effect of diet and polysaccharide-based complex administration in the treatment of children and adolescents with metabolically unhealthy obesity: the Polymets Study

GFGiulia FioreUniversity of Milan AAAsli AltayevaIstituto Nazionale Genetica Molecolare SPSimona PanelliIstituto Nazionale Genetica Molecolare

Key Points

The trial aims to assess how a polysaccharide complex combined with dietary changes affects gut microbiota in children with metabolically unhealthy obesity.
Participants aged 8-14 with obesity were enrolled.
They received a polysaccharide complex and Mediterranean diet for four months, followed by diet alone for four months.
Gut microbiota, body composition, and blood markers were measured at three time points (baseline, 4 months, 8 months).
BMI SDS significantly decreased at all time points (p < 0.001).
Fat mass% decreased significantly at 4 months (p = 0.035).
There was a notable shift in gut microbiota composition, with significant enrichments and reductions in specific bacterial families and genera.

Abstract

The primary aim of the Polymets Study is to evaluate the effect on gut microbiota composition of a polysaccharide-based complex administration combined with dietary and lifestyle interventions in a group of children and adolescents with metabolically unhealthy obesity (MUO). In this clinical trial, children and adolescents (8–14 years) with obesity (defined as body mass index > + 2 standard deviation score BMI SDS according to World Health Organization) and cardio-metabolic alteration (hypertriglyceridemia, hypertension, hypo-HDL cholesterol, altered glucose metabolism) were enrolled. Participants received from baseline (T0) to 4 months (T1) combined polysaccharide-based complex administration (5 g/day mixture of soluble and insoluble fibres) and Mediterranean diet intervention; from 4 to 8 months (T2) they underwent dietary intervention alone. At T0, T1 and T2 gut microbiota analysis, body composition assessment, blood tests and Mediterranean diet adherence (KIDMED score) were assessed. Overall, 31 children were enrolled (10. 9 ± 1. 6 years, F/M 8/23). BMI SDS significantly decreased at each timepoint (p < 0. 001), whilst fat mass% significantly decreased only at T1 (p = 0. 035), vs T0. The Principal Component Analysis showed a trend of reduced dispersion at the phylum taxonomic level at T1, having Firmicutes, Bacteroidota and Proteobacteria as major contributors to the variance. At T1, there was an enrichment in Barnesiellaceae family, ErysipelotrichaceaeUCG-003 and Parabacteroides genera (p < 0. 05), vs. T0. At T2 Oscillospiraceaeᵤnclassified and Clostridiaᵤnclassified increased significantly, whereas ErysipelotrichaceaeUCG − 003 and EscherichiaShigella decreased significantly (p < 0. 05), vs T1. Polysaccharide-based complex intervention synergistically contributes for enrichment in microbial marker of metabolic health and body adiposity reduction, while the subsequent solo-diet phase triggers expansion of butyrate-producing lineages and overall reduction of pathogenic taxa.

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