The BALANCE Study - Improving Glucose Control Through Prebiotic Gut Health Drink in Postmenopausal Women (BALANCE)
Improving Glucose Control Through Prebiotic Gut Health Drink in Postmenopausal Women
The menopausal transition is associated with a decline in oestrogen levels, contributing to adverse metabolic changes including increased central adiposity, systemic inflammation, and insulin resistance. These changes are linked to a higher risk of developing type 2 diabetes in postmenopausal women.
Recent evidence suggests that the gut microbiota plays an important role in metabolic regulation and glucose homeostasis. Menopause-related hormonal changes may alter the composition and function of the gut microbiome, with downstream effects on insulin sensitivity. Additionally, certain gut bacteria (i.e., Bifidobacterium species) regulate circulating oestrogen via β-glucuronidase activity, highlighting a potential interaction between microbial composition and hormonal balance. Observational findings support associations between menopausal stage, gut microbiota alterations, and insulin homeostasis.
Prebiotics are non-digestible compounds that selectively stimulate beneficial gut bacteria and may improve metabolic outcomes. Modulation of the gut microbiota through prebiotic supplementation represents a promising non-pharmacological strategy to improve glucose control. Multiple studies have demonstrated that inulin (a common prebiotic) can improve glucose regulation and aid weight loss in individuals with obesity, prediabetes, or type 2 diabetes. However, to date, no randomised controlled trials have specifically investigated prebiotic supplementation in postmenopausal women with prediabetes using dynamic measures such as the Oral Glucose Tolerance Test (OGTT).
The present study aims to investigate the effect of daily consumption of an inulin-containing prebiotic gut health drink (ió everyday) on glucose control in postmenopausal women with prediabetes. The primary objective is to determine whether the intervention improves glycaemic control. Secondary objectives include exploration of changes in metabolic markers and assessment of the role of the gut microbiota in mediating these effects.
It is hypothesised that consumption of ió everyday will improve glucose control in prediabetic women who have recently undergone menopause. This hypothesis is supported by evidence demonstrating that inulin and soluble corn fibre can improve glucose regulation and support weight management in individuals with obesity, prediabetes, or type 2 diabetes, as well as findings from a previous study (Ethics Ref ID: LSC 23/383), which demonstrated that one month of ió everyday consumption significantly reduced fasting glucose, with a trend towards weight reduction and no reported adverse effects.
Studieoversigt
Status
Betingelser
Detaljeret beskrivelse
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: ADELE COSTABILE, Prof
- Telefonnummer: 3571 02083923571
- E-mail: adele.costabile@roehampton.ac.uk
Undersøgelse Kontakt Backup
- Navn: Savriniso Nazarova-Lewis, Master
- Telefonnummer: 07535721482
- E-mail: S.Nazarova-Lewis@roehampton.ac.uk
Studiesteder
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UK
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London, UK, Det Forenede Kongerige, SW15 4JD
- Health Sciences Research Centre, Life Sciences Department, University of Roehampton
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria::
- Female, aged 45-60 years
- Post-menopausal (no menstrual period for ≥12 months)
- No serious long-term medical conditions
- Living in the UK
- Able to read English and provide electronic informed consent
- Willing and able to comply with study procedures, including dietary intervention and sample collection
- Willing to provide stool samples at specified time points
BMI ≥25 kg/m² with one of the following:
- Impaired glucose tolerance (7.8-11.0 mmol/L at 2-hour OGTT), or
- Impaired fasting glucose (5.6-6.9 mmol/L), or
- HbA1c 5.7%-6.4%
- No intentional dieting within the past month
- No >5% body weight loss in the past year
- No changes in physical activity in the past 2-4 weeks and no intention to change during the study
Exclusion Criteria:
- Significant gastrointestinal disease (e.g., inflammatory bowel disease, coeliac disease) or other major medical conditions affecting gut microbiota or study safety
- Immunocompromised status or other serious chronic illness
- Use of antibiotics within the past 2-3 months
- Regular use of probiotics or prebiotics within the past 4 weeks
- Use of medications or special diets that significantly affect gut microbiota (e.g., chronic laxatives, immunosuppressants)
- Known allergies or intolerances to components of the prebiotic formulation
- Participation in another interventional clinical trial within the past 3 months
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Aktiv komparator: Dietary Supplement: Formulation 1
Each sachet contains 4.5 g inulin and 6 g total fibre.
Participants will consume one sachet daily in week 1 to allow acclimatisation, increasing to two sachets daily in weeks 2-4.
Sachets are diluted in 500 mL of water and consumed with lunch and dinner.
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Participants will consume the equivalent placebo comparator for 4 weeks.
Each sachet contains 5 g inulin of maltodextrin.
Participants will consume one sachet daily in week 1 to allow acclimatisation, increasing to two sachets daily in weeks 2-4.
Sachets are diluted in 500 mL of water and consumed with lunch and dinner.
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Placebo komparator: Dietary Supplement: Formulation 2
Calorie-matched comparator containing ~5 g maltodextrin
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Participants will consume ió everyday for 4 weeks.
Each sachet contains 4.5 g inulin and 6 g total fibre.
Participants will consume one sachet daily in week 1 to allow acclimatisation, increasing to two sachets daily in weeks 2-4.
Sachets are diluted in 500 mL of water and consumed with lunch and dinner.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Fasting Plasma Glucose
Tidsramme: Baseline and 4 weeks (end of intervention).
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Change in fasting plasma glucose measured from venous blood samples.
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Baseline and 4 weeks (end of intervention).
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Anthropometric Measurements
Tidsramme: Baseline and 4 weeks (end of intervention).
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Change in body fat percentage measured using standardised clinical methods.
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Baseline and 4 weeks (end of intervention).
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HbA1c (Glycated Haemoglobin)
Tidsramme: Baseline and 4 weeks (end of intervention).
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Change in HbA1c as an exploratory marker of glycaemic control (interpretation is limited due to the short 4-week intervention duration).
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Baseline and 4 weeks (end of intervention).
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Inflammatory Markers
Tidsramme: Baseline and 4 weeks (end of intervention).
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Change in circulating inflammatory markers associated with metabolic risk
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Baseline and 4 weeks (end of intervention).
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Gut Microbiota Composition
Tidsramme: Baseline and 4 weeks (end of intervention).
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Changes in gut microbiota diversity and composition assessed via stool samples and 16S rRNA sequencing.
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Baseline and 4 weeks (end of intervention).
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Dietary Intake
Tidsramme: Baseline and 4 weeks (end of intervention).
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Change in habitual dietary intake assessed using 4-day food records at baseline and after 4 weeks.
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Baseline and 4 weeks (end of intervention).
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Gastrointestinal Symptoms
Tidsramme: Baseline and 4 weeks (end of intervention).
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Changes in self-reported gastrointestinal symptoms (score max 10 and less of 1) including stool frequency and consistency (Bristol Stool Scale), bloating, abdominal pain, and flatulence.
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Baseline and 4 weeks (end of intervention).
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Studieleder: Adele Costabile, Prof, University of Roehampton
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- LSC-2025-14
- Patterson-BIV-Sept25 (Andet bevillings-/finansieringsnummer: INFORM BBSRC)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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