Gut microbiome enterotypes and temporal variations during a six-month inulin-supplemented weight loss randomized controlled trial in Thai children with obesity.

Gut microbiome profiles can reflect the host's health status and have the potential to predict the effectiveness of medical interventions. In this study, gut microbiome enterotypes of 143 Thai children with obesity who participated in a randomized controlled trial of inulin supplementation were analyzed to identify microbial markers for weight loss responses and healthier lifestyles. Two gut microbiome enterotypes, which encompass 25 % of the children with obesity, were exclusive to children with obesity, including a rarely described Megasphaera enterotype. Megasphaera enterotype was also positively associated with dietary fiber intake specifically in the inulin group. Prevotella and Bacteroides enterotypes are significantly associated with poor health status, including longer times spent on electronic devices and lower concentrations of butyrate, a beneficial short-chain fatty acid. Children with these enterotypes also exhibited some of the best weight loss outcomes after receiving only behavioral and dietary advice. Observed associations between enterotypes and clinical parameters are consistent with earlier research of different populations. Intervention-specific associations suggest potential criteria for a personalized selection of weight loss interventions.