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36 studies in the last 5 years · Latest meta-analysis: 2025
201020182026
1HbA1c reductionMeta-AnalysisCited 26×n=2,685 · very large study2023
Galactomannans were the most effective dietary fiber for reducing the levels of HbA1c, fasting blood glucose, triglycerides, and LDL cholesterol in patients with type 2 diabetes.
Juhász AE et al. · The American journal of clinical nutrition (2023)
Galactomannans had the highest effect on reducing the levels of HbA1c (SUCRA: 92.33%) and fasting blood glucose (SUCRA: 85.92%).
With regard to fasting insulin level, HOMA-IR, β-glucans (SUCRA: 73.45%), and psyllium (SUCRA: 96.67%) were the most effective interventions.
Galactomannans were ranked first in reducing the levels of triglycerides (SUCRA: 82.77%) and LDL cholesterol (SUCRA: 86.56%).
3Body weight reductionMeta-AnalysisCited 4×n=1,184 · large study2024
Chicory ITF supplementation may benefit weight management by reducing body weight, BMI, fat mass, waist circumference, and, to a certain extent, body fat percentage.
Reimer RA et al. · The American journal of clinical nutrition (2024)
Noticeable benefit
← WorseNo effectBetter →
Chicory ITF significantly reduced body weight [mean difference (MD): -0.97 kg; 95% CI: -1.34, -0.59); n = 1184] compared with placebo.
Except for considerable heterogeneity in body weight (I2: 73%) and body fat percentage (I2: 75%), all other outcomes had negligible to moderate heterogeneity.
Significant reduction in body weight, BMI, and waist circumference was evident irrespective of participants' health status.
4Bifidobacterium abundanceSystematic ReviewCited 3×n=1,500 · large study2022
ITF promotes abundances of Bifidobacterium, Lactobacillus, and Faecalibacterium prausnitzii.
Le Bastard Q et al. · Advances in Nutrition (2022)
Significant prebiotic effect on intestinal microbiota
Improved intestinal barrier function
Increased calcium and magnesium absorption
5Meta-AnalysisCited 66×n=1,346 · large study2019
Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population.
Wang L et al. · Journal of translational medicine (2019)
Overall, ITF supplementation could significantly reduce concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR).
Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population.
Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management.
FMT and multistrain probiotics showed superior efficacy in UC.
Zhang T et al. · Journal of gastroenterology and hepatology (2025)
FMT and multistrain probiotics showed superior efficacy in UC.
However, the efficacy of MTTs varies among different IBD subtypes and disease stages; thus, the personalized treatment strategies of MTTs are necessary.
8Clinical outcomes in cystic fibrosisSystematic ReviewCited 4×2023
This review did not find any evidence for the use of prebiotics in people with CF.
Williams NC et al. · The Cochrane database of systematic reviews (2023)
This review did not find any evidence for the use of prebiotics in people with CF.
Until such evidence is available, it is reasonable for clinicians to follow any local guidelines and to discuss the use of dietary prebiotics with their patients.
Large and robust RCTs assessing the dietary prebiotics of inulin or galacto-oligosaccharides or fructo-oligosaccharides, or any combination of these, are needed.
Based on the results of network meta-analysis, it seems that Hypocaloricdiet+MonCam, LED, HFCS20+Ex, catechin-rich green tea +inulin, VLCD, NPD+RT, Hyc+Ex, SD, Hyc+BWL, are the better treatments for weight loss in patients with overweight and obesity.
Morsali M et al. · Journal of research in health sciences (2021)
Based on the results of network meta-analysis, it seems that Hypocaloricdiet+MonCam, LED, HFCS20+Ex, catechin-rich green tea +inulin, VLCD, NPD+RT, Hyc+Ex, SD, Hyc+BWL, are the better treatments for weight loss in patients with overweight and obesity.
The meta-analysis indicated that the numbers of subjects with ≥1 RTI were reduced with prebiotic (OR, 0.73; 95% CI: 0.62-0.86; P = 0.0002; n = 17) and synbiotic (OR, 0.75; 95% CI: 0.65-0.87; P = 0....
Williams LM et al. · Advances in nutrition (Bethesda, Md.) (2022)
Large benefit
← WorseNo effectBetter →
Likely real
The meta-analysis indicated that the numbers of subjects with ≥1 RTI were reduced with prebiotic (OR, 0.73; 95% CI: 0.62-0.86; P = 0.0002; n = 17) and synbiotic (OR, 0.75; 95% CI: 0.65-0.87; P = 0.0001; n = 9) supplementation compared to placebo.
Further, NK cell activity was increased with synbiotic (standardized mean difference, 0.74; 95% CI: 0.42-1.06; P < 0.0001, n = 3) supplementation.
This review provides evidence that prebiotic, specifically oligosaccharide, supplementation may play a protective role in RTIs in infants and children.
12Short-chain fatty acid productionSystematic ReviewCited 164×n=11 · very small study2022
Future studies are needed to better elucidate the relationship between DFs and gut microbiota in terms of SCFA production and impact on health-related markers.
Vinelli V et al. · Nutrients (2022)
Regarding the results obtained on the ability of fiber to modulate total SCFAs, seven studies reported a significant increase, while no significant changes were reported in five studies, depending on the analytical methodology used.
Overall, these results underline that, although affecting microbiota composition and derived metabolites, DFs do not produce univocal significant increase in SCFA levels in apparently healthy adults.
The effect of DF interventions on the SCFA profile seemed to be strictly dependent on the dose and the type and structure of DFs.
In summary, the use of ITF may have benefits for LDL-c reduction across all study populations, whereas HDL-c improvement and glucose control were demonstrated only in the T2DM subgroup.
Liu F et al. · European journal of clinical nutrition (2017)
Noticeable benefit
← WorseNo effectBetter →
Likely real
In the overall analysis, the supplementation of ITF reduced only the low density lipoprotein-cholesterol (LDL-c) (mean difference (MD): -0.15; 95% confidence interval (CI): -0.29, -0.02; P=0.03) without affecting the other endpoints.
Within the T2DM subgroup analysis, ITF supplementation was positively associated with a decreased fasting insulin concentration (MD: -4.01; 95% CI: -5.92, -2.09; P<0.0001) and increased high density lipoprotein-cholesterol (HDL-c) (MD: 0.07; 95% CI: 0, 0.14; P=0.05).
Moreover, a reduced fasting glucose tendency was identified only in the T2DM subgroup (MD: -0.42; 95% CI: -0.90, 0.06; P=0.09).
Some prebiotics and synbiotics may have immunomodulatory action, however, more randomized controlled trials are needed to support the clinical use of inulin-type fructans, galacto-oligosaccharides or related synbiotics for the treatment of metabolic endotoxaemia or low-grade inflammation in overweight/obese people.
Fernandes R et al. · Clinical nutrition (Edinburgh, Scotland) (2017)
Zang J et al. · Comprehensive reviews in food science and food safety (2026)
In the colon, fermentable carbohydrates, such as inulin, and fructooligosaccharides promote microbial fermentation and short-chain fatty acid (SCFA) production-especially butyrate-which strengthens epithelial integrity, stimulates mucus secretion, and regulates immune responses.
Finally, this review emphasizes the need to assess coordinated dietary effects along the entire small-to-large intestine continuum to better guide targeted nutritional strategies for human health.
16Pain and pain sensitivity in knee osteoarthritisRCTn=117 · medium study2026
Only inulin improved pain sensitivity and grip strength, the latter paralleled by increased GLP-1, and had much higher rates of retention compared to PSE.
Kouraki A et al. · Nutrients (2026)
Noticeable benefit
← WorseNo effectBetter →
Likely real
Results: A total of 117 participants (58.1% female; mean ± SD age = 67.5 ± 9.4 years; BMI = 29.5 ± 5.3 kg/m2; NRS = 3.96 ± 2.67) completed the trial.
Pain improved with inulin (baseline-adjusted between-group mean difference (Δ) = -1.11 [95%CI -2.18, -0.04], p = 0.045) and PSE (Δ = -1.55 [95%CI -2.52, -0.58], p = 0.002) compared to placebo, with no synergistic effect.
PSE improved TUG (p = 0.02) and 30-CST (p = 0.0004), while inulin improved grip strength (p = 0.002), pressure pain thresholds (p = 0.009) and temporal summation (p = 0.025) compared to placebo and had significantly lower dropout rates (3.6%) compared with PSE (21% p < 0.01).
17Gut health modulationSystematic Reviewn=22 · very small study2026
Prebiotics are effective modulators of gut health, driving clinical benefits through selective microbial fermentation and SCFA production.
Monteiro CRAV et al. · Nutrients (2026)
Prebiotics are effective modulators of gut health, driving clinical benefits through selective microbial fermentation and SCFA production.
The documented heterogeneity and variability highlight the need for future research to focus on personalized nutritional strategies.
Key priorities include standardizing intervention protocols, elucidating dose-response relationships, integrating multi-omics data to link taxonomy to function, and exploring novel applications such as synbiotic formulations and gut-brain axis modulation.
Well-powered, placebo-controlled trials with standardized migraine endpoints and integrated microbiome and metabolomic analyses are needed to define responders, optimal interventions, and clinical relevance.
Kozák M et al. · Nutrients (2026)
Emerging evidence also supports a potential role for prebiotics (e.g., inulin-type fructans) and microbiota-derived metabolites such as short-chain fatty acids, although direct clinical data remain limited.
Conclusions: Modulation of the microbiome-gut-brain axis represents a biologically plausible adjunct approach in migraine management.
While probiotics, prebiotics, and postbiotics show potential benefits with favorable safety profiles, current evidence of their strain-, formulation-, and population-specific characteristics is lacking.
19Atopic dermatitis at 1 yearRCTCited 1×n=188 · medium study2026
We found no evidence that maternal intervention with prebiotics protects against AD at 1 year of age in infants at risk of allergic diseases.
Barbarot S et al. · The British journal of dermatology (2026)
No clear effect
← WorseNo effectBetter →
Could be chance
Of 376 pregnant women included in the trial, prebiotic supplementation did not prevent AD at 1 year (intention-to-treat population odds ratio 1.01, 95% confidence interval 0.59-1.74; P = 0.97) or reduce disease severity in their children.
We found no evidence that maternal intervention with prebiotics protects against AD at 1 year of age in infants at risk of allergic diseases.
20Body weight reductionRCTCited 10×n=112 · medium study2024
Dietary supplementation with glucomannan, inulin, and psyllium effectively promotes weight loss and improves body composition in individuals with obesity, particularly those with specific genetic polymorphisms.
Pokushalov E et al. · Nutrients (2024)
Barely noticeable benefit
← WorseNo effectBetter →
Likely real
The experimental group showed significant reductions in body weight (treatment difference: -4.9%; 95% CI: -6.9% to -2.9%; p < 0.01) and BMI (treatment difference: -1.4 kg/m2; 95% CI: -1.7 to -1.2; p < 0.01) compared to placebo.
Further significant decreases in fat mass (treatment difference: -13.0%; 95% CI: -14.4 to -11.7; p < 0.01) and visceral fat rating (treatment difference: -1.3; 95% CI: -1.6 to -1.0; p < 0.01) were noted.
Homozygous minor allele carriers experienced greater decreases in body weight (treatment difference: -3.2%; 95% CI: -4.9% to -1.6%; p < 0.01) and BMI (treatment difference: -1.2 kg/m2; 95% CI: -2.0 to -0.4; p < 0.01) compared to heterozygous allele carriers.