High-fiber diet altered gut microbiota, improved glycemic control, and reduced body weight in newly diagnosed type 2 diabetes and obesity
- 1State Key Laboratory of Microbial Metabolism, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University , ,
- 2Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Diabetes Microecology Diagnosis and Treatment and Transformation Engineering Research Center of Henan Province, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University , ,
Abstract
Type 2 diabetes and obesity commonly coexist, making glycemia and body weight both central treatment goals. Few trials have directly compared a high-fiber dietary intervention with metformin. The factors associated with individual responses to high-fiber diet also remain unclear. In this single-center, open-label, head-to-head clinical trial, 48 adults with newly diagnosed type 2 diabetes and overweight or obesity were randomized to a high-fiber dietary intervention without glucose-lowering medication ( n = 36) or metformin ( n = 12) monotherapy for 84 days; 46 completed the trial. Clinical outcomes and 184 fecal samples were assessed longitudinally using shotgun metagenomic and metabolite profiling. At Day 84, the high-fiber group had greater reductions in glycated hemoglobin and body mass index and lower glycemic variability than the metformin group. The diet altered gut microbiota by Day 28, enriching genomes from Bifidobacterium and Lactobacillus and depleting genomes from Bilophila wadsworthia , but metformin produced little detectable microbiota change. These changes included increased acetate-production functions and decreased hydrogen sulfide-production functions; fecal hydrogen sulfide was lower at Days 28 and 56, although short-chain fatty acid concentrations did not differ between groups at matched time points. Within the high-fiber group, participants with increased fecal acetate (25 of 34) had larger glycated hemoglobin reductions at Days 28 and 56, and baseline microbial features differed between acetate-response subgroups. These findings support high-fiber diet as a non-pharmacologic strategy for diabesity, with baseline microbial features as candidate markers of response.
Clinical trial registration: ChiCTR-INR-17011752.
Related
- Association Between Glycemic Variability and Bone Turnover and the Sema3A Signaling Pathway in Postmenopausal Women with Type 2 Diabetes Mellitus
- Serum Fatty Acid Profiles Across Normoglycemia, Prediabetes, and Type 2 Diabetes: Associations with Glycemic and Cardiometabolic Parameters in a Kazakh Population
- Stable tetraploid olive (Olea europaea L.) plants derived from embryogenic cultures show altered growth and improved water retention
- Altered gut microbiota and untargeted metabolomic features in patients with schizophrenia: a case–control study
- Online co-care management and glycemic control in patients with type 2 diabetes mellitus: A propensity score-matched retrospective cohort study
BibTeX
@article{li2026highfiber,
title = {{High-fiber diet altered gut microbiota, improved glycemic control, and reduced body weight in newly diagnosed type 2 diabetes and obesity}},
author = {Yan Li and Yalei Liu and Yiqi Chen and Baoyu Xiang and Huaqing Fu and Han Pan and Ting Xu and Zhaojie Li and Yajie Zhang and Huijuan Yuan and Chenhong Zhang},
journal = {Frontiers in microbiology},
year = {2026},
month = oct,
doi = {10.3389/fmicb.2026.1972983},
url = {https://europepmc.org/article/PMC/PMC13672211},
note = {CC BY},
}
RIS
TY - JOUR
TI - High-fiber diet altered gut microbiota, improved glycemic control, and reduced body weight in newly diagnosed type 2 diabetes and obesity
AU - Yan Li
AU - Yalei Liu
AU - Yiqi Chen
AU - Baoyu Xiang
AU - Huaqing Fu
AU - Han Pan
AU - Ting Xu
AU - Zhaojie Li
AU - Yajie Zhang
AU - Huijuan Yuan
AU - Chenhong Zhang
PY - 2026
DA - 2026/10/02
JO - Frontiers in microbiology
DO - 10.3389/fmicb.2026.1972983
UR - https://europepmc.org/article/PMC/PMC13672211
AB - Type 2 diabetes and obesity commonly coexist, making glycemia and body weight both central treatment goals. Few trials have directly compared a high-fiber dietary intervention with metformin. The factors associated with individual responses to high-fiber diet also remain unclear. In this single-center, open-label, head-to-head clinical trial, 48 adults with newly diagnosed type 2 diabetes and overweight or obesity were randomized to a high-fiber dietary intervention without glucose-lowering medication ( n = 36) or metformin ( n = 12) monotherapy for 84 days; 46 completed the trial. Clinical outcomes and 184 fecal samples were assessed longitudinally using shotgun metagenomic and metabolite profiling. At Day 84, the high-fiber group had greater reductions in glycated hemoglobin and body mass index and lower glycemic variability than the metformin group. The diet altered gut microbiota by Day 28, enriching genomes from Bifidobacterium and Lactobacillus and depleting genomes from Bilophila wadsworthia , but metformin produced little detectable microbiota change. These changes included increased acetate-production functions and decreased hydrogen sulfide-production functions; fecal hydrogen sulfide was lower at Days 28 and 56, although short-chain fatty acid concentrations did not differ between groups at matched time points. Within the high-fiber group, participants with increased fecal acetate (25 of 34) had larger glycated hemoglobin reductions at Days 28 and 56, and baseline microbial features differed between acetate-response subgroups. These findings support high-fiber diet as a non-pharmacologic strategy for diabesity, with baseline microbial features as candidate markers of response. Clinical trial registration: ChiCTR-INR-17011752.
SN - 1664-302X
ER -