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Obesity is characterized by gut microbiota dysbiosis, in which beneficial metabolites such as butyrate are reduced. Butyrate is a short-chain fatty acid produced by microbial fermentation that plays a key role in maintaining intestinal barrier integrity, regulating immune responses, and supporting mitochondrial function. Its depletion contributes to disruption of the intestinal barrier, facilitating the translocation of bacterial components and promoting systemic inflammation mediated by immune cell activation, like monocytes. This chronic inflammatory state is associated with mitochondrial dysfunction and impaired cellular bioenergetics. Butyrate has been investigated for its anti-inflammatory and metabolic effects, however, its direct impact on monocyte mitochondrial function and its relationship with gut microbiota composition in humans remains unclear.
This randomized, double-blind, placebo-controlled trial will evaluate the effect of oral calcium butyrate supplementation (1000 mg/day) compared with placebo for 4 weeks in adults with obesity. The primary objective is to determine the change in monocyte mitochondrial maximal respiration baseline to week 4.
The study will consist of a screening phase (pre-admission) and two visits, followed by asynchronous follow-up.
Pre-admission visit Participants meeting inclusion criteria (presence of obesity) will be recruited through advertisements published on official institutional platforms.
Informed consent will be explained and signed prior to any study-related procedures.
Participants will be informed about the study characteristics, procedures, risks, and expected benefits, including dietary intervention and biochemical assessments.
A clinical history will be obtained, including identification data, contact information, medical history, and current or recent use of medications and supplements.
Anthropometric measurements (weight and height) will be obtained for BMI calculation.
Blood pressure will be measured after at least 5 minutes of rest, with two readings per arm separated by 3 minutes and averaged.
A blood sample will be collected to determine glucose, creatinine, and liver function tests.
Eligible participants will receive a stool collection kit with instructions for microbiota analysis and will be instructed to return the sample at the next visit.
Visit 1: Baseline Anthropometric measurements will be recorded (weight, height, waist circumference).
Body composition will be assessed using bioimpedance (fat mass, lean mass). Blood pressure will be measured following standardized procedures. A 24-hour dietary recall will be administered. The International Physical Activity Questionnaire will be applied. A blood sample will be collected to assess: Glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, liver enzymes, C-reactive protein, interleukin 6 and mitochondrial function.
The stool sample collected will be received for microbiota and short-chain fatty acids analysis.
Intervention Participants will be randomly assigned to either: Butyrate supplement group, or placebo group. An isocaloric maintenance diet will be prescribed (50% carbohydrates, 20% protein, 30% fat, 25 g/day fiber), including menus and food lists. Study capsules will be provided along with: Instructions for administration, adherence logbook, identification of adverse event monitoring (nausea, vomiting, abdominal discomfort, diarrhea, constipation, headache, dizziness, fatigue)
Visit 2: Final (After 4 weeks of intervention) Nutritional and Clinical Assessment Anthropometric measurements will be recorded (weight, height, waist circumference).
Body composition will be assessed using bioimpedance (fat mass, lean mass). Blood pressure will be measured following standardized procedures. A 24-hour dietary recall will be administered. The International Physical Activity Questionnaire will be applied. A blood sample will be collected to assess: Glucose, A blood sample will be collected to assess: Glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, liver enzymes, C-reactive protein, interleukin 6 and mitochondrial function and mitochondrial function.
The stool sample collected will be received for microbiota and short-chain fatty acids analysis.
Capsule count and adherence log review will be conducted. The adverse events questionnaire will be administered.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | Participants will receive oral placebo capsules containing maltodextrin at a dose of 600 mg/day, administered as two 300 mg capsules once daily for 4 weeks. Furthermore, the participants will follow the same standardized isocaloric maintenance diet (50% carbohydrates, 20% protein, 30% fat) throughout the study. |
|
| Butyrate | Experimental | Participants will receive calcium butyrate capsules at a dose of 1000 mg/day (2 capsules of 500 mg) by oral administration once daily for 4 weeks. Furthermore, the participants will follow the same standardized isocaloric maintenance diet (50% carbohydrates, 20% protein, 30% fat) throughout the study. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Dietary Supplement | Oral placebo capsules containing maltodextrin, 300 mg per capsule. Participants assigned to the placebo comparator arm will take two capsules once daily, for a total dose of 600 mg/day, for 4 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Monocyte mitochondrial maximal respiration in pmol O₂/min/10⁶ | Change in maximal respiration measured in Cluster of differentiation 14 (CD14+) monocytes using extracellular flux mitochondrial stress testing. Maximal respiration will be calculated as peak oxygen consumption rate (OCR) after Carbonyl cyanide-p-trifluoromethoxyphenylhydrazone (FCCP) stimulation minus non-mitochondrial respiration, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Gut microbiota composition as relative abundance percentage | Changes in gut microbiota composition will be assessed by 16 svedberg unit (16S) ribonucleic acid ribosomal (rRNA) sequencing, including alpha diversity (Chao1, Shannon), beta diversity, and relative taxonomic. and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Monocyte mitochondrial reserve respiratory capacity in pmol O₂/min/10⁶ cells | Change in reserve respiratory capacity measured in CD14+ monocytes using extracellular flux mitochondrial stress testing, will be calculated as the difference between maximal oxygen consumption rate and basal oxygen consumption rate, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Body mass index in kg/m² | Change in body mass index calculated as weight in kilograms divided by height in meters squared, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Skeletal muscle mass percentage |
Inclusion Criteria:
Exclusion Criteria:
Drug treatment:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Martha Guevara, MD, PhD | Contact | +52 55 5487 0900 | 2802 | martha.guevarac@incmnsz.mx |
| Lilia Noriega, PhD | Contact | +52 55 5487 0900 | 2802 | lilia.noriegal@incmnsz.mx |
| Name | Affiliation | Role |
|---|---|---|
| Martha Guevara, PhD | Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán | Mexico City | Mexico City | 14080 | Mexico |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37437746 | Background | Borja-Magno AI, Furuzawa-Carballeda J, Guevara-Cruz M, Arias C, Granados J, Bourges H, Tovar AR, Sears B, Noriega LG, Gomez FE. Supplementation with EPA and DHA omega-3 fatty acids improves peripheral immune cell mitochondrial dysfunction and inflammation in subjects with obesity. J Nutr Biochem. 2023 Oct;120:109415. doi: 10.1016/j.jnutbio.2023.109415. Epub 2023 Jul 10. | |
| 39003957 |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| Calcium butyrate | Dietary Supplement | Oral calcium butyrate capsules, 500 mg per capsule. Participants assigned to the experimental arm will take two capsules once daily, for a total dose of 1000 mg/day, for 4 weeks. |
|
| Monocyte Bioenergetic Health Index (BHI) score | Change in Bioenergetic Health Index measured in CD14+ monocytes using extracellular flux mitochondrial stress test. BHI will be calculated as (ATP-linked respiration × spare respiratory capacity) / (proton leak × non-mitochondrial respiration), and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Fecal butyrate concentration in µmol/g | Change in fecal butyrate concentration measured in stool samples by gas chromatography, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
Change in skeletal muscle mass measured by bioimpedance, and compared between the intervention and placebo groups.
| From baseline to 4 week of the intervention |
| Waist circumference in centimeter | Change in waist circumference measured at the midpoint between the lower costal margin and the iliac crest at the end of a normal expiration, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Lean body mass percentage | Change in lean body mass measured by bioimpedance, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Fat body mass percentage | Change in fat mass percentage measured by bioimpedance, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Body weight in kilograms | Change in body weight measured using a calibrated scale under fasting conditions and light clothing, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Systolic and diastolic blood pressure in mmHg | Change in systolic and diastolic blood pressure with an appropriately sized cuff, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Serum glucose concentration in mg/dL | Changes in the concentration of serum glucose measured by automated analyzer, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Total cholesterol serum concentration in mg/dL | Changes in total cholesterol concentrations measured by automated analyzer, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| High-density lipoprotein cholesterol serum concentration in mg/dL | Changes in H igh-density lipoprotein cholesterol concentrations measured by automated analyzer, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Serum alanine aminotransferase concentration in IU/mL | Changes in Serum alanine aminotransferase measured by automated analyzer, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Serum aspartate aminotransferase concentration in IU/mL | Change in serum aspartate aminotransferase measured by automated analyzer, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Serum high-sensitivity C-reactive protein concentration in mg/dL | Changes in high-sensitivity C-reactive protein determined by autoanalyzer, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Serum interleukin-6 (IL-6) concentration in pg/mL | Changes in IL-6 concentrations measured by enzyme-linked immunosorbent assay, and compared between the intervention and placebo groups. | From baseline to 4 week of the intervention |
| Low-density lipoprotein cholesterol serum concentration in mg/dL | Changes in High-density lipoprotein cholesterol concentrations measured by automated analyzer, and compared between the intervention and placebo groups. | From baseline to week 4 of the intervention |
| Background |
| Guevara-Cruz M, Hernandez-Gomez KG, Condado-Huerta C, Gonzalez-Salazar LE, Pena-Flores AK, Pichardo-Ontiveros E, Serralde-Zuniga AE, Sanchez-Tapia M, Maya O, Medina-Vera I, Noriega LG, Lopez-Barradas A, Rodriguez-Lima O, Mata I, Olin-Sandoval V, Torres N, Tovar AR, Velazquez-Villegas LA. Intermittent fasting, calorie restriction, and a ketogenic diet improve mitochondrial function by reducing lipopolysaccharide signaling in monocytes during obesity: A randomized clinical trial. Clin Nutr. 2024 Aug;43(8):1914-1928. doi: 10.1016/j.clnu.2024.06.036. Epub 2024 Jul 5. |
| 40427531 | Background | Marino F, Petrella L, Cimmino F, Pizzella A, Monda A, Allocca S, Rotondo R, D'Angelo M, Musco N, Iommelli P, Catapano A, Bagnato C, Paolini B, Cavaliere G. From Obesity to Mitochondrial Dysfunction in Peripheral Tissues and in the Central Nervous System. Biomolecules. 2025 Apr 29;15(5):638. doi: 10.3390/biom15050638. |
| 38999647 | Background | Guo Y, Shao M, Guan P, Yu M, Geng L, Gao Y, Meng L, Qu B. Co-Invasion of Congeneric Invasive Plants Adopts Different Strategies Depending on Their Origins. Plants (Basel). 2024 Jun 30;13(13):1807. doi: 10.3390/plants13131807. |
| 40284169 | Background | Kalkan AE, BinMowyna MN, Raposo A, Ahmad MF, Ahmed F, Otayf AY, Carrascosa C, Saraiva A, Karav S. Beyond the Gut: Unveiling Butyrate's Global Health Impact Through Gut Health and Dysbiosis-Related Conditions: A Narrative Review. Nutrients. 2025 Apr 9;17(8):1305. doi: 10.3390/nu17081305. |
| 33525625 | Background | Coppola S, Avagliano C, Calignano A, Berni Canani R. The Protective Role of Butyrate against Obesity and Obesity-Related Diseases. Molecules. 2021 Jan 28;26(3):682. doi: 10.3390/molecules26030682. |
| 30692581 | Background | Cleophas MCP, Ratter JM, Bekkering S, Quintin J, Schraa K, Stroes ES, Netea MG, Joosten LAB. Effects of oral butyrate supplementation on inflammatory potential of circulating peripheral blood mononuclear cells in healthy and obese males. Sci Rep. 2019 Jan 28;9(1):775. doi: 10.1038/s41598-018-37246-7. |
| 36469320 | Background | Coppola S, Nocerino R, Paparo L, Bedogni G, Calignano A, Di Scala C, de Giovanni di Santa Severina AF, De Filippis F, Ercolini D, Berni Canani R. Therapeutic Effects of Butyrate on Pediatric Obesity: A Randomized Clinical Trial. JAMA Netw Open. 2022 Dec 1;5(12):e2244912. doi: 10.1001/jamanetworkopen.2022.44912. |
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |