Daily Dose: Pediatric Obesity Treatment

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On December 7, 2022, we reported on a study published in JAMA Network Open that examined the therapeutic effects of butyrate on pediatric obesity.

The study

The randomized, placebo-controlled Butyrate Against Pediatric Obesity (BAPO) trial evaluated the effect of oral butyrate 20 mg/kg body weight per day vs placebo when added to standard of care for obesity over a period of 6 months. The primary outcome was defined as a decrease of at least 0.25 BMI SD scores at study end.

The results

In an intention-to-treat analysis, the investigators found that compared with placebo, butyrate supplementation led to a 40% absolute increase in the rate of children who experienced this decrease.

Butyrate supplementation was also linked to greater reductions in waist circumference, HOMA-IR, and levels of interleukin-6.

Clinical implications

"These data support the importance of the GM-derived metabolite butyrate as a protective factor against obesity, highlighting the central role of a healthy diet and GM function to achieve an optimal endogenous production of butyrate. Randomized clinical trials with longer follow-up are needed to confirm our findings. The lower adherence rate and higher frequency of mild adverse effects observed in patients treated with butyrate suggest that the unpleasant organoleptic features of this compound may limit its clinical application. Hence, development of new butyrate-based compounds free of these unpleasant features is advocated for a more effective therapeutic action of butyrate against pediatric obesity."

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