The Effects of a Commercially Available Synbiotic on the Gut Microbiome and Cardiometabolic Health: A Randomized Double-Blind Placebo-Controlled Trial

Accordingly, the purpose of this study is to evaluate the efficacy of 1) supplementation with a novel Synbiotic (JuicePlus), or 2) placebo control over 30 days on the gut microbiome, cardiometabolic health, body weight, and body composition in healthy individuals.

Specific Aim 1. Explore the changes in the gut microbiome using 16s rRNA sequencing to determine total bacterial counts, microbial diversity (alpha- and beta-diversity), short chain fatty acid (SCFA) concentration, circulating inflammatory biomarkers and mucosal immunity as a result of a novel synbiotic vs. placebo control.

Specific Aim 2. Document the functional changes in cardiometabolic health-related parameters; specifically, heart rate, heart rate variability (HRV), blood pressure (central and peripheral), vascular stiffness (augmentation index, AIx, and pulse wave velocity, PWV), body weight and composition, blood glucose and lipids as a result of a novel synbiotic vs. placebo control.

Specific Aim 3. Characterize the impact of synbiotic vs. placebo control on perceptions of gut health (questionnaire), and mood states, given the gut-brain axis.

Inclusion criteria

• To be included participants must be healthy, weight stable (± 4.4 lb for > 6 months prior), and 18 to 60 years of age. Participants will be expected to be relatively healthy without uncontrolled chronic disease (e.g. cardiovascular, metabolic, or pulmonary) and 2 or fewer positive risk factors for cardiovascular disease (e.g. high blood pressure, high cholesterol, etc.) as described by the American College of Sports Medicine/American Heart Association Criteria [18] and presented in the table 1 below. Participants will be screened for eligibility by a health history form (Appendix A) in person before baseline measurements are made (Figure 1). To ensure greater inclusion, ecological validity, and representation, women will be included in this study; however, we will not control for the menstrual cycle phase, but will document for possible statistical consideration.

Exclusion criteria

• Given the focus of the study, those who are currently, or have recently used (<3 months), oral antibiotics or have diagnosed irritable bowel syndrome or gut/bowel maladies (short bowel syndrome, etc.) will be excluded [19]. Subjects who present with more than 2 CVD risk factors (table above) or have uncontrolled/overt cardiovascular, pulmonary, or metabolic disease (Diabetes Mellitus), or recent blood donation (<8 weeks) will be excluded. Those who have cancer or are being treated for cancer will also be excluded. Women who are currently pregnant, breastfeeding, attempting to conceive, or amenorrheic (not associated with menopause or use of contraceptive medications) will also be excluded from the study. Anyone with severe illness or compromised or suppressed immune system (e.g. taking immunosuppressants, chronic viral infection or treatment) will be excluded [20]. Anyone recently diagnosed (<1yr) with an eating disorder will also be excluded. Finally, anyone with food allergies should be cautioned but those with known sensitivity to wheat, acacia gum, stevia, maltodextrin, or rice flour should not participate and will be excluded.