Meta-analysis finds dietary fibre reduces metabolic endotoxemia and inflammatory cytokines

This systematic review and meta-analysis pooled data from 773 participants to evaluate the effect of dietary fibre (DF) supplementation on metabolic endotoxemia (ME) and inflammatory markers. The primary outcome was ME, assessed via serum lipopolysaccharide levels, and secondary outcomes included TNF-α, IL-10, lipopolysaccharide-binding protein, C-reactive protein, IL-6, HDL, and LDL.

DF supplementation significantly decreased serum lipopolysaccharide levels (p < 0.00001, I² = 97%) and TNF-α levels (p < 0.02, I² = 90%), and significantly increased IL-10 levels (p < 0.02, I² = 85%). However, no significant effects were observed on lipopolysaccharide-binding protein, C-reactive protein, IL-6, HDL, or LDL.

Notable limitations include very high heterogeneity for the significant outcomes (I² ≥ 85%), which reduces confidence in the pooled estimates. Additionally, the comparator, follow-up duration, and adverse events were not reported, limiting clinical applicability. The authors suggest DF supplementation may help ameliorate ME and inflammatory cytokines, potentially preventing chronic inflammation-related diseases, but the evidence is preliminary.

Clinicians should interpret these findings cautiously due to high heterogeneity and incomplete reporting. Further well-designed trials with standardized protocols are needed before recommending DF supplementation specifically for reducing endotoxemia.