Effect of gut microbiome modulation on muscle function and cognition: the PROMOTE randomised controlled trial

Studies suggest that inducing gut microbiota changes may alter both muscle physiology and cognitive behaviour. In this placebo-controlled, double-blinded randomised controlled trial of 36 twin pairs (72 individuals) aged ≥60, each twin within a pair was randomised to receive either a daily prebiotic (inulin/fructo-oligosaccharides) or placebo for 12 weeks; all participants received resistance exercise guidance and branched-chain amino acid (BCAA) supplementation. Outcomes were physical function and cognition, assessed remotely. The prebiotic was well tolerated and altered the gut microbiome (e.g., increased relative Bifidobacterium abundance). There was no significant difference between prebiotic and placebo for the primary outcome of chair rise time (β = 0.579; 95% CI -1.080 to 2.239; p = 0.494). The prebiotic improved cognition versus placebo (cognitive factor score β = -0.482; 95% CI -0.813 to -0.141; p = 0.014). These findings suggest that low-cost gut microbiome interventions may improve cognition in older adults and demonstrate the feasibility of remotely delivered trials in this population. ClinicalTrials.gov: NCT04309292.