CClinicalTrials.gg
RecruitingNCT07724522PILIUpdated Aug 11, 2026

Prebiotic Inulin for Late-Reproductive Individuals

An interventional study of Inulin and Maltodextrin (Placebo) in Obesity & Overweight, Perimenopausal Women and Prebiotics, sponsored by George Washington University. Recruiting at 1 site in United States. Open to female participants aged 40 Years to 55 Years. Per ClinicalTrials.gov, last updated 2026-08-11.

Sponsored by George Washington University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
27
Allocation
Randomized
Ages
40 Years to 55 Years
Sex
Female
01

Study summary

This study aims to evaluate the effects of 2 weeks of inulin supplementation in perimenopausal women with overweight or obesity. The primary questions this study seeks to answer are:

  1. Does 2 weeks of inulin supplementation alter the gut and vaginal estrobolome compared with placebo?
  2. Does 2 weeks of inulin supplementation affect cardiovascular health compared with placebo?
  3. Does 2 weeks of inulin supplementation affect skeletal muscle health compared with placebo?

Researchers will compare inulin with a placebo (a similar-looking supplement that does not contain inulin) to determine whether inulin influences gut and vaginal microbial function, cardiovascular health, and skeletal muscle health during the perimenopausal transition.

Participants will:

  • Take either inulin or a placebo for 2 weeks, followed by a 2- to 4-week washout period, and then switch to the other supplement for an additional 2 weeks.
  • Attend 8 study visits over approximately 12 to 16 weeks for assessments and sample collection.
  • Complete weekly phone calls to monitor symptoms, supplement adherence, and dietary intake.
  • Wear a Fitbit device throughout the study to monitor physical activity.
Read the detailed description

This proposal presents a proof-of-concept study of the Prebiotic Inulin for Late Reproductive Individuals (PILI) intervention, a prebiotic fiber supplementation among women with perimenopause and overweight or obesity.

More specifically, the PILI intervention integrates multi-omics, physiological, and cardiometabolic assessments to examine the effects of inulin supplementation on overall health during the menopausal transition. Outcomes include changes in the gut and vaginal microbiome and their functional activity, gut-derived metabolites, vascular health, metabolic flexibility, skeletal muscle oxidative capacity, body composition, physical activity, sleep, dietary intake, and other cardiometabolic health markers. The target age range for this intervention is 40-55 years, reflecting the perimenopausal stage of life. Participants must also have overweight or obesity.

Participants will be randomly assigned to receive both the study intervention, inulin, and placebo, in a blind crossover design. Each participant will complete two intervention periods, separated by a washout period, allowing every participant to serve as her own control. Throughout the study, participants will consume the assigned supplement daily and attend scheduled in-person research visits before and after each intervention period.

At these visits, the research team will collect biological samples, including blood, stool, and vaginal swabs, and perform a comprehensive series of clinical assessments. These assessments include body composition, vascular health, metabolic flexibility, skeletal muscle oxidative capacity using near-infrared spectroscopy, physical function, and cardiometabolic testing. Participants will also complete questionnaires related to dietary intake, physical activity, sleep, menopausal symptoms, and quality of life, while wearing a Fitbit device to objectively monitor physical activity and sleep throughout the study.

The PILI study team will evaluate the feasibility of the intervention by assessing recruitment, retention, adherence to supplement consumption and study procedures, participant acceptability and tolerability, and completion of biological sample collection and clinical assessments. Preliminary changes in microbiome composition and function, microbial metabolites, and cardiometabolic health outcomes will also be evaluated to generate data that will inform the design of a future larger clinical trial.

This research has the potential to advance understanding of how prebiotic supplementation influences the gut-muscle-metabolism axis during the menopausal transition and to identify a safe, low-cost nutritional strategy to improve cardiometabolic health among perimenopausal women.

02

Conditions studied

  • Obesity & Overweight
  • Perimenopausal Women
  • Prebiotics
  • Inulin
  • Muscle, Skeletal
  • Cardiovascular Diseases (CVD)
  • Microbiota
  • Gastrointestinal Microbiome
  • Dietary Fiber
  • Women Health
  • Vascular Health
  • Insulin Resistance

Keywords

  • Perimenopause
  • Nutrition
  • Menopause transition
  • Overweight
  • Obesity
  • Cardiometabolic Health
  • Vascular function
  • Randomized Controlled Trial
  • Gut microbiome
  • Vaginal microbiome
  • Supplements
  • Inulin
  • Vascular Health
03

Who can participate

Ages eligible
40 Years to 55 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Body mass index: 25 - 40 kg/m2;
  • Menstrual cycle irregularity (cycle length outside 21 - 35 days or variation > 7 days) or/and ≥ 2 skipped cycles and interval of ≥ 60 days of amenorrhea; with or without hot flashes or/and night sweats;
  • Weight stable within the last 3 months (body weight fluctuations within the 5% of their habitual body weight);
  • Spending ≥ 6 hours sitting;
  • \< 150 minutes per week (50 minutes per day, 3 days per week OR 30 minutes per day, 5 days per week) of moderate to vigorous structured physical activity (i.e., planned intentional physical activity, not incidental movement).

Exclusion criteria

Exclusion Criteria:

  • Recent antibiotic use oral or vaginal (≥ 6months);
  • Diagnosed with any chronic disease (e.g., any gastrointestinal condition like IBD, type 2 diabetes, or cancer);
  • Prescription of hormone replacement therapy, hormonal contraceptives, probiotics, GLP-1 medications, or weight loss medications
  • Smoking;
  • Recent blood donation (within the past 8-12 weeks);
  • Significant weight changes (≥5%) in the last 4 weeks;
  • Use of dietary supplements (unless discontinued 4 weeks prior);
  • Participants taking long-term, stable medications for chronic conditions such as hypertension or hyperlipidemia will not be excluded if their medication regimen has been unchanged for at least 2 years, as these treatments are part of their usual health status. Recent medication changes (within the past 6 months), initiation of new prescriptions, or use of medications known to affect metabolic, vascular, vaginal, hormonal, or gastrointestinal function will result in exclusion.
  • Fructose intolerance.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Participant)
Enrollment
27 participants (estimated)

Study arms

  • Experimental
    Sequence A (Inulin → Placebo)

    Participants receive inulin daily for 2 weeks, followed by a 2-4 week washout period, then placebo for 2 weeks.

    Dietary Supplement: Inulin · Dietary Supplement: Maltodextrin (Placebo)

  • Experimental
    Arm 2: Sequence B (Placebo → Inulin)

    Participants receive a placebo daily for 2 weeks, followed by a 2-4-week washout period, then inulin for 2 weeks.

    Dietary Supplement: Inulin · Dietary Supplement: Maltodextrin (Placebo)

Interventions

  • Dietary supplementInulin

    10g per day for 2 weeks

  • Dietary supplementMaltodextrin (Placebo)

    10g per day for 2 weeks

05

What researchers measure

Primary outcomes

  1. Change in Gut Microbiome Composition

    Change in gut microbiome composition, assessed by shotgun metagenomic sequencing, comparing inulin versus placebo in a randomized crossover design.

    Time frame: Baseline, end of each 2-week intervention period (inulin and placebo), and after washout period (2-4 weeks).

  2. Change in Gut Microbiome Functional Capacity

    Change in gut microbiome functional capacity, including biosynthetic gene clusters (BGCs) and estrobolome-related microbial pathways, assessed by shotgun metagenomic sequencing, comparing inulin versus placebo in a randomized crossover design.

    Time frame: Baseline, end of each 2-week intervention period (inulin and placebo), and after washout period (2-4 weeks).

  3. Change in Vaginal Microbiome Composition

    Change in vaginal microbiome composition, assessed by shotgun metagenomic sequencing, comparing inulin versus placebo in a randomized crossover design.

    Time frame: Baseline, end of each 2-week intervention period (inulin and placebo), and after washout period (2-4 weeks).

Secondary outcomes

  1. Vascular Function

    Change in vascular function, assessed by pulse-wave velocity (PWV), comparing inulin versus placebo in a randomized crossover design.

    Time frame: Baseline and end of each 2-week intervention period (inulin and placebo), with assessments conducted during each intervention period following the washout phase (2-4 weeks).

  2. Metabolic Flexibility

    Change in metabolic flexibility, assessed as the change in respiratory exchange ratio (RER) from the fasted resting state to the postprandial period following a standardized high-fat mixed meal, measured continuously via indirect calorimetry, comparing inulin versus placebo in a randomized crossover design.

    Time frame: Baseline and end of each 2-week intervention period (inulin and placebo), with assessments conducted during each intervention period following the washout phase (2-4 weeks).

  3. Skeletal muscle mitochondrial oxidative capacity

    Change in skeletal muscle mitochondrial oxidative capacity in the gastrocnemius muscle, comparing inulin versus placebo in a randomized crossover design. Muscle oxidative capacity will be assessed using near-infrared spectroscopy (NIRS).

    Time frame: Baseline and end of each 2-week intervention period (inulin and placebo), with assessments conducted during each intervention period following the washout phase (2-4 weeks)

06

Study locations

1 of 1 sites recruiting
  • Milken Institute School of Public Health
    Washington D.C., District of Columbia 20052, United States
    Recruiting
07

References and documents

Publications

  • Huang F, Cao Y, Liang J, Tang R, Wu S, Zhang P, Chen R. The influence of the gut microbiome on ovarian aging. Gut Microbes. 2024 Jan-Dec;16(1):2295394. doi: 10.1080/19490976.2023.2295394. Epub 2024 Jan 3. PubMed 38170622 ↗
  • Wang H, Shi F, Zheng L, Zhou W, Mi B, Wu S, Feng X. Gut microbiota has the potential to improve health of menopausal women by regulating estrogen. Front Endocrinol (Lausanne). 2025 Jun 9;16:1562332. doi: 10.3389/fendo.2025.1562332. eCollection 2025. PubMed 40551890 ↗
  • Houghton MJ, Kerimi A, Mouly V, Tumova S, Williamson G. Gut microbiome catabolites as novel modulators of muscle cell glucose metabolism. FASEB J. 2019 Feb;33(2):1887-1898. doi: 10.1096/fj.201801209R. Epub 2018 Sep 5. PubMed 30183376 ↗
  • Cross TL, Simpson AMR, Lin CY, Hottmann NM, Bhatt AP, Pellock SJ, Nelson ER, Loman BR, Wallig MA, Vivas EI, Suchodolski J, Redinbo MR, Rey FE, Swanson KS. Gut microbiome responds to alteration in female sex hormone status and exacerbates metabolic dysfunction. Gut Microbes. 2024 Jan-Dec;16(1):2295429. doi: 10.1080/19490976.2023.2295429. Epub 2023 Dec 28. PubMed 38153260 ↗
  • Cavallari JF, Schertzer JD. Intestinal Microbiota Contributes to Energy Balance, Metabolic Inflammation, and Insulin Resistance in Obesity. J Obes Metab Syndr. 2017 Sep;26(3):161-171. doi: 10.7570/jomes.2017.26.3.161. Epub 2017 Sep 30. PubMed 31089513 ↗
  • Cabre HE, Gould LM, Gordon AN, Giuliani-Dewig HK, Moore SR, Ryan ED, Smith-Ryan AE. Differences in strength, leg lean mass, and lifestyle factors between premenopausal and perimenopausal women. Clin Physiol Funct Imaging. 2022 Nov;42(6):460-464. doi: 10.1111/cpf.12771. Epub 2022 Jul 26. PubMed 35762156 ↗
  • Gould LM, Gordon AN, Cabre HE, Hoyle AT, Ryan ED, Hackney AC, Smith-Ryan AE. Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism. Menopause. 2022 Feb 28;29(4):377-389. doi: 10.1097/GME.0000000000001932. PubMed 35231009 ↗
  • Le Bastard Q, Chapelet G, Javaudin F, Lepelletier D, Batard E, Montassier E. The effects of inulin on gut microbial composition: a systematic review of evidence from human studies. Eur J Clin Microbiol Infect Dis. 2020 Mar;39(3):403-413. doi: 10.1007/s10096-019-03721-w. Epub 2019 Nov 9. PubMed 31707507 ↗
  • Peters BA, Santoro N, Kaplan RC, Qi Q. Spotlight on the Gut Microbiome in Menopause: Current Insights. Int J Womens Health. 2022 Aug 10;14:1059-1072. doi: 10.2147/IJWH.S340491. eCollection 2022. PubMed 35983178 ↗
  • Ervin SM, Li H, Lim L, Roberts LR, Liang X, Mani S, Redinbo MR. Gut microbial beta-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens. J Biol Chem. 2019 Dec 6;294(49):18586-18599. doi: 10.1074/jbc.RA119.010950. Epub 2019 Oct 21. PubMed 31636122 ↗
  • El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick ML, Allison MA; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 22;142(25):e506-e532. doi: 10.1161/CIR.0000000000000912. Epub 2020 Nov 30. PubMed 33251828 ↗

Individual participant data

Plan to share: No — Individual participant data (IPD) will not be shared because the dataset contains sensitive health and behavioral information, and full de-identification and public release are not planned within the scope of this study.

08

Registry details

Key details

Study ID
NCT07724522
Lead sponsor
George Washington University
Responsible party
Carmen Ortega-Santos (Assistant Professor, George Washington University) — Principal investigator
First posted
Jul 24, 2026
Start date
Aug 1, 2026
Primary completion
Feb 2028 (estimated)
Completion
Feb 2028 (estimated)
Last update
Aug 11, 2026

Study contacts

Carmen Ortega-Santos, PhD, RD
Contact
fitgutlab@gwu.edu
202-994-2757

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion