Randomised trial · Clinical nutrition ESPEN · 2025Conflicts declared

Inulin changes gut and blood metabolites in alcohol withdrawal

What it found

In people with alcohol use disorder going through withdrawal, 17 days of inulin changed many metabolites in feces and blood compared with a placebo.

Some of these changes were linked to liver function.

What they found

Studies in people

Fecal metabolites

Inulin increased two fecal metabolites (N8-acetylspermidine and an unidentified compound) and decreased 12 others, including bile acids, indole-3-butyric acid, 5-AVAB, and some fatty acids and amines.

Blood metabolites

Inulin led to higher levels of several long-chain fatty acids, medium-chain acylcarnitines, and sphingomyelin in the blood, while lowering 3-methylhistidine.

Gut bacteria links

Some fecal bacteria were correlated with the changed metabolites. For example, Lachnoclostridium was linked to six fecal metabolites, and Ruminococcus torques group and Flavonifractor were linked to blood lipids.

Liver function

Blood markers of liver damage (ALT, AST, M65) were inversely correlated with sphingomyelin SM 36:2, meaning higher sphingomyelin went with lower liver damage markers.

Short-chain fatty acids

Inulin did not change the levels of short-chain fatty acids (like acetate, propionate, butyrate) in the feces.

What the authors conclude

“Three weeks of inulin supplementation during alcohol withdrawal leads to specific and different changes in the plasma and fecal metabolome of AUD patients, some of these gut microbiota-related metabolites being correlated with liver function.”
Amadieu C, Ahmed H, Leclercq S, et al, 2025

Also in their conclusions

  • They conclude that three weeks of inulin supplementation during alcohol withdrawal leads to specific and different changes in the plasma and fecal metabolome of AUD patients.
  • They note that some of these gut microbiota-related metabolites are correlated with liver function.
  • They call for further research to understand the specific microbial and metabolic alterations induced by inulin and their implications for managing AUD and associated neuropsychiatric symptoms.

How it was done

The authors wanted to find out how a prebiotic fiber like inulin affects the metabolites produced by gut bacteria and circulating in the blood in people with alcohol use disorder, since these patients often have gut bacteria imbalances and low fiber intake.

They studied 50 patients with alcohol use disorder who were hospitalized for a 3-week alcohol detox program. Patients were randomly assigned to take either inulin or a placebo (maltodextrin) for 17 days, with the dose increasing from 4 to 16 grams per day. The researchers analyzed fecal and blood samples before and after the intervention to measure metabolites, gut bacteria, and markers of inflammation and liver health.

What it can’t tell you

  • This study was in people with alcohol use disorder going through withdrawal, so the results may not apply to other groups.
  • The study was relatively small (50 people) and short (17 days), so it cannot show long-term effects or prove cause and effect.
  • The authors note that correlations between metabolites and health markers do not prove that one causes the other.

The paper

Title
Effect of inulin supplementation on fecal and blood metabolome in alcohol use disorder patients: A randomised, controlled dietary intervention
Type
Randomised controlled trial
Evidence
Studies in people
Summarised from
Full text
Cite
Amadieu C, Ahmed H, Leclercq S, et al (2025). Effect of inulin supplementation on fecal and blood metabolome in alcohol use disorder patients: A randomised, controlled dietary intervention. Clinical nutrition ESPEN. doi:10.1016/j.clnesp.2025.01.046Free full textPubMed 39864520DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error