A groundbreaking clinical trial has revealed that the effectiveness of broccoli sprout extract (BSE) in managing prediabetes depends significantly on an individual's gut microbiome composition, marking a crucial step toward personalized nutritional interventions for metabolic disorders.
Key Clinical Findings
The double-blind, placebo-controlled trial enrolled 89 drug-naive individuals with prediabetes, administering 150 μmol of sulforaphane daily through BSE supplementation. Results showed a modest but significant reduction in fasting blood glucose levels of 0.2 mmol/L compared to placebo (95% CI -0.44 to -0.01, p=0.04).
Notably, treatment response varied considerably among participants, with the strongest benefits observed in those classified with mild age-related diabetes (MARD). These individuals experienced a more substantial glucose reduction of 0.4 mmol/L (p=0.008).
Microbiome's Critical Role
The study's most significant finding centers on the gut microbiota's influence on treatment efficacy. Participants showing the best glycemic response possessed higher levels of butyrate-producing bacteria, including Faecalibacterium and Eubacterium. The presence of the bacterial gene BT2160, crucial for sulforaphane activation, emerged as a key determinant of treatment success.
Individuals with abundant BT2160 in their gut microbiota demonstrated higher serum sulforaphane concentrations and more significant reductions in fasting glucose. Conversely, those lacking this bacterial gene showed minimal metabolic improvements from BSE supplementation.
Patient Response Predictors
Beyond microbial composition, the research identified several predictive factors for treatment outcomes. Liver health markers, particularly gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP), combined with specific gut bacterial profiles, helped predict treatment success. Patients achieving prediabetes remission (fasting glucose <6.1 mmol/L) typically showed higher BT2160 abundance and lower GGT levels.
Safety and Tolerability
The trial experienced some attrition, with 15 participants discontinuing primarily due to gastrointestinal side effects. Of these, nine were from the BSE group and six from the placebo group, suggesting generally acceptable tolerability but highlighting the need for careful patient monitoring.
Clinical Implications
These findings represent a significant advance in understanding how dietary interventions might be optimized for individual patients. With one in three adults worldwide having prediabetes and up to 70% at risk of developing type 2 diabetes, this research opens new possibilities for targeted nutritional strategies.
The study suggests that microbiome testing could become an essential tool in personalizing prediabetes interventions, potentially improving treatment outcomes while reducing reliance on pharmaceutical interventions. However, the relatively short 12-week follow-up period indicates the need for longer-term studies to confirm sustained benefits.
