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This is an investigational, donor-derived oral fecal microbiota transplantation intervention developed at the University of Alberta for severe obesity and metabolic syndrome. It was administered as a single oral dose of approximately 20 capsules containing screened fecal microbiota from lean healthy donors, with participants subsequently assigned to fiber supplementation regimens. The intended mechanism is engraftment or modulation of recipient gut microbial communities to improve microbial ecology and insulin sensitivity. In the Phase 2 randomized, double-blind trial NCT03477916, fecal microbial transplantation with low-fermentable fiber was associated with improved insulin sensitivity at 6 weeks in participants with severe obesity and metabolic syndrome. ([clinicaltrials.gov](https://clinicaltrials.gov/study/NCT03477916))
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