a, Akkermansia muciniphila abundance in feces evaluated by quantitative PCR. Differential values (mean difference and mean difference from placebo) are expressed as the mean ± s.e.m. as raw data. The bars represent the mean change from baseline value per group, with their s.e.m. Mann–Whitney U-tests were performed to compare the differential values of both treated groups versus the placebo group (intergroup changes) according to the distribution. The respective P values are shown in the table below each plot. The lines represent the raw values before and after 3 months of supplementation. The distribution of values within each group for each timing is illustrated by a box-and-whisker plot. In the box plots, the line in the middle of the box is plotted at the median, and the inferior and superior limits of the box correspond to the 25th and the 75th percentiles, respectively. Matched-pairs Wilcoxon signed-rank tests were performed to verify changes from baseline (intragroup changes) according to the distribution. When the difference is significant, a capped line is marked above the group concerned with the corresponding P value. Kruskal–Wallis analyses were used to compare changes between 0 and 3 months across the 3 groups according to the distribution. Placebo group, n = 11; pasteurized bacteria group, n = 12; live bacteria, n = 9. All tests were two-tailed. *P < 0.05. b, Visualization of participants’ fecal microbiota composition at baseline and end point of the intervention. Fecal microbiota dissimilarity between samples is represented by principal coordinates analysis (genus-level Aitchison distance), with six sample groups corresponding to the three different treatment arms at baseline or at end point represented by confidence ellipses (80% confidence interval). Intervention effects are symbolized by the colored arrows, with direction and length corresponding to the shift in group centroid coordinates from baseline to end point for each treatment arm (rescaled ×4 and re-centered at the baseline global centroid). Placebo group, n = 11; pasteurized bacteria group, n = 12; live bacteria, n = 9.