In urine, change in hippurate, a metabolite previously found to be inversely associated with metabolic syndrome risk, gut microbiota richness (Pallister et al., 2017), and obesity (Elliott et al., 2015), was positively associated with improvement in IS, specifically, with a decrease in plasma insulin, HOMA-IR and FIRI (Supplementary Figure 4B). The gene discussed is INS; the disease is obesity due to melanocortin 4 receptor deficiency.