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Low-methoxy (LM) pectin, a fermentable dietary fibre derived from plant cell walls, has demonstrated immunomodulatory and microbiome-modifying effects in preclinical studies, but evidence in older adults with frailty is scarce. We conducted a 4-week double-blind, randomised, placebo-controlled trial evaluating LM pectin supplementation in older adults with frailty. Thirty-one participants were enrolled, and 29 completed the intervention. Physical performance, psychological well-being, quality of life, inflammatory biomarkers, and gut microbiome composition were assessed at baseline and follow-up. Compared with placebo, low-methoxy pectin supplementation significantly improved lower limb function measured by the 30-second sit-to-stand test (2.07 \u00b1 1.94 vs 0.71 \u00b1 2.27 repetitions; p = 0.038), while no significant changes were observed in Timed Up and Go performance. Supplementation also reduced anxiety and depression scores and improved several Short Form-36 domains, including physical functioning, vitality, mental health, and social functioning. No significant differences were detected in circulating inflammatory biomarkers. Gut microbiome analysis demonstrated increased relative abundance of\n                    <jats:italic>Coprococcus comes<\/jats:italic>\n                    , an acetate-producing species linked to gut\u2013brain signalling and psychological health. These findings provide preliminary evidence that LM pectin supplementation may improve physical and psychological outcomes and alter gut microbial composition in older adults with frailty. Larger, adequately powered trials are needed to determine whether these changes are reproducible and to investigate potential microbiome-related mechanisms.\u00a0Trial registration number:\u00a0NCT06955975 (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06955975\" ext-link-type=\"uri\">https:\/\/clinicaltrials.gov\/study\/NCT06955975<\/jats:ext-link>\n                    ; Clinical Trials.gov; 2025-06-22).\n                  <\/jats:p>","DOI":"10.1007\/s11357-026-02562-8","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:52:10Z","timestamp":1790567530000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of pectin supplementation on geriatric individuals with frailty: a randomised placebo-controlled dietary intervention study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5712-5889","authenticated-orcid":false,"given":"Noor Kifah","family":"Al-Tameemi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afroditi","family":"Kouraki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane I.","family":"Grove","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie E.","family":"Rollins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guruprasad P.","family":"Aithal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Valdes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"2562_CR1","doi-asserted-by":"publisher","unstructured":"The Lancet Healthy Longevity. 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Ethical approval was obtained from the University of Nottingham Faculty of Medicine and Health Sciences Research Ethics Committee on November 19, 2024 (Ref: FMHS 280-0924), and the study was registered with ClinicalTrials.gov reference number NCT06955975 on June 22, 2025. Adhering to the CONSORT guidelines, the study ensured transparent and rigorous reporting. All participants provided written informed consent before involvement.","order":1,"name":"Ethics","label":"Ethics\u00a0approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"GPA has received consulting fees from Amryth, Agios, DNDi, PureTech LYT Inc, Pfizer Inc, GlaxoSmithKline, Clinipace, Merck Healthcare KGaA, JnJ, Suzhou MDCE Co Ltd, SynOx Therapies, Novartis Pharma, AstraZeneca and BenevolentAI Bio, paid to the University of Nottingham, and has received investigator-led research funding from Ipsen Ltd and Pfizer Inc. AMV is affiliated with commercial entities not related to the present study. Specifically, AMV is a member of the Scientific Advisory Board of Chuckling Goat and OLIPOP Inc. These roles are unrelated to the present study and had no influence on study design, data collection and analysis, decision to publish, or preparation of the manuscript. All other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}