The Potential Role of Probiotics in Controlling Overweight/Obesity and Associated Metabolic Parameters in Adults: A Systematic Review and Meta-Analysis

Zhi-Bin Wang, Shan-Shan Xin, Li-Na Ding, Wen-Yu Ding, Yan-Li Hou, Chang-Qing Liu, Xian-Dang Zhang, Zhi-Bin Wang, Shan-Shan Xin, Li-Na Ding, Wen-Yu Ding, Yan-Li Hou, Chang-Qing Liu, Xian-Dang Zhang

Abstract

Background: The prevalence of overweight/obesity in adults is raised to 39%, which is nearly tripled more than 1975. The alteration of the gut microbiome has been widely accepted as one of the main causal factors. To find an effective strategy for the prevention and treatment of overweight/obesity, a systematic review and meta-analysis were designed.

Methods: In this study, we systematically reviewed the article published from January 2008 to July 2018 and conducted a meta-analysis to examine the effects of probiotics on body weight control, lipid profile, and glycemic control in healthy adults with overweight or obesity. The primary outcomes were body weight, body mass index (BMI), waist circumference, fat mass, fat percentages, plasma lipid profiles, and glucose metabolic parameters.

Results: We systematically searched PubMed, Embase, and the Web of Science and identified 1248 articles, and 7 articles which were manually searched by the references of included studies and previously systematic reviews. Twelve randomized controlled trials (RCTs), including 821 participants, were included in the meta-analysis via full-text screening. Probiotics supplementation resulted in a statistical reduction in body weight (WMD [95% CI]; -0.55 [-0.91, -0.19] kg), BMI (WMD [95% CI]; -0.30 [-0.43, -0.18] kg m-2), waist circumference (WMD [95% CI]; -1.20 [-2.21, -0.19] cm), fat mass (WMD [95% CI]; -0.91 [-1.19, -0.63] kg), and fat percentage (WMD [95% CI]; -0.92 [-1.27, -0.56] %) compared with control groups. As expected, the metabolic parameters were improved significantly, with a pooled standardized mean difference in TC (SMD [95% CI]; -0.43 [-0.80, -0.07]), LDL-C (SMD [95% CI]; -0.41 [-0.77, -0.04]), FPG (SMD [95% CI]; -0.35 [-0.67, -0.02]), insulin (SMD [95% CI]; -0.44 [-0.84, -0.03]), and HOMA-IR (SMD [95% CI]; -0.51 [-0.96, -0.05]), respectively. The changes in TG (SMD [95% CI]; 0.14 [-0.23, 0.50]), HDL-C (SMD [95% CI]; -0.31 [-0.70, 0.07]), and HbA1c (SMD [95% CI]; -0.23 [-0.46, 0.01]) were not significant.

Conclusion: This study suggests that the probiotics supplementation could potentially reduce the weight gain and improve some of the associated metabolic parameters, which may become an effective strategy for the prevention and treatment of obesity in adult individuals.

Figures

Figure 1
Figure 1
Study flow diagram for study selection.
Figure 2
Figure 2
Risk of bias assessment: (a) details of included studies; (b) overall summary.
Figure 3
Figure 3
Forest plot of effect of probiotics on (a) body weight; (b) BMI; (c) waist circumference; (d) fat mass; (e) fat percentage.
Figure 4
Figure 4
Forest plot of effect of probiotics on (a) TC; (b) TG; (c) LDL-C; (d) HDL-C.
Figure 5
Figure 5
Forest plot of effect of probiotics on (a) fasting plasma glucose; (b) HbA1c; (c) insulin; (d) HOMA-IR.

References

    1. Gonzalez-Muniesa P., Mártinez-González M., Hu F. B., et al. Obesity. Nature Reviews Disease Primers. 2017;3:p. 17034. doi: 10.1038/nrdp.2017.34.
    1. Hill J. O., Wyatt H. R., Peters J. C. Energy balance and obesity. Circulation. 2012;126(1):126–132. doi: 10.1161/CIRCULATIONAHA.111.087213.
    1. Marchesi J. R., Adams D. H., Fava F., et al. The gut microbiota and host health: a new clinical frontier. Gut. 2016;65(2):330–339. doi: 10.1136/gutjnl-2015-309990.
    1. Cani P. D., Delzenne N. M. The role of the gut microbiota in energy metabolism and metabolic disease. Current Pharmaceutical Design. 2009;15(13):1546–1558. doi: 10.2174/138161209788168164.
    1. Jung U. J., Choi M. S. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease. International Journal of Molecular Sciences. 2014;15(4):6184–6223. doi: 10.3390/ijms15046184.
    1. Henao-Mejia J., Elinav E., Jin C., et al. Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity. Nature. 2012;482(7384):167–179. doi: 10.1038/nature10809.
    1. Dongarrà M. L., Rizzello V., Muccio L., et al. Mucosal immunology and probiotics. Current Allergy and Asthma Reports. 2013;13(1):19–26. doi: 10.1007/s11882-012-0313-0.
    1. Sun L., Ma L., Ma Y., Zhang F., Zhao C., Nie Y. Insights into the role of gut microbiota in obesity: pathogenesis, mechanisms, and therapeutic perspectives. Protein & Cell. 2018;9(5):397–403. doi: 10.1007/s13238-018-0546-3.
    1. Reilly S. M., Saltiel A. R. Adapting to obesity with adipose tissue inflammation. Nature Reviews Endocrinology. 2017;13(11):633–643. doi: 10.1038/nrendo.2017.90.
    1. Brunkwall L., Orho-Melander M. The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities. Diabetologia. 2017;60(6):943–951. doi: 10.1007/s00125-017-4278-3.
    1. Delzenne N. M., Neyrinck A. M., Bäckhed F., Cani P. D. Targeting gut microbiota in obesity: effects of prebiotics and probiotics. Nature Reviews Endocrinology. 2011;7(11):639–646. doi: 10.1038/nrendo.2011.126.
    1. Cho I., Yamanishi S., Cox L., et al. Antibiotics in early life alter the murine colonic microbiome and adiposity. Nature. 2012;488(7413):621–626. doi: 10.1038/nature11400.
    1. Kim J., Yun J. M., Kim M. K., Kwon O., Cho B. Lactobacillus gasseri BNR17 supplementation reduces the visceral fat accumulation and waist circumference in obese adults: a randomized, double-blind, placebo-controlled trial. Journal of Medicinal Food. 2018;21(5):454–461. doi: 10.1089/jmf.2017.3937.
    1. Gomes A. C., de Sousa R. G. M., Botelho P. B., Gomes T. L. N., Prada P. O., Mota J. F. The additional effects of a probiotic mix on abdominal adiposity and antioxidant Status: a double-blind, randomized trial. Obesity. 2017;25(1):30–38. doi: 10.1002/oby.21671.
    1. Kim M., Kim M., Kang M., et al. Effects of weight loss using supplementation with Lactobacillus strains on body fat and medium-chain acylcarnitines in overweight individuals. Food & Function. 2017;8(1):250–261.
    1. Chung H.-J., Yu J. G., Lee I.-A., et al. Intestinal removal of free fatty acids from hosts by Lactobacilli for the treatment of obesity. FEBS Open Bio. 2016;6(1):64–76. doi: 10.1002/2211-5463.12024.
    1. Jung S., Lee Y. J., Kim M., et al. Supplementation with two probiotic strains, Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032, reduced body adiposity and Lp-PLA2 activity in overweight subjects. Journal of Functional Foods. 2015;19:744–752. doi: 10.1016/j.jff.2015.10.006.
    1. Zarrati M., Salehi E., Nourijelyani K., et al. Effects of probiotic yogurt on fat distribution and gene expression of proinflammatory factors in peripheral blood mononuclear cells in overweight and obese people with or without weight-loss diet. Journal of the American College of Nutrition. 2014;33(6):417–425. doi: 10.1080/07315724.2013.874937.
    1. Kadooka Y., Sato M., Ogawa A., et al. Effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity in adults in a randomised controlled trial. British Journal of Nutrition. 2013;110(9):1696–1703. doi: 10.1017/S0007114513001037.
    1. Stenman L. K., Lehtinen M. J., Meland N., et al. Probiotic with or without fiber controls body fat mass, associated with serum zonulin, in overweight and obese adults—randomized controlled trial. EBioMedicine. 2016;13:190–200. doi: 10.1016/j.ebiom.2016.10.036.
    1. Fathi Y., Faghih S., Zibaeenezhad M. J., Tabatabaei S. H. R. Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: a randomized controlled trial. European Journal of Nutrition. 2016;55(1):295–304. doi: 10.1007/s00394-015-0846-9.
    1. Madjd A., Taylor M. A., Mousavi N., et al. Comparison of the effect of daily consumption of probiotic compared with low-fat conventional yogurt on weight loss in healthy obese women following an energy-restricted diet: a randomized controlled trial. American Journal of Clinical Nutrition. 2016;103(2):323–329. doi: 10.3945/ajcn.115.120170.
    1. Hendijani F., Akbari V. Probiotic supplementation for management of cardiovascular risk factors in adults with type II diabetes: a systematic review and meta-analysis. Clinical Nutrition. 2018;37(2):532–541. doi: 10.1016/j.clnu.2017.02.015.
    1. Serena C., Ceperuelo-Mallafré V., Keiran N., et al. Elevated circulating levels of succinate in human obesity are linked to specific gut microbiota. The ISME Journal. 2018;12(7):1642–1657. doi: 10.1038/s41396-018-0068-2.
    1. John G. K., Wang L., Nanavati J., Twose C., Singh R., Mullin G. Dietary alteration of the gut microbiome and its impact on weight and fat mass: a systematic review and meta-analysis. Gene. 2018;9(3):p. 167.
    1. Tabrizi R., Moosazadeh M., Lankarani K. B., et al. The effects of synbiotic supplementation on glucose metabolism and lipid profiles in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials. Probiotics and Antimicrobial Proteins. 2018;10(2):329–342. doi: 10.1007/s12602-017-9299-1.
    1. Borgeraas H., Johnson L. K., Skattebu J., Hertel J. K., Hjelmesæth J. Effects of probiotics on body weight, body mass index, fat mass and fat percentage in subjects with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. Obesity Reviews. 2018;19(2):219–232. doi: 10.1111/obr.12626.
    1. Higgins J. P. T., Altman D. G., Gøtzsche P. C., et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal. 2011;343(7829) doi: 10.1136/bmj.d5928.d5928
    1. Higgins J. P., Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011] The Cochrane Collaboration; 2011. .
    1. Higgins J. P. T., Thompson S. G., Deeks J. J., Altman D. G. Measuring inconsistency in meta-analyses. British Medical Journal. 2003;327(7414):557–560. doi: 10.1136/bmj.327.7414.557.
    1. Szulińska M., Łoniewski I., van Hemert S., Sobieska M., Bogdański P. Dose-dependent effects of multispecies probiotic supplementation on the lipopolysaccharide (LPS) level and cardiometabolic profile in obese postmenopausal women: a 12-week randomized clinical trial. Nutrients. 2018;10(6):p. 773.
    1. Higashikawa F., Noda M., Awaya T., et al. Antiobesity effect of Pediococcus pentosaceus LP28 on overweight subjects: a randomized, double-blind, placebo-controlled clinical trial. European Journal of Clinical Nutrition. 2016;70(5):582–587. doi: 10.1038/ejcn.2016.17.
    1. Wang X., Juan Q. F., He Y. W., Zhuang L., Fang Y. Y., Wang Y. H. Multiple effects of probiotics on different types of diabetes: A systematic review & meta-analysis of randomized, placebo-controlled trials. Journal of Pediatric Endocrinology and Metabolism. 2017;30(6):611–622.
    1. Sun J., Buys N. Effects of probiotics consumption on lowering lipids and CVD risk factors: a systematic review and meta-analysis of randomized controlled trials. Annals of Medicine. 2015;47(6):430–440. doi: 10.3109/07853890.2015.1071872.
    1. Sherwin E., Dinan T. G., Cryan J. F. Recent developments in understanding the role of the gut microbiota in brain health and disease. Annals of the New York Academy of Sciences. 2018;1420(1):5–25. doi: 10.1111/nyas.13416.
    1. Jayashree B., Bibin Y. S., Prabhu D., et al. Increased circulatory levels of lipopolysaccharide (LPS) and zonulin signify novel biomarkers of proinflammation in patients with type 2 diabetes. Molecular and Cellular Biochemistry. 2014;388(1-2):203–210. doi: 10.1007/s11010-013-1911-4.
    1. Roager H. M., Licht T. R. Microbial tryptophan catabolites in health and disease. Nature Communications. 2018;9(1):p. 3294.
    1. Rizzetto L., Fava F., Tuohy K. M., Selmi C. Connecting the immune system, systemic chronic inflammation and the gut microbiome: the role of sex. Journal of Autoimmunity. 2018;92:12–34. doi: 10.1016/j.jaut.2018.05.008.
    1. Mulders R. J., de Git K. C. G., Schéle E., Dickson S. L., Sanz Y., Adan R. A. H. Microbiota in obesity: interactions with enteroendocrine, immune and central nervous systems. Obesity Reviews. 2018;19(4):435–451. doi: 10.1111/obr.12661.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する