Is Probiotic Supplementation Useful for the Management of Body Weight and Other Anthropometric Measures in Adults Affected by Overweight and Obesity with Metabolic Related Diseases? A Systematic Review and Meta-Analysis

Simone Perna, Zahra Ilyas, Attilio Giacosa, Clara Gasparri, Gabriella Peroni, Milena Anna Faliva, Chiara Rigon, Maurizio Naso, Antonella Riva, Giovanna Petrangolini, Ali A Redha, Mariangela Rondanelli, Simone Perna, Zahra Ilyas, Attilio Giacosa, Clara Gasparri, Gabriella Peroni, Milena Anna Faliva, Chiara Rigon, Maurizio Naso, Antonella Riva, Giovanna Petrangolini, Ali A Redha, Mariangela Rondanelli

Abstract

The aim of this systematic review and meta-analysis is to assess the effectiveness of probiotics in inducing body weight loss in patients with overweight or obesity with related metabolic diseases. The research was carried out on PubMed and Scopus, focusing on studies reporting the effect on anthropometric measures (weight, body mass Index (BMI), waist circumference (WC), and hip circumference (HC) after administration of various probiotic strains compared to placebo. Twenty randomized controlled trials, that included 1411 patients, were considered. The meta-analyzed mean differences (MD) for random effects showed no significant decrease in body weight after probiotic supplementation (-0.26 kg [-075, 0.23], p = 0.30), while a significant BMI decrease was found (-0.73 kg/m2 [-1.31, -0.16], p = 0.01). For WC and HC, the meta-analyzed MD for random effects showed a significant decrease (WC: -0.71 cm [-1.24; -0.19], p = 0.008 and HC: -0.73 cm [-1.16; -0.30], p = 0.0008). The risk of bias was also evaluated considering a high risk and a low risk according to PRISMA criteria. In conclusion, the results of this meta-analysis highlight a positive trend of probiotics supplementation on the amelioration of anthropometric measures of overweight and obese patients with related metabolic diseases. However, further research is needed before recommending the use of probiotics as a therapeutic strategy for these patients. The focus of the future research should be to evaluate the efficacy of different probiotic strains, the quantities to be administered, and the duration of the intervention.

Keywords: body weight; obesity; probiotics; weight loss.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Forest plot for randomized controlled trials of probiotic supplementation included in body weight (kg) subgroup meta-analysis (n = 1057). The studies are listed by first author and year. IV = equation that can be estimated by inverse variance (linear, exponential). The square represents the measures of effect (i.e., an odd ratio) for each study; the area of each square is proportional to the study’s weight in the meta-analysis. Horizontal line represents the confidence interval (CI) at the 95% level. The diamond represents the meta-analyzed measure of effect; the lateral points of diamond indicate CIs for this estimate. The vertical line represents no effects; if the CI for an individual study overlaps with this line, the given level of confidence for the effect size does not differ from no effect for that study. Risk of bias indicates the level of high and low risk associated with the article. With green signal for low risk and red for high risk of bias.
Figure 2
Figure 2
Forest plot for randomized controlled trials of probiotic supplementation included in body mass index (kg/m2) subgroup meta-analysis (n = 1123). The studies are listed by first author and year. IV = equation that can be estimated by inverse variance (linear, exponential). The square represents the measures of effect (i.e., an odd ratios) for each study; the area of each square is proportional to the study’s weight in the meta-analysis. Horizontal line represents the confidence interval (CI) at the 95% level. The diamond represents the meta-analyzed measure of effect; the lateral points of diamond indicate CIs for this estimate. The vertical line represents no effects; if the CI for an individual study overlaps with this line, the given level of confidence for the effect size does not differ from no effect for that study. Risk of bias indicates the level of high and low risk associated with the article, with green signal for low risk and red for high risk of bias.
Figure 3
Figure 3
Forest plot for randomized controlled trials of probiotic supplementation included in waist circumference (cm) subgroup meta-analysis (n = 621). The studies are listed by first author and year. IV = equation that can be estimated by inverse variance (linear, exponential). The square represents the measures of effect (i.e., an odd ratios) for each study; the area of each square is proportional to the study’s weight in the meta-analysis. The horizontal line represents the confidence interval CI) at the 95% level. The diamond represents the meta-analyzed measure of effect; the lateral points of diamond indicate CIs for this estimate. The vertical line represents no effects; if the CI for an individual study overlaps with this line, the given level of confidence for the effect size does not differ from no effect for that study. Risk of bias indicate the level of high and low risk associated with the article, with green signal for low risk and red for high risk of bias.
Figure 4
Figure 4
Forest plot for randomized controlled trials of probiotic supplementation included in hip circumference (cm) subgroup meta-analysis (n = 621). The studies are listed by first author and year. IV = equation that can be estimated by inverse variance (linear, exponential). The square represents the measures of effect (i.e., an odd ratios) for each study; the area of each square is proportional to the study’s weight in the meta-analysis. The horizontal line represents the confidence interval CI) at the 95% level. The diamond represents the meta-analyzed measure of effect; the lateral points of diamond indicate CIs for this estimate. The vertical line represents no effects; if the CI for an individual study overlaps with this line, the given level of confidence for the effect size does not differ from no effect for that study. Risk of bias indicate the level of high and low risk associated with the article, with green signal for low risk and red for high risk of bias.

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