Effects of probiotic/synbiotic supplementation on body weight in patients with diabetes: a systematic review and meta-analyses of randomized-controlled trials

Abstract

Objective The aim of the present study was to assess the effect of probiotic/synbiotic supplementation on anthropometric measures in adults with diabetes, independent of body weight. Methods PubMed, Scopus, Web of Sciences and the Cochrane Library were searched for randomized controlled trials (RCTs) up until December 14, 2022. The effect sizes were pooled using an inverse-variance random-effects model. The methodological quality of studies as well as the quality of evidence was assessed using standard tools. Results Thirty-two RCTs met the established inclusion criteria. Overall, compared with the respective control groups, probiotic/synbiotic supplementation resulted in a significant reduction in body weight (weighted mean difference [WMD]: -0.50 kg; 95% CI: -0.83, -0.17; I2 = 79.8%, n = 27 studies]), body mass index (WMD: -0.24 kg/m2; 95% CI: -0.39, -0.09; I2 = 85.7%, n = 30 studies), and waist circumference (WMD: -0.90 cm; 95% CI: -1.13, -0.52; I2 = 0%, n = 11 studies). However, hip circumference and waist to hip ratio were not significantly improved. Conclusions Our analysis revealed that probiotic/synbiotic supplementation may assist with weight management in patients with diabetes, especially when consumed at higher doses, in younger adults, and in participants with obesity. However, more studies are needed to elucidate the anti-obesity effects of specific strains of probiotics/synbiotics.

What’s gut got to do with it? The role of the microbiota and inflammation in the development of adiposity and obesity

“…The use of prebiotics [ 66 , 67 ] and probiotics [ 23 , 25 , 68 , 69 ] to stabilize the gut microbiota has demonstrated reasonable success in ameliorating or preventing adiposity and certain comorbidities. In humans, the use of probiotics as a treatment for obesity and metabolic disease has shown positive results, although higher doses and longer duration of treatment (compared with rodent models) seem necessary for the best effects [ 68 , 70 – 72 ] . Probiotics are likely not a “silver bullet”, but can be an effective complementary approach to other treatments [ 72 ] .…”

“…In humans, the use of probiotics as a treatment for obesity and metabolic disease has shown positive results, although higher doses and longer duration of treatment (compared with rodent models) seem necessary for the best effects [ 68 , 70 – 72 ] . Probiotics are likely not a “silver bullet”, but can be an effective complementary approach to other treatments [ 72 ] . Similarly, the use of anti-inflammatory drugs, either systemic [ 73 – 75 ] or gut-specific [ 31 ] , can also limit fattening, IR, and other effects of metabolic inflammation in laboratory models.…”

The effects of prebiotic, probiotic or synbiotic supplementation on overweight/obesity indicators: an umbrella review of the trials’ meta-analyses

“…There is accumulating evidence that individuals who are overweight or obese exhibit a distinct profile of the gut microbiota, including reduced microbial gene richness and diversity (known as dysbiosis) compared with normal weight ( 10 , 20 , 21 ). These alterations have been linked to low-grade inflammation, impaired energy metabolism homeostasis, elevated body weight, and dysregulation of insulin signaling ( 22 ). Hence, targeting gut microbiota has recently been a promising strategy for treating obesity and related metabolic disorders.…”

“…Numerous systematic reviews with meta-analysis, though yielding conflicting results, have been conducted to assess the effects of biotics on anthropometric indices such as weight, body mass index (BMI), and waist circumference (WC) ( 9 , 22 , 25 – 29 ). Moreover, no review of the meta-analysis studies from these trials has comprehensively examined the effect of biotics on various obesity indices in both adults and infants.…”

“…Numerous systematic reviews with meta-analysis, though yielding conflicting results, have been conducted to assess the effects of biotics on anthropometric indices such as weight, body mass index (BMI), and waist circumference (WC) (9,22,(25)(26)(27)(28)(29).…”