Randomized controlled trial demonstrates response to a probiotic intervention for metabolic syndrome that may correspond to diet.

Hannah C Wastyk, Dalia Perelman, Madeline Topf, Gabriela K Fragiadakis, Jennifer L Robinson, Justin L Sonnenburg, Christopher D Gardner, Erica D Sonnenburg

Journal: Gut microbes 2023;15(1):2178794

PMID: 36803658

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Plain Language Summary

Rates of metabolic syndrome are high throughout developed countries. Metabolic syndrome is a cluster of conditions that occur together and increase your risk for heart disease, stroke, and type 2 diabetes. Studies in animals and humans have shown that the composition of the gut microbiome may be linked to metabolic syndrome and that it is affected by diet. This randomised control trial of 39 individuals showed that the supplementation of a probiotic containing three different probiotic strains did not have a population wide effect but did influence a subset of individuals. These individuals had a different microbiome by the end of the trial and a decrease in blood pressure and blood lipids. Interestingly these individuals also had a higher dietary intake of sugar, yet a lower blood sugar level. It was concluded that the response to probiotic supplements may be dependent upon an individual’s diet. This study could be used by healthcare professionals to understand that diet may influence the success of probiotics, however more research is warranted before firm conclusions are made on the optimal diet during supplementation.

Abstract

An individual's immune and metabolic status is coupled to their microbiome. Probiotics offer a promising, safe route to influence host health, possibly via the microbiome. Here, we report an 18-week, randomized prospective study that explores the effects of a probiotic vs. placebo supplement on 39 adults with elevated parameters of metabolic syndrome. We performed longitudinal sampling of stool and blood to profile the human microbiome and immune system. While we did not see changes in metabolic syndrome markers in response to the probiotic across the entire cohort, there were significant improvements in triglycerides and diastolic blood pressure in a subset of probiotic arm participants. Conversely, the non-responders had increased blood glucose and insulin levels over time. The responders had a distinct microbiome profile at the end of the intervention relative to the non-responders and placebo arm. Importantly, diet was a key differentiating factor between responders and non-responders. Our results show participant-specific effects of a probiotic supplement on improving parameters of metabolic syndrome and suggest that dietary factors may enhance stability and efficacy of the supplement.

Address: Department of Bioengineering, Stanford School of Medicine, Stanford, CA, USA.; Stanford Prevention Research Center, Department of Medicine, Stanford School of 4Medicine, Stanford, CA, USA.; Microbiology & Immunology, Stanford School of Medicine, Stanford, CA, USA.; Center for Human Microbiome Studies, Stanford School of Medicine, Stanford University, Stanford, CA, USA.; Chan Zuckerberg Biohub, San Francisco, CA, USA.

DOI: 10.1080/19490976.2023.2178794