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The Influence of a blend of Probiotic Lactobacillus and Prebiotic Inulin on the Duration and Severity of Symptoms among Individuals with Covid-19
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2024
Abstract
Gut microbial irregularities can lead to increased gut inflammation and gut membrane damage in people with long covid. Symptoms such as cough and breathlessness are apparent in Covid 19 patients with harmful gut bacterial overgrowth. In Covid patients, antibiotic and dexamethasone treatment also aggravates gut microbial imbalances. Lactobacillus supplementation has been shown to lessen upper respiratory tract infection, increase gut bacterial diversity, improve gut wall integrity, reduce gastrointestinal symptoms and gut inflammation, decrease oxidative stress and improve immunity. This study analysed the efficacy of probiotics and prebiotics combined supplements in reducing the severity and longevity of symptomatic Covid infection. 126 participants with Covid symptoms consumed two capsules a day for a month of a supplement containing 5 species of Lactobacillus and chicory inulin. 32% of participants were in the early phase of infection, and 68% were in the late phase. Both early and late phase participants showed significant improvements in cough, fatigue, and subjective wellbeing after 30 days of intervention. The gut symptoms of 82% of the participants improved after a month of intervention. Inulin and Lactobacillus strains need to be studied further robustly to determine whether they provide additional benefits. Healthcare practitioners can use the results of this study to consider symbiotic interventions for those with Covid symptoms.
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Effect of Continuous Ingestion of Bifidobacteria and Dietary Fiber on Improvement in Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Trial.
Azuma, N, Mawatari, T, Saito, Y, Tsukamoto, M, Sampei, M, Iwama, Y
Nutrients. 2023;15(19)
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Dementia is now the seventh leading cause of death and one of the leading causes of disability and dependency among the elderly. Alzheimer’s disease, a disease of progressive cognitive decline, is the most common form of dementia, with a prevalence of more than 60%. The aim of this study was to investigate the effects of consuming a dairy beverage containing Bifidobacterium animalis subsp. lactis GCL2505 (GCL2505) [a probiotic strain] and inulin on cognitive function in healthy adults. This study was a randomised double-blind, placebo-controlled, parallel-group study. Participants were randomly assigned to one of the two groups (1:1) - the test drink intake group and the control food intake group. Results showed that elderly participants with early memory loss who consumed GCL2505 and inulin for 12 weeks showed significant improvements in scores in the neurocognitive index domain. Additionally, the number of bifidobacteria in faeces increased significantly. Authors concluded that their findings suggest that continuous intake of GCL2505 and inulin may be an effective approach to protect memory function in the elderly.
Abstract
Bifidobacterium animalis subsp. lactis GCL2505 has been shown to have some positive effects on health, including improved defecation frequency and reduced visceral fat. These effects are thought to be due to GCL2505's unique ability to reach the intestine in a viable form and proliferate after a single intake. This leads to an increased number of intestinal bifidobacteria. This randomized, double-blind, placebo-controlled, parallel-group study was conducted to confirm that intake of GCL2505 and inulin (a prebiotic) improve cognitive function (n = 80). Participants consumed test drinks containing 1 × 1010 colony-forming units of GCL2505 per 100 g and 2.0 g of inulin per 100 g for 12 weeks. The change in cognitive function assessment scores was set as the primary endpoint. There were significant improvements in scores in the neurocognitive index domain, which is an assessment of overall cognitive function, in addition to overall attention, cognitive flexibility, and executive function domains. The intervention significantly increased the number of fecal bifidobacteria and affected the levels of several inflammatory markers. These results suggest that intake of GCL2505 and inulin improves cognitive function by improving the intestinal environment and alleviating inflammation.
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Effects of inulin supplementation on body composition and metabolic outcomes in children with obesity.
Visuthranukul, C, Chamni, S, Kwanbunbumpen, T, Saengpanit, P, Chongpison, Y, Tepaamorndech, S, Panichsillaphakit, E, Uaariyapanichkul, J, Nonpat, N, Chomtho, S
Scientific reports. 2022;12(1):13014
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The prevalence of overweight and obesity among children and adolescents has risen dramatically. Overweight and obese children are at risk of developing co-morbidities such as type 2 diabetes mellitus, hypertension, dyslipidaemia, metabolic syndrome, non-alcohol fatty liver disease and premature cardiovascular diseases. Furthermore, obese children are highly prone to become obese adults. The aim of this study was to determine the effects of prebiotic (as inulin) supplementation on body weight, adiposity, and metabolic profiles in obese Thai children. This study is a randomised double-blinded placebo-controlled trial. Participants (n=165) were randomly allocated to 3 groups: inulin, placebo, and dietary fibre advice group. Results show that the intensive behavioural modification and frequent follow-up are effective strategies to reduce body mass index and adiposity in obese children. Furthermore, even though inulin supplementation did not demonstrate considerable effect on adiposity and metabolic outcomes, it can increase fat-free mass in these children. Authors conclude that further research regarding the change of gut microbiota composition and their metabolites are needed to determine inulin’s impact on host microbe interaction in obese paediatric population.
Abstract
Inulin might improve body composition in obese children. We aimed to determine the effects of inulin supplementation on body composition and metabolic outcomes in obese children. A randomized, double-blinded placebo-controlled study was conducted in obese Thai children aged 7-15 years. Participants were assigned to 3 treatment groups for 6 months: 13 g of extracted inulin powder from Thai Jerusalem artichoke, isocaloric maltodextrin, and dietary fiber advice groups. Body composition was assessed by bioelectrical impedance analysis. One-hundred and fifty-five children completed the study (mean age 10.4 ± 2.2 years, BMI z-score 3.2 ± 1.0, 59% male). The drop-out rate was 6%. The inulin extract yielded more than 90% compliance without significant gastrointestinal side effects. All three groups demonstrated a significant decrease in BMI z-score, fat mass index (FMI), and trunk FMI, but the differences between groups were not observed. Fat-free mass index significantly increased only in the inulin group (16.18 ± 1.90 vs. 16.38 ± 1.98 kg/m2, P = 0.009). There were no significant differences in the metabolic profiles between groups. Despite showing no substantial effect on adiposity, inulin may increase fat-free mass in obese children. Further research in the change of gut microbiota composition is needed to determine inulin's impact on host-microbe interaction in pediatric obesity.
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Link between gut microbiota and health outcomes in inulin -treated obese patients: Lessons from the Food4Gut multicenter randomized placebo-controlled trial.
Hiel, S, Gianfrancesco, MA, Rodriguez, J, Portheault, D, Leyrolle, Q, Bindels, LB, Gomes da Silveira Cauduro, C, Mulders, MDGH, Zamariola, G, Azzi, AS, et al
Clinical nutrition (Edinburgh, Scotland). 2020;39(12):3618-3628
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A global obesity epidemic has become a growing concern today. Modifying the microbial population in our gut has been identified as a nutritional intervention strategy for managing obesity. Fermentable dietary fibres such as inulin-type fructans may alter the microbial population in the gut. In this randomised, single-blind, multicentric, placebo-controlled study, researchers examined the effect of 16g/d native inulin supplementation with inulin-rich vegetables on obesity and gut bacteria composition over three months in 106 Caucasian subjects. Furthermore, the study examined the synergistic effects of metformin and inulin on gut microbial composition. 75% of the participants lost body weight after taking inulin and making dietary changes. In addition, BMI, fat mass and other metabolic markers decreased in this group. Combined with inulin, metformin showed gut microbial modulation, although an increase in Bifidobacterium species was less noticeable. Supplementing inulin with inulin-rich vegetables caused uncomfortable side effects such as bloating and flatulence. Even though subjects showed a reduction in side effects after the first month of supplementation, it should be considered when making intervention decisions for people prone to digestive issues. Nutrition practitioners can use these results when developing obesity intervention strategies.
Abstract
BACKGROUND The gut microbiota is altered in obesity and is strongly influenced by nutrients and xenobiotics. We have tested the impact of native inulin as prebiotic present in vegetables and added as a supplement on gut microbiota-related outcomes in obese patients. Metformin treatment was analyzed as a potential modulator of the response. METHODS A randomized, single-blinded, multicentric, placebo-controlled trial was conducted in 150 obese patients who received 16 g/d native inulin versus maltodextrin, coupled to dietary advice to consume inulin-rich versus -poor vegetables for 3 months, respectively, in addition to dietary caloric restriction. Anthropometry, diagnostic imaging (abdominal CT-scan, fibroscan), food-behavior questionnaires, serum biology and fecal microbiome (primary outcome; 16S rDNA sequencing) were analyzed before and after the intervention. RESULTS Both placebo and prebiotic interventions lowered energy intake, BMI, systolic blood pressure, and serum γ-GT. The prebiotic induced greater weight loss and additionally decreased diastolic blood pressure, AST and insulinemia. Metformin treatment compromised most of the gut microbiota changes and metabolic improvements linked to prebiotic intervention. The prebiotic modulated specific bacteria, associated with the improvement of anthropometry (i.e. a decrease in Desulfovibrio and Clostridium sensu stricto). A large increase in Bifidobacterium appears as a signature of inulin intake rather than a driver of prebiotic-linked biological outcomes. CONCLUSIONS Inulin-enriched diet is able to promote weight loss in obese patients, the treatment efficiency being related to gut microbiota characteristics. This treatment is more efficacious in patients who did not receive metformin as anti-diabetic drugs prior the intervention, supporting that both drug treatment and microbiota might be taken into account in personalized nutrition interventions. Registered under ClinicalTrials.gov Identifier no NCT03852069.
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The effects of dietary supplementation with inulin and inulin-propionate ester on hepatic steatosis in adults with non-alcoholic fatty liver disease.
Chambers, ES, Byrne, CS, Rugyendo, A, Morrison, DJ, Preston, T, Tedford, C, Bell, JD, Thomas, L, Akbar, AN, Riddell, NE, et al
Diabetes, obesity & metabolism. 2019;21(2):372-376
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Non-alcoholic fatty liver disease (NAFLD) is characterised by an accumulation of fat within the liver, and is strongly associated with obesity. Recent investigations suggest that diet, the gut microbiota and liver fat storage could be linked through a mechanism involving short chain fatty acids (SCFA), in particular the SCFA propionate, which are produced by the gut bacteria. The aim of this randomised controlled study was to evaluate whether an inulin-propionate ester (IPE) has benefits in patients with NAFLD. Subjects with NAFLD received either 20 g/d of inulin (control) or IPE for 42 days. 18 subjects completed the trial. Intrahepatocellular lipids IHCL (a marker of fat accumulation in the liver) increased post supplementation in both groups with no significant difference between control and IPE group. There was a change in insulin resistance (HOMA-IR) which was significantly different between groups, with a non-significant increase in the inulin-control group and decrease in the IPE group. There were no within- or between-group differences in body composition. The authors discuss these unexpected results and suggest that the SCFA acetate, from inulin fermentation by gut bacteria, may have led to an increase in IHCL which was attenuated by the propionate.
Abstract
The short chain fatty acid (SCFA) propionate, produced through fermentation of dietary fibre by the gut microbiota, has been shown to alter hepatic metabolic processes that reduce lipid storage. We aimed to investigate the impact of raising colonic propionate production on hepatic steatosis in adults with non-alcoholic fatty liver disease (NAFLD). Eighteen adults were randomized to receive 20 g/d of an inulin-propionate ester (IPE), designed to deliver propionate to the colon, or an inulin control for 42 days in a parallel design. The change in intrahepatocellular lipid (IHCL) following the supplementation period was not different between the groups (P = 0.082), however, IHCL significantly increased within the inulin-control group (20.9% ± 2.9% to 26.8% ± 3.9%; P = 0.012; n = 9), which was not observed within the IPE group (22.6% ± 6.9% to 23.5% ± 6.8%; P = 0.635; n = 9). The predominant SCFA from colonic fermentation of inulin is acetate, which, in a background of NAFLD and a hepatic metabolic profile that promotes fat accretion, may provide surplus lipogenic substrate to the liver. The increased colonic delivery of propionate from IPE appears to attenuate this acetate-mediated increase in IHCL.
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Prebiotic inulin-type fructans induce specific changes in the human gut microbiota.
Vandeputte, D, Falony, G, Vieira-Silva, S, Wang, J, Sailer, M, Theis, S, Verbeke, K, Raes, J
Gut. 2017;66(11):1968-1974
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Inulin is a water-soluble fibre present in chicory, onions, garlic, bananas and many other plants. It acts as prebiotic, passing through the small intestine into the colon where the fibres are fermented by the gut bacteria. This double-blind, randomised controlled cross-over intervention study aimed to assess the impacts of inulin supplementation on the diversity of intestinal bacterial profiles and on mild constipation in study participants. Modest effects of 12g of daily inulin consumption were detected on microbial composition and specific changes in the relative abundance were found for 3 particular bacterial species (Anaerostipes, Bilophila and Bifidobacterium). The reduction in the abundance of Bilophila was associated with reduced constipation and improved constipation-specific quality of life measures.
Abstract
OBJECTIVE Contrary to the long-standing prerequisite of inducing selective (ie, bifidogenic) effects, recent findings suggest that prebiotic interventions lead to ecosystem-wide microbiota shifts. Yet, a comprehensive characterisation of this process is still lacking. Here, we apply 16S rDNA microbiota profiling and matching (gas chromatography mass spectrometry) metabolomics to assess the consequences of inulin fermentation both on the composition of the colon bacterial ecosystem and faecal metabolites profiles. DESIGN Faecal samples collected during a double-blind, randomised, cross-over intervention study set up to assess the effect of inulin consumption on stool frequency in healthy adults with mild constipation were analysed. Faecal microbiota composition and metabolite profiles were linked to the study's clinical outcome as well as to quality-of-life measurements recorded. RESULTS While faecal metabolite profiles were not significantly altered by inulin consumption, our analyses did detect a modest effect on global microbiota composition and specific inulin-induced changes in relative abundances of Anaerostipes, Bilophila and Bifidobacterium were identified. The observed decrease in Bilophila abundances following inulin consumption was associated with both softer stools and a favourable change in constipation-specific quality-of-life measures. CONCLUSIONS Ecosystem-wide analysis of the effect of a dietary intervention with prebiotic inulin-type fructans on the colon microbiota revealed that this effect is specifically associated with three genera, one of which (Bilophila) representing a promising novel target for mechanistic research. TRIAL REGISTRATION NUMBER NCT02548247.