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The Health Effects of Vitamin D and Probiotic Co-Supplementation: A Systematic Review of Randomized Controlled Trials.
Abboud, M, Rizk, R, AlAnouti, F, Papandreou, D, Haidar, S, Mahboub, N
Nutrients. 2020;(1)
Abstract
Evidence of synergic health effects of co-supplementation with vitamin D and probiotics is emerging. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement, scientific databases and the grey literature were searched, and a narrative review and risk of bias assessment were conducted. Seven randomized controlled trials were included, which had low risk of bias. Six studies were double-blind, and once single-blind, extended over 6-12 weeks, and included 50-105 participants. Conditions explored included schizophrenia, gestational diabetes, type 2 diabetes and coronary heart disease, polycystic ovarian syndrome, osteopenia, irritable bowel syndrome (IBS), and infantile colic. Supplementation frequency was daily or bi-monthly, with mainly vitamin D3, and Lactobacillus, Bifidobacterium, and Streptococcus. Comparators were placebo, vitamin D, lower vitamin D dose, and probiotics and lower vitamin D dose. The co-supplementation yielded greater health benefits than its comparators did in all studies except in one assessing IBS. Beneficial effects included decreased disease severity, improved mental health, metabolic parameters, mainly insulin sensitivity, dyslipidemia, inflammation, and antioxidative capacity, and lower use of healthcare. Co-supplementation of vitamin D and probiotics generated greater health benefits than its comparators did. More studies in other diseases and various populations are needed to confirm these findings and to elucidate the optimal form, composition, and frequency of this co-supplementation.
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Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: a systematic review and meta-analysis of randomised controlled trials.
Koutnikova, H, Genser, B, Monteiro-Sepulveda, M, Faurie, JM, Rizkalla, S, Schrezenmeir, J, Clément, K
BMJ open. 2019;(3):e017995
Abstract
OBJECTIVE To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, EMBASE and COCHRANE from 1990 to June 2018. ELIGIBILITY CRITERIA Randomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years. RESULTS One hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=-0.94 kg mean difference, 95% CI -1.17 to -0.70, I²=0.0%), body mass index (k=32, d=-0.55 kg/m², 95% CI -0.86 to -0.23, I²=91.9%), waist circumference (k=13, d=-1.31 cm, 95% CI -1.79 to -0.83, I²=14.5%), body fat mass (k=11, d=-0.96 kg, 95% CI -1.21 to -0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=-6.30 cm², 95% CI -9.05 to -3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=-0.66 mmol/L, 95% CI -1.00 to -0.31, I²=27.7%), glycated haemoglobin (k=13, d=-0.28 pp, 95% CI -0.46 to -0.11, I²=54.1%), insulin (k=13, d=-1.66 mU/L, 95% CI -2.70 to -0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=-1.05 pp, 95% CI -1.48 to -0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=-10.2 U/L, 95% CI -14.3 to -6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=-9.9 U/L, 95% CI -14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria (Bifidobacterium breve, B. longum), Streptococcus salivarius subsp. thermophilus and lactobacilli (Lactobacillus acidophilus, L. casei, L. delbrueckii) containing mixtures and influenced by trials conducted in one country. CONCLUSIONS The intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases. TRIAL REGISTRATION NUMBER CRD42016033273.
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The Effects of Probiotics or Synbiotics Supplementation in Women with Polycystic Ovarian Syndrome: a Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Heshmati, J, Farsi, F, Yosaee, S, Razavi, M, Rezaeinejad, M, Karimie, E, Sepidarkish, M
Probiotics and antimicrobial proteins. 2019;(4):1236-1247
Abstract
We searched bibliographic databases from inception through May 2018 to evaluate the effect of probiotics (or synbiotics) supplementation in women suffering from polycystic ovary syndrome (PCOS). Seven trials involving 236 women with PCOS and 235 controls were included in the meta-analysis. Comparing with the control group, probiotics (or synbiotics) may improve Quantitative insulin sensitivity check index (QUICKI) (standardized mean difference (SMD) 0.41, 95% confidence intervals (CI) 0.01 to 0.82, P = 0.04), decrease triglyceride (TG) level (mean difference (MD) - 17.51 mg/dL, 95% CI - 29.65 to - 5.36); fasting insulin: (MD - 2.14 μIU/mL, 95% CI - 4.24 to - 0.04), and increase high-density lipoprotein (HDL) (SMD 1.55 mg/dL, 95% CI 0.28 to 2.81). No significant effect of probiotics (or synbiotics) on homeostatic model assessment-insulin resistance (HOMA-IR), fasting plasma glucose (FPG), low-density lipoprotein (LDL), total cholesterol (TC), and anthropometric indices was found in women with PCOS. Although probiotic (or synbiotics) supplementation was effective on some metabolic indices, the effect was negligible and not clinically significant.
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Probiotic Foods and Supplements Interventions for Metabolic Syndromes: A Systematic Review and Meta-Analysis of Recent Clinical Trials.
Dong, Y, Xu, M, Chen, L, Bhochhibhoya, A
Annals of nutrition & metabolism. 2019;(3):224-241
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Abstract
BACKGROUND Individual clinical trials suggested that when treated with probiotic foods or supplements with Lactobacillus and Bifidobacterium, specific symptoms of metabolic syndrome (MetS) could be alleviated, but the results have been inconclusive. AIMS The objective of the present meta-analysis was to use anthropometric and biochemical as indicators to evaluate the efficacy of using these probiotic foods or supplements among individuals with MetS. METHODS PubMed, Cochrane Library, and CINAHL Plus were used to collect randomized controlled trials (RCTs) studies published from January 2000 to January 2018. Studies were included if they had at least one of the following outcome measurements: body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, body fat mass (BFM), body fat percentage (BFP), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, fasting insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, and/or hemoglobin A1c (HbA1c). RESULTS The 356 records were identified during the literature search, of which only 18 met the selection criteria. The 18 RCTs with a total of 1,544 participants were included in this analysis. This meta-analysis indicated that there were no significant differences of BMI, BFM, waist circumference, hip circumference, waist-to-hip ratio, SBP, DBP, fasting glucose, fasting insulin, TC, HDL-C, HbA1c, or triglycerides between the intervention and control groups. Significant standardized mean net differences were found in the BFP and LDL-C between the intervention and control groups. CONCLUSIONS The results indicated that probiotic food and supplement with Lactobacillus and Bifidobacterium could be used as interventions to improve specific anthropometric and biochemical outcomes among individuals with MetS. However, probiotic treatment alone could not reduce overall health risks. In addition, there were methodological drawbacks among reviewed studies, and further research is needed.
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Meta-analysis of the effects of probiotic supplementation on glycemia, lipidic profiles, weight loss and C-reactive protein in women with polycystic ovarian syndrome.
Liao, D, Zhong, C, Li, C, Mo, L, Liu, Y
Minerva medica. 2018;(6):479-487
Abstract
INTRODUCTION Several studies have been designed to investigate the beneficial effects of probiotic supplementation on metabolic parameters and inflammation status in women with polycystic ovarian syndrome (PCOS), but results have been inconsistent. Herein, we perform a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of probiotic supplementation on glycemia control, lipidic profiles, weight loss and C-reactive protein (CRP) in women with PCOS. EVIDENCE ACQUISITION MELINE, EMBASE, and Cochrane Library were searched for RCTs that investigated the effects of probiotic in women with PCOS. Two investigators independently performed the screening, data extraction, and methodological quality assessment. Data were pooled as mean differences (MDs) with 95% confidence intervals (CIs). The statistical heterogeneity was assessed with the I2 test. Sensitivity analyses were performed by the leave-one-out approach. EVIDENCE SYNTHESIS From the literature search, 26 publications were screened and 6 RCTs involving 406 PCOS participants (aged 25-28.5 years) with follow-up period between 8-12 weeks were included. The pooled results showed that probiotic supplement significantly affected the levels of fasting blood insulin (FBI), quantitative insulin sensitivity check index (QUICKI), triglycerides (TG), and very low density lipoprotein-cholesterol (VLDL-C). However, no significant changes were found in other markers, including fasting plasma glucose, homeostatic model assessment-insulin resistance, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, body weight, CRP, and dehydroepiandrosterone sulfate levels. The pooled result was robust after the sensitivity analysis. CONCLUSIONS Our finding provides evidence that daily probiotic consumption has beneficial effects on decreasing FBI, TG, and VLDL-C, and increasing the QUICKI score in PCOS patients.