Effects of oral supplementation with probiotics or synbiotics in overweight and obese adults: a systematic review and meta-analyses of randomized trials

Abstract Context Recent evidence suggests that modulation of the gut microbiota may contribute to body weight control. Objective This systematic review aimed to assess the effects of oral supplementation with probiotics or synbiotics on body weight, body mass index (BMI), and waist circumference in...

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Published in:	Nutrition reviews Vol. 77; no. 6; pp. 430 - 450
Main Authors:	Suzumura, Erica A, Bersch-Ferreira, Ângela C, Torreglosa, Camila R, da Silva, Jacqueline T, Coqueiro, Audrey Y, Kuntz, Marilyn G F, Chrispim, Pedro P, Weber, Bernardete, Cavalcanti, Alexandre B
Format:	Journal Article
Language:	English
Published:	United States Oxford University Press 01-06-2019
Subjects:	Administration, Oral Adult Aged Aged, 80 and over Body Mass Index Body Weight Female Humans Male Middle Aged Obesity - drug therapy Overweight - drug therapy Probiotics - administration & dosage Probiotics - pharmacology Randomized Controlled Trials as Topic Synbiotics - administration & dosage Waist Circumference Young Adult meta-analyses, obesity dietary supplements systematic review probiotics
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Summary:	Abstract Context Recent evidence suggests that modulation of the gut microbiota may contribute to body weight control. Objective This systematic review aimed to assess the effects of oral supplementation with probiotics or synbiotics on body weight, body mass index (BMI), and waist circumference in overweight and obese adults (BMI ≥ 25 kg/m2). Data Sources Five electronic databases—PubMed, Embase, Cochrane Library/CENTRAL, LILACS, and Web of Science—were searched from inception to August 2017. No language restrictions were applied. Study Selection Randomized and quasi-randomized parallel trials that assessed the effects of oral supplementation with probiotics or synbiotics vs any other intervention but bariatric surgery or fecal transplantation in overweight or obese adults were selected. Data Extraction Three teams of 2 authors independently assessed risk of bias and extracted data from the included trials. Data were pooled using inverse-variance random-effects meta-analyses. The quality of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Results Nineteen randomized trials (28 publications, 1412 participants) were included. There were no differences in mean body weight change [mean difference (MD), −0.54 kg; 95%CI, −1.09 to 0.01; I2 = 0%; moderate quality of evidence) or mean BMI change (MD, −0.19 kg/m2; 95%CI, −0.43 to 0.04; I2 = 51%; low quality of evidence) between groups who received probiotics or synbiotics and control groups. Oral supplementation with probiotics or synbiotics reduced mean waist circumference compared with control (MD, −0.82 cm; 95%CI, −1.43 to −0.21; I2 = 46%; low quality of evidence). Conclusions The findings suggest that oral supplementation with probiotics or synbiotics has a small effect to reduce waist circumference but no effect on body weight or BMI, although the quality of evidence is low to moderate. Therefore, the current evidence is not definitive. Large-scale trials are needed and may help to better inform clinical practice. Systematic Review Registration PROSPERO registration number CRD42018075126.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0029-6643 1753-4887
DOI:	10.1093/nutrit/nuz001