Early probiotics to prevent childhood metabolic syndrome: A systematic review

Balasubramanian, Hari

doi:10.5662/wjm.v5.i3.157

Cited by 7 publications

(5 citation statements)

References 53 publications

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“…Lactobacillus rhamnosus has been extensively studied in NAFLD both in vitro and in vivo . This strain modulated gut microbiota, reversed small intestinal barrier impairments, reduced hepatic inflammation, improved lipid metabolism and, probably most importantly, increased the production of certain anorexigenic gut hormones[ 87 , 88 ]. The results of a recent double-blind clinical trial showed the benefits of the multi-strain probiotic VSL#3 on weight reduction and liver fibrosis in obese children with NAFLD aged 6-12 years[ 89 ].…”

Section: Treatmentmentioning

confidence: 99%

Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions

Clemente

Mandato

Poeta

et al. 2016

WJG

164

160

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Non-alcoholic fatty liver disease (NAFLD) in children is becoming a major health concern. A “multiple-hit” pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance (IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis (NASH)]. Simple clinical and laboratory parameters, such as age, history, anthropometrical data (BMI and waist circumference percentiles), blood pressure, surrogate clinical markers of IR (acanthosis nigricans), abdominal ultrasounds, and serum transaminases, lipids and glucose/insulin profiles, allow a clinician to identify children with obesity and obesity-related conditions, including NAFLD and cardiovascular and metabolic risks. A liver biopsy (the “imperfect” gold standard) is required for a definitive NAFLD/NASH diagnosis, particularly to exclude other treatable conditions or when advanced liver disease is expected on clinical and laboratory grounds and preferably prior to any controlled trial of pharmacological/surgical treatments. However, a biopsy clearly cannot represent a screening procedure. Advancements in diagnostic serum and imaging tools, especially for the non-invasive differentiation between NAFLD and NASH, have shown promising results, e.g., magnetic resonance elastography. Weight loss and physical activity should be the first option of intervention. Effective pharmacological treatments are still under development; however, drugs targeting IR, oxidative stress, proinflammatory pathways, dyslipidemia, gut microbiota and gut liver axis dysfunction are an option for patients who are unable to comply with the recommended lifestyle changes. When morbid obesity prevails, bariatric surgery should be considered.

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Section: Treatmentmentioning

confidence: 99%

Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions

Clemente

Mandato

Poeta

et al. 2016

WJG

164

160

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“…Studies on adults and mice show that administration of probiotics is associated with a decrease of body weight gain, adipose tissue mass, leptin, and cholesterol levels and, further, an improvement of insulin and glucagon-like peptide 1 (GLP-1) secretion. [37][38][39] Even though the majority of clinical evidence from probiotic supplements on the effect on body mass and metabolism originates from adult and animal studies, 39 it is hypothesized that newborns constitute one of the most likely populations to benefit from the use of probiotics in regard to later body weight. 9,40 Two recent studies with 8 and 10 years of follow-up data in 120 and 113 children found no significant association between probiotic supplementation within the first year of life and development of obesity or metabolic derangement.…”

Section: Probioticsmentioning

confidence: 99%

The Role of the Gut Microbiota in Childhood Obesity

et al. 2016

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“…In several RCTs, probiotics have been administered with the aim of targeting the microbiome during pregnancy to improve maternal and infant health, but the findings have often been confounded by mode of delivery, antibiotic use, ethnicity, infant sex, maternal health, and length of exposure. Two RCTs ( n = 233) reporting on the effects of early probiotics administration in children aged 2–19 years failed to show benefit on one or more components of the metabolic syndrome . Current evidence is insufficient to assess the effects of probiotics in reducing the risk of metabolic syndrome in children and adolescents.…”

Section: Resultsmentioning

confidence: 99%

Consensus and contentious statements on the use of probiotics in clinical practice: A south east Asian gastro‐neuro motility association working team report

Gwee

Lee²,

Ling

et al. 2018

J of Gastro and Hepatol

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The concept of consuming microorganisms in the treatment of a medical condition and in health maintenance has gained much attraction, giving rise to an abundance of medical claims and of health supplements. This study identified relevant clinical questions on the therapeutic use of probiotics and reviewed the literature in irritable bowel syndrome, inflammatory bowel disease, impaired intestinal immunity, liver disease, intestinal infections, and common childhood digestive disorders. Statements were developed to address these clinical questions. A panel of experienced clinicians was tasked to critically evaluate and debate the available data. Both consensus and contentious statements are presented to provide to clinicians a perspective on the potential of probiotics and importantly their limitations.

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Early probiotics to prevent childhood metabolic syndrome: A systematic review

Cited by 7 publications

References 53 publications

Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions

Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions

The Role of the Gut Microbiota in Childhood Obesity

Consensus and contentious statements on the use of probiotics in clinical practice: A south east Asian gastro‐neuro motility association working team report

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