Effect of synbiotic bread containing lactic acid on glycemic indicators, biomarkers of antioxidant status and inflammation in patients with type 2 diabetes: a randomized controlled trial

Abstract

BackgroundThe aim of this randomized, double-blinded, controlled trial was to investigate the effect of daily consumption of a synbiotic bread containing lactic acid on glycemic status, antioxidant biomarkers and inflammation in patients with type 2 diabetes (T2D).MethodsT2D patients, aged 20 to 60 years, were randomly assigned to consume synbiotic + lactic acid (n = 30), synbiotic (n = 30), lactic acid (n = 30), or control (n = 30) bread for 8 weeks. Patients consumed bread 3 times a day in a 40 g package for a total of 120 g/day. Glycemic status, antioxidant capacity, and serum hs-CRP were assessed before and after the intervention.ResultsOf a total of 120 patients that were included in the study, 100 completed the trial. In the adjusted analysis, it was found that consumption of synbiotic + lactic acid bread caused a significant decrease in HbA1c compared to the control bread (− 0.41 ± 0.33 vs 0.004 ± 0.10%, respectively; P < 0.001), while it significantly increased serum superoxide dismutase (SOD) (0.87 ± 1.14 vs. 0.18 ± 0.85 mmol/L, P = 0.02). Also, changes in glutathione peroxidase (GSH-Px) were significantly higher following the consumption of synbiotic + lactic acid bread than lactic acid bread. However, it had no significant effect on fasting plasma glucose, serum insulin, and total antioxidant capacity.ConclusionOverall, daily consumption of a synbiotic bread containing lactic acid for 8 weeks had beneficial effects on HbA1c, SOD, and GSH-Px among T2D patients.Trial registration This study was registered in Iranian Registry of Clinical Trials with number: IRCT201505242709N33 (Registration date: 2015-11-23, http://www.irct.ir/trial/2544)

The Promising Role of Microbiome Therapy on Biomarkers of Inflammation and Oxidative Stress in Type 2 Diabetes: A Systematic and Narrative Review

“…Asemi et al reported that a single species synbiotic mixture of Bacillus coagulans (previously Lactobacillus sporogenes ) and inulin significantly correlated to hs-CRP level changes from baseline of –1.057 ± 0.283 mg/L compared to a slight mean increase of 0.0054 ± 0.385 mg/L in control, whereas another intervention group from a study using B. coagulans and inulin rich bread presented a significant change of –689.76 ± 368.98 μg/L compared to an increase of 33.80 ± 237.60 μg/L in a control group consuming lactic acid-enriched bread ( 156 , 157 ). Similar studies investigating the effects of single species synbiotics using other formulations of B. coagulans and inulin have all showed a trend of decrease in the levels of either CRP or hs-CRP, although these results were not significant ( 157 – 159 ).…”

“…The effect of synbiotics on SOD levels in diabetics were investigated by three studies, all of whom have reported an increasing effect following intervention ( Table 4 ). Ghafouri et al reported significant rise in SOD levels of + 0.40 ± 0.13 and + 0.87 ± 0.22 mmol/L following an 8-week supplementation with bread containing single-species probiotics without and with lactic acid, respectively ( 157 ). Mirmiranpour et al presented a statistically insignificant increase of 0.14 U/mL in mean SOD levels between the two groups ( 144 ).…”

“…Bazyar et al has recently presented a significant promising change of + 14.72 ± 24.9 U/mL from baseline compared to control ( 164 ). On the other hand, Ghafouri et al has reported another significant change of + 19.02 ± 17.10 U/mL in GPX following administration of a bread containing another synbiotic combination ( 157 ). The results of Mirmiranpour et al show promise in their large mean increase from baseline compared to control, however, it was not statistically significant ( 144 ).…”

An Updated Overview on Nanonutraceuticals: Focus on Nanoprebiotics and Nanoprobiotics

“…The synbiotic agents are a combination of prebiotics and probiotics with beneficial effects on host through the enhancement of activity and survival of beneficial microorganisms in the gastrointestinal tract, so that they can selectively provoke the growth and stimulate the metabolism of one or more health-promoting bacteria, thereby enhancing the host welfare [88][89][90][91][92][93][94][95][96][97]. The most The reported key mechanisms of action of probiotics [87] have been mentioned as follows (see Figure 2): enhancement of epithelial barrier, modulation of insulin-sensitive tissues, synthesis of antimicrobial substances, multi-pathogen competition, and induction of mucin secretion.…”

Effects of probiotic supplementation on major cardiovascular-related parameters in patients with type-2 diabetes mellitus: a secondary-data analysis of a randomized double-blind controlled trial

“…In contrast, another meta-analysis of human studies reported that although probiotic intervention had a significant effect on both SBP and DBP measures, it did not affect the LDL-C concentration in patients with T2DM [ 20 ]. In a randomized controlled trial study, probiotic intervention was shown to have a significant effect on TAC measures in patients with T2DM [ 21 ], while other studies found no significant effects [ 17 , 18 ]. Our previous findings also showed a significant improvement in serum glucose and HDL-C measures following probiotic supplementation, while no significant changes were seen in the levels of serum TC [ 22 ].…”