Probiotic Foods and Supplements Interventions for Metabolic Syndromes: A Systematic Review and Meta-Analysis of Recent Clinical Trials

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.

Effect of Probiotics on Metabolic Syndrome

“…As there were significant heterogeneities and the results differed in different contents of probiotics. This paper was not cited by Dong et al [1], and the published year of each paper differed. A meta-analysis was conducted by using almost different papers, and the advantage of probiotics for controlling blood pressure should be specified by further studies.…”

“…Finally, Dong et al [1] recognized that there were no significant standardized mean differences in the fasting glucose and fasting insulin between the intervention and control groups. There were no heterogeneities regarding fasting glucose and fasting insulin, and I recommend the authors specifying the effect of probiotics on insulin resistance such as homeostasis model assessment of insulin resistance.…”

“…Dear Editor, Dong et al [1] conducted a meta-analysis of 18 clinical studies regarding the effect of probiotic foods or supplements with Lactobacillus and Bifidobacterium on components of metabolic syndrome (MetS). Although there were no significant differences of body mass index, body fat mass, waist circumference, hip circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, fasting glucose, fasting insulin, total cholesterol, high-density lipoprotein cholesterol, hemoglobin A1c, or triglycerides between the intervention and control groups, there was a significant standardized mean difference in the body fat percentage and low-density lipoprotein cholesterol between the intervention and control groups.…”

“…They only cited the study outcomes of each paper, and conclusive remarks cannot be determined. They cited a meta-analysis by Dong et al [1], and mentioned the study limitation regarding heterogeneities. But scientific evidence might be derived from a meta-analysis of randomized clinical trials.…”

“…But scientific evidence might be derived from a meta-analysis of randomized clinical trials. Dong et al [1] presented heterogeneities on each component of MetS, and handled specific probiotics. I am afraid that selected papers for reviews were almost different and selection criteria might be important for conducting a meta-analysis.…”