Probiotics may benefit energy metabolism in obese people: Human data

An imbalance in microbial populations in the gut has been linked to obesity, and may promote intestinal inflammation-induced metabolic disorders, including insulin resistance and diabetes.

Daily supplements of probiotics combined with an herbal preparation may improve obesity-related parameters, according to a new study from South Korea.

The study used a combination of seven probiotic strains and an herbal preparation called Bofutsushosan in obese people, and found significant differences in HDL levels, compared with people who received Bofutsushosan alone.

“Changes in gut microbiota of certain phylum or genus such as L. plantarum and Gram negative bacteria showed positive correlation with many body composition parameters and metabolic biomarkers implicating the impact of probiotics on obesity-related energy metabolism,” wrote researchers in Clinical Nutrition.

“Modulation of gut microbiota composition showed close association with both endotoxin and obesity-related parameters.

“From this study, new correlations between parameters affecting endotoxin and gut permeability suggest promising strategies for treatment of obesity by setting a target for gut microbiota modification.”

Gut health and obesity

The study adds to emerging body of science supporting the effects of gut microflora on metabolic factors and obesity.

In 2006, Jeffrey Gordon and his group at Washington University in St. Louis reported in Nature (Vol. 444, pp. 1022-1023, 1027-1031) that microbial populations in the gut are different between obese and lean people, and that when the obese people lost weight their microflora reverted back to that observed in a lean person, suggesting that obesity may have a microbial component.

Dr Gordon and his group recently pushed back the scientific boundaries even further in this area. In an ‘elegant’ study, the St Louis-based scientists reported that probiotics in a yogurt did not colonize the gut microflora when studied in identical twins, but additional study in mice revealed that ingestion of probiotic bacteria produced a change in many metabolic pathways, particularly those related to carbohydrate metabolism (Science Translational Medicine, Vol. 3, 106ra106).

According to the FAO/WHO, probiotics are defined as "live microorganisms which when administered in adequate amounts confer a health benefit on the host".

Study details

Researchers from Dongguk University and Cell Biotech Co. performed a randomized, double-blind, placebo controlled study with 64 obese women (50 completed the study). The women were randomly assigned to receive capsules of Bofutsushosan with or without probiotics for eight weeks.

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The probiotic supplement used in the study was called Duolac 7 (manufactured by Cell Biotech in Korea), and is described as a, “fourth generation dual coated probiotic”, by the researchers. One capsule of the probiotic supplement provided five billion viable cells of Streptococcus thermophiles (KCTC 11870BP), Lactobacillus plantarum (KCTC 10782BP), L. acidophilus (KCTC 11906BP), L. rhamnosus (KCTC 12202BP), Bifidobacterium lactis (KCTC 11904BP), B. longum (KCTC 12200BP), and B. breve (KCTC 12201BP).

The herbal Bofutsushosan preparation (Tsumura & Co, Japan) is described as an oriental herbal medicine with 18 components.

Results showed that, while no significant differences in body composition and metabolic markers were recorded between the groups, the HDL cholesterol benefits of the probiotic supports previous results from another study.

“Dyslipidemia consists of elevated triglyceride, high LDL cholesterol, and low HDL cholesterol concentration and this is known to show an association with increased visceral fat found in abdominal obesity,” explained the researchers. “Hypocholesterolemic effect of probiotics can improve abnormal lipid metabolism as it reduces hypertriglyceridemia induced by insulin resistance.

“In a study investigating the question of whether intra-abdominal fat and HDL cholesterol have correlation with hepatic-triglyceride lipase activity, it was concluded that low HDL cholesterol level plays an important role as it can affect triglyceride activity disturbing plasma lipoprotein transport, which can be found in abdominal obesity.

“Accordingly, it is conceivable that a significant change in HDL cholesterol level between the two groups in our study may provide a positive outlook in effective treatment of obesity dealing with metabolic disorders such as dyslipidemia and insulin resistance.”

The researchers also noted that microbial imbalance in the gut, known as dysbiosis, has been linked to obesity, and that this unbalanced state may promote intestinal inflammation-induced metabolic disorders, including insulin resistance and diabetes.

“In this study, B. breve, B. lactis, and L. rhamnosus were increased in the probiotics group, compared to the placebo group, indicating that administration of herbal medicine with probiotics might result in effective modification of composition of gut microbiota,” they added.

Source: Clinical Nutrition
Published online ahead of print, doi: 10.1016/j.clnu.2013.12.006
“The effects of co-administration of probiotics with herbal medicine on obesity, metabolic endotoxemia and dysbiosis: A randomized double-blind controlled clinical trial”
Authors: S.J. Lee, S. Bose, J-G. Seo, W-S. Chung, C-Y. Lim, H. Kim

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