September 09, 2020
2 min read
Solito A, et al. Supplementation with Bifidobacterium breve BR03 and Bifidobacterium breve B632 favored weight loss and improved insulin metabolism in children and adolescents with obesity in the BIFI-OBESE cross-over, randomized placebo-controlled trial. Presented at: European Congress of Endocrinology Annual Meeting; Sept. 5-9, 2020 (virtual meeting).
Probiotical, an Italian manufacturer of probiotics, provided probiotics free for this study. Researchers are also working with Caelus Health and Probiotical on other probiotics in a project funded by a European ERANET grant.
A probiotic supplement with two strains of bifidobacteria was associated with increased insulin sensitivity and lower BMI for children with obesity, according to study data.
“Investigating how probiotics, as well as prebiotics, could have an impact on the relationship among resident microbiota, diet and metabolism is a new hot topic,” Flavia Prodam, MD, PhD, associate professor in nutrition in the department of health sciences at the University of Eastern Piedmont in Novara, Italy, told Healio. “Because diet is the first-line therapy in the management of pediatric obesity, the introduction of a food supplement as a support strategy could be well accepted from young patients and families.”
Prodam presented the findings at the European Congress of Endocrinology virtual meeting.
Prodam and colleagues conducted a crossover randomized controlled trial with 100 participants aged 6 to 18 years who had obesity with insulin resistance. Participants were randomly assigned to a supplement of Bifidobacterium breve BR03 and Bifidobacterium breve B632 or a placebo for 8 weeks followed by a 4-week washout period. Participants received the reverse protocol for 8 weeks after the washout period. Weight, BMI, waist circumference, fasting insulin, Escherichia Coli concentrations, blood glucose and insulin resistance were measured at the start and end of each period.
Other than a higher concentration of E. Coli in the placebo group, there were no differences between the two groups at baseline. At 8 weeks, participants in both groups had decreases in BMI z score, waist circumference, blood pressure, insulin after an oral glucose tolerance test, and E. Coli concentrations. The probiotic group had larger reductions in waist circumference (mean decrease, –3.51 cm; P < .05), BMI z score (mean decrease, –0.17 kg/m2; P = .07), fasting insulin, (mean decrease, –4.57 µUI/mL; P = .06), homeostatic model assessment of insulin resistance (mean decrease, –1.1; P < .05) and E. Coli concentrations (P < .02). The probiotic group also had a decrease in 2-methylpropanoic acid relative abundance (P < .02).
Participants were later categorized into four clusters based on analysis of short-chain fatty acids.
In this analysis, two clusters showed improvement in BMI z score, waist circumference and insulin resistance and sensitivity within the probiotics group.
“We gave the first evidence about the efficacy of two B. Breve strains in support of standard weight-loss strategies in pediatric obesity,” Prodam said of the findings. “Bifidobacteria are thought to be beneficial for metabolism and the immune system, mainly due to evidence in animal studies. Furthermore, many of functions depend on specific strains, and clear data in humans are needed on this aspect. This study is one of the first conducted in children.”
Data from after the washout period were not analyzed due to a prolonged effect from the probiotics. Prodam said this means some metabolic changes may not stop after the end of probiotic treatment.
Prodam said future research should be conducted with a larger population during a longer period and data also be generated on adults. She also suggested the role of enterotypes in response to the probiotic treatment should be evaluated.
“We think that, in the future, ‘the right probiotic in the right person in the right condition,’ should drive the research in this field,” Prodam said.