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Probiotics in Weight Loss : Unpacking Scientific Evidence and Safety

Probiotics have surged in popularity in recent years, becoming a much sought-after nutritional supplement renowned for their potential health benefits. These tiny live microorganisms boast connections to many benefits, especially when it comes to strengthening your gut health and fortifying the immune system.(1,2)

What’s more, the extensive spectrum of these health benefits is not limited to only your digestive well-being. In fact, emerging research now also hints at the potential role of probiotics in influencing weight management. Scientific inquiries delve into the intriguing prospect of probiotics playing a role in weight loss efforts, shedding light on their potential impact on body weight regulation.(3)

Amidst this promising discovery, it is, of course, important to acknowledge the concerns surrounding the widespread use of probiotic supplements. Safety considerations and prudent evaluation are needed, especially looking at the sharp increase in the consumption of these supplements.

Let us take a look at what the evidence shows on whether probiotics can actually help with weight loss or not. But before that, we must take a closer look to understand what exactly are probiotics. 

What Exactly are Probiotics? 

Probiotics are tiny living organisms that can be helpful for our health when we consume enough of them. They are found naturally in some foods or added to others by manufacturers. The study discussed here actually just focuses on probiotic supplements, which are capsules or pills filled with lots of these live bacteria.(4) 

These supplements contain high amounts of specific bacteria like Lactobacilli and Bifidobacteria. When we consume them, they can help make our gut bacteria healthier and it is believed that they also make us feel better.(5)

Scientists have been studying probiotics a lot in the last 20 years, and more and more people are buying these supplements. Estimates suggest that by 2023, people might spend over $64 billion on probiotics because they are linked to so many health benefits.(6)

Even though we are still learning more about how exactly probiotics work in our bodies, studies show they can help boost our immune system, reduce inflammation, and even make our nervous system work better.(7)

There is also an interesting idea from a 2020 study that suggests probiotics could potentially help people who are overweight or have obesity.(8)

Exploring the Link Between Gut Microbiome and Body Weight

The gut microbiome, essentially the bustling community of microorganisms residing in our gut, plays a pivotal role in our overall health. It encompasses an array of diverse bacteria, numbering over a thousand, such as Bacteroidetes, Firmicutes, Actinobacteria, and more, each contributing to the many bodily functions.(9,10)

Researchers have unraveled a correlation between the gut microbiome and body weight. We already know that disruptions or alterations in the composition of these gut bacteria can significantly impact health, potentially leading to adverse outcomes, including certain diseases.

There is now a growing understanding that changes in gut bacteria might also contribute to conditions like overweight and obesity through different mechanisms.(11) For instance, these alterations might heighten insulin resistance, foster inflammation, and promote increased fat storage, potentially leading to weight-related issues.

While the exact ways in which altered gut bacteria may contribute to obesity still remains a subject of ongoing research, studies have highlighted notable differences in gut bacteria between individuals with and without excess weight. Notably, individuals with obesity tend to exhibit a higher ratio of Firmicutes to Bacteroidetes bacteria in their gut.(12)

Moreover, antibiotic use, known for its ability to change the composition of gut bacteria, has also been associated with weight gain in certain studies. These findings hint at the intricate relationship between antibiotic-induced changes in the gut microbiome and potential weight-related effects.(13,14)

Understanding and exploring this complex interplay between the gut microbiome and body weight is vital in uncovering potential avenues for managing weight-related concerns and promoting overall well-being. Yet, further research is needed to comprehensively grasp the intricate mechanisms governing this relationship.

Role of Probiotics in Weight Management: Looking at the Scientific Insights

Research exploring the efficacy of probiotics in weight management has shown promising results, suggesting their potential in promoting weight loss and preventing weight gain in humans. 

A comprehensive 2018 systematic review and meta-analysis encompassing twelve randomized controlled trials (RCTs) and 821 participants unveiled significant findings. People receiving probiotic supplementation showed notable reductions in body weight, waist circumference, body fat, and body mass index (BMI) compared to control groups. Interestingly, higher doses of probiotics and single-strain supplementation displayed more pronounced reductions in body fat.(15)

Further supporting these findings, a 2019 systematic review and meta-analysis incorporating 105 articles and 6,826 participants also corroborated the positive impact of probiotic treatment on body fat, waist circumference, and BMI. Notably, the beneficial effects predominantly came from specific bacterial strains like bifidobacteria (B. breve, B. longum), Streptococcus salivarius subsp. thermophilus, and lactobacilli (L. acidophilus, L. casei, L. delbrueckii).(16)

Additionally, intriguing evidence has also shown that probiotics might actually guard against weight gain. A small-scale study involving 20 non-obese men revealed that supplementation with a multi-strain probiotic led to less weight gain and reduced body fat when following a high-calorie, high-fat diet compared to those taking a placebo.(17)

Researchers speculate on several potential mechanisms through which probiotics could influence weight. These include increasing the presence of short-chain fatty acid (SCFA) producing bacteria, which aid in fat oxidation and storage reduction, reducing inflammation by decreasing lipopolysaccharide (LPS) producers, impacting appetite and metabolism, curbing fat accumulation, regulating pro-inflammatory genes, and enhancing insulin sensitivity.(18,19)

However, while these insights offer promising avenues for understanding the potential role of probiotics in weight management, ongoing research seeks to unveil the exact mechanisms involved. Scientists are continuously investigating how probiotics may influence weight, underscoring the need for further exploration and understanding in this evolving field.

Looking at the Risks and Safety Concerns of Probiotic Supplements

Amidst the widespread popularity of probiotic supplements, concerns have surfaced regarding their potential risks and long-term safety, raising flags among scientists and healthcare experts.(20)

One prominent concern revolves around the uncertainty about the prolonged safety of probiotic supplements. Researchers highlight the limited knowledge about the extended use of these supplements, emphasizing the need for a deeper understanding of their long-term effects.(21,22)

Of particular concern is the high concentration of specific probiotics in supplements, which may potentially transfer resistant genes to harmful pathogens. This transfer could lead to the development of antibiotic resistance and other health complications, posing risks to individuals’ well-being.(23)

Furthermore, the safety reports on probiotics remain relatively sparse. Scientists caution about the underpowered and poorly designed nature of several probiotic studies, often influenced by funding from probiotic companies, which might change the results and also obscure the potential risks.

Probiotic use also comes with some potential drawbacks, including the possibility of bacterial overgrowth in the intestines, heightened vulnerability to opportunistic infections, and the risk of severe infections in individuals with compromised immune systems.

Acknowledging these concerns, it is crucial to recognize that while probiotic supplements are commonly used and even recommended by healthcare providers, their universal safety and effectiveness remain undetermined.

Some experts advocate for stricter regulation and classification of probiotics as drugs rather than dietary supplements to ensure consumer safety. Particularly, they argue for stringent regulations to safeguard individuals from potential risks associated with probiotic use.(24)

Given these considerations, it’s prudent for individuals, especially those with weakened immune systems, to refrain from probiotic intake unless advised and supervised by qualified healthcare professionals. This cautious approach underscores the need for careful evaluation and supervision when considering probiotic supplementation.

Conclusion

The evidence surrounding probiotics and weight loss shows promise, suggesting a potential role in reducing body weight and fat. However, concerns about long-term safety and limited comprehensive studies urge caution. While probiotics might offer benefits, further research is needed to understand their mechanisms and ensure safety, especially for vulnerable individuals. 

The evolving understanding of probiotics and their impact on weight management underscores the need for further comprehensive and well-designed studies to delineate their mechanisms of action, safety profiles, and efficacy in diverse populations. This ongoing exploration is crucial in elucidating the true potential and limitations of probiotics in the realm of weight loss and overall health. Seeking guidance from healthcare providers is crucial before considering probiotic supplementation. Continued scientific inquiry will provide a clearer picture of probiotics’ role in weight management.

References:

  1. Goldin, B.R., 1998. Health benefits of probiotics. British Journal of Nutrition, 80(S2), pp.S203-S207.
  2. Kechagia, M., Basoulis, D., Konstantopoulou, S., Dimitriadi, D., Gyftopoulou, K., Skarmoutsou, N. and Fakiri, E.M., 2013. Health benefits of probiotics: a review. International Scholarly Research Notices, 2013.
  3. Shi, L.H., Balakrishnan, K., Thiagarajah, K., Ismail, N.I.M. and Yin, O.S., 2016. Beneficial properties of probiotics. Tropical life sciences research, 27(2), p.73.
  4. Reid, G., Gadir, A.A. and Dhir, R., 2019. Probiotics: reiterating what they are and what they are not. Frontiers in microbiology, 10, p.424.
  5. Aoun, A., Darwish, F. and Hamod, N., 2020. The influence of the gut microbiome on obesity in adults and the role of probiotics, prebiotics, and synbiotics for weight loss. Preventive nutrition and food science, 25(2), p.113.
  6. Reid, G., Gadir, A.A. and Dhir, R., 2019. Probiotics: reiterating what they are and what they are not. Frontiers in microbiology, 10, p.424.
  7. Shahrokhi, M. and Nagalli, S., 2020. Probiotics.
  8. Wiciński, M., Gębalski, J., Gołębiewski, J. and Malinowski, B., 2020. Probiotics for the treatment of overweight and obesity in humans—a review of clinical trials. Microorganisms, 8(8), p.1148.
  9. Marchesi, J.R. and Ravel, J., 2015. The vocabulary of microbiome research: a proposal. Microbiome, 3, pp.1-3.
  10. Wiciński, M., Gębalski, J., Gołębiewski, J. and Malinowski, B., 2020. Probiotics for the treatment of overweight and obesity in humans—a review of clinical trials. Microorganisms, 8(8), p.1148.
  11. Wiciński, M., Gębalski, J., Gołębiewski, J. and Malinowski, B., 2020. Probiotics for the treatment of overweight and obesity in humans—a review of clinical trials. Microorganisms, 8(8), p.1148.
  12. Aoun, A., Darwish, F. and Hamod, N., 2020. The influence of the gut microbiome on obesity in adults and the role of probiotics, prebiotics, and synbiotics for weight loss. Preventive nutrition and food science, 25(2), p.113.
  13. Stark, C.M., Susi, A., Emerick, J. and Nylund, C.M., 2019. Antibiotic and acid-suppression medications during early childhood are associated with obesity. Gut, 68(1), pp.62-69.
  14. Podolsky, S.H., 2017. Historical perspective on the rise and fall and rise of antibiotics and human weight gain. Annals of Internal Medicine, 166(2), pp.133-138.
  15. Wang, Z.B., Xin, S.S., Ding, L.N., Ding, W.Y., Hou, Y.L., Liu, C.Q. and Zhang, X.D., 2019. The potential role of probiotics in controlling overweight/obesity and associated metabolic parameters in adults: a systematic review and meta-analysis. Evidence-based complementary and alternative medicine, 2019.
  16. Koutnikova, H., Genser, B., Monteiro-Sepulveda, M., Faurie, J.M., Rizkalla, S., Schrezenmeir, J. and Clément, K., 2019. Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: a systematic review and meta-analysis of randomised controlled trials. BMJ open, 9(3), p.e017995.
  17. Osterberg, K.L., Boutagy, N.E., McMillan, R.P., Stevens, J.R., Frisard, M.I., Kavanaugh, J.W., Davy, B.M., Davy, K.P. and Hulver, M.W., 2015. Probiotic supplementation attenuates increases in body mass and fat mass during high‐fat diet in healthy young adults. Obesity, 23(12), pp.2364-2370.
  18. Wang, Z.B., Xin, S.S., Ding, L.N., Ding, W.Y., Hou, Y.L., Liu, C.Q. and Zhang, X.D., 2019. The potential role of probiotics in controlling overweight/obesity and associated metabolic parameters in adults: a systematic review and meta-analysis. Evidence-based complementary and alternative medicine, 2019.
  19. Den Besten, G., Van Eunen, K., Groen, A.K., Venema, K., Reijngoud, D.J. and Bakker, B.M., 2013. The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism. Journal of lipid research, 54(9), pp.2325-2340.
  20. Wang, Y., Jiang, Y., Deng, Y., Yi, C., Wang, Y., Ding, M., Liu, J., Jin, X., Shen, L., He, Y. and Wu, X., 2020. Probiotic supplements: hope or hype?. Frontiers in Microbiology, 11, p.160.
  21. Zheng, M., Zhang, R., Tian, X., Zhou, X., Pan, X. and Wong, A., 2017. Assessing the risk of probiotic dietary supplements in the context of antibiotic resistance. Frontiers in microbiology, 8, p.908.
  22. Kothari, D., Patel, S. and Kim, S.K., 2019. Probiotic supplements might not be universally-effective and safe: A review. Biomedicine & Pharmacotherapy, 111, pp.537-547.
  23. Lerner, A., Shoenfeld, Y. and Matthias, T., 2019. Probiotics: if it does not help it does not do any harm. Really?. Microorganisms, 7(4), p.104.
  24. Zucko, J., Starcevic, A., Diminic, J., Oros, D., Mortazavian, A.M. and Putnik, P., 2020. Probiotic–friend or foe?. Current Opinion in Food Science, 32, pp.45-49.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:December 7, 2023

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