Research Institute at Hospital do Coração, São Paulo, Brazil.
Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Nutr Rev. 2019 Jun 1;77(6):430-450. doi: 10.1093/nutrit/nuz001.
Recent evidence suggests that modulation of the gut microbiota may contribute to body weight control.
This systematic review aimed to assess the effects of oral supplementation with probiotics or synbiotics on body weight, body mass index (BMI), and waist circumference in overweight and obese adults (BMI ≥ 25 kg/m2).
Five electronic databases-PubMed, Embase, Cochrane Library/CENTRAL, LILACS, and Web of Science-were searched from inception to August 2017. No language restrictions were applied.
Randomized and quasi-randomized parallel trials that assessed the effects of oral supplementation with probiotics or synbiotics vs any other intervention but bariatric surgery or fecal transplantation in overweight or obese adults were selected.
Three teams of 2 authors independently assessed risk of bias and extracted data from the included trials. Data were pooled using inverse-variance random-effects meta-analyses. The quality of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.
Nineteen randomized trials (28 publications, 1412 participants) were included. There were no differences in mean body weight change [mean difference (MD), -0.54 kg; 95%CI, -1.09 to 0.01; I2 = 0%; moderate quality of evidence) or mean BMI change (MD, -0.19 kg/m2; 95%CI, -0.43 to 0.04; I2 = 51%; low quality of evidence) between groups who received probiotics or synbiotics and control groups. Oral supplementation with probiotics or synbiotics reduced mean waist circumference compared with control (MD, -0.82 cm; 95%CI, -1.43 to -0.21; I2 = 46%; low quality of evidence).
The findings suggest that oral supplementation with probiotics or synbiotics has a small effect to reduce waist circumference but no effect on body weight or BMI, although the quality of evidence is low to moderate. Therefore, the current evidence is not definitive. Large-scale trials are needed and may help to better inform clinical practice.
PROSPERO registration number CRD42018075126.
最近的证据表明，调节肠道微生物群可能有助于控制体重。
本系统评价旨在评估口服补充益生菌或合生元对超重和肥胖成年人（BMI≥25kg/m2）体重、体重指数（BMI）和腰围的影响。
从开始到 2017 年 8 月，五个电子数据库-PubMed、Embase、Cochrane 图书馆/CENTRAL、LILACS 和 Web of Science-进行了搜索。未应用语言限制。
选择了随机和半随机平行试验，评估了口服补充益生菌或合生元与任何其他干预措施（但不包括减肥手术或粪便移植）相比对超重或肥胖成年人的影响。
由 2 名作者组成的三个小组独立评估了纳入试验的偏倚风险并提取了数据。使用逆方差随机效应荟萃分析对数据进行汇总。使用 GRADE（推荐评估、制定和评估分级）系统评估证据质量。
纳入了 19 项随机试验（28 篇文献，1412 名参与者）。益生菌或合生元组与对照组之间的平均体重变化[平均差异（MD），-0.54kg；95%CI，-1.09 至 0.01；I2=0%；中等质量证据]或平均 BMI 变化（MD，-0.19kg/m2；95%CI，-0.43 至 0.04；I2=51%；低质量证据）无差异。与对照组相比，口服补充益生菌或合生元可降低平均腰围（MD，-0.82cm；95%CI，-1.43 至 -0.21；I2=46%；低质量证据）。
研究结果表明，口服补充益生菌或合生元对减少腰围有一定作用，但对体重或 BMI 没有影响，尽管证据质量为低到中等。因此，目前的证据并不确定。需要大规模试验，这可能有助于更好地为临床实践提供信息。
PROSPERO 注册号 CRD42018075126。
