article · Endocrinology Diabetes & Metabolism
A clinical trial evaluated the effects of prebiotics and probiotics alongside dietary restriction in forty-five obese patients over one month. Participants followed a low-carbohydrate, reduced-energy diet alone, or combined with either thirty grams of carob daily as a prebiotic or a multi-strain probiotic tablet containing Bifidobacterium longum, Lactobacillus helveticus, Lactococcus lactis, and Streptococcus thermophilus. All groups achieved significant reductions in weight, body mass index, waist circumference, depression, anxiety, and stress. Both supplemented groups experienced significant decreases in fat mass and significant increases in muscle strength, though these changes did not differ significantly between the three cohorts. Prebiotic supplementation significantly reduced insulin levels and insulin resistance compared to diet alone, alongside improving sleep quality. Probiotic supplementation significantly reduced fasting blood glucose relative to diet alone, indicating potential benefits for metabolic parameters and sarcopenic obesity.
Obesity treatments that rely solely on lifestyle changes frequently face high failure rates. Demonstrating that specific prebiotics, such as carob, or multi-strain probiotic supplements can improve glucose regulation, insulin resistance, fat loss, muscle strength, and sleep provides clinicians and individuals with actionable dietary strategies. These adjunct therapies may offer targeted support for managing complex metabolic issues and sarcopenic obesity alongside psychological well-being.
This work indicates potential applications in clinical nutrition, functional foods, and dietary supplements formulated for weight management and metabolic health. Healthcare providers and nutraceutical manufacturers could utilise these findings to develop carob-derived prebiotics or targeted probiotic formulations. As this trial represents an applied clinical study conducted over one month in a small cohort, further clinical validation is required before these supplements can be established as standard therapeutic interventions.
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INTRODUCTION: The management of obesity is difficult with many failures of lifestyle measures, hence the need to broaden the range of treatments prescribed. The aim of our work was to study the influence of pre and probiotics on weight loss psychological profile and metabolic parameters in obese patients. METHODS: It is a clinical trial involving 45 obese patients, recruited from the Obesity Unit of the National Institute of Nutrition between March and August 2022 divided into three groups: diet only (low-carbohydrate and reduced energy diet), prebiotics (30 g of carob/day) and probiotics (one tablet containing Bifidobacterium longum, Lactobacillus helveticus, Lactococcus lactis, Streptococcus thermophilus/day). The three groups were matched for age, sex and BMI. Patients were seen after 1 month from the intervention. Anthropometric measures, biological parameters, dietary survey and psychological scores were performed. RESULTS: The average age of our population was 48.73 ± 7.7 years, with a female predominance. All three groups showed a significant decrease in weight, BMI and waist circumference with p < .05. Only the prebiotic and probiotic group showed a significant decrease in fat mass (p = .001) and a significant increase in muscle strength with p = .008 and .004, but the differences were not significant between the three groups. Our results showed also a significant decrease in insulinemia and HOMA-IR in the prebiotic group compared to the diet-alone group (p = .03; p = .012) and the probiotic group showed a significant decrease in fasting blood glucose compared to the diet alone group (p = .02). A significant improvement in sleep quality was noted in the prebiotic group (p = .02), with a significant decrease in depression, anxiety and stress in all three groups. CONCLUSIONS: The prescription of prebiotics and probiotics with the lifestyle measures seems interesting for the management of obesity especially if it is sarcopenic, in addition to the improvement of metabolic parameters and obesity-related psychiatric disorders.
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DOI: 10.1002/edm2.402
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