The Effects of Synbiotic Supplementation on Body Mass Index, Metabolic and Inflammatory Biomarkers, and Appetite in Patients with Metabolic Syndrome: A Triple-Blind Randomized Controlled Trial

ABSTRACT

It has been shown recently that metabolic syndrome is associated with gut dysbiosis. The gut microbiota may be the main target for prevention or treatment of metabolic syndrome. We investigated the effects of synbiotic supplementation on metabolic syndrome. In this triple-blinded clinical trial, 46 Iranian patients with metabolic syndrome, from both sexes, aged 25–70 years, who fulfilled inclusion criteria were randomly categorized to receive either the synbiotic or a placebo capsule, twice a day for three months, plus a weight-loss diet using stratified random sampling based on body mass index (BMI). Each synbiotic capsule consisted of seven strains probiotic bacteria (2× 10⁸) plus fructooligosaccharide as a prebiotic. Anthropometric measurements and biochemical tests were assessed at baseline and at the end of week 12 for fasting blood sugar (FBS), insulin, lipid profile, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), peptide YY (PYY), and glucagon-like peptide-1 (GLP-1). The mean changes of weight, BMI, FBS, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and GLP-1 between the two groups was statistically significant (p < .001). Furthermore, peptide YY (PYY) increased significantly in the synbiotic group (p ≤ .05). The trend of weight loss in the synbiotic group was significant until the end of the study (p < .001) while it stopped at week 6 in the placebo group. Synbiotic treatment may improve the status of BMI, FBS, insulin resistance, HOMA-IR, GLP-1, and PYY in patients with metabolic syndrome.

KEYWORDS:

• appetite
• body mass index
• insulin resistance
• microflora
• synbiotic

Acknowledgment

This work was supported by the National Nutrition and Food Technology Research Institute of Shahid Behehshti University of Medical Sciences. The authors thank the PROTEXIN Company, England, for providing the multispecies synbiotic supplements and placebo capsules for the present study. We are also grateful to Nicootec Company, Tehran, Iran, for their cooperation to provide these capsules. We appreciate the cooperation of the Health Services Centre personnel in district 2, Tehran, Iran, and the patients in this study.

Declaration of interest

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of the article.

About the authors

Samira Rabiei, PhD in Nutrition Sciences. National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences and Health Services, (SBMU) Tehran, Iran.

Mehdi Hedayati, PhD in Biochemistry. Research Institute for Endocrine Sciences, SBMU, Tehran, Iran.

Bahram Rashidkhani, MD, PhD in Epidemiology. Department of Community Nutrition, SBMU, Tehran, Iran.

Navid Saadat, MD. Research Institute for Endocrine Sciences, SBMU, Tehran, Iran.

Rahebeh Shakerhosseini, PhD in Nutrition sciences. Department of Clinical Nutrition & Dietetics, SBMU, Tehran, Iran.