Omega-3 fatty acid-, micronutrient-, and probiotic-enriched nutrition helps body weight stabilization in head and neck cancer cachexia. Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It? Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial Probiotics in obese pregnancy do not reduce maternal fasting glucose: a double-blind, placebo-controlled, randomized trial (Probiotics in Pregnancy Study). Limitations of Probiotic Therapy in Acute, Severe Dehydrating Diarrhea Hypocaloric diet supplemented with probiotic cheese improves body mass index and blood pressure indices of obese hypertensive patients - a randomized double-blind placebo-controlled pilot study An extensively hydrolysed casein-based formula for infants with cows' milk protein allergy: tolerance/hypo-allergenicity and growth catch-up. Effects of Probiotic Yogurt on Fat Distribution and Gene Expression of Proinflammatory Factors in Peripheral Blood Mononuclear Cells in Overweight and Obese People with or without Weight-Loss Diet Probiotic supplementation and the effects on weight loss, glycaemia and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial SPRING: an RCT study of probiotics in the prevention of gestational diabetes mellitus in overweight and obese women Comparative Effectiveness of Dipeptidylpeptidase-4 Inhibitors in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison Probiotics and growth in preterm infants: A randomized controlled trial, PREMAPRO study. Effects of weight loss using supplementation with Lactobacillus strains on body fat and medium-chain acylcarnitines in overweight individuals. Probiotics for the Prevention of Gestational Diabetes Mellitus in Overweight and Obese Women: Findings From the SPRING Double-Blind Randomized Controlled Trial Are probiotics safe for use during pregnancy and lactation? Effect of body weight and BMI on the efficacy of levonorgestrel emergency contraception. Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial. Randomized, Double-blind, Placebo-controlled Study of a Multispecies Probiotic Mixture in Nonalcoholic Fatty Liver Disease Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Lactobacillus gasseri BNR17 Supplementation Reduces the Visceral Fat Accumulation and Waist Circumference in Obese Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. What are the causal effects of breastfeeding on IQ, obesity and blood pressure? Evidence from comparing high-income with middle-income cohorts Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: a randomized controlled trial Efficacy of Lactobacillus casei Shirota for patients with irritable bowel syndrome A simple estimate of mortality attributable to excess weight in the European Union
OBJECTIVE To evaluate whether an oral nutritional supplement enriched with omega-3 fatty acids , micronutrients , and probiotics affected body weight ( BW ) changes , serum albumin and prealbumin levels in patients with head and neck cancer ( HNC ) cachexia . STUDY DESIGN Sixty-eight HNC patients were r and omly assigned to receive either an Ethanwell/Ethanzyme ( EE ) regimen enriched with omega-3 fatty acids , micronutrients , and probiotics , or control ( Isocal ) for a 3-month period . Analysis of covariance was used to examine the association between BW change and variables . RESULTS Patients with body mass index ( BMI ) < 19 and those receiving the EE regimen consumed fewer daily calories but showed significantly increased BW and maintained higher serum albumin and prealbumin levels than other patients ( P<.05 ) . Their BW changes were significantly associated with changes in serum albumin and prealbumin levels . CONCLUSIONS EE regimen improved BW as well as serum albumin and prealbumin levels in HNC patients with BMI < 19 Background / Aims Despite numerous r and omized clinical trials and meta-analyses , there is no increased evidence for the efficacy of  probiotics  in the treatment of irritable bowel syndrome ( IBS ) . We review this evidence , identify and analyse the reasons for this lack of evidence and propose method ological improvements for future studies . Methods Based on a literature search , we identified 56 papers that matched the purpose of our analyses . Twenty-seven studies used multi-species bacterial preparations and 29 used single-strain probiotics . They were analysed regarding  patients included , treatment duration , probiotic dosage , and outcome measures . Results Trials in both groups suffered from heterogeneity with respect to probiotic concentration , duration of treatment , and other method ological issues ( crossover design and underpowered studies ) . This heterogeneity did not allow the application of a meta-analytic approach and a systematic review was therefore performed instead . Multi-strain preparations combined 2 to 8 different bacterial subspecies , mostly lactobacilli or bifidobacteria , and used variable lengths of treatments . Overall , more than 50 % of trials presented negative outcomes . The majority of the single-strain probiotic trials employing lactobacilli or Saccharomyces were negative , whereas trials employing bifidobacteria showed positive results . Conclusions The heterogeneity of the studies of probiotics in IBS questions the value of meta-analyses . The use of different bacterial strains and different mixtures of these strains , as well as different dosages , are the main contributors to this heterogeneity . Current data provides limited evidence for the efficacy of a small number of  single-strain probiotics  in IBS ( mostly bifidobacteria ) and sound studies following strict trial guidelines ( Food and Drug Administration and European Medicines Agency guidelines for clinical trials ) are needed . We summarised and proposed some method ological issues for future studies in the field Background / Objectives : In spite of the much evidence for the beneficial effects of probiotics , their anti-obesity effects have not been well examined . We evaluated the effects of the probiotic Lactobacillus gasseri SBT2055 ( LG2055 ) on abdominal adiposity , body weight and other body measures in adults with obese tendencies . Subjects/ Methods : We conducted a multicenter , double-blind , r and omized , placebo-controlled intervention trial . Subjects ( n=87 ) with higher body mass index ( BMI ) ( 24.2–30.7 kg/m2 ) and abdominal visceral fat area ( 81.2–178.5 cm2 ) were r and omly assigned to receive either fermented milk ( FM ) containing LG2055 ( active FM ; n=43 ) or FM without LG2055 ( control FM ; n=44 ) , and were asked to consume 200 g/day of FM for 12 weeks . Abdominal fat area was determined by computed tomography . Results : In the active FM group , abdominal visceral and subcutaneous fat areas significantly ( P<0.01 ) decreased from baseline by an average of 4.6 % ( mean ( confidence interval ) : −5.8 ( −10.0 , −1.7 ) cm2 ) and 3.3 % ( −7.4 ( −11.6 , −3.1 ) cm2 ) , respectively . Body weight and other measures also decreased significantly ( P<0.001 ) as follows : body weight , 1.4 % ( −1.1 ( −1.5 , −0.7 ) kg ) ; BMI , 1.5 % ( −0.4 ( −0.5 , −0.2 ) kg/m2 ) ; waist , 1.8 % ( −1.7 ( −2.1 , −1.4 ) cm ) ; hip , 1.5 % ( −1.5 ( −1.8 , −1.1 ) cm ) . In the control group , by contrast , none of these parameters decreased significantly . High-molecular weight adiponectin in serum increased significantly ( P<0.01 ) in the active and control groups by 12.7 % ( 0.17 ( 0.07 , 0.26 ) μg/ml ) and 13.6 % ( 0.23 ( 0.07 , 0.38 ) μg/ml ) , respectively . Conclusion : The probiotic LG2055 showed lowering effects on abdominal adiposity , body weight and other measures , suggesting its beneficial influence on metabolic disorders BACKGROUND Recent studies have reported beneficial effects of probiotics on maternal glycemia in healthy pregnant women . Obesity significantly increases risk of impaired glucose tolerance in pregnancy , but glycemic effects of probiotics in this specific obstetric group require additional investigation . OBJECTIVE The aim of the Probiotics in Pregnancy Study was to investigate the effect of a probiotic capsule on maternal fasting glucose in obese pregnant women . DESIGN In this placebo-controlled , double-blind , r and omized trial , 175 pregnant women with an early pregnancy body mass index ( BMI ; in kg/m² ) from 30.0 to 39.9 were recruited from antenatal clinics at the National Maternity Hospital , Dublin , Irel and . Exclusion criteria were BMI < 30.0 or > 39.9 , prepregnancy or gestational diabetes , age < 18 y , multiple pregnancy , and fetal anomaly . Women were r and omly assigned to receive either a daily probiotic or a placebo capsule from 24 to 28 wk of gestation in addition to routine antenatal care . The primary outcome was the change in fasting glucose between groups from preintervention to postintervention . Secondary outcomes were the incidence of gestational diabetes and neonatal anthropometric measures . RESULTS In 138 women who completed the study ( 63 women in the probiotic group ; 75 women in the placebo group ) , mean ( ±SD ) early pregnancy BMI was 33.6 ± 2.6 , which differed significantly between probiotic ( 32.9 ± 2.4 ) and placebo ( 34.1 ± 2.7 ) groups . With adjustment for BMI , the change in maternal fasting glucose did not differ significantly between treated and control groups [ -0.09 ± 0.27 compared with -0.07 ± 0.39 mmol/L ; P = 0.391 ; B = -0.05 ( 95 % CI : -0.17 , 0.07 ) ] . There were also no differences in the incidence of impaired glycemia ( 16 % in the probiotic group compared with 15 % in the placebo group ; P = 0.561 ) , birth weight ( 3.70 kg in the probiotic group compared with 3.68 kg in the placebo group ; P = 0.723 ) , or other metabolic variables or pregnancy outcomes . A secondary analysis of 110 women , excluding antibiotic users and poor compliers , also revealed no differences in maternal glucose or other outcomes between groups . CONCLUSION Probiotic treatment of 4 wk during pregnancy did not influence maternal fasting glucose , the metabolic profile , or pregnancy outcomes in obese women Background Recent studies have shown that probiotics , most commonly Lactobacillus GG , may be useful in treating acute gastroenteritis . However , beneficial effects appear to be limited to a modest decrease in the duration of diarrhea . No studies have evaluated this therapy in moderate to severe dehydrating diarrhea in a metabolic facility . Methods Male children less than 2 years of age were admitted to a metabolic unit of the Department of Pediatrics at the Federal University of Bahia , Brazil , with moderate dehydration and were r and omized in a double-blind , placebo-controlled fashion . Oral rehydration solution ( ORS ) was administered per protocol and either placebo or Lactobacillus GG was given in combination with the ORS .  Output of urine , stool , and vomitus was recorded along with stool weight , nude body weight , and st and ard laboratory assessment s for hydration . Results There was no significant reduction in diarrhea duration and stool output in the Lactobacillus GG group . However , Kaplan-Meier survival analysis demonstrated that , even in moderate to severe diarrhea , resolution of the illness occurred so rapidly , that statistically significant benefits of probiotic therapy could not be demonstrated . Conclusion Our data implies that colonization must occur before benefits of probiotics can be realized . Probiotics are , therefore , likely to be of limited benefit in treating diarrheal illnesses of short duration such as viral enteritis . The beneficial effects of probiotics may be limited to prophylactic usage in high-risk population Background Gut lactobacilli can affect the metabolic functions of healthy humans . We tested whether a 1500 kcal/d diet supplemented with cheese containing the probiotic Lactobacillus plantarum TENSIA ( Deutsche Sammlung für Mikroorganismen , DSM 21380 ) could reduce some symptoms of metabolic syndrome in Russian adults with obesity and hypertension . Methods In this 3-week , r and omized , double-blind , placebo-controlled , parallel pilot study , 25 subjects ingested probiotic cheese and 15 ingested control cheese .  Fifty grams of each cheese provided 175 kcal of energy . Blood pressure ( BP ) , anthropometric characteristics , markers of liver and kidney function , metabolic indices ( plasma glucose , lipids , and cholesterol ) , and urine polyamines were measured . Counts of fecal lactobacilli and L. plantarum TENSIA were evaluated using molecular methods . The data were analyzed by t-test for independent sample s and Spearman ’s partial correlation analysis . Results The probiotic L. plantarum TENSIA was present in variable amounts ( 529.6 ± 232.5 gene copies ) in 16/25 ( 64 % ) study subjects . Body mass index ( BMI ) was significantly reduced ( p = 0.031 ) in the probiotic cheese group versus the control cheese group . The changes in BMI were closely associated with the water content of the body ( r = 0.570 , p = 0.0007 ) when adjusted for sex and age . Higher values of intestinal lactobacilli after probiotic cheese consumption were associated with higher BMI ( r = 0.383 , p = 0.0305 ) and urinary putrescine content ( r = 0.475 , p = 0.006 ) . In patients simultaneously treated with BP-lowering drugs , similar reductions of BP were observed in both groups . A positive association was detected between TENSIA colonization and the extent of change of morning diastolic BP ( r = 0.617 , p = 0.0248 ) and a trend toward lower values of morning systolic BP ( r = −0.527 , p = 0.0640 ) at the end of the study after adjusting for BMI , age , and sex . Conclusion In a pilot study of obese hypertensive patients , a hypocaloric diet supplemented with a probiotic cheese helps to reduce BMI and arterial BP values , recognized symptoms of metabolic syndrome . Trial registration Current Controlled Trials IS RCT Children with cows ' milk protein allergy ( CMPA ) are at risk of insufficient length and weight gain , and the nutritional efficacy of hypo-allergenic formulas should be carefully assessed . In 2008 , a trial assessed the impact of probiotic supplementation of an extensively hydrolysed casein-based formula ( eHCF ) on acquisition of tolerance in 119 infants with CMPA . First analysis of the study results showed that the studied formula allowed improvement of food-related symptoms . The scoring of atopic dermatitis ( SCORAD ) index was assessed at r and omisation and after 6 months of feeding . A post hoc analysis was performed using WHO growth software 's nutritional survey module ( WHO Anthro version 3.2.2 ) . All infants who were fed the study formula tolerated it well . The SCORAD index significantly improved from r and omisation to 6 months of feeding with the study formula . Anthropometric data indicated a significant improvement in the weight-for-age , length-for-age and weight-for-length z scores , as well as in the restoration of normal BMI . The probiotic supplementation did not show any impact on these parameters . The present data showed that this eHCF was clinical ly tolerated and significantly improved the SCORAD index and growth indices Objectives : The purpose of this study was to investigate whether probiotics had an effect on proinflammatory markers and cytokines in overweight and obese individuals and whether they could have synergistic effects with weight-loss diets . Methods : A total of 75 healthy overweight and obese individuals completed this r and omized doubled-blind controlled clinical trial . Participants were r and omly assigned to groups consuming regular yogurt with a low-calorie diet ( LCD , RLCD ; n = 25 ) or receiving probiotic yogurt with LCD ( PLCD ; n = 25 ) or consuming probiotic yogurt without LCD ( PWLCD ; n = 25 ) for 8 weeks . The pribiotic regimen contained 200 g/day yogurt , enriched by Lactobacillus acidophilus La5 , Bifidobacterium BB12 , and Lactobacillus casei DN001 108 colony-forming units/g . Body fat percentage , high-sensitive C-reactive protein ( hs-CRP ) , tumor necrosis factor-alpha ( TNF-α ) , leptin , and mRNA levels of inflammation-related genes ( TNF-α and RAR-related orphan receptor gamma [ ROR-γt ] ) in peripheral blood mononuclear cells ( P BMC s ) were measured . Results : A reduction in body mass index ( BMI ) , fat percentage , and leptin level was observed that was more obvious in groups who received the weight-loss diet with probiotic yogurt . Reduction in the gene expression of ROR-γt was significant in the PLCD group ( p < 0.001 ) . The expression of TNF-α did not change among all groups after intervention . The mean concentration of leptin was significantly decreased in all groups after the dietary intervention , but the mean changes in leptin level in the PLCD group was more prominent compared to the other two groups ( −2.38 , p < 0.001 [ PLCD ] vs −1.75 , p = 0.002 [ RLCD ] and −0.55 ng/mL , p = 0.12 [ PWLCD ] ) . The reduction in serum levels of hs-CRP was more evident in the PWLCD group compared to the PLCD and RLCD groups after the 8-week intervention ( −3.4 , p = 0.03 vs −1.76 , p < 0.001 and −2.98 pg/mL , p < 0.001 , respectively ) . Conclusion : Our results suggested that the weight-loss diet and probiotic yogurt had synergistic effects on T-cells subset specific gene expression in P BMC s , fat percentage , and body weight among overweight and obese individuals Abstract The aim of the current study was to assess the effects of probiotic supplementation on weight loss , glycaemia and lipid profiles in women with polycystic ovary syndrome ( PCOS ) . In a r and omized , double-blind , placebo-controlled trial , 60 women with PCOS were r and omized to receive probiotic capsule ( n = 30 ) or placebo ( n = 30 ) for 12 weeks . Consumption of probiotic supplements result ed in a significant reduction in weight ( −0.5 ± 0.4 vs. + 0.1 ± 1.0 kg , p = 0.004 ) and BMI ( −0.2 ± 0.2 vs. + 0.03 ± 0.4 kg/m2 , p = 0.004 ) compared with the placebo . In addition , compared with the placebo , probiotic administration was associated with a significant decrease in fasting plasma glucose ( −2.4 ± 8.4 vs. + 2.1 ± 7.0 mg/dL , p = 0.02 ) , serum insulin concentrations ( −2.0 ± 5.8 vs. + 1.6 ± 5.0 μIU/mL , p = 0.01 ) , homoeostasis model of assessment -insulin resistance ( −0.5 ± 1.4 vs. + 0.3 ± 1.1 , p = 0.01 ) , homoeostatic model assessment -beta cell function ( −7.5 ± 22.3 vs. + 6.3 ± 21.7 , p = 0.01 ) , serum triglycerides ( −13.3 ± 51.3 vs. + 13.6 ± 37.1 mg/dL , p= 0.02 ) and a significant increase in quantitative insulin sensitivity check index ( QUICKI ) ( + 0.006 ± 0.01 vs. −0.005 ± 0.02 , p = 0.01 ) . When we adjusted the analysis for baseline values of biochemical parameters , age and baseline BMI , except for QUICKI ( p = 0.08 ) , other findings did not alter . We found that probiotic supplementation among PCOS women for 12 weeks had favourable effects on weight loss , markers of insulin resistance , triglycerides and VLDL-cholesterol concentrations Background Obesity is increasing in the child-bearing population as are the rates of gestational diabetes . Gestational diabetes is associated with higher rates of Cesarean Section for the mother and increased risks of macrosomia , higher body fat mass , respiratory distress and hypoglycemia for the infant . Prevention of gestational diabetes through life style intervention has proven to be difficult . A Finnish study showed that ingestion of specific probiotics altered the composition of the gut microbiome and thereby metabolism from early gestation and decreased rates of gestational diabetes in normal weight women . In SPRING ( the Study of Probiotics IN the prevention of Gestational diabetes ) , the effectiveness of probiotics ingestion for the prevention of gestational diabetes will be assessed in overweight and obese women . Methods / design SPRING is a multi-center , prospect i ve , double-blind r and omized controlled trial run at two tertiary maternity hospitals in Brisbane , Australia . Five hundred and forty ( 540 ) women with a BMI > 25.0 kg/m2 will be recruited over 2 years and receive either probiotics or placebo capsules from 16 weeks gestation until delivery . The probiotics capsules contain > 1x109 cfu each of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 per capsule . The primary outcome is diagnosis of gestational diabetes at 28 weeks gestation . Secondary outcomes include rates of other pregnancy complications , gestational weight gain , mode of delivery , change in gut microbiome , preterm birth , macrosomia , and infant body composition . The trial has 80 % power at a 5 % 2-sided significance level to detect a > 50 % change in the rates of gestational diabetes in this high-risk group of pregnant women . Discussion SPRING will show if probiotics can be used as an easily implementable method of preventing gestational diabetes in the high-risk group of overweight and obese pregnant women Objective To compare the safety and efficacy of the dipeptidylpeptidase-4 ( DPP-4 ) inhibitors in patients with type 2 diabetes and inadequate glycemic control . Design Systematic review of r and omized controlled trials ( RCTs ) , health economic evaluation studies , systematic review s , and meta-analyses , followed by primary Bayesian mixed treatment comparison meta-analyses ( MTCs ) , and secondary frequentist direct-comparison meta-analyses using a r and om-effects model . Outcomes were reported as weighted mean change from baseline , or odds ratio ( OR ) with 95 % credible interval . Data sources MEDLINE , MEDLINE In-Process , EMBASE , and BIOSIS via Dialog ProQuest ; Cochrane Central Register of Controlled Trials and Cochrane Data base of Systematic Review s via EBSCO ; four diabetes and two technical congress abstract s ; and health technology assessment organization websites . Eligibility criteria Patients with type 2 diabetes and inadequate glycemic control receiving any pharmacological anti-diabetic treatment . Data extraction and analysis Title/ abstract s were review ed for eligibility , followed by full-text review of publications remaining after first pass . A three-person team filtered articles and an independent review er checked a r and om selection ( 10 % ) of filtered articles . Data extraction and quality assessment of studies were also independently review ed . Five DPP-4 inhibitors ( alogliptin , linagliptin , saxagliptin , sitagliptin , and vildagliptin ) were compared via meta- analysis ( where data were available ) as monotherapy , dual therapy ( plus metformin , sulfonylurea , pioglitazone , or insulin ) , and triple therapy ( plus metformin/sulfonylurea ) . Results The review identified 6,601 articles ; 163 met inclusion criteria and 85 publications from 83 RCTs contained sufficient or appropriate data for analysis . MTCs demonstrated no differences between DPP-4 inhibitors in mean change from baseline in glycosylated hemoglobin ( HbA1c ) or body weight , or the proportions of patients achieving HbA1c < 7 % or experiencing a hypoglycemic event , apart from in patients on alogliptin plus metformin , who achieved HbA1c < 7 % more frequently than those treated with saxagliptin plus metformin [ OR 6.41 ( 95 % CI 3.15–11.98 ) versus 2.17 ( 95 % CI 1.56–2.95 ) ] . Conclusions This systematic review and MTC showed similar efficacy and safety for DPP-4 inhibitors as treatment for type 2 diabetes , either as monotherapy or combination therapy BACKGROUND & AIMS Recent studies have suggested that the gut microflora has metabolic effects . We aim ed to evaluate postnatal growth in preterm infants who received different probiotic supplements  , and to assess the safety of probiotic administration . METHODS This prospect i ve , r and omized , double-blind , controlled trial was performed at three tertiary care neonatal units . Preterm infants were r and omly assigned to receive daily supplementation over 4 - 6 weeks with placebo ( group C ) or probiotics ( group P ) . Group P comprised three subgroups : P1 received Bifidobacterium lactis , P2 received Bifidobacterium longum , and P3 received B. lactis and B. longum . We assessed postnatal growth during the supplementation period and up to a corrected gestational age ( GA ) of 41 weeks when body composition was assessed using whole-body dual-energy X-ray absorptiometry . Aerobic and anaerobic blood cultures were performed on suspicion of late-onset sepsis . RESULTS The study comprised 199 preterm infants with a mean GA of 29.1 ± 1.4 weeks and a mean birth weight of 1173 ± 210 g , who received a placebo  ( group C , n = 52 )  or probiotics  ( group P , n = 147 ) from the first week of life . At the end of the supplementation period , no statistically significant differences were seen between the groups in relation to the mean body weight ( group C = 1906 ± 23 g , group P = 1875 ± 14 g , p = 0.25 ) , length , or head circumference . The incidence rates of necrotizing enterocolitis and late-onset sepsis were similar in the two groups . At the corrected GA of 41 weeks , there were no differences between the groups with respect to anthropometric measurements or body composition analysis . CONCLUSIONS Preterm infants receiving  Bifidobacterium supplements did not exhibit better postnatal growth compared with those who received placebo treatment . No adverse effects were associated with probiotic administration . Registered under Clinical Trials.gov Identifier no. NCT01379417 Our previous study showed that supplementation with a combination of Lactobacillus curvatus ( L. curvatus ) HY7601 and Lactobacillus plantarum ( L. plantarum ) KY1032 reduced the body weight , body fat percentage , body fat mass and L1 subcutaneous fat area in overweight subjects . We aim ed to evaluate whether the changes in adiposity after supplementation with Lactobacillus strains were associated with metabolic intermediates . A r and omized , double-blind , placebo-controlled study was conducted on 66 non-diabetic and overweight individuals . Over a 12-week period , the probiotic group consumed 2 g of probiotic powder , whereas the placebo group consumed the same product without the probiotics . To investigate metabolic alterations , we performed plasma metabolomics using ultra-performance liquid chromatography and mass spectrometry ( UPLC-LTQ/Orbitrap MS ) . Probiotic supplementation significantly increased the levels of octenoylcarnitine ( C8:1 ) , tetradecenoylcarnitine ( C14:1 ) , decanoylcarnitine ( C10 ) and dodecenoylcarnitine ( C12:1 ) compared with the levels from placebo supplementation . In the probiotic group , the changes in the body weight , body fat percentage , body fat mass and L1 subcutaneous fat area were negatively associated with changes in the levels of C8:1 , C14:1 , C10 and C12:1 acylcarnitines . In overweight individuals , probiotic-induced weight loss and adiposity reduction from the probiotic supplementation were associated with an increase in medium-chain acylcarnitines OBJECTIVE Given the role of gut microbiota in regulating metabolism , probiotics administered during pregnancy might prevent gestational diabetes mellitus ( GDM ) . This question has not previously been studied in high-risk overweight and obese pregnant women . We aim ed to determine whether probiotics ( Lactobacillus rhamnosus and Bifidobacterium animalis subspecies lactis ) administered from the second trimester in overweight and obese women prevent GDM as assessed by an oral glucose tolerance test ( OGTT ) at 28 weeks ’ gestation . Secondary outcomes included maternal and neonatal complications , maternal blood pressure and BMI , and infant body composition . RESEARCH DESIGN AND METHODS This was a double-blind r and omized controlled trial of probiotic versus placebo in overweight and obese pregnant women in Brisbane , Australia . RESULTS The study was completed in 411 women .  GDM occurred in 12.3 % ( 25 of 204 ) in the placebo arm and 18.4 % ( 38 of 207 ) in the probiotics arm ( P = 0.10 ) . At OGTT , mean fasting glucose was higher in women r and omized to probiotics ( 79.3 mg/dL ) compared with placebo ( 77.5 mg/dL ) ( P = 0.049 ) . One- and two-hour glucose measures were similar . Preeclampsia occurred in 9.2 % of women r and omized to probiotics compared with 4.9 % in the placebo arm ( P = 0.09 ) . Excessive weight gain occurred in 32.5 % of women in the probiotics arm ( 55 of 169 ) compared with 46 % in the placebo arm ( 81 of 176 ) ( P = 0.01 ) . Rates of small for gestational age ( < 10th percentile ) were 2.4 % in the probiotics arm ( 5 of 205 ) and 6.5 % in the placebo arm ( 13 of 199 ) ( P = 0.042 ) . There were no differences in other secondary outcomes . CONCLUSIONS The probiotics used in this study did not prevent GDM in overweight and obese pregnant women QUESTION There has been a great deal of discussion in both the medical and lay literature about the use of probiotics to improve general health . Subsequently , pregnant women have been asking me if probiotics used for treating conditions such as bacterial vaginosis and diarrhea are safe to use during pregnancy and lactation . ANSWER Current data suggest that probiotic supplementation is rarely systemically absorbed when used by healthy individuals . One meta- analysis and several r and omized controlled trials conducted with women during the third trimester of pregnancy did not report an increase in adverse fetal outcomes . There have been no published studies addressing Saccharomyces species use in pregnancy . Probiotics are unlikely to be transferred into breast milk OBJECTIVES To further evaluate the effect of weight and body mass index ( BMI ) on the efficacy of levonorgestrel emergency contraception . METHODS Data from two large , multicenter , r and omized controlled trials design ed to assess emergency contraceptive efficacy were pooled to evaluate the effect of weight and BMI on pregnancy rates among women who received levonorgestrel .  Descriptive methods ( comparison of means and distributions according to pregnancy status and pregnancy rates across weight and BMI categories ) as well as cubic spline modeling were used to describe the relationship between pregnancy risk and weight/ BMI . RESULTS The analysis population comprised 1731 women , among whom 38 pregnancies were reported . Women for whom levonorgestrel was not effective in preventing pregnancy had a significantly higher mean body weight and BMI than women who did not become pregnant ( 76.7 vs. 66.4 kg , p<.0001 ; 28.1 vs. 24.6 kg/m² , p<.0001 ) . The estimated pregnancy rate increased significantly from 1.4 % [ 95 % confidence interval ( CI ) : 0.5%-3.0 % ] among the group of women weighing 65 - 75 kg to 6.4 % ( 95 % CI : 3.1%-11.5 % ) and 5.7 % ( 95 % CI : 2.9%-10.0 % ) in the 75 - 85 kg and > 85 kg groups , respectively . Statistical modeling demonstrated a steep increase in pregnancy risk starting from a weight near 70 - 75 kg to reach a risk of pregnancy of 6 % or greater around 80 kg . Similar results were obtained for statistical modeling of BMI as well as when the two studies were analyzed individually . CONCLUSIONS All analyses showed a significant drop in the efficacy of levonorgestrel emergency contraception with increasing body weight , with pregnancy risk in the higher weight categories similar to expected rates in the absence of contraception . Like body weight , increasing BMI was highly correlated with increased pregnancy risk BACKGROUND Although recent reports suggest that supplementation with probiotics may enhance intestinal function in premature infants , the mechanisms are unclear , and questions remain regarding the safety and efficacy of probiotics in extremely low-birth-weight infants . OBJECTIVE The objective was to evaluate the efficacy of probiotics on the digestive tolerance to enteral feeding in preterm infants born with a very low or extremely low birth weight . DESIGN In a bicentric , double-blind , r and omized controlled clinical trial that was stratified for center and birth weight , 45 infants received enteral probiotics ( Bifidobacterium longum BB536 and Lactobacillus rhamnosus GG ; BB536-LGG )  and 49 received placebo .  The primary endpoint was the percentage of infants receiving > 50 % of their nutritional needs via enteral feeding on the 14th day of life . A triangular test was used to perform sequential analysis . RESULTS The trial was discontinued after the fourth sequential analysis concluded a lack of effect . The primary endpoint was not significantly different between the probiotic ( 57.8 % ) and placebo ( 57.1 % ) groups ( P = 0.95 ) . However , in infants who weighed > 1000 g , probiotic supplementation was associated with a shortening in the time to reach full enteral feeding ( P = 0.04 ) . Other than colonization by the probiotic strains , no alteration in the composition of intestinal microbiota or changes in the fecal excretion of calprotectin was observed . No colonization by probiotic strains was detected in infants who weighed < or = 1000 g , presumably because of more frequent suspensions of enteral feeding , more courses of antibiotic treatment , or both . CONCLUSIONS Supplementation with BB536-LGG may not improve the gastrointestinal tolerance to enteral feeding in very-low-birth-weight infants but may improve gastrointestinal tolerance in infants weighing > 1000 g. This trial was registered at clinical trials.gov as NCT 00290576 The intestinal microbiota is closely associated with the development of obesity and nonalcoholic fatty liver disease ( NAFLD ) . This study investigated the effects of probiotic treatment on visceral fat area ( VFA ) and intrahepatic fat ( IHF ) fraction in NAFLD . Sixty-eight obese NAFLD patients ( > 5 % proton density fat fraction [ PDFF ] on magnetic resonance imaging [ MRI ] ) were r and omized to probiotic and placebo groups for 12 weeks . The probiotic mixture included 6 bacterial species . VFA and IHF were measured using the MRI-PDFF technique . Body weight and total body fat were reduced in the probiotic group but not in the placebo group . The mean IHF fraction was reduced after 12 weeks of treatment in the probiotic group compared to that at baseline ( from 16.3 ± 15.0 % to 14.1 ± 7.7 % , p = 0.032 ) but was not reduced in the placebo group . The decrease in IHF ( mean difference : −2.61 % , p = 0.012 ) was also greater in the probiotic group than in the placebo group . Reduction of triglyceride was greater in the probiotic treatment group than in the placebo group ( mean difference : −34.0 mg/dl , p = 0.0033 ) . However , the changes in IHF percentage and triglyceride levels were not different between placebo and control groups after adjusting for changes in body weight . Treatment with probiotics for 12 weeks result ed in significant reduction in IHF and body weight in obese NAFLD patients OBJECTIVES Lack of exercise and excess body weight may exacerbate treatment-related declines in quality of life ( QoL ) in endometrial cancer survivors . The primary purpose of this study was to examine the associations among exercise , body weight , and QoL in a population -based sample of endometrial cancer survivors . METHODS Participants were 386 endometrial cancer survivors residing in Alberta , Canada who completed a mailed survey that assessed self-reported exercise , height , and weight to calculate body mass index ( BMI ) and QoL using the Functional Assessment of Cancer Therapy-Anemia ( FACT-An ) scale . RESULTS Descriptive data indicated that 70 % of the sample were not meeting public health exercise guidelines and 72 % were overweight or obese . Multivariate analyses of variance demonstrated that endometrial cancer survivors meeting public health guidelines for exercise and body weight reported significantly better QoL than survivors not meeting guidelines . The differences in QoL between the groups were clinical ly meaningful and were not altered when controlling for important demographic and medical variables . There were no interactions between exercise , BMI , age , or time since diagnosis . Lastly , multiple regression analysis identified that both exercise ( beta = .21 ; P < .001 ) and BMI ( beta = -.17 ; P < .001 ) were independently associated with QoL. CONCLUSIONS These results suggest that exercise and body weight are important independent correlates of QoL in endometrial cancer survivors . R and omized controlled trials design ed to test the causal effects of exercise and /or weight loss on QoL in endometrial cancer survivors are warranted Lactobacillus gasseri BNR17 is a probiotic strain isolated from human breast milk . Animal studies reported that BNR17 inhibited increases in body weight and adipose tissue weights . The purpose of this study was to evaluate the antiobesity effects of BNR17 in humans . In a r and omized , double-blind , placebo-controlled trial , 90 volunteers aged 20 - 75 years with body mass index ( BMI ) from 25 to 35 kg/m2 were r and omized to receive a placebo , low-dose BNR ( BNR-L , 109 CFU/day ) , or high-dose BNR ( BNR-H , 1010 CFU/day ) for 12 weeks . Body weight , BMI , waist and hip circumferences , waist-to-hip ratio , abdominal adipose tissue areas , body fat mass , lean body mass , and biochemical parameters were assessed at the beginning and end of the trial . Visceral adipose tissue ( VAT ) was significantly decreased in the BNR-H group compared with the placebo group ( P = .038 ) . Difference of VAT areas of the BNR-H group compared with the placebo group after 12-week consumption of BNR17 was significant ( -21.6 cm2 , P = .012 ) . Waist circumferences were significantly decreased in both the BNR-L and BNL-H groups ( P = .045 and .012 , respectively ) compared with the baseline values , but not in the placebo group . Biochemical parameters were not significantly different among the groups . These findings suggest that daily consumption of BNR17 may contribute to reduced visceral fat mass in obese adults Background A novel approach is explored for improving causal inference in observational studies by comparing cohorts from high-income with low- or middle-income countries ( LMIC ) , where confounding structures differ . This is applied to assessing causal effects of  breastfeeding  on child blood pressure ( BP ) , body mass index ( BMI ) and intelligence quotient ( IQ ) . Methods St and ardized approaches for assessing the confounding structure of breastfeeding by socio-economic position were applied to the British Avon Longitudinal Study of Parents and Children ( ALSPAC ) ( N ≃ 5000 ) and Brazilian Pelotas 1993 cohorts ( N ≃ 1000 ) . This was used to improve causal inference regarding associations of breastfeeding with child BP , BMI and IQ . Analyses were extended to include results from a meta- analysis of five LMICs ( N ≃ 10 000 ) and compared with a r and omized trial of breastfeeding promotion . Findings Although higher socio-economic position was strongly associated with breastfeeding in ALSPAC , there was little such patterning in Pelotas . In ALSPAC , breastfeeding was associated with lower BP , lower BMI and higher IQ , adjusted for confounders , but in the directions expected if due to socioeconomic patterning . In contrast , in Pelotas , breastfeeding was not strongly associated with BP or BMI but was associated with higher IQ . Differences in associations observed between ALSPAC and the LMIC meta- analysis were in line with those observed between ALSPAC and Pelotas , but with robust evidence of heterogeneity detected between ALSPAC and the LMIC meta- analysis associations . Trial data supported the conclusions inferred by the cross-cohort comparisons , which provided evidence for causal effects on IQ but not for BP or BMI . Conclusion While reported associations of breastfeeding with child BP and BMI are likely to reflect residual confounding , breastfeeding may have causal effects on IQ . Comparing associations between population s with differing confounding structures can be used to improve causal inference in observational studies Purpose Controversy exists regarding whether increasing dairy intake without energy restriction would lead to weight loss . We aim ed to compare the potential weight-reducing effects of kefir drink ( a probiotic dairy product ) and milk in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women . Methods One hundred and forty-four subjects were assessed for eligibility in this single-center , multi-arm , parallel-group , r and omized controlled trial . Of these , seventy-five eligible women aged 25–45 years were r and omly assigned to three groups , labeled as control , milk , and kefir , to receive an outpatient dietary regimen for 8 weeks . Subjects in the control group received a diet providing a maintenance level of energy intake , containing 2 servings/day of low-fat dairy products , while those in the milk and kefir groups received a weight maintenance diet , containing 2 additional servings/day ( a total of 4 servings/day ) of dairy products from low-fat milk or commercial kefir drink , respectively . Anthropometric outcomes including weight , body mass index ( BMI ) , and waist circumference ( WC ) were measured every 2 weeks . Results Fifty-eight subjects completed the study . Using analysis of covariance models in the intention-to-treat population ( n = 75 ) , we found that at 8 weeks , subjects in the kefir and milk groups had significantly greater reductions in weight , BMI , and WC compared to those in the control group ( all p < 0.01 ) . However , no such significant differences were found between the kefir and milk groups . Conclusions Kefir drink leads to a similar weight loss , compared with milk , in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women . However , further studies are warranted Background and aims Meta-analyses point to a modest but significant effect of probiotics on symptoms in irritable bowel syndrome ( IBS ) . We aim ed to assess the effect of the probiotic Lactobacillus casei Shirota ( LcS ) on symptoms and quality of life in IBS patients in a r and omized , double-blind , placebo-controlled intervention study . Material s and methods IBS patients ( Rome II ) between 18 and 65 years of age were included . The study consisted of an 8-week intervention period in which the participants received probiotic ( LcS ) or placebo twice daily , followed by an 8-week follow-up period . Symptom diaries and quality of life were scored at weeks 0 , 8 and 16 . The primary outcome parameter was a decrease of at least 30 % in a composite mean symptom score ( MSS ) at week 8 on the basis of an intention-to-treat analysis . Results Thirty-nine individuals ( 67 % women ) were included in the probiotic group and 41 individuals ( 71 % women ) were included in the placebo group . After the intervention period , the mean relative improvement did not reach 30 % for MSS or any individual symptom score . After follow-up ( week 16 ) , a mean improvement of at least 30 % was achieved for MSS in the probiotic group , but no significant difference was found between both treatment groups ( mean±SD : 34±7 % ; 13±8 % , P=0.06 ) . Conclusion After probiotic treatment with LcS , no improvement of 30 % in MSS was observed after 8 weeks Objective : To estimate the current burden of mortality attributable to excess weight in the European Union ( EU ) . Methods : Prevalence of overweight ( body mass index , BMI 25–29.9 kg/m2 ) and obesity ( BMI ≥30 kg/m2 ) were based on self-reported data from a survey with sample s representative of the 15 EU Member States in 1997 . Primary source of relative risk ( RR ) of death by BMI was the first American Cancer Prevention Study ( CPS I ) . Additional calculations were performed to account for effect of smoking ( using CPS I data for non- or never-smokers ) , for pre-existing illness ( using the second CPS , CPS II , data for healthy never-smokers ) and using RRs derived from European rather than US data ( using data from a meta- analysis of prospect i ve studies ) . Mortality attributable to excess weight was calculated by combining the prevalences of overweight and obesity , the RRs , and the number of deaths in the EU countries . Results : Annual deaths attributable to overweight and obesity totalled approximately 279 000 when RRs for all subjects were used . When RRs for nonsmokers only were applied to the entire population , about 304 000 deaths were attributable to excess weight . In analyses using RRs which controlled for both smoking and history of disease , the number of deaths attributable to excess weight was estimated at about 337 000 based on European data and at about 401 000 based on US data . In the EU , therefore , a minimum of 279 000 deaths were attributable to excess weight ( 7.7 % of all deaths , varying from 5.8 % for France through 8.7 % for the UK ) . More attributable deaths occurred among the obese ( 175 000 ) than among the overweight ( 104 000 ) . Around 70 % were cardiovascular disease deaths ( 195 000 ) and 20 % cancer deaths ( 53 000 ) . Conclusion : Mortality attributable to excess weight is a major public health problem in the EU . At least one in 13 annual deaths in the EU are likely to be related to excess weight . Sponsorship : This study has been partially funded by Madrid Regional Authority ( Comunidad de Madrid ) grant no. 08.4/0011/2000
A greater reduction in BMI was found with multiple species of probiotics .
Consuming probiotics  could reduce body weight and BMI , with a potentially greater effect when multiple species of probiotics were consumed , the duration of intervention was ≥8 weeks , or the objects were overweight
OBJECTIVE To assess the efficacy of probiotic therapies on body weight and BMI  using a meta- analysis of r and omized , controlled trials .