DISCUSSION
obesity, anxiety, appetite, satiety, diabetic, depression, weight loss
OBESITY
This study was an interventional clinical trial designed to examine the effects of a combination of probiotic bacteria Our work has some strength—to our knowledge in Tunisia no one studied the association between prebiotics or probiotics and obesity, the only Tunisian study that has worked on the microbiota has studied the imbalance of the microbiota in diabetic patients.Many studies have shown the effect of pre or probiotic on the weight loss. Sergeev et al.,Indeed, the microbiota intervenes in the regulation of energy expenditure by acting on specific hormones, thanks to a bidirectional signalling between the brain and the intestine, the gut microbiota regulates appetite and energy expenditure then follows a weight regulation.Our study showed a significant increase in muscle strength in both the prebiotic group and the probiotic group. As well as Zahao and Kang in their studies.Our results showed a beneficial effect of prebiotics and probiotics on carbohydrate metabolism. These results were in agreement with the study conducted by Miller et al.,Oral supplementation with prebiotics and probiotics acts on the regulation of glycaemia, the mechanism of action consists in reducing the secretion of inflammatory markers such as IFN‐γ and IL‐1β by increasing the production of IL‐10 anti‐inflammatory. In addition, probiotics stimulate the secretion of the neurotransmitter GABA which decreases the production of glucagon and stimulates the production of insulin.Our study showed a decrease in uric acid in the probiotic group with a significant difference compared to the diet‐alone group and the prebiotic group. To study the effect of probiotics on uric acid, there was first the pilot study of Garcia‐Arroyo carried out in 2018 on six rats which affirmed this hypothesis.The decrease in energy intake found after prebiotic and probiotic supplementation is explained by the stimulation of leptin secretion and the decrease in ghrelin secretion, which increase satiety and consequently decrease in intake. In addition, the reduction of microbiome lipopolysaccharides by pre and probiotics promotes reduced appetite by increasing satiety.A decrease in Epworth score was found in all three groups. Our study was consistent with others.The three means were comparable in their influence on depression and anxiety. Other studies proved a good improvement of these symptoms when patients took probiotic.As for the stress, prebiotics and probiotics increase the production of serotonin, which is a molecule involved in mood regulation, by stimulating the synthesis of tryptophan