4. Discussion
reduced fasting glucose, fasting insulin, HOMA-IR, obesity, bloating, obese, DM, abdominal pain, weight loss diet, constipation, overweight, hypoglycemic, TG, weight loss
OBESITY, OBESE
The present study was an open-label randomized clinical trial aimed to evaluate the effects of a synbiotic supplement containing An increased DF diet can lead to the occurrence of bloating, abdominal pain, and constipation [The results of the current trial revealed that the use of a synbiotic supplement alone had no significant effects on body composition and metabolic biomarkers in overweight and obese individuals. In line with our results, a meta-analysis reported that oral supplementation with synbiotics has a mild effect on the reduction in waist circumference yet no effect on body weight or BMI [One of the interesting points of our study was the optimal weight loss performance in terms of body weight, BMI, body fat mass, trunk fat mass, and visceral fat rating in DSG compared to SG and DG. Our findings coincide with a previous report showing that synbiotic supplementation plus weight loss diet had more synergistic effects on body weight and BMI compared to the placebo group [DF has been identified as the only nutritional variable to predict health outcomes, and its adequacy should be highly emphasized in a diet-based weight loss program [Although reduced fasting glucose, fasting insulin, HOMA-IR, and TG were observed compared to baseline in DSG, no significant difference in these metabolic outcomes was detected between DG and DSG. This is understandable, because the level of these biochemical indices fell into a normal range after intervention in DG and DSG. Our findings are similar to another study in which these metabolic outcomes were not significantly altered when a very-low-calorie ketogenic diet was accompanied with synbiotic supplementation [The pronounced weight loss effects demonstrated in DSG compared to DG could be modulated by the gut microbiota because of the synergistic action of the synbiotic supplement and DF. It has been suggested that there is a positive association between obesity and the F/B [LEfSe analysis showed that the genus It is worth highlighting that different associations of We were unable to detect the two probiotic species in the fecal samples of SG and DSG participants due to the limitation of 16S rRNA gene sequencing, which can only detect the identity of bacteria up to the genus level. Although the sample size was small and the study period was relatively short, the difference in weight loss percentage between DG and DSG was noteworthy and clinically meaningful. Research has suggested that any type of weight loss diet can be effective if participants demonstrate strong adherence with persistence and enthusiasm [The absence of a placebo group is one of the limitations of this study, since we are unable to show whether the same analyzed parameters would undergo modifications if participants had not undergone an intervention. The age and gender effects on the overall results could not be determined because of the relatively small sample size and uneven gender distribution of participants. The short study duration might explain the insignificant weight loss and metabolic health improvement after synbiotic supplementation compared to baseline. Since there could be bias in the self-reported dietary data, it is hoped that standardized catering services could be offered to participants to ensure similar dietary intake between DG and DSG. We suggest assessing the serum zonulin level and fecal SCFAs to understand the effects of our weight loss program on intestinal permeability and microbial fermentation, respectively. As DSG showed a significant decrease in fasting glucose, fasting insulin, and HOMA-IR compared to its baseline values, it would be meaningful to investigate the hypoglycemic effect of our weight loss program on type 2 DM patients who are overweight or obese.