A systematic review and meta-analysis of the probiotics and synbiotics effects on oxidative stress

Consumption of a new developed synbiotic yogurt improves oxidative stress status in adults with metabolic syndrome: a randomized controlled clinical trial

Association between metabolic syndrome (MetS) and oxidative stress has been shown in numerous studies. It has been shown that probiotics could be the effective treatment strategy in improving oxidative stress. This study aimed to determine the effects of a new developed synbiotic yogurt on oxidative stress status in adults with MetS. Forty-four individuals were assigned into two groups and given 300 g of synbiotic yogurt containing Lactobacillus plantarum, Lactobacillus pentosus, and Chloromyces marcosianos yeast or regular yogurt for 12 weeks in this randomized, placebo-controlled clinical trial. Before and after the intervention, biochemical parameters were assessed. Daily consumption of synbiotic yogurt in adults with MetS showed a statistically significant improvement in the level of glutathione peroxidase (p = 0.01) and total oxidant status (p = 0.006) compared to the regular yogurt. Total Antioxidant Capacity and superoxide dismutase levels increased significantly (p = 0.002 and p = 0.02, respectively) in the intervention group compared to the baseline levels. In adults with MetS, daily consumption of the synbiotic yogurt containing native strains of Lactobacillus plantarum, Lactobacillus pentosus, and Chloromyces marcosianos yeast for 12 weeks was associated with improvements in oxidative stress status.Trial registration number: Iranian Registry of Clinical Trials (IRCT20220426054667N1) (18/05/2022).

Functional Cyperus esculentus L. Cookies Enriched with the Probiotic Strain Lacticaseibacillus rhamnosus SL42

This study presents for the first time functional cookies for diabetics made with 100% organic Cyperus esculentus L. flour, either plain or enhanced with 5% polyfloral honey syrup containing the probiotic strain Lacticaseibacillus rhamnosus SL42. The flour's chemical composition and rheological and functional properties were analyzed, and 33 diabetic and semi-naive panelists assessed the cookies' sensory properties. MRS-cys agar cultures and SEM analysis evaluated SL42 survival and adhesion capacity over 21 days at 25 °C. Results showed that the flour and its extracts are rich in polyphenols and flavonoids, indicating strong antioxidant and antibacterial properties. Both cookie types met international standards when compared to commercial cookies and had similar physical properties. Sensory evaluation on day 1 revealed higher quality indicators for honey syrup-enriched cookies, but after 15 days, control cookies were preferred. The CIE LAB analysis confirmed the dietetic flour's typical dark color, with honey syrup-enriched cookies being darker. Despite textural differences, both cookies maintained detectable crispness over storage. Honey syrup-enriched cookies effectively carried L. rhamnosus SL42, remaining viable at 6.43 Log CFU per cookie after 21 days and adhering to the cookie's surface, as confirmed by SEM analysis. Further research is recommended to better understand the therapeutic value of these cookies.

Revolutionizing lung health: Exploring the latest breakthroughs and future prospects of synbiotic nanostructures in lung diseases

The escalating prevalence of lung diseases underscores the need for innovative therapies. Dysbiosis in human body microbiome has emerged as a significant factor in these diseases, indicating a potential role for synbiotics in restoring microbial equilibrium. However, effective delivery of synbiotics to the target site remains challenging. Here, we aim to explore suitable nanoparticles for encapsulating synbiotics tailored for applications in lung diseases. Nanoencapsulation has emerged as a prominent strategy to address the delivery challenges of synbiotics in this context. Through a comprehensive review, we assess the potential of nanoparticles in facilitating synbiotic delivery and their structural adaptability for this purpose. Our review reveals that nanoparticles such as nanocellulose, starch, and chitosan exhibit high potential for synbiotic encapsulation. These offer flexibility in structure design and synthesis, making them promising candidates for addressing delivery challenges in lung diseases. Furthermore, our analysis highlights that synbiotics, when compared to probiotics alone, demonstrate superior anti-inflammatory, antioxidant, antibacterial and anticancer activities. This review underscores the promising role of nanoparticle-encapsulated synbiotics as a targeted and effective therapeutic approach for lung diseases, contributing valuable insights into the potential of nanomedicine in revolutionizing treatment strategies for respiratory conditions, ultimately paving the way for future advancements in this field.

Comparison of the effectiveness of probiotic supplementation in glucose metabolism, lipid profile, inflammation and oxidative stress in pregnant women

Objective: The optimal probiotic supplementation in pregnant women has not been thoroughly evaluated. By employing a network meta-analysis (NMA) approach, we compared the effectiveness of different probiotic supplementation strategies for pregnant women. Methods: A comprehensive search across multiple databases was performed to identify studies comparing the efficacy of probiotic supplements with each other or the control (placebo) among pregnant women. Results: This NMA, including 32 studies, systematically evaluated 6 probiotic supplement strategies: Lactobacillus, Lacticaseibacillus rhamnosus and Bifidobacterium (LRB), Lactobacillus acidophilus and Bifidobacterium (LABB), Lactobacillus acidophilus, Lacticaseibacillus casei, and Bifidobacterium bifidum (LLB), multi-combination of four probiotics (MP1), and multi-combination of six or more probiotics (MP2). Among these strategies, LLB, MP1, and MP2 all contain LABB. The NMA findings showed that MP1 was the most effective in reducing fasting blood sugar (FBS) (surface under the cumulative ranking curve [SUCRA]: 80.5%). In addition, MP2 was the most efficacious in lowering the homeostasis model assessment of insulin resistance (HOMA-IR) (SUCRA: 89.1%). LABB was ranked as the most effective in decreasing low-density lipoprotein cholesterol (LDLC) (SUCRA: 95.5%), total cholesterol (TC) (SUCRA: 95.5%), and high-sensitivity C-reactive protein (hs-CRP) (SUCRA: 94.8%). Moreover, LLB was ranked as the most effective in raising total antioxidant capacity (TAC) (SUCRA: 98.5%). Conclusion: Multi-combination of probiotic strains, especially those strategies containing LABB, may be more effective than a single probiotic strain in glycolipid metabolism, inflammation, and oxidative stress of pregnant women.

Comparison and effect of plain and calcium fortified yogurt on glycemic responses, anthropometrics and metabolic biomarkers

Metabolic syndromes including obesity and diabetes are the most common health issues due to insulin resistance, disturbance in glucose homeostasis, lack of exercise, and improper diet. The current study was planned to evaluate the potential effects of regular diet with fortified yogurt on blood glycemia and anthropometric responses. Plain yogurt was procured from the local market, and then it was fortified with calcium. Furthermore, the subsequent effect of fortified yogurt on blood glucose, insulin, and anthropometric measurements was assessed at different time intervals. A total of 40 healthy females and males aged about 20 years with a normal BMI range (20-24.9 kg/m2) were recruited within the Government College University Faisalabad. Participants filled out the habits Performa, stress factors questionnaire, and activity questionnaire. Blood glucose (BG) and visual analogous scale (VAS) performs were also taken in the fasting stage and then assigned treatment was given. After 15, 30, 45, 60, 90, and 120 min intervals VAS and BG estimation was carried out. The results shows that fortified yogurt contained a higher amount of calcium. Likewise, a similar trend was observed for the desire to eat, a feeling of fullness, palatability, physical comfort, and overall acceptability. The results obtained from various analyses were statistically evaluated.

The Role of Vitamin D and Its Molecular Bases in Insulin Resistance, Diabetes, Metabolic Syndrome, and Cardiovascular Disease: State of the Art

In the last decade, an increasing awareness was directed to the role of Vitamin D in non-skeletal and preventive roles for chronic diseases. Vitamin D is an essential hormone in regulating calcium/phosphorous balance and in the pathogenesis of inflammation, insulin resistance, and obesity. The main forms of vitamin D, Cholecalciferol (Vitamin D3) and Ergocalciferol (Vitamin D2) are converted into the active form (1,25-dihydroxyvitamin D) thanks to two hydroxylations in the liver, kidney, pancreas, and immune cells. Some anti-inflammatory cytokines are produced at higher levels by vitamin D, while some pro-inflammatory cytokines are released at lower levels. Toll-Like Receptor (TLR) expression is increased, and a pro-inflammatory state is also linked to low levels of vitamin D. Regardless of how it affects inflammation, various pathways suggest that vitamin D directly improves insulin sensitivity and secretion. The level of vitamin D in the body may change the ratio of pro- to anti-inflammatory cytokines, which would impact insulin action, lipid metabolism, and the development and function of adipose tissue. Many studies have demonstrated an inverse relationship between vitamin D concentrations and pro-inflammatory markers, insulin resistance, glucose intolerance, metabolic syndrome, obesity, and cardiovascular disease. It is interesting to note that several long-term studies also revealed an inverse correlation between vitamin D levels and the occurrence of diabetes mellitus. Vitamin D supplementation in people has controversial effects. While some studies demonstrated improvements in insulin sensitivity, glucose, and lipid metabolism, others revealed no significant effect on glycemic homeostasis and inflammation. This review aims to provide insight into the molecular basis of the relationship between vitamin D, insulin resistance, metabolic syndrome, type 1 and 2 diabetes, gestational diabetes, and cardiovascular diseases.

Investigation into the Potential Role of Propionibacterium freudenreichii in Prevention of Colorectal Cancer and Its Effects on the Diversity of Gut Microbiota in Rats

Colorectal cancer (CRC) accounts for 10% of all cancer diagnoses and cancer-related deaths worldwide. Over the past two decades, several studies have demonstrated the clinical benefits of probiotic supplementation and some studies have shown that certain probiotics can modulate immunity and strengthen gut microbiota diversity. This study aims to assess the impact of the Propionibacterium freudenreichii (PF) probiotic against CRC induced by azoxymethane (AOM), and to investigate its effects on gut microbiota diversity in rats, as well as to evaluate the anti-proliferative activities of PF in HCT116 CRC cells. This experiment was performed using four groups of SD rats: normal control, AOM group, PF group (1 × 10⁹ CFU/mL), and standard drug control (5-fluorouracil, 35 mg/kg). Methylene blue staining of colon tissues showed that the administration of PF significantly reduced the formation of colonic aberrant crypt foci (ACF) compared to the AOM control group. In addition, treated rats had lower levels of malondialdehyde in their colon tissue homogenates, indicating that lipid peroxidation was suppressed by PF supplementation. Furthermore, 16S rRNA gene analysis revealed that probiotic treatment enhanced the diversity of gut microbiota in rats. In vitro study showed that the viability of HCT116 cells was inhibited by the probiotic cell-free supernatant with an IC₅₀ value of 13.3 ± 0.133. In conclusion, these results reveal that consuming PF as probiotic supplements modulates gut microbiota, inhibits the carcinogenic effects of AOM, and exerts anti-proliferative activity against CRC cells. Further studies are required to elucidate the role of PF on the immune response during the development and growth of CRC.

Effects of Probiotic Supplementation on Exercise and the Underlying Mechanisms

Long-term, high-intensity exercise can trigger stress response pathways in multiple organs, including the heart and lungs, gastrointestinal tract, skeletal muscle, and neuroendocrine system, thus affecting their material and energy metabolism, immunity, oxidative stress, and endocrine function, and reducing exercise function. As a natural, safe, and convenient nutritional supplement, probiotics have been a hot research topic in the field of biomedical health in recent years. Numerous studies have shown that probiotic supplementation improves the health of the body through the gut-brain axis and the gut-muscle axis, and probiotic supplementation may also improve the stress response and motor function of the body. This paper reviews the progress of research on the role of probiotic supplementation in material and energy metabolism, intestinal barrier function, immunity, oxidative stress, neuroendocrine function, and the health status of the body, as well as the underlying mechanisms.

A systematic review and meta-analysis of randomized controlled trials investigating the effects of probiotics on oxidative stress in healthy adults

BACKGROUND

The oxidative stress (OS) theory of disease stipulates that a chronic imbalance in the ratio of oxidants to antioxidants in the cellular environment leads to a variety of debilitating conditions, including type 2 diabetes, cardiovascular and liver diseases. Metabolites in the gut microbiome have been associated with increases in reactive oxygen species (ROS). Many randomized controlled trials (RCTs) have thus investigated the potential of probiotics as a nutraceutical intervention to improve parameters of OS.

AIM

The objective of this paper is to review relevant human RCTs exploring the potential of probiotic supplementation to prevent OS in metabolically healthy individuals.

METHODS

This systematic review and meta-analysis was registered on PROSPERO (CRD42021297210). The PubMed database was searched using keywords related to probiotics and OS. In total, out of the 652 studies were screened, 9 respected the inclusion criteria.

RESULTS

Total antioxidant capacity (TAC) (SMD: 0.83 mmol/L, 95% CI: 0.25-1.40, p = 0.005) and glutathione (GSH) (SMD: 0.45, 95% CI: 0.13-0.77, p = 0.006) are improved with probiotic ingestion, although there are no alterations in superoxide dismutase (SOD) (SMD: 0.33, 95% CI: -0.27-0.93, p = 0.28). Decreases in plasma concentrations of the OS biomarker malondialdehyde (MDA) (SMD: -0.55, 95% CI: -1.11-0.00, p = 0.05) are also detected.

CONCLUSION

Probiotics improve AS and OS in metabolically healthy individuals. However, more studies are needed to address the moderate to high degree of heterogeneity in methodology.

Rosmarinic acid alone or in combination with Lactobacillus rhamnosus ameliorated ammonia stress in the rainbow trout, Oncorhynchus mykiss: growth, immunity, antioxidant defense and liver functions

Rosmarinic acid (RS) and Lactobacillus rhamnosus (LR) were added singularly or in combination to rainbow trout (Oncorhynchus mykiss) diets to test their efficacy in the protection against ammonia stress. Fish (31.4±0.6 g) were randomly allocated to six groups in three replicates, as follows: T1: basic food as control, T2: LR with a concentration of 1.5 × 108 CFU/g, T3: LR with a concentration of 3 × 108 CFU/g, T4: 1 g RS/kg, T5: 3 g RS/kg, and T6: 1.5 × 108 CFU/g LR + 1 g RS/kg and T7: 3 × 108 CFU/g LR + 3 g RS/kg. After 60 days feeding, fish exposed to 0ammonia stress. After the feeding period, the supplemented fish had the highest final body weight (FW), weight gain (WG), and specific growth rate (SGR), and the lowest feed conversion ratio (FCR) as compared with the control group (P<0.05). Amylase, protease and lipase activities were noticed markedly higher in fish supplemented with 1.5 × 108 CFU/g LR + 1 g RS/kg and 1.5 × 108 CFU/g LR diets compared to the control (P<0.05). Generally, fish in supplemented diets, particularly T2 and T6 groups, had the highest lysozyme, alternative complement activity (ACH50), total Ig, nitroblue tetrazolium test (NBT), myeloperoxidase (MPO), complement component 3 (C3), complement component 4 (C4), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx). On the other hand, T2 and T6 groups had the lowest malondialdehyde (MDA), glucose, and cortisol concentrations as well as alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) enzyme levels when were compared with the control (P<0.05). After ammonia stress, fish in the supplemented groups, particularly T2 and T6, generally showed significantly higher values of lysozyme, ACH50, total Ig, NBT, MPO, C3, C4, SOD, CAT, GPx and lower levels of MDA, glucose, cortisol, ALT, ALP, LDH when compared with the control (P<0.05). In conclusion, a combined administration of RS and L. rhamnosus effectively improved growth performance and health status as well as enhanced the resistance of rainbow trout against ammonia toxicity.

L-Carnitine and synbiotic co-supplementation: beneficial effects on metabolic-endotoxemia, meta-inflammation, and oxidative-stress biomarkers in obese patients: a double blind, randomized, controlled clinical trial

Obesity, a chronic pandemic disease, is characterized by low-grade chronic inflammation, accompanied by over-expression of pro-inflammatory cytokines, thereby contributing to metabolic disorders pathogenesis. Oxidative-stress, an adverse cellular response to adipocyte hypertrophy, promotes inflammation. Furthermore, gut-microbiota dysbiosis may induce oxidative-stress, low-grade inflammation, and metabolic-endotoxemia as major drivers of obesity. Functional-foods/nutraceuticals have attracted extensive attention due to their plausible anti-inflammatory/anti-oxidative properties; evidence supports the superiority of the nutraceutical combined-supplementation approach versus conventional mono-therapies. Current data suggest the anti-oxidative/anti-inflammatory properties of either L-carnitine or pre/pro/synbiotics. This trial compared the effects of co-supplementing L-carnitine and multi-species/multi-strain synbiotic versusL-carnitine mono-therapy on inflammatory/anti-inflammatory, oxidative-stress, and metabolic-endotoxemia biomarkers in 46 female obese patients, receiving either co-supplementation (L-carnitine-tartrate (2 × 500 mg d^-1) + multi-species/multi-strain synbiotic (1 capsule per day)) or mono-therapy (L-carnitine-tartrate (2 × 500 mg d^-1) + maltodextrin (1 capsule per day)) for eight weeks. L-Carnitine + synbiotic co-supplementation significantly decreased interleukin-6 (IL-6, -33.98%), high-sensitivity-C-reactive-protein (hs-CRP, -10%), tumor-necrosis-factor-alpha (TNF-α, -18.73%), malondialdehyde (MDA, -21.73%), and lipopolysaccharide (LPS, -10.14%), whereas the increase in interleukin-10 (IL-10, 7.69%) and total-antioxidant-capacity (TAC, 4.13%) levels was not significant. No significant changes were observed for the above-mentioned parameters in the L-carnitine + placebo group, except for a significant reduction in IL-10 (-17.59%) and TNF-α (-14.78%); however, between-group differences did not reach the significant threshold. Co-supplementing L-carnitine + multi-strain synbiotic led to significant amelioration of inflammatory, oxidative, and metabolic-endotoxemia responses in female obese patients; nevertheless, no improving effects were observed in patients receiving single-supplementation, suggesting that L-carnitine + synbiotic co-supplementation might represent an adjuvant approach to improve oxidative-stress/pro-inflammatory indicators in women with obesity, possibly through beneficial effects of the synbiotic alone. Further longer duration studies with higher doses of L-carnitine in a three-group setting are warranted to elucidate the possibility of synergistic or complementary mechanisms.

Probiotic supplements and stress-related occupational health outcomes: A scoping review

BACKGROUND

Prolonged and constant stress from work often leads to numerous adverse health effects. In recent years, interest in probiotics, living microorganisms that can benefit their host when consumed in adequate amounts, to aid health and well-being has increased. This scoping review is to systematically evaluate the current state of science on the effects of probiotic supplements on health, stress, and stress-related symptoms among working adults in occupational settings.

METHODS

We performed a systematic scoping review following the Arksey and O'Malley Framework. Studies that examined the effects of probiotics on workers' health and stress-related indicators/outcomes in occupational settings were included. A comprehensive search was performed from November 2021 to January 2022 using MEDLINE/PubMed, Cochrane Library, CINAHL, PsychInfo, Scopus, and Embase.

RESULTS

A total of 14 papers met the inclusion and exclusion criteria. Probiotics consisted primarily of Lactobacillus and/or Bifidobacterium strains in various forms and doses. Three out of eight studies reported statistical differences in inflammatory markers or stress hormone levels between probiotic and placebo groups. Three of six reported reduced respiratory tract infection incidents in the probiotic groups and three out of four studies reported no differences in anxiety and depression between groups. Lastly, three studies found that absenteeism and presentism were lower in probiotic groups compared with placebo groups.

CONCLUSION

The potential benefits of probiotics exist; however, the measurements of outcomes, the types of probiotics used, and the characteristics of the intervention varied across studies. Further research is needed focusing on probiotics' direct and indirect mechanisms of action on the stress response and the standardization of strains and dosing.

Coenzyme Q10 Supplementation and Oxidative Stress Parameters: An Updated Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials

Background: Oxidative stress (OS) contributes to the development of some disorders, including malignancies, metabolic diseases, Alzheimer's disease, and Parkinson's disease. Objectives: The effects of coenzyme Q10 (CoQ10) supplementation on OS parameters have been assessed through an updated systematic review and meta-analysis. Methods: SCOPUS, PubMed, Cochrane Library, EMBASE, and Web of Sciences were used for article searching. Standardized mean difference (SMD) and its standard error were calculated using a random-effects DerSimonian and Laird model. All analyses were done using the STATA software version 16.0 (StataCorp, College Station, TX). Results: Based on twenty-five studies which remained to be incorporated in the meta-analysis, a statistically significant decrease in malondialdehyde (MDA) (SMD -2.74; 95% CI -3.89, -1.58; I2 = 96.9%) as well as nitric oxide (NO) (SMD -5.16; 95% CI -7.98, 2.34; I2 = 92.5%) was associated with CoQ10 supplementation, and a significant increase in total antioxidant capacity (TAC) (SMD 3.40; 95% CI 1.98, 4.83; I2 = 97.4%) and superoxide dismutase (SOD) activity (SMD 1.22; 95% CI 0.32, 2.12; I2 = 94.32%). Conclusions: The results showed no significant effect of CoQ10 supplementation on glutathione peroxidase (GPx), catalase (CAT) activities, and glutathione (GSH) levels. CoQ10 supplementation significantly reduced MDA and NO concentrations and increased TAC and SOD activity.

Synbiotics and Their Antioxidant Properties, Mechanisms, and Benefits on Human and Animal Health: A Narrative Review

Antioxidants are often associated with a variety of anti-aging compounds that can ensure human and animal health longevity. Foods and diet supplements from animals and plants are the common exogenous sources of antioxidants. However, microbial-based products, including probiotics and their derivatives, have been recognized for their antioxidant properties through numerous studies and clinical trials. While the number of publications on probiotic antioxidant capacities and action mechanisms is expanding, that of synbiotics combining probiotics with prebiotics is still emerging. Here, the antioxidant metabolites and properties of synbiotics, their modes of action, and their different effects on human and animal health are reviewed and discussed. Synbiotics can generate almost unlimited possibilities of antioxidant compounds, which may have superior performance compared to those of their components through additive or complementary effects, and especially by synergistic actions. Either combined with antioxidant prebiotics or not, probiotics can convert these substrates to generate antioxidant compounds with superior activities. Such synbiotic-based new routes for supplying natural antioxidants appear relevant and promising in human and animal health prevention and treatment. A better understanding of various component interactions within synbiotics is key to generating a higher quality, quantity, and bioavailability of antioxidants from these biotic sources.

The impact of probiotic yogurt versus ordinary yogurt on serum sTWEAK, sCD163, ADMA, LCAT and BUN in patients with chronic heart failure: a randomized, triple-blind, controlled trial

BACKGROUND

To date, no study has investigated the effects of probiotic yogurt as a functional food in patients with chronic heart failure (CHF). Therefore, the aim of this study was to compare the impact of probiotic yogurt versus ordinary yogurt on inflammatory, endothelial, lipid and renal indices in CHF patients. In this randomized, triple-blind clinical trial, 90 patients with CHF were randomly allocated into two groups to take either probiotic or ordinary yogurt for 10 weeks. Serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), soluble cluster of differentiation 163 (sCD163), asymmetric dimethylarginine (ADMA), and lecithin cholesterol acyltransferase (LCAT) were measured by using ELISA kits, and blood urea nitrogen (BUN) was measured by calorimetry method at baseline and at the end of trial. The P-value <0.05 was defined as statistically significant.

RESULTS

Seventy-eight patients completed the study. At the end of the intervention, the levels of sTWEAK in both groups increased significantly, and this increase was greater in the probiotic yogurt group [691.84 (335.60, 866.95)] compared to control group [581.96 (444.99, 929.40)], and the difference between the groups was statistically significant after adjusting for confounders (P-value: 0.257, adjusted P-value: 0.038). However, no significant differences were found between the groups in the cases of other study indices.

CONCLUSION

Probiotic yogurt may be useful for improving the inflammatory status in patients with CHF through increasing sTWEAK levels, however, further studies are needed in this area. © 2022 Society of Chemical Industry.

Effects of probiotic supplementation on cognitive function in elderly: A systematic review and Meta-analysis

OBJECTIVES

Probiotic supplementation has been linked to changes in cognitive function via the gut-brain axis (GBA). However, the current literature lacks a comprehensive review regarding this matter in the elderly population.

METHOD

Electronic databases including Medline (PubMed), Scopus, Embase, Web of Science, and Google Scholar were comprehensively searched for identifying studies that assessed the effects of probiotics on the cognitive function of the elderly published until July 2020. Articles were critically reviewed and if met the inclusion criteria, entered the study.

RESULTS

Among a total of 1374 studies, 10 were eligible for meta-analysis. No significant alteration was found in the cognition of the elderly (SMD=-0.04; 95% CI [- 1.07,0.98]; P = 0.93). There was a nonsignificant increase in the level of brain-derived neurotrophic factor (SMD = 0.58; 95% CI [-1.40,2.56]; P = 0.56) and a nonsignificant reduction in malondialdehyde levels (SMD=-0.44; 95% CI [-1.07,0.19]; P = 0.17). Levels of total antioxidant capacity (SMD = 39.93; 95% CI [2.92,76.95]; P = 0.03) and total glutathione (SMD = 61.51; 95% CI [12.39,110.62]; P = 0.01) significantly increased. A significant reduction was also noted in total cholesterol levels (SMD=-4.23; 95% CI [-8.32, -0.14]; P = 0.04).

CONCLUSION

Our study did not support the hypothesis of the positive effect of probiotics on cognitive function in the elderly population; which might be due to the heterogeneity across the studies.

The Effect of Synbiotic Consumption on Serum NTproBNP, hsCRP and Blood Pressure in Patients With Chronic Heart Failure: A Randomized, Triple-Blind, Controlled Trial

Background

In recent years, there has been a positive attitude toward gut microbiota and its effect on cardiovascular diseases, including heart failure.

Objective

The purpose of this study was to evaluate the effect of synbiotics on left ventricular hypertrophy by measuring NT-proBNP, and their effect on blood pressure and hsCRP as an inflammatory biomarker in patients with chronic heart failure.

Design

In this triple-blind randomized clinical trial, 90 eligible patients were included in the study. They were randomly assigned to receive one capsule (500 mg) of synbiotics or placebo per day for 10 weeks. NTproBNP, hsCRP and blood pressure were measured at the beginning and end of the study. Statistical analysis was performed on 80 patients by using SPSS 24, and p < 0.05 as statistically significant.

Result

At the end of the study, the level of NT-proBNP decreased significantly in the synbiotic group compared to the placebo group (r = −256.55; P = 0.04). However, hsCRP increased in both groups as compared to the beginning of the study, but only in the placebo group the increase in hsCRP was significant (P = 0.01). The results showed that the changes in hs-CRP was not significant between the two groups. No statistically significant differences were observed in systolic and diastolic blood pressure between the two groups at the end of the intervention.

Conclusion

Synbiotics have favorable effect on cardiac hypertrophy index (NT-proBNP). Although the inflammatory factor increased in both groups, the significant increase in hsCRP in the placebo group could indicate the beneficial effects of synbiotics on the inflammatory status of these patients.

Clinical Trial Registration

https://en.irct.ir/user/trial/42905/view, identifier: IRCT20091114002709N52.

Biomarkers and Utility of the Antioxidant Potential of Probiotic Lactobacilli and Bifidobacteria as Representatives of the Human Gut Microbiota

Lactobacilli and bifidobacteria are an important part of human gut microbiota. Among numerous benefits, their antioxidant properties are attracting more and more attention. Multiple in vivo and in vitro studies have demonstrated that lactobacilli and bifidobacteria, along with their cellular components, possess excellent antioxidant capacity, which provides a certain degree of protection to the human body against diseases associated with oxidative stress. Recently, lactobacilli and bifidobacteria have begun to be considered as a new source of natural antioxidants. This review summarizes the current state of research on various antioxidant properties of lactobacilli and bifidobacteria. Special emphasis is given to the mechanisms of antioxidant activity of these bacteria in the human gut microbiota, which involve bacterial cell components and metabolites. This review is also dedicated to the genes involved in the antioxidant properties of lactobacilli and bifidobacteria strains as indicators of their antioxidant potential in human gut microbiota. Identification of the antioxidant biomarkers of the gut microbiota is of great importance both for creating diagnostic systems for assessing oxidative stress and for choosing strategies aimed at restoring the normal functioning of the microbiota and, through it, restoring human health. In this review, the practical application of probiotic strains with proven antioxidant properties to prevent oxidative stress is also considered.

Four Weeks of Probiotic Supplementation Alters the Metabolic Perturbations Induced by Marathon Running: Insight from Metabolomics

Few data are available that describe how probiotics influence systemic metabolism during endurance exercise. Metabolomic profiling of endurance athletes will elucidate mechanisms by which probiotics may confer benefits to the athlete. In this study, twenty-four runners (20 male, 4 female) were block randomised into two groups using a double-blind matched-pairs design according to their most recent Marathon performance. Runners were assigned to 28-days of supplementation with a multi-strain probiotic (PRO) or a placebo (PLB). Following 28-days of supplementation, runners performed a competitive track Marathon race. Venous blood samples and muscle biopsies (vastus lateralis) were collected on the morning of the race and immediately post-race. Samples were subsequently analysed by untargeted ¹H-NMR metabolomics. Principal component analysis (PCA) identified a greater difference in the post-Marathon serum metabolome in the PLB group vs. PRO. Univariate tests identified 17 non-overlapped metabolites in PLB, whereas only seven were identified in PRO. By building a PLS-DA model of two components, we revealed combinations of metabolites able to discriminate between PLB and PRO post-Marathon. PCA of muscle biopsies demonstrated no discernible difference post-Marathon between treatment groups. In conclusion, 28-days of probiotic supplementation alters the metabolic perturbations induced by a Marathon. Such findings may be related to maintaining the integrity of the gut during endurance exercise.

The Effects of Supplementation with Probiotic on Biomarkers of Oxidative Stress in Adult Subjects: a Systematic Review and Meta-analysis of Randomized Trials

Previous studies have supposed that probiotic supplementation led to a positive effect on different health outcomes. Furthermore, several studies indicated that probiotics supplementation improved antioxidant status, while some studies did not indicate these effects. Hence, current systematic review and meta-analysis study was conducted to determine the effect of probiotic supplementation on some oxidative stress biomarkers among adult subjects. We searched four electronic databases PubMed, SCOPUS, ISI Web of Science, and the Cochrane Library till November 2017. Clinical trials that compared the effects of probiotic supplementation with the control group were included. A random-effect model was used to pool weighted mean difference (WMD). Finding of 11 included studies (n = 577) indicated that probiotic supplementation increased total antioxidant capacity (TAC) (WMD 77.30 mmol/L; 95% confidence interval [CI] 2.60, 152.01; I² = 88.3%) and reduced malondialdehyde (MDA) (WMD - 0.31 μmol/L; 95% CI - 0.54, - 0.08; I² = 71.5%) significantly compared to the control group. However, its effects on glutathione (GSH) was not significant (WMD = 19.32 μmol/L; 95% CI - 18.70, 57.33; I² = 64.9%). The current meta-analysis revealed that probiotic supplementation may result in increasing TAC and lowering MDA, which improve antioxidant status. However, due to high heterogeneity, findings should be interpreted with caution. Further investigations are required to elucidate the effect of supplementation with probiotics on biomarkers of antioxidants.

A multiple-strain probiotic product provides a better enzymatic antioxidant response in individuals with constipation in a double-blind randomized controlled trial

OBJECTIVES

Probiotics may have beneficial effects on intestinal dysbiosis. However, the effects of probiotics on redox and inflammatory responses in intestinal constipation remain unknown. The aim of this study was to investigate the effect of a multiple-strain probiotic on the redox and inflammatory responses in individuals with intestinal constipation.

METHODS

A randomized, double-blind, placebo controlled clinical trial was conducted with individuals diagnosed with constipation (defined according to the Rome IV criteria). The participants were randomized into two groups to receive either a probiotic capsule (PC; n = 25) containing probiotic strains or to receive a control capsule (CC; n = 20) containing a matching placebo for 30 d. In the baseline and at the end of the study, biomarkers of the redox (malondialdehyde, carbonylated protein, antioxidant enzymes, and ferric-reducing antioxidant power) and inflammatory responses, and Rome IV criteria for constipation were analyzed.

RESULTS

The consumption of a multiple-strain probiotic attenuated the reduction of glutathione peroxidase (PC = -9.41 and CC = -19.60; P = 0.041) and glutathione-s-transferase activity (PC = -3.28 and CC = -12.08, P < 0.0001) in erythrocytes and marginally improved the symptom of feeling incomplete defecation in ≥25% of bowel movements, compared with the placebo group. No changes were observed in total antioxidant capacity, oxidative damage, and levels of inflammatory markers in the serum.

CONCLUSIONS

Our data suggested that a multiple-strain probiotic may provide a better enzymatic antioxidant response and partially alleviate the feeling of incomplete defecation in ≥25% of bowel movements in individuals with intestinal constipation.

Effect of Probiotic, Prebiotic, and Synbiotic Supplementation on Cardiometabolic and Oxidative Stress Parameters in Patients With Chronic Kidney Disease: A Systematic Review and Meta-analysis

PURPOSE

Chronic kidney disease (CKD) is a major health problem worldwide. Evidence supporting the use of probiotic, prebiotic, and synbiotic supplementation in the management of CKD is mixed, although some studies suggest they may be useful. A systematic review and meta-analysis was performed to evaluate the effectiveness of probiotic, prebiotic, and synbiotic supplementation for improving cardiometabolic and oxidative stress parameters in patients with CKD.

METHODS

A comprehensive key word search was performed in EMBASE, Medline, Scopus, Cochrane Central, and Web of Science until April 2020. Randomized controlled trials investigating the effectiveness of probiotic, synbiotic, and prebiotic supplementation for the management of adults with CKD were included. Primary outcomes were measures of cardiometabolic parameters such as cholesterol and fasting blood glucose. Secondary outcomes were measures of oxidative stress (eg, malondialdehyde levels) and body mass index. Random effects meta-analyses were used to estimate mean treatment effects. Results are reported as standardized mean differences (SMDs) and 95% CIs.

FINDINGS

Fourteen articles were included. In patients with CKD, probiotic, prebiotic, and synbiotic supplementation significantly reduced total cholesterol (SMD, -0.25; 95% CI, -0.46 to -0.04; I² = 00.0%), fasting blood glucose (SMD, -0.41; 95% CI, -0.65 to -0.17; I² = 00.0%), homeostatic model assessment of insulin resistance (SMD, -0.63; 95% CI, -0.95 to -0.30; I² = 43.3%), insulin levels (SMD, -0.49; 95% CI, -0.90 to -0.08; I² = 65.2%), high-sensitivity C-reactive protein levels (SMD, -0.52; 95% CI, -0.81 to -0.22; I² = 52.7%), and malondialdehyde levels (SMD, -0.79; 95% CI, -1.22 to -0.37; I² = 69.8%) compared with control interventions. Supplementation significantly increased the quantitative insulin sensitivity check index (SMD, 0.78; 95% CI, 0.51 to 1.05; I² = 00.0%), total antioxidant capacity (SMD, 0.42; 95% CI, 0.18 to 0.66; I² = 00.0%), and glutathione levels (SMD, 0.52; 95% CI, 0.19 to 0.86; I² = 37.0%).

IMPLICATIONS

Probiotic, prebiotic, and synbiotic supplementation seems to be a promising intervention for improving cardiometabolic and oxidative stress parameters in patients with CKD.

Probiotic Yogurt Fortified with Vitamin D Can Improve Glycemic Status in Non-Alcoholic Fatty Liver Disease Patients: a Randomized Clinical Trial

Non-alcoholic fatty liver disease (NAFLD) is a significant public health problem globally and the most notable chronic liver disease in Asian countries. Various dietary supplements have been assessed as potential methods to alleviate the metabolic damages related to NAFLD, but the results of these works have been equivocal. This study aimed to evaluate the effects of probiotic yogurt fortified with vitamin D (Pro-YFD) on glycemic and anthropometric indices in patients with NAFLD. One hundred and four NAFLD patients of both sexes were randomly allocated to 2 groups: group A (Pro-YFD) and group B (unfortified yogurt). The intervention period was 3 months. Fasting blood samples were obtained for measuring fasting blood sugar (FBS) and insulin level. Food intake was measured using a validated food frequency questionnaire. Body composition was estimated by bio-impedance. Eighty-eight patients completed the study. The mean serum level of 25(OH)D₃ was elevated significantly (p < 0.001), while insulin level decreased significantly (p < 0.003) in group A at the end of the study. FBS levels showed no significant differences between the groups at the end of the trial. Also, there were no significant changes in diet caloric intake, physical activity, or anthropometric indices in the 2 groups during the interventions. Pro-YFD in the diets of patients with NAFLD may attenuate insulin resistance and improve serum level of 25(OH)D₃.

Efficacy of probiotics in multiple sclerosis: a systematic review of preclinical trials and meta-analysis of randomized controlled trials

Preliminary evidence shows the potential role of probiotics in ameliorating multiple sclerosis (MS); however, the effects of probiotics on MS remain unclear.

Effect of probiotics on oxidative stress and inflammatory status in diabetic nephropathy: A systematic review and meta-analysis of clinical trials

This systematic review and meta-analysis was performed to evaluate the effect of probiotics on serum high sensitivity-C reactive protein (hs-CRP) and oxidative stress biomarkers among patients with Diabetic Nephropathy (DN). Electronic databases were searched through May 10, 2020. Seven trials that included 340 patients were identified for analysis. Meta-analysis indicated that probiotics significantly reduced hs-CRP (WMD = -1.53 mg/L; 95% CI = -2.38, -0.69; P < 0.001) and Malondialdehyde (MDA) (WMD = -0.62 ɥmol/L; 95% CI = -1.18, -0.06; P = 0.030) levels in DN patients, whereas they increased Glutathione (GSH) (WMD = 73.84 ɥmol/L; 95% CI = 24.3, 123.29; P = 0.003) and Total Antioxidant Capacity (TAC) (WMD = 26.54 mmol/L; 95% CI = 6.23, 46.85; P = 0.010). Therefore, probiotics may improve hs-CRP and oxidative stress biomarkers in DN population.

Comparison of probiotic yogurt and ordinary yogurt consumption on serum Pentraxin3, NT-proBNP, oxLDL, and ApoB100 in patients with chronic heart failure: a randomized, triple-blind, controlled trial

BACKGROUND AND AIMS

Nowadays, the potential beneficial effects of probiotic yogurt as a functional food has raised much interest. Thus, the aim of this study was to compare the probiotic yogurt and ordinary yogurt consumption on some indices in patients with chronic heart failure (CHF).

METHODS AND RESULTS

In this randomized, triple-blind clinical trial, 90 patients with CHF were randomly allocated into two groups to take either probiotic yogurt or ordinary yogurt for 10 weeks. The serum levels of pentraxin3 (PTX3), N-terminal pro-brain natriuretic peptide (NT-proBNP), oxidized low density lipoprotein (oxLDL), and apolipoprotein B100 (ApoB100) were measured at the baseline and at the end of week 10. P-Value <0.05 was defined as statistically significant. Final analyses were performed on 78 patients. The levels of PTX3 and oxLDL in both the groups decreased significantly after 10 weeks, and these reductions were greater in the probiotic group, where the difference between the groups was statistically significant for oxLDL (P-value: 0.051, adjusted P-value: 0.010) but not significant for PTX3 (P-value: 0.956, adjusted P-value: 0.236). The changes in the serum NT-proBNP levels were not statistically significant between the groups (P-value: 0.948, adjusted P-value: 0.306). ApoB100 significantly decreased in the control group compared to the probiotic group and the difference between the groups was significant at first but was not significant after adjusting for the confounders (P-value: 0.004, adjusted P-value: 0.280).

CONCLUSION

The serum oxLDL significantly reduced due to probiotic yogurt consumption after 10 weeks compared to ordinary yogurt; thus, it may be useful for improving the oxidative status of CHF patients. The clinical trial registry number is IRCT20091114002709N48 (https://www.irct.ir/IRCT20091114002709N48, registered 12 March 2018).

The effects of probiotic/synbiotic supplementation compared to placebo on biomarkers of oxidative stress in adults: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND AIMS

During the last decades, there has been a burst of scientific literature hypothesizing the antioxidant effect of probiotics. However, the results of these studies are inconsistent and a final conclusion has yet to be reached. Thus, the aim of this study was to assess the effects of probiotic/synbiotic supplementation on serum total antioxidant capacity (TAC), glutathione (GSH), malondialdehyde (MDA) and nitric oxide (NO) levels in adults.

METHODS AND RESULTS

The following online databases were searched until August 26th 2020: PubMed/Medline, Scopus, Clarivate Analytics Web of Science, Cochrane Central Register of Controlled Trials, Science Direct, Google Scholar and Igaku Chuo Zasshi. The effect sizes were expressed as the weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 31 eligible trials with 1681 participants (839 cases and 842 controls) were included in this meta-analysis. The results revealed that the supplementation with probiotics/synbiotics, significantly increased serum TAC (WMD: 54.14 mmol/L, 95% CI: 27.87, 80.40, P < 0.001), GSH (WMD: 40.38 μmol/L, 95% CI: 20.72, 60.03, P < 0.001) and NO (WMD: 3.54 μmol/L, 95% CI: 1.73, 5.34, P < 0.001) levels. In addition, MDA levels were significantly reduced (WMD: -0.45 μmol/L, 95% CI: -0.58,-0.32, P < 0.001) following probiotic/synbiotic supplementation. None of the variables showed a significant change in the sensitivity analysis.

CONCLUSION

Available evidence suggests that probiotic/synbiotic supplementation can significantly increase serum TAC, GSH and NO, as well as reduce MDA levels in adults. Therefore, probiotic/synbiotic supplementation may play a role in improving antioxidant indices and reducing oxidative stress in the body.

Coenzyme Q10 supplementation and oxidative stress parameters: a systematic review and meta-analysis of clinical trials

PURPOSE

Oxidative stress (OS) is associated with several chronic complications and diseases. The use of coenzyme Q10 (CoQ10) as an adjuvant treatment with routine clinical therapy against metabolic diseases has shown to be beneficial. However, the impact of CoQ10 as a preventive agent against OS has not been systematically investigated.

METHODS

A systematic literature search was performed using the PubMed, SCOPUS, EMBASE, and Cochrane Library databases to identify randomized clinical trials evaluating the efficacy of CoQ10 supplementation on OS parameters. Standard mean differences and 95% confidence intervals were calculated for net changes in OS parameters using a random-effects model.

RESULTS

Seventeen randomized clinical trials met the eligibility criteria to be included in the meta-analysis. Overall, CoQ10 supplementation was associated with a statistically significant decrease in malondialdehyde (MDA) (SMD - 0.94; 95% CI - 1.46, - 0.41; I² = 87.7%) and a significant increase in total antioxidant capacity (TAC) (SMD 0.67; 95% CI 0.28, 1.07; I² = 74.9%) and superoxide dismutase (SOD) activity (SMD 0.40; 95% CI 1.12, 0.67; I² = 9.6%). The meta-analysis found no statistically significant impact of CoQ10 supplementation on nitric oxide (NO) (SMD - 1.40; 95% CI - 0.12, 1.93; I² = 92.6%), glutathione (GSH) levels (SMD 0.41; 95% CI - 0.09, 0.91; I² = 70.0%), catalase (CAT) activity (SMD 0.36; 95% CI - 0.46, 1.18; I² = 90.0%), or glutathione peroxidase (GPx) activities (SMD - 1.40; 95% CI: - 0.12, 1.93; I² = 92.6%).

CONCLUSION

CoQ10 supplementation, in the tested range of doses, was shown to reduce MDA concentrations, and increase TAC and antioxidant defense system enzymes. However, there were no significant effects of CoQ10 on NO, GSH concentrations, or CAT activity.

Effect of Nigella sativa oil supplement on risk factors for cardiovascular diseases in patients with type 2 diabetes mellitus

This study aimed to evaluate the effects of Nigella sativa oil on serum level of systemic inflammation, oxidative stress, fasting blood glucose (FBG), and lipid profile in patients with type 2 diabetes mellitus (T2DM). This double-blind randomized clinical trial study was based on 50 patients with T2DM. Patients were allocated randomly to either N. sativa oil or placebo groups. The intervention group received 1,000 mg N. sativa oil as two capsules, daily for 8 weeks, whereas the placebo group received a corresponding placebo. At baseline and the end of the study, 5 ml blood was collected from each patient after 14-hour fasting for measuring serum C-reactive protein (hs-CRP), malondialdehyde (MDA), FBS, and lipid profile. Analyses covariance was performed to compare investigated parameters between two groups, controlled for relevant covariates. Using N. sativa supplement was significantly associated with decrease in FBS (p < .001), triglyceride (p < .001), total cholesterol (p < .001), low-density lipoprotein cholesterol (p < .001), serum hs-CRP, MDA (p < .001) and increase in serum level of high-density lipoprotein cholesterol (p < .001) in intervention group compared with placebo group. Nigella sativa oil supplement has cardiovascular protective effects in patients with T2DM, by improving the lipid profile and glycemia, by reducing the C-reactive protein level and the lipid peroxidation.

Probiotics supplementation improves hyperglycemia, hypercholesterolemia, and hypertension in type 2 diabetes mellitus: An update of meta-analysis

Background: Although many studies have shown that consumption of probiotics is relevant to diabetes, the effects of probiotics improves clinical outcomes in type 2 diabetes have yielded conflicting results. The aim of this meta-analysis was conducted to assess the effects of probiotics supplementation on glycemic, blood lipids, pressure and inflammatory control in type 2 diabetes.Methods: PubMed, Web of science, Embase and the Cochrane Library databases were searched for relevant studies from February 2015 up to Janurary 2020, with no language restrictions. The pooled results were calculated with the use of a random-effects model to assess the impact of supplemental probiotics on glycemic, blood lipids, pressure and inflammatory control in type 2 diabetes. Additionally, subgroup analysis was conducted based on patients age, body mass index (BMI), country and duration of the probiotics supplement, respectively.Results: 13 studies were included in this meta-analysis, involving a total of 818 participants in 8 countries. Overall, compared with control groups, the subjects who received multiple species of probiotics had a statistically significant reduction in fasting blood sugar (FBS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and tumor necrosis factor (TNF) -α [standardized mean difference (SMD): -0.89 mg/Dl, 95% CI: -1.66, -0.12 mg/dL; SMD: -0.43, 95% CI: -0.63, -0.23; SMD: -0.19 mg/dL, 95% CI: -0.36, -0.01 mg/dL; SMD: -0.23 mg/dL, 95% CI: -0.40, -0.05 mg/dL; SMD: -5.61 mmHg, 95% CI: -9.78, -1.45 mmHg; SMD: -3.41 mmHg, 95% CI: -6.12, -0.69 mmHg; and SMD: 6.92 pg/ml, 95% CI: 5.95, 7.89 pg/ml, respectively]. However, the subjects who received single-species of probiotic or probiotic with co-supplements in food only changed FBS, HOMA-IR, DBP and TG levels. Moreover, subgroup analyses revealed that the effects of probiotics supplementation on FBS, HMOA-IR, SBP and DBP are significantly influenced by patients age, body mass index (BMI), country and duration of the probiotics supplement.Conclusion: Our analysis revealed that glycemic, lipids, blood pressure and inflammation indicators are significantly improved by probiotic supplementation, particularly the subjects who ages ≤ 55, baseline BMI< 30 kg/m², duration of intervention more than 8 weeks, and received multiple species probiotic.

Probiotics, prebiotics, and synbiotics for the improvement of metabolic profiles in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to quantify the effects of probiotic, prebiotic, and synbiotic supplementation on biomarkers of inflammation and oxidative stress, as well as lipid profiles among patients with chronic kidney disease (CKD). Electronic databases, including PubMed, the Cochrane Database, and the Web of Science were searched from January 1, 2000, to May 15, 2019. All RCTs that investigated the effect of prebiotics, probiotics, and synbiotics on a circulating (serum and plasma) inflammatory marker (C-reactive protein [CRP]), oxidative stress indicators (malondialdehyde [MDA], glutathione [GSH], and total anti-oxidant capacity [TAC]); and lipid profiles (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-c], and high-density lipoprotein cholesterol [HDL-c]) among patients with CKD were included. Data were pooled and expressed as a standardized mean difference (SMD) with a 95% confidence interval (CI). The protocol for this meta-analysis is registered with PROSPERO; No. CRD42019139090. Thirteen trials that included 671 patients were identified for analysis. The methodological quality varied across studies. Meta-analysis indicated that microbial therapies significantly reduced CRP (SMD, -0.75; 95% CI, -1.03 to -0.47; p = 0.000), MDA (SMD, -1.06; 95% CI, -1.59 to -0.52; p = 0.000), TC (SMD, -0.33; 95% CI, -0.52 to -0.13; p = 0.000), and LDL-c (SMD, -0.44; 95% CI, -0.86 to -0.02; p = 0.000) levels; they also increased the GSH (SMD, 0.44; 95% CI, 0.25 to 0.65; p = 0.000), TAC (SMD, 0.61; 95% CI, 0.07 to 1.15; p = 0.000), and HDL-c (SMD, 0.45; 95% CI, 0.03 to 0.87; p = 0.000) levels in CKD patients, as compared to the placebo groups; however, there was no statistically significant TG concentration among patients with CKD. Subgroup analyses showed that other key factors, such as the duration of intervention, participants' baseline body mass index (BMI), type of intervention, and age, had an effect of microbial therapies on outcomes. This meta-analysis supports the potential use of probiotic, prebiotic, and synbiotic supplements in the improvement of established biomarkers of inflammation and oxidative stress, as well as lipid profiles among patients with CKD, which are well-known cardiovascular risk factors. Further research into these interventions should consider the limitations of our study to explore the effect of long-term administration of these supplements in the CKD population.

Screening for Potential Novel Probiotics With Dipeptidyl Peptidase IV-Inhibiting Activity for Type 2 Diabetes Attenuation in vitro and in vivo

Diabetes has become the second most severe disease to human health. Probiotics are important for maintaining gastrointestinal homeostasis and energy balance and have been demonstrated to play a positive role in the prevention and treatment of metabolic syndromes, such as obesity, inflammation, dyslipidemia, and hyperglycemia. The objective of this study was to screen potential antidiabetic strains in vitro and evaluate its effects in vivo. For the in vitro section, dipeptidyl peptidase IV (DPP-IV) inhibitory and antioxidant activities of 14 candidate Lactobacillus spp. strains were tested. Then hydrophobicity and acid and bile salt tolerance assays were determined. The most promising in vitro strain was further evaluated for its antidiabetic properties in vivo using type 2 diabetes mice induced by high-fat diet and intraperitoneal injection of streptozotocin (STZ). The reference strain for this study was Lactobacillus rhamnosus GG. Results showed that cell-free excretory supernatants and cell-free extracts of Lactobacillus acidophilus KLDS1.0901 had better DPP-IV inhibitory activity, antioxidative activities, and biological characteristics than other strains. At the end of the treatment, we found that L. acidophilus KLDS1.0901 administration decreased the levels of fasting blood glucose (FBG), glycosylated hemoglobin, insulin in serum and AUC_glucose, and increased the level of glucagon-like peptide 1 in serum compared with diabetic mice (p < 0.05). Moreover, L. acidophilus KLDS1.0901 supplementation increased the activities of superoxide dismutase, glutathione peroxidase, the level of glutathione, and reduced the level of malondialdehyde in serum. These results indicated that L. acidophilus KLDS1.0901 could be used as a potential antidiabetic strain; its application as food supplement and drug ingredient is thus recommended.

Association of the Elderly Dietary Index with cardiovascular disease risk factors in elderly men: A cross-sectional study

AIM

There is limited evidence regarding the association between the Elderly Dietary Index (EDI) and cardiovascular disease (CVD) risk factors. The aim of the study was to examine how the EDI relates to CVD risk factors in elderly men.

METHODS

In this cross-sectional study, we recruited 362 elderly men aged 60 to 80 years old. Diet was measured with a validated and reliable food frequency questionnaire. The EDI assesses adherence to nutritional recommendations for older adults based on the Modified MyPyramid for Older Adults. The EDI includes meat, fish, fruits, vegetables, cereals, legumes, olive oil, bread and dairy products. Anthropometric indices, biochemical markers and blood pressure were measured using standard methods. Multivariate logistic regression assessed relationships between tertiles of EDI scores and CVD risk factors.

RESULTS

The mean age and body mass index of participants were 65.43 ± 5.63 years and 25.34 ± 3.17 kg/m² , respectively. After controlling for potential confounders, the EDI was inversely associated with the risk of obesity and overweight (Odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.27, 0.89; P = .004) and was associated with a reduced likelihood of elevated low-density lipoprotein cholesterol (LDL-C) concentrations (OR: 0.19, 95% CI: 0.09, 0.41; P < .001).

CONCLUSIONS

Higher EDI was associated with lower risk of overweight and obesity and high LDL-C concentrations. However, there was no significant association between EDI and other CVD risk factors in elderly men.

Health promoting activities of probiotics

In recent years, probiotics have received increasing attention and become one type of popular functional food because of their many biological functions. Among these desirable biological functions, the immune regulation, antioxidative activities, and antimicrobial effects are essential properties to maintain host health. Probiotics can regulate the immune system and improve the antioxidative system by producing microbial components and metabolites. Meanwhile, probiotics also possess antimicrobial abilities owing to their competition for nutrient requirements and mucus adherence, reducing pathogenic toxins, producing antimicrobial metabolites (short-chain fatty acids, bacteriocins, reuterin, linoleic acid, and secondary bile acids) and enhancing intestinal, or systemic immunity. Therefore, probiotics could be used to alleviate heavy metal toxicity and metabolic disorders by improving immunity, the antioxidative system, and intestinal micro-environment. This comprehensive review mainly highlights the potential health promoting activities of probiotics based on their antioxidative, antimicrobial, and immune regulatory effects. PRACTICAL APPLICATIONS: The antioxidative defense and the immune system are essential to maintain human health. However, many factors may result in microbial dysbiosis in the gut, which subsequently leads to pathogenic expansion, oxidative stress, and inflammatory responses. Therefore, it is important to explore beneficial foods to prevent or suppress these abnormal responses. Successful application of probiotics in the functional foods has attracted increasing attention due to their immune regulatory, antioxidative, and antimicrobial properties. The aim of this review is to introduce immune regulatory antioxidative and antimicrobial effects of probiotics, which provides some basic theories for scientific research and development of potential functional foods.

Effect of omega-3 fatty acid plus vitamin E Co-Supplementation on oxidative stress parameters: A systematic review and meta-analysis

BACKGROUND & AIMS

The impact of combined omega-3 FAs and vitamin E supplementation on oxidative stress (OS) has been evaluated in several studies. However the results are inconsistent. Therefore, we performed a systematic review and meta-analysis to assess the role of omega-3 FAplus vitamin E on anti-oxidant and OS parameters.

METHODS

We searched five databases (PubMed, Embase, Web of Sciences, Scopus and the Cochrane Central Register of Controlled Trials) from inception until March 15th 2018 for RCT covering OS parameters combined with omega-3 FAs and vitamin E. The effect of omega-3 FAs plus vitamin E combination on OS factors was determined as the standardized mean difference (SMD) calculated according to DerSimonian and Laird for the random effects model.

RESULTS

Nine articles were included in our analyses, significant improvements were observed in trials supplementing with omega-3 FAs plus vitamin E vs placebo for total antioxidant capacity (TAC) (SMD=0.63, 95%CI: 0.31 to 0.95, P<0.001) and nitric oxide (NO) (SMD=0.55, 95%CI: 0.23 to 0.87, P<0.001). Significant reduction was observed for malondialdehyde (MDA) (SMD: -0.48, 95%CI: -0.68 to -0.28, P<0.001). However, the results of meta-analysis did not show a significant difference in levels of glutathione (GSH) (SMD=0.34, 95%CI: -0.07 to 0.75, P=0.10), superoxide dismutase (SOD) activity (SMD: 0.07, 95% CI: -0.58 to 0.73, P=0.82) and Catalase (CAT) activity (SMD: 0.74, 95% CI: -0.30 to 1.79, P=0.16).

CONCLUSION

Co-supplementation with omega-3 FAs and vitamin E increases the levels of NO and TAC, while MDA levels decrease compared to placebo. However, the results showed no significant alterations on GSH concentrations, CAT, and SOD activities.

The effect of vitamin D supplementation on oxidative stress parameters: A systematic review and meta-analysis of clinical trials

Recent studies have shown that vitamin D supplementation beneficially decreases oxidative stress (OS) parameters; however, there is no consensus on this subject. In this systematic review and meta-analysis we aimed to investigate the effect of vitamin D supplementation on OS parameters. We searched electronic databases including Medline, Embase, Scopus, Web of Science and Cochrane Library up to July 2018 without any language restriction. Trials were reviewed using preferred reporting items for systematic reviews and meta-analyses (PRISMA) and Cochrane handbook. To compare the effects of vitamin D with placebo, standardized mean difference (SMD) with 95% confidence intervals (CI) were pooled using random effects model. Across thirteen clinical trials, we found that vitamin D supplementation increased serum levels of total antioxidant capacity (TAC) (SMD: 0.54 mmol/L, 95% CI: 0.29 to 0.79; I² = 65.4%, P = 0.001) and glutathione (GSH) (SMD: 0.33; 95% CI: 0.11 to 0.54, P = 0.003; I² = 61.2%, P = 0.001). Besides, malondialdehyde (MDA) concentration decreased significantly (SMD: -0.40 mmol/L, 95% CI: -0.60 to -0.21, P < 0.001) following vitamin D supplementation compared to placebo. However, its effects on nitric oxide (NO) was not significant (0.17, 95% CI: -0.10 to 0.45, I² = 71.1%, P = 0.21). Finally, we showed that vitamin D supplementation can improve OS parameters; however, this finding may not be clinically significant. Further large prospective clinical trials are needed to confirm the effect of vitamin D supplement on other OS parameters.