Evaluating probiotic efficacy on weight loss in adults with overweight through a double-blind, placebo-controlled randomized trial

Remolding probiotics for effective treatment of type 2 diabetes via oral administration

Effective, user-friendly, lifestyle-compatible, and economic treatment for type 2 diabetes (T2D) is urgently needed due to its high incidence and health threats. Here, we remolded Lactococcus lactis through genetic engineering to persistently secrete glucagon-like peptide-1 (L. lactis-GLP-1) and subsequent bioorthogonal arming with dopamine (DA)-based "gripper" and β-glucan (GN)-based "shield" (L. lactis-GLP-1-DA@GN) for treatment of T2D mice via oral administration. With protection by GN-based "shield", L. lactis-GLP-1-DA@GN achieved an impressive enhancement of survival by 20666 times compared with bare L. lactis-GLP-1 after experiencing gastrointestinal conditions and DA-based "gripper" was shielded from interaction with the upper digestive tract. Once prebiotic GN was metabolized by gut microbiota into short-chain fatty acids (SCFAs), underlying DA-based "gripper" was exposed to assist intestinal colonization of L. lactis-GLP-1, achieving synergistic treatment effects through secreted GLP-1 and SCFAs. With all advances, oral administration of L. lactis-GLP-1-DA@GN realized effective T2D treatment through improving glucose/lipid homeostasis, repairing major organs' damages, and positively modulating gut microbiota. Moreover, multi-omics analysis revealed that L. lactis-GLP-1-DA@GN also mainly intervened in liver's signaling pathways regarding lipid metabolism and oxidative regulation to advance anti-T2D process. Our strategy marks reconstruction of probiotics by combining chemical and biological tools, broadening the avenue of manipulating probiotics for disease treatments.

Effects of oral supplementation of probiotics on body weight and visceral fat in obese patients: a meta-analysis and systematic review

Obesity can mediate the occurrence of many cardiovascular metabolic diseases, such as coronary heart disease and diabetes, which will lead to a significant increase in all-cause mortality in obese people. Visceral fat refers to the excessive accumulation of adipose tissue in abdominal organs, which can lead to impaired normal function of organs. In recent years, it has been reported that probiotics can reduce obesity and visceral fat content, and some studies have put forward the opposite conclusion. In order to guide the practice of nutrition, we use Meta-analysis method to analyze these conclusions. The authors searched randomized controlled trials on the effects of oral probiotics on body weight and visceral fat content in obese people published before January 2024 in several public databases, such as PubMed, Web of Science, EMBASE, Cochrane Library and CNKI. The primary outcome was body weight, and the secondary outcomes included BMI, waist circumference, visceral fat content, and low-density lipoprotein levels. This trial has been registered in PROSPERO (CRD42024521353). A total of 8 randomized controlled trials involving 412 patients were included in this meta-analysis. Meta-analysis showed that the weight loss of the experimental group taking probiotics was significantly higher than that of the control group (P < 0.00001). The reduction of waist circumference in the experimental group taking probiotics was significantly different from that in the control group (P = 0.01). The decrease of visceral fat content in the experimental group taking probiotics was significantly different from that in the control group (P < 0.00001). There was no significant difference in BMI and LDL-C levels between the experimental group and the control group. Oral probiotics can reduce weight loss, waist circumference and visceral fat content in obese patients, which may be a potential nutritional treatment for obese patients in the future. However, whether oral probiotics can reduce BMI and LDL-C levels in obese patients needs to be included in more RCTs and further discussed in the future.

Probiotics in reducing obesity by reconfiguring the gut microbiota

Obesity, as a global health crisis, is increasingly linked to intestinal microecology. Probiotics colonise the body, effectively regulating the balance of intestinal flora, while strengthening the intestinal barrier, activating the immune response, releasing beneficial substances, and maintaining micro-ecological balance. This process not only enhances the defence against pathogens, but also reduces the production of inflammatory factors and lowers the level of chronic inflammation. However, the specific process and mechanism by which probiotics influence the intestinal microecology through the immune response, improve metabolic disorders caused by obesity, and participate in weight management are not clear. Through multiple neural pathways including the 'gut-brain axis' and their direct interaction with the intestine, probiotics increase the number of beneficial bacteria in the intestine and inhibit the growth of harmful bacteria, thus effectively restructuring the balance of the intestinal flora. This restructuring of the balance can optimise the intestinal environment and enhance the efficiency of food digestion and nutrient absorption. Probiotics show positive effects on obesity management by regulating the metabolic process and reducing fat accumulation, providing individuals with a new way to control body weight and prevent obesity. Therefore, the application of probiotics is of great significance in promoting gut health and weight management.

Clinically Effective Molecules of Natural Origin for Obesity Prevention or Treatment

The prevalence and incidence of obesity and the comorbidities linked to it are increasing worldwide. Current therapies for obesity and associated pathologies have proven to cause a broad number of adverse effects, and often, they are overpriced or not affordable for all patients. Among the alternatives currently available, natural bioactive compounds stand out. These are frequently contained in pharmaceutical presentations, nutraceutical products, supplements, or functional foods. The clinical evidence for these molecules is increasingly solid, among which epigallocatechin-3-gallate, ellagic acid, resveratrol, berberine, anthocyanins, probiotics, carotenoids, curcumin, silymarin, hydroxy citric acid, and α-lipoic acid stand out. The molecular mechanisms and signaling pathways of these molecules have been shown to interact with the endocrine, nervous, and gastroenteric systems. They can regulate the expression of multiple genes and proteins involved in starvation-satiety processes, activate the brown adipose tissue, decrease lipogenesis and inflammation, increase lipolysis, and improve insulin sensitivity. This review provides a comprehensive view of nature-based therapeutic options to address the increasing prevalence of obesity. It offers a valuable perspective for future research and subsequent clinical practice, addressing everything from the molecular, genetic, and physiological bases to the clinical study of bioactive compounds.