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Li YK, Xiao CL, Ren H, Li WR, Guo Z, Luo JQ. Comparison of the effectiveness of probiotic supplementation in glucose metabolism, lipid profile, inflammation and oxidative stress in pregnant women. Food Funct 2024; 15:3479-3495. [PMID: 38456359 DOI: 10.1039/d3fo04456d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
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.
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Affiliation(s)
- Yi-Ke Li
- Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha 410011, China
- Institute of Clinical Pharmacy, Central South University, Changsha 410011, China.
| | - Chen-Lin Xiao
- Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha 410011, China
- Institute of Clinical Pharmacy, Central South University, Changsha 410011, China.
| | - Huan Ren
- Department of Pharmacy, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, China
| | - Wen-Ru Li
- Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha 410011, China
- Institute of Clinical Pharmacy, Central South University, Changsha 410011, China.
| | - Zhen Guo
- Hunan Provincial Key Laboratory of the Fundamental and Clinical Research on Functional Nucleic Acid, Changsha Medical University, Changsha 410219, China
| | - Jian-Quan Luo
- Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha 410011, China
- Institute of Clinical Pharmacy, Central South University, Changsha 410011, China.
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Houttu N, Vahlberg T, Miles EA, Calder PC, Laitinen K. The impact of fish oil and/or probiotics on serum fatty acids and the interaction with low-grade inflammation in pregnant women with overweight and obesity: secondary analysis of a randomised controlled trial. Br J Nutr 2024; 131:296-311. [PMID: 37642166 PMCID: PMC10751948 DOI: 10.1017/s0007114523001915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/10/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
N-3 long-chain PUFA (LC-PUFA) and probiotics are generally considered to induce health benefits. The objective was to investigate (1) the impact of fish oil and/or probiotics on serum fatty acids (sFA), (2) the interaction of sFA with low-grade inflammation and (3) the relation of sFA to the onset of gestational diabetes mellitus (GDM). Pregnant women with overweight/obesity were allocated into intervention groups with fish oil + placebo, probiotics + placebo, fish oil + probiotics or placebo + placebo in early pregnancy (fish oil: 1·9 g DHA and 0·22 g EPA, probiotics: Lacticaseibacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 CFU, each daily). Blood samples were collected in early (n 431) and late pregnancy (n 361) for analysis of fatty acids in serum phosphatidylcholine (PC), cholesteryl esters (CE), TAG and NEFA with GC and high-sensitivity C-reactive protein and GlycA by immunoassay and NMR spectroscopy, respectively. GDM was diagnosed according to 2 h 75 g oral glucose tolerance test. EPA in PC, CE and TAG and DHA in PC, CE, TAG and NEFA were higher in fish oil and fish oil + probiotics groups compared with placebo. EPA in serum NEFA was lower in women receiving probiotics compared with women not receiving. Low-grade inflammation was inversely associated with n-3 LC-PUFA, which were related to an increased risk of GDM. Fish oil and fish oil + probiotics consumption increase serum n-3 LC-PUFA in pregnant women with overweight/obesity. Although these fatty acids were inversely related to inflammatory markers, n-3 LC-PUFA were linked with an increased risk for GDM.
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Affiliation(s)
- Noora Houttu
- Institute of Biomedicine, Integrative Physiology and Pharmacology Unit, University of Turku, 20520Turku, Finland
| | - Tero Vahlberg
- Department of Clinical Medicine, Biostatistics, University of Turku, 20520Turku, Finland
| | - Elizabeth A. Miles
- School of Human Development and Health, Faculty of Medicine, University of Southampton, SouthamptonSO16 6YD, UK
| | - Philip C. Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, SouthamptonSO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, SouthamptonSO16 6YD, UK
| | - Kirsi Laitinen
- Institute of Biomedicine, Integrative Physiology and Pharmacology Unit, University of Turku, 20520Turku, Finland
- Department of Obstetrics and Gynaecology, Turku University Hospital, 20500Turku, Finland
- Functional Foods Forum, University of Turku, Turku, Finland
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Soukka J, Polari L, Kalliomäki M, Saros L, Laajala TD, Vahlberg T, Toivola DM, Laitinen K. The Effect of a Fish Oil and/or Probiotic Intervention from Early Pregnancy Onwards on Colostrum Immune Mediators: A Randomized, Placebo-Controlled, Double-Blinded Clinical Trial in Overweight/Obese Mothers. Mol Nutr Food Res 2023; 67:e2200446. [PMID: 37326413 DOI: 10.1002/mnfr.202200446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 04/23/2023] [Indexed: 06/17/2023]
Abstract
SCOPE Modifying the composition of colostrum by external factors may provide opportunities to improve the infant's health. Here, we evaluated how fish oil and/or probiotics supplementation modify concentrations of colostrum immune mediators and their associations with perinatal clinical factors on mothers with overweight/obesity. METHODS AND RESULTS Pregnant women were randomized in a double-blind manner into four intervention groups, and the supplements were consumed daily from early pregnancy onwards. Colostrum samples were collected from 187 mothers, and 16 immune mediators were measured using bead-based immunoassays. Interventions modified colostrum composition; the fish oil+probiotics group had higher concentrations of IL-12p70 than probiotics+placebo and higher FMS-like tyrosine kinase 3 ligand (FLT-3L) than fish oil+placebo and probiotics+placebo (one-way analysis of variance, post-hoc Tukey's test). Although the fish oil+probiotics group had higher levels of IFNα2 compared to the fish oil+placebo group, these differences were not statistically significant after correction for multiple testing. Multivariate linear model revealed significant associations between several immune mediators and the perinatal use of medication. CONCLUSION Fish oil/probiotics intervention exerted a minor effect on concentrations of colostrum immune mediators. However, medication during the perinatal period modulated the immune mediators. These changes in colostrum's composition may contribute to immune system development in the infant.
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Affiliation(s)
- Jenni Soukka
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Kiinamyllynkatu 10, Turku, FI-20520, Finland
| | - Lauri Polari
- Department of Biosciences, Cell Biology, Faculty of Science and Engineering, Åbo Akademi University, Turku, FI-20520, Finland
- InFLAMES Research Flagship Center, Turku, FI-20520, Finland
| | - Marko Kalliomäki
- Department of Pediatrics, University of Turku, Turku, FI-20521, Finland
- Department of Pediatrics, Turku University Hospital, Turku, FI-20521, Finland
| | - Lotta Saros
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, FI-20520, Finland
| | - Teemu D Laajala
- Biomathematics Research Group, Fican West Cancer Centre, University of Turku, Turku, FI-20500, Finland
- Department of Mathematics and Statistics, University of Turku, Turku, FI-20014, Finland
| | - Tero Vahlberg
- Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, FI-20014, Finland
| | - Diana M Toivola
- Department of Biosciences, Cell Biology, Faculty of Science and Engineering, Åbo Akademi University, Turku, FI-20520, Finland
- InFLAMES Research Flagship Center, Turku, FI-20520, Finland
| | - Kirsi Laitinen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, FI-20520, Finland
- Functional Foods Forum, University of Turku, Turku, FI-20014, Finland
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Deng YF, Wu LP, Liu YP. Probiotics for preventing gestational diabetes in overweight or obese pregnant women: A review. World J Clin Cases 2022; 10:13189-13199. [PMID: 36683622 PMCID: PMC9851018 DOI: 10.12998/wjcc.v10.i36.13189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/12/2022] [Accepted: 12/08/2022] [Indexed: 12/26/2022] Open
Abstract
Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. Specific probiotics or probiotic foods can be used to reduce the risk of diseases associated with aberrant gut microbiota composition. The incidence of gestational diabetes mellitus (GDM) has increased annually with the proportion of overweight and obese people. Overweight or obese pregnant women are at high risk of GDM and have obvious changes in gut microbiota compared with normal-weight pregnant women. Specific probiotics or probiotic foods may alter gut microbiota in overweight or obese pregnant women and inhibit the expression of inflammatory factors, consequently resulting in weight loss and reduced insulin resistance. This review discusses the mechanism of probiotics on GDM, as well as the dose, method and duration of probiotics use, and summarizes current evidence on probiotics in improving glucose metabolism and other maternal and infant outcomes in overweight/obese pregnant women.
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Affiliation(s)
- Ya-Fang Deng
- Chinese Academy of Medical Sciences and Peking Union Medical College, School of Nursing, Beijing 100730, China
| | - Li-Ping Wu
- Chinese Academy of Medical Sciences and Peking Union Medical College, School of Nursing, Beijing 100730, China
| | - Yan-Ping Liu
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
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Trifkovič KČ, Mičetić-Turk D, Kmetec S, Strauss M, Dahlen HG, Foster JP, Fijan S. Efficacy of Direct or Indirect Use of Probiotics for the Improvement of Maternal Depression during Pregnancy and in the Postnatal Period: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10060970. [PMID: 35742022 PMCID: PMC9223194 DOI: 10.3390/healthcare10060970] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 12/21/2022] Open
Abstract
The mother and infant form a unique bond, with maternal mental health affecting the interactions with the infant and infant behaviours impacting maternal mental health. One of the possible mechanisms influencing maternal mental health is the manipulation of the gut-brain axis by consuming probiotic supplements. Probiotics can also have an indirect influence on maternal mental health via the modulation of the infant microbiome and consequently improving the infant’s health and thus, indirectly leading to an improvement in maternal mood. This systematic review evaluated the efficacy of probiotics on maternal mental health by searching for randomised controlled trials via international databases: Cochrane Library, PubMed, Scopus, ScienceDirect, and Web of Science until January 2022. A meta-analysis was performed using the Cochrane Collaboration methodology where possible. We found seven clinical trials that included the word probiotics and addressed maternal depression and/or anxiety. Of these, five trials investigated the influence of maternal probiotic supplementation on the gut-brain axis. Two trials investigated the indirect influence of probiotics on maternal depression via supplementation of probiotics by infants and subsequent influence on the crying of colicky infants. Meta-analysis of two studies of pregnant and postnatal women and two studies of infants consuming probiotics on the outcome of the Edinburgh Postnatal Depression Scale for mothers showed no statistical difference. The findings indicate that maternal depression is very complex and is influenced by various bidirectional factors. One of the factors that can improve maternal mental health is probiotics, however, careful consideration must be given to correct strain selection as strain-specific effectiveness was observed. Further well-designed, robust clinical studies are warranted.
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Affiliation(s)
- Klavdija Čuček Trifkovič
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (K.Č.T.); (S.K.); (M.S.)
| | - Dušanka Mičetić-Turk
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia;
| | - Sergej Kmetec
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (K.Č.T.); (S.K.); (M.S.)
| | - Maja Strauss
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (K.Č.T.); (S.K.); (M.S.)
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, University of Western Sydney, Parramatta, NSW 2751, Australia; (H.G.D.); (J.P.F.)
| | - Jann P. Foster
- School of Nursing and Midwifery, University of Western Sydney, Parramatta, NSW 2751, Australia; (H.G.D.); (J.P.F.)
- Ingham Research Institute, Liverpool, NSW 2170, Australia
- NSW Centre for Evidence Based Health Care: A JBI Affiliated Group, Parramatta, NSW 2751, Australia
| | - Sabina Fijan
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (K.Č.T.); (S.K.); (M.S.)
- Correspondence:
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Mokkala K, Gustafsson J, Vahlberg T, Vreugdenhil ACE, Ding L, Shiri-Sverdlov R, Plat J, Laitinen K. Serum CathepsinD in pregnancy: Relation with metabolic and inflammatory markers and effects of fish oils and probiotics. Nutr Metab Cardiovasc Dis 2022; 32:1292-1300. [PMID: 35304048 DOI: 10.1016/j.numecd.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Elevated circulating levels of CathepsinD (CatD) have been linked to metabolic deviations including liver inflammation. We investigated 1) whether supplementation with probiotics and/or fish oil affects CatD and 2) whether the CatD concentration would associate with gestational diabetes (GDM), low-grade inflammation, lipid metabolism, body fat % and dietary composition. METHODS AND RESULTS Overweight/obese pregnant women (n = 438) were randomized into fish oil + placebo, probiotics + placebo, fish oil + probiotics or placebo + placebo groups. Fish oil contained 1.9 g docosahexaenoic acid and 0.22 g eicosapentaenoic acid and probiotics were Lacticaseibacillusrhamnosus HN001 (formerly Lactobacillusrhamnosus HN001) and Bifidobacteriumanimalis ssp. lactis 420, 1010 colony-forming units each). Serum CatD levels were analysed by ELISA, GlycA and lipid metabolites by NMR, high sensitive C-reactive protein (hsCRP) by immunoassay, and intakes of energy yielding nutrients and n-3 and n-6 fatty acids from food diaries at both early and late pregnancy. GDM was diagnosed by OGTT. CatD concentrations did not differ between the intervention groups or by GDM status. Multivariable linear models revealed that body fat % and GlycA affected CatD differently in healthy women and those with GDM. CONCLUSION The serum CatD concentration of pregnant women was not modified by this dietary intervention. Serum CatD was influenced by two parameters, body fat and low grade inflammation, which were dependent on the woman's GDM status. CLINICAL TRIAL REG. NO: NCT01922791, clinicaltrials.gov (secondary analysis).
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Affiliation(s)
- Kati Mokkala
- Institute of Biomedicine, Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - Johanna Gustafsson
- Institute of Biomedicine, Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - Tero Vahlberg
- Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland
| | - Anita C E Vreugdenhil
- Department of Pediatrics, School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University, 6229 ER, Maastricht, the Netherlands
| | - Lingling Ding
- Department of Molecular Genetics, School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University, 6229 ER, Maastricht, the Netherlands
| | - Ronit Shiri-Sverdlov
- Department of Molecular Genetics, School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University, 6229 ER, Maastricht, the Netherlands
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University, 6229 ER, Maastricht, the Netherlands
| | - Kirsi Laitinen
- Institute of Biomedicine, Integrative Physiology and Pharmacology, University of Turku, Turku, Finland; Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.
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Impact of combined consumption of fish oil and probiotics on the serum metabolome in pregnant women with overweight or obesity. EBioMedicine 2021; 73:103655. [PMID: 34740110 PMCID: PMC8577343 DOI: 10.1016/j.ebiom.2021.103655] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND If a pregnant woman is overweight, this can evoke metabolic alterations that may have health consequences for both mother and child. METHODS Pregnant women with overweight/obesity (n = 358) received fish oil+placebo, probiotics+placebo, fish oil+probiotics or placebo+placebo from early pregnancy onwards. The serum metabolome was analysed from fasting samples with a targeted NMR-approach in early and late pregnancy. GDM was diagnosed by OGTT. FINDINGS The intervention changed the metabolic profile of the women, but the effect was influenced by their GDM status. In women without GDM, the changes in nine lipids (FDR<0.05) in the fish oil+placebo-group differed when compared to the placebo+placebo-group. The combination of fish oil and probiotics induced changes in more metabolites, 46 of the lipid metabolites differed in women without GDM when compared to placebo+placebo-group; these included reduced increases in the concentrations and lipid constituents of VLDL-particles and less pronounced alterations in the ratios of various lipids in several lipoproteins. In women with GDM, no differences were detected in the changes of any metabolites due to any of the interventions when compared to the placebo+placebo-group (FDR<0.05). INTERPRETATION Fish oil and particularly the combination of fish oil and probiotics modified serum lipids in pregnant women with overweight or obesity, while no such effects were seen with probiotics alone. The effects were most evident in the lipid contents of VLDL and LDL only in women without GDM. FUNDING State Research Funding for university-level health research in the Turku University Hospital Expert Responsibility Area, Academy of Finland, the Diabetes Research Foundation, the Juho Vainio Foundation, Janssen Research & Development, LLC.
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