What’s the latest in prebiotic research? December Edition

This monthly feature provides an overview of some of the latest studies on prebiotics. We’ll share key findings and insights from the studies. Have a study you’d like us to cover? Email GPA Communications Director Traci Kantowski traci@prebioticassociation.org.

 Gastrointestinal symptoms, gut microbiome, probiotics and prebiotics in anorexia nervosa: A review of mechanistic rationale and clinical evidence

Research related to the gut microbiome and the gut brain access has exponentially increased our understanding of the role the microbiome and anything that alters it may play in mental health. Due to this research hypotheses and evidence have been presented for the role of the microbiome in the development and maintenance of Anorexia Nervosa (AN) and other eating disorders. Among the different eating disorders AN is studied the most to test this relationship due to the profound impact the extreme energy restriction and the refeeding have on gastrointestinal health. This review “collates evidence for the potential role of gut microbiota in AN, including modulation of the immune system, the gut-brain axis and GI function”. Additionally, some evidence indicates that pre-morbid gut microbiota may influence risk of developing AN. There is evidence of gut dysbiosis in AN with some similarities of microbiota seen in AN and IBD. Probiotics have been used in some GI disorders and in mental health illnesses such as depression and anxiety with some studies showing improvement in symptoms. Less is known about prebiotics, but the mechanism of action suggests a potential benefit. Therefore, the use of probiotics in AN should theoretically be a helpful adjunct to nutritional rehabilitation with the potential to mitigate GI symptoms and improve immune responses. This is a very new area of research that deserves attention.

Key takeaways.

  • AN appears to have similarities to other GI disorders and to mental health disorders where the mechanism of action of gut microbiota has been postulated in relation to pathology and gut symptoms
  • The use of probiotics has been shown to have some effect.
  • Less is known about the potential benefit of prebiotics but the mechanism of action supports a hypothesis that prebiotics may also be a helpful adjunct to nutritional treatment of AN

Access the study: https://www.sciencedirect.com/science/article/pii/S0306453022003006

Reference. Dhopatkar N, Keeler JL, Mutwalli H, Whelan K, Treasure J, Himmerich H. Gastrointestinal symptoms, gut microbiome, probiotics and prebiotics in anorexia nervosa: A review of mechanistic rationale and clinical evidence. Psychoneuroendocrinology. 2023 Jan;147:105959. doi: 10.1016/j.psyneuen.2022.105959. Epub 2022 Oct 21. PMID: 36327759.

The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials

A systematic review, meta-analyses and meta-regressions were conducted to investigate the effect of probiotics, prebiotics, and synbiotics on various biomarkers of glucose homeostasis based on a multi-database search of clinical trials published through April 10, 2022. Data from 68 trial comparisons across 58 studies (n = 3835) in a pooled analysis revealed that, compared to placebo/control group, administration of pro/pre/synbiotics was associated with statistically significant changes in fasting plasma glucose, HbA1c, and fasting insulin. The potential effect of prebiotics only (− 0.45%; assessed by 12 trials) and multispecies synbiotics only (− 0.57%; assessed by 8 trials) on HbA1c were slightly more promising. Although also statistically significant, the effects on HbA1c from multispecies probiotics (MD: − 0.28% [95% CI:− 0.36; − 0.19], p effect <0.0001) did not reach this threshold of clinical significance. The authors conclude that Pro/pre/synbiotic supplementation improved glucose homeostasis in diabetic patients. Our results support their potential use as adjunct therapy for improving glycemia and insulinemia alongside pharmacological therapeutics.

Key takeaways:

  • Pro/pre/synbiotic supplementation improved glucose homeostasis in diabetic patients
  • Prebiotics and synbiotics had a more clinically significant effect on HbA1c than probiotics
  • Studies between 8 and 12 weeks showed the best results suggesting a potential optimum duration of supplementation

Access the study https://pubmed.ncbi.nlm.nih.gov/36272640/

Reference Paul P, Kaul R, Harfouche M, Arabi M, Al-Najjar Y, Sarkar A, Saliba R, Chaari A. The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials. Pharmacol Res. 2022 Nov;185:106520. doi: 10.1016/j.phrs.2022.106520. Epub 2022 Oct 20. PMID: 36272640.

Microbial effects of prebiotics, probiotics and synbiotics after Caesarean section or exposure to antibiotics in the first week of life: A systematic review

This systematic review aimed to summarize the evidence regarding the effects of prebiotics, probiotics and synbiotics on the intestinal microbiota composition of term infants born by Caesarean section or exposed to antibiotics in the first week of life. A systematic search was conducted of studies through August 2022. 12 randomized controlled trials which included term-born infants who were born following Caesarean section or who were exposed to postpartum antibiotics in the first week of life, pre-, pro- or synbiotics were administered &lt;6 weeks after birth and outcome(s) consisted of microbiota analyses were included. Supplementation significantly increased the abundance of the supplemented bacterial species (of the Bifidobacterium and Lactobacillus genus), and there was a decrease in Enterobacteriaceae, especially &lt;4 weeks of age. At phylum level, Actinobacteria (two studies), Proteobacteria (one study) and Firmicutes (one study) increased after probiotic supplementation. In three studies on prebiotics, two studies reported a significant increase in Bifidobacteria and one study found a significant increase in Enterobacteriaceae.

Key takeaway:

  • Supplementation of pre-, pro- or synbiotics in Caesarean-born infants and infants who received antibiotics early in life mostly increased the phyla, families, genera and species that corresponded to the pro- or synbiotic intervention that was administered.
  • Supplementation of these at-risk children to restore the microbiota to a composition more similar to vaginally born infants (i.e. predominant colonisation by Bifidobacteria and Lactobacilli) may alleviate some of the negative consequences of a disrupted microbiota.

 Access the study: https://pubmed.ncbi.nlm.nih.gov/36350926/

Reference Carpay NC, Kamphorst K, de Meij TGJ, Daams JG, Vlieger AM, van Elburg RM. Microbial effects of prebiotics, probiotics and synbiotics after Caesarean section or exposure to antibiotics in the first week of life: A systematic review. PLoS One. 2022 Nov 9;17(11):e0277405. doi: 10.1371/journal.pone.0277405. PMID: 36350926; PMCID: PMC9645654.