Synbiotic as an ameliorating factor in the health-related quality of life in women with polycystic ovary syndrome. A randomized, triple-blind, placebo-controlled trial

Polycystic ovary syndrome (PCOS) is a chronic endocrine disorder that is prevalent among reproductive-aged women and can have a tremendous impact on their quality of life. PCOS symptoms can include amenorrhea, oligomenorrhea, polymenorrhea, delayed ovulation, anovulation, infertility, weight gain, obesity, acne, alopecia, and hirsutism. PCOS is a risk factor for endometrial cancer, and women who suffer from PCOS are more likely to exhibit mental and behavioural disorders such as depression, anxiety, panic attacks, eating disorders, bipolar disorder, mood swings, and psychosis. There is a suggestive relationship between gut health and PCOS. Notably, a defective microbiome can influence PCOS progression through hyperandrogenism, gut-brain axis disorder, impaired epithelial receptor-mediated signalling, and increased secretion of inflammatory cytokines. This study aimed to evaluate the effects of synbiotics on overall health (physical and mental) and stress levels in life-facing situations in women diagnosed with PCOS. Study participants received 2 g of synbiotic sachets containing fructooligosaccharide (FOS) and Bacillus coagulans GBI-30, Lactobacillus rhamnosus, Lactobacillus helveticus, or placebo sachets daily for a 12-week duration. 52 participants completed Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ-26), 12-Item Short-Form Health Survey (SF-12), and Perceived Stress Scale (PSS-10) prior to and after completion of the study. The PCOSQ-26 scores showed that synbiotic supplementation significantly improved emotional, body hair, weight, and infertility domains when compared with the placebo group. The physical score within SF-12 also showed a significant enhancement. There were no significant improvements seen in the PSS-10 score at the end of the trial. These findings suggest that supplementation with synbiotics has an advantageous effect on the health-related quality of life in women suffering from PCOS.

Key takeaways:

• Women that have PCOS suffer from a variety of symptoms that can impact physical, emotional, and mental well-being.
• Previous studies suggest a relationship between the gut microbiome and PCOS.
• This study supports the use of synbiotics (FOS, Bacillus coagulans GBI-30, Lactobacillus rhamnosus, and Lactobacillus helveticus) for managing health-related quality of life factors in women diagnosed with PCOS.

Access the study: https://pubmed.ncbi.nlm.nih.gov/38172876/

Reference: Hariri, Z., Yari, Z., Hoseini, S., Abhari, K., & Sohrab, G. (2024). Synbiotic as an ameliorating factor in the health-related quality of life in women with polycystic ovary syndrome. A randomized, triple-blind, placebo-controlled trial. BMC women’s health, 24(1), 19. https://doi.org/10.1186/s12905-023-02868-1

Modulating a prebiotic food source influences inflammation and immune-regulating gut microbes and metabolites: insights from the BE GONE trial

It has been well established that the consumption of dietary fibre and protein influences the gastrointestinal microbiota. Prebiotic foods are proven to provide numerous health benefits and patient outcomes such as managing obesity-related cardiometabolic conditions, inflammation, and immunity. Dry beans are comprised of indigestible oligosaccharides that increase the growth of beneficial gut bacteria and prevent the development of pathogens. However, beans are not regularly consumed within the typical United States diet. Disruptions in normal microbial balance in patients with obesity, poor diet, and colorectal neoplasia have been observed. Poor diets continually impact the gut microbiome balance and may attribute to further illness. Therefore, modulating the microbiome through diet presents a challenging but promising alternative for the management of high-risk patients. This study aimed to observe the effects of an 8-week addition of navy bean consumption in obese patients with a history of colorectal neoplasia through a low-risk, non-invasive dietary intervention trial, the Beans to Enrich the Gut microbiome vs. Obesity’s Negative Effects (BE GONE) trial. Fifty-five participants were randomized to continue their usual diet without beans or to add a daily cup of study beans to their usual diet, with an immediate crossover after 8-weeks. Stool and fasting blood samples were collected and changes in gut microbiome, circulating markers, and metabolites were assessed. Significant increases in Faecalibacterium, Eubacterium, and Bifidobacterium were observed, indicating prebiotic efficacy. Metabolite samples showed significant changes in nutrient and microbiome-derived metabolites such as increased pipecolic acid and decreased indole that regressed when patients returned to their usual diet. No significant changes were observed in circulating lipoproteins after eight weeks of intervention; however, proteomic biomarkers of intestinal and systemic inflammatory response showed an increase in fibroblast growth factor-19 and a decrease in interleukin-10 receptor-α. These findings suggest that the daily addition of beans to the diet may enhance the gut microbiome and regulate patient markers associated with metabolic obesity and colorectal cancer in high-risk patients.

Key takeaways:

• Prebiotic foods are proven to increase the growth of healthy gut bacteria and inhibit the growth of pathogenic bacteria, which can decrease inflammation and improve immune-related functions.
• High-risk patients suffering from obesity and/or colorectal neoplasia, in combination with poor diet, can be at risk of further illness.
• This study supports the use of prebiotics (navy beans) for improving the gut microbiome and regulating patient markers associated with metabolic obesity and colorectal cancer in high-risk patients.

Access the study: https://pubmed.ncbi.nlm.nih.gov/38040541/

Reference: Zhang, X., Irajizad, E., Hoffman, K.L., Fahrmann, J.F., Li, F., Seo, Y.D., Browman, G.J., Dennison, J.B., Vykoukal, J., Luna, P.N., Siu, W., Wu, R., Murage, E., Ajami, N.J., McQuade, J.L., Wargo, J.A., Long, J.P., Do, K.A., Lampe, J.W., Basen-Engquist, K.M., & Daniel, C.R. (2023). Modulating a prebiotic food source influences inflammation and immune-regulating gut microbes and metabolites: insights from the BE GONE trial. EBioMedicine, 98, 104873. https://doi.org/10.1016/j.ebiom.2023.104873

Prebiotic diet changes neural correlates of food decision-making in overweight adults: a randomised controlled within-subject cross-over trial

High-caloric food cravings and unhealthy eating are critical factors when it comes to managing obesity. The consumption of plant-based diets containing prebiotics has been associated with brain modulation functions such as feeding and psychological functioning via the microbiota-gut-brain axis. Previous studies have shown that microbiota-derived metabolites are able to cross the blood-brain barrier and modulate hypothalamic signalling. This suggests that inulin-type fructans and short-chain fatty acids (SCFA) such as butyrate can lower body weight, restore obesity-induced functional brain changes, modulate hypothalamic-pituitary-adrenal axis-dependent stress-induced cortisol responses, reduce subjective hunger, and improve gut hormonal-driven appetite regulation. This is achieved through changes in the appetite-related peptides, postprandial glucagon-like peptide (GLP)-1, neuropeptide y (PYY)13 and ghrelin. This study aimed to evaluate the effects of a high-dose prebiotic fibre intervention on the gut microbiome and neural activation patterns of food reward in populations at risk of weight gain and insulin resistance. A randomized clinical trial was conducted in 59 overweight, healthy adults (18-42 years). Study participants received 30 g of supplemental inulin per day or placebo for a two-week duration and underwent functional task MRI testing before and upon completion of the study. Samples of faeces and blood serum were collected and analyzed throughout the study. The prebiotic group showed significant decreased brain activation towards high-caloric “wanted” food stimuli in the ventral tegmental area and right orbitofrontal cortex. Fasting blood levels observed no difference; however, 16S-rRNA sequencing showed significant shifts in the microbiome towards an increase in SCFA-producing Bifidobacteriaceae, and changes predicted functional signalling pathways after the prebiotic intake. Modifications in brain activation were observed to be correlated with changes in Actinobacteria microbial abundance and associated activity previously linked with SCFA production, such as ABC transporter metabolism. These findings suggest that prebiotic intervention decreased brain responses to high-caloric food cues during food decision-making and created shifts in the gut microbiota.

Key takeaways:

• Obesity concerns are often linked to high-caloric food cravings and unhealthy eating.
• Evidence suggests that prebiotics can lower body weight, restore obesity-induced functional brain changes, modulate hypothalamic-pituitary-adrenal axis-dependent stress-induced cortisol responses, reduce subjective hunger, and improve gut hormonal-driven appetite regulation.
• This study supports the use of prebiotics (inulin) for reducing reward-related brain activation in response to high-caloric food stimuli.

Access the study: https://pubmed.ncbi.nlm.nih.gov/37793780/

Reference: Medawar, E., Beyer, F., Thieleking, R., Haange, S.B., Rolle-Kampczyk, U., Reinicke, M., Chakaroun, R., von Bergen, M., Stumvoll, M., Villringer, A., & Witte, A. V. (2024). Prebiotic diet changes neural correlates of food decision-making in overweight adults: a randomised controlled within-subject cross-over trial. Gut, 73(2):298-310. https://doi.org/10.1136/gutjnl-2023-330365

Prebiotic and Probiotic: A Promising Tool in Human Colon Cancer Prevention

Prebiotics and probiotics are used globally for the prevention and management of human diseases, including cancer. The risk of developing cancer depends on many factors, including the body’s immune response and genetics. Previous studies have established that probiotics support the immune system, improve intestinal health, and reduce the incidence of colon cancer. Research has also shown that fibre-enriched diets with prebiotic activity increases the growth of beneficial bacteria, which can be associated with the prevention of colorectal cancer. This in vitro study aimed to investigate the effects of probiotics (Enterococcus faecium) and prebiotics (glucan and mannan of yeast Saccharomyces cerevisiae cell wall) on the proliferation and immune response genes of human colon cancer Caco-2 cells. The adhesion between probiotics, prebiotics, and Caco-2 cells were measured by plate count agar technique and confocal microscope, estimation of mucin expression by measuring (MUC-2gene), estimation of cytokine expression by measuring interleukin 6, 8, 10 (IL6, IL8, IL10), CXCL1, and tumor necrosis factor (TNF) genes. The results of the confocal microscope indicated beneficial properties of probiotics and prebiotics in modulating the proliferation and apoptosis of cancer cells. These results indicate that the Enterococcus faecium probiotic strain induced elevation on the expression of cxcl1 and IL10 genes and decreased the expression of IL6, IL8, MUC, and TNF genes. Whereas the glucan and mannan of Saccharomyces cerevisiae cell wall induced elevation in the expression of IL6, and MUC genes and decreased the expression of cxcl1, IL8, IL10, and TNF genes. Synbiotic combination of the probiotic and prebiotic induced elevation in the expression of cxcl1, and MUC genes and decreased the expression of IL6, IL8, IL10, and TNF genes. These findings suggest that the Enterococcus faecium probiotic strain is effective at decreasing the proliferation of cancer cells and has a protective effect against cancer, and that the synbiotic combination of Enterococcus faecium and glucan and mannan of yeast Saccharomyces cerevisiae cell wall exhibits protective properties, but further studies involving the synbiotic are encouraged.

Key takeaways:

• Prebiotic and probiotics are frequently used for the prevention and management of many illnesses, including cancer.
• Previous research has established immune, intestinal health, and risk of colon and colorectal cancer mitigation properties exhibited by prebiotics and probiotics.
• This in vitro study supports the use of Enterococcus faecium probiotic for decreasing the risk of cancer and encourages further investigations of the health properties of Enterococcus faecium and glucan and mannan on Saccharomyces cerevisiae cell wall synbiotic.

Access the study: https://ejvs.journals.ekb.eg/article_329432.html

Reference: Bashir, S.K., El Moghazy, G.M., Abdel Aal, M.H., & El Jakee, J.K. (2024). Prebiotic and Probiotic: A Promising Tool in Human Colon Cancer Prevention. Egyptian Journal of Veterinary Sciences, 55(3):817-824. https://doi.org/10.21608/ejvs.2023.238590.1626