title: Hypocaloric diet supplemented with probiotic cheese improves body mass index and blood pressure indices of obese hypertensive patients--a randomized double-blind placebo-controlled pilot study.
abstract: BACKGROUND
  Gut lactobacilli can affect the metabolic functions of healthy humans. We tested whether a 1500 kcal/d diet supplemented with cheese containing the probiotic Lactobacillus plantarum TENSIA (Deutsche Sammlung für Mikroorganismen, DSM 21380) could reduce some symptoms of metabolic syndrome in Russian adults with obesity and hypertension.
  
  
  METHODS
  In this 3-week, randomized, double-blind, placebo-controlled, parallel pilot study, 25 subjects ingested probiotic cheese and 15 ingested control cheese. Fifty grams of each cheese provided 175 kcal of energy. Blood pressure (BP), anthropometric characteristics, markers of liver and kidney function, metabolic indices (plasma glucose, lipids, and cholesterol), and urine polyamines were measured. Counts of fecal lactobacilli and L. plantarum TENSIA were evaluated using molecular methods. The data were analyzed by t-test for independent samples and Spearman's partial correlation analysis.
  
  
  RESULTS
  The probiotic L. plantarum TENSIA was present in variable amounts (529.6 ± 232.5 gene copies) in 16/25 (64%) study subjects. Body mass index (BMI) was significantly reduced (p = 0.031) in the probiotic cheese group versus the control cheese group. The changes in BMI were closely associated with the water content of the body (r = 0.570, p = 0.0007) when adjusted for sex and age. Higher values of intestinal lactobacilli after probiotic cheese consumption were associated with higher BMI (r = 0.383, p = 0.0305) and urinary putrescine content (r = 0.475, p = 0.006). In patients simultaneously treated with BP-lowering drugs, similar reductions of BP were observed in both groups. A positive association was detected between TENSIA colonization and the extent of change of morning diastolic BP (r = 0.617, p = 0.0248) and a trend toward lower values of morning systolic BP (r = -0.527, p = 0.0640) at the end of the study after adjusting for BMI, age, and sex.
  
  
  CONCLUSIONS
  In a pilot study of obese hypertensive patients, a hypocaloric diet supplemented with a probiotic cheese helps to reduce BMI and arterial BP values, recognized symptoms of metabolic syndrome.
authors.affiliation: Department of Microbiology, University of Tartu, Ravila str, 19, Tartu 50411, Estonia. marika.mikelsaar@ut.ee.
authors.forename: Khaider K
authors.initials: KK
authors.lastname: Sharafedtinov
authors.forename: Oksana A
authors.initials: OA
authors.lastname: Plotnikova
authors.forename: Ravilay I
authors.initials: RI
authors.lastname: Alexeeva
authors.forename: Tatjana B
authors.initials: TB
authors.lastname: Sentsova
authors.forename: Epp
authors.initials: E
authors.lastname: Songisepp
authors.forename: Jelena
authors.initials: J
authors.lastname: Stsepetova
authors.forename: Imbi
authors.initials: I
authors.lastname: Smidt
authors.forename: Marika
authors.initials: M
authors.lastname: Mikelsaar
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D002611:Cheese / Q000009:adverse effects / Q000032:analysis / Q000382:microbiology*; D003131:Combined Modality Therapy / Q000009:adverse effects; D004038:Diet, Reducing / Q000009:adverse effects; D004311:Double-Blind Method; D004957:Estonia; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D007777:Lactobacillaceae / Q000254:growth & development / Q000302:isolation & purification / Q000378:metabolism; D048191:Lactiplantibacillus plantarum / Q000254:growth & development* / Q000302:isolation & purification / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy* / Q000382:microbiology / Q000503:physiopathology / Q000652:urine; D008875:Middle Aged; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D010865:Pilot Projects; D019936:Probiotics / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D011700:Putrescine / Q000032:analysis / Q000378:metabolism / Q000652:urine; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents; D011700:Putrescine