Probiotic With or Without Fiber Controls Body Fat Mass, Associated With Serum Zonulin, in Overweight and Obese Adults-Randomized Controlled Trial.
BACKGROUND
The gut microbiota is interlinked with obesity, but direct evidence of effects of its modulation on body fat mass is still scarce. We investigated the possible effects of Bifidobacterium animalisssp. lactis 420 (B420) and the dietary fiber Litesse® Ultra polydextrose (LU) on body fat mass and other obesity-related parameters.


METHODS
225 healthy volunteers (healthy, BMI 28-34.9) were randomized into four groups (1:1:1:1), using a computer-generated sequence, for 6months of double-blind, parallel treatment: 1) Placebo, microcrystalline cellulose, 12g/d; 2) LU, 12g/d; 3) B420, 1010CFU/d in microcrystalline cellulose, 12g/d; 4) LU+B420, 12g+1010CFU/d. Body composition was monitored with dual-energy X-ray absorptiometry, and the primary outcome was relative change in body fat mass, comparing treatment groups to Placebo. Other outcomes included anthropometric measurements, food intake and blood and fecal biomarkers. The study was registered in Clinicaltrials.gov (NCT01978691).


RESULTS
There were marked differences in the results of the Intention-To-Treat (ITT; n=209) and Per Protocol (PP; n=134) study populations. The PP analysis included only those participants who completed the intervention with >80% product compliance and no antibiotic use. In addition, three participants were excluded from DXA analyses for PP due to a long delay between the end of intervention and the last DXA measurement. There were no significant differences between groups in body fat mass in the ITT population. However, LU+B420 and B420 seemed to improve weight management in the PP population. For relative change in body fat mass, LU+B420 showed a-4.5% (-1.4kg, P=0.02, N=37) difference to the Placebo group, whereas LU (+0.3%, P=1.00, N=35) and B420 (-3.0%, P=0.28, N=24) alone had no effect (overall ANOVA P=0.095, Placebo N=35). A post-hoc factorial analysis was significant for B420 (-4.0%, P=0.002 vs. Placebo). Changes in fat mass were most pronounced in the abdominal region, and were reflected by similar changes in waist circumference. B420 and LU+B420 also significantly reduced energy intake compared to Placebo. Changes in blood zonulin levels and hsCRP were associated with corresponding changes in trunk fat mass in the LU+B420 group and in the overall population. There were no differences between groups in the incidence of adverse events.


CONCLUSIONS
This clinical trial demonstrates that a probiotic product with or without dietary fiber controls body fat mass. B420 and LU+B420 also reduced waist circumference and food intake, whereas LU alone had no effect on the measured outcomes.
Global Health and Nutrition Science, DuPont Nutrition & Health, FI-02460 Kantvik, Finland. Electronic address: lotta.stenman@dupont.com.
Lotta K
LK
Stenman
Global Health and Nutrition Science, DuPont Nutrition & Health, FI-02460 Kantvik, Finland.
Markus J
MJ
Lehtinen
Smerud Medical Research, N-0212 Oslo, Norway.
Nils
N
Meland
Vaiomer S.A.S, FR-31670 Labège, France.
Jeffrey E
JE
Christensen
Global Health and Nutrition Science, DuPont Nutrition & Health, FI-02460 Kantvik, Finland.
Nicolas
N
Yeung
Global Health and Nutrition Science, DuPont Nutrition & Health, FI-02460 Kantvik, Finland.
Markku T
MT
Saarinen
Vaiomer S.A.S, FR-31670 Labège, France.
Michael
M
Courtney
Vaiomer S.A.S, FR-31670 Labège, France.
Rémy
R
Burcelin
FinnMedi, FI-33520 Tampere, Finland.
Marja-Leena
ML
Lähdeaho
Kerava Health Centre, FI-04200 Kerava, Finland.
Jüri
J
Linros
VL-Medi, FI-00101 Helsinki, Finland.
Dan
D
Apter
Clinical Research Services Turku, FI-20520 Turku, Finland.
Mika
M
Scheinin
Smerud Medical Research, N-0212 Oslo, Norway.
Hilde
H
Kloster Smerud
Obesity Research Unit, University of Helsinki, FI-00290 Helsinki, Finland.
Aila
A
Rissanen
Global Health and Nutrition Science, DuPont Nutrition & Health, FI-02460 Kantvik, Finland.
Sampo
S
Lahtinen
D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D015415:Biomarkers; D001823:Body Composition; D015992:Body Mass Index; D002772:Cholera Toxin / Q000097:blood*; D004043:Dietary Fiber; D005260:Female; D000069196:Gastrointestinal Microbiome; D006242:Haptoglobins; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000178:diet therapy* / Q000473:pathology; D050177:Overweight / Q000097:blood* / Q000178:diet therapy* / Q000473:pathology; D019936:Probiotics; D011498:Protein Precursors; D016896:Treatment Outcome; D055105:Waist Circumference
D015415:Biomarkers; D004043:Dietary Fiber; D006242:Haptoglobins; D011498:Protein Precursors; C408043:zonulin; D002772:Cholera Toxin
Clinical trial; Fiber; Obesity; Prebiotic; Probiotic; Synbiotic