Effect of probiotic and synbiotic formulations on anthropometrics and adiponectin in overweight and obese participants: A systematic review and meta-analysis of randomized controlled trials

Accumulating evidence suggests obesity and its complication are linked to gut microbiota and probiotics can affect the metabolic functions of humans. The goal of this study was to systematically review the effect of probiotic and synbiotic formulations on body mass index (BMI), total body fat, waist circumstance (WC), Waist-hip ratio (WHR), and adiponectin in overweight and obese Participants in randomized trials (RCTs). A comprehensive search performed in PubMed/MEDLINE, Cochrane and SCOPUS by two researchers, independently without language or release date restrictions up to 15th October 2019. PRISMA guidelines followed to perform this meta-analysis. The inclusion criteria were: 1) RCT design, 2) intervention by pro or synbiotic, 3) Anthropometrics and/or adiponectin levels as outcome. DerSimonian and Laird random effect model used to combine results of included studies. Thirty-two studies contained 2105 participants (n = 28-200) were analyzed in this meta-analysis. Average length of intervention in included studies was 10.18 weeks and ranged from 3 to 12 weeks. Combined results showed significant reduction in BMI (WMD: -0.25 kg/m(2); 95% CI -0.33, -0.17; 12 = 96%), total body fat (WMD: -0.75%; 95% CI -0.90, -0.61; 12 = 63%), WC (WMD: -0.99 cm; 95% CI -1.33, -0.66; 12 = 92%), and WHR (WMD: -0.01; 95% CI -0.02, 0.01; 12 = 15%) in probiotic group compared to placebo. There was no significant effect on adiponectin levels by probiotic intervention (WMD: -0.01 mu g/ml; 95% CI -0.33, 0.32; 12 = 90%). Furthermore, meta-regression showed significant relation between duration of intervention and reduction of BMI (coef = -0.1533, p < 0.001) and WC (coef = -0.7131, p < 0.001). The combined results showed reduction in BMI, body fat, WC, and WHR in overweight and obese patients by supplementation with probiotics or synbiotics. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of King Saud University.