Synbiotic (Pro + Pre)

AIM: To investigate effects of host- and gut microbiota (GM)-altering interventions on sarcopenia (parameters). METHODS: Upon PROSPERO registration (CRD42022347363), six databases and one registry were searched until January 5th 2024 and updated on June 10th 2025 for diet, pre-, pro-, or synbiotics mono-interventions in populations with mean age ≥ 50 years. (Standardized) mean differences (SMD) and 95% confidence intervals (CI) were computed using random-effects models if heterogeneity was > 50%. Risk of bias (Rob) & GRADE assessments were carried out to assess the evidence' quality and certainty. RESULTS: The qualitative analysis included 38 diet, 13 prebiotics, 11 probiotics and 1 synbiotics studies, totaling 4842 participants (59%♀), mostly of high RoB. The quantitative analysis included 49 studies. Probiotics improved muscle strength by 1.90 kg and gait speed by 0.08 m/s. Fiber (whole-food)-enriched diets improved muscle strength with 1.25 kg and energy-restricted diets, aimed at weight loss, improved muscle mass if mean age was < 60 years and if the intervention lasted no longer than 12 weeks. High-protein diets improved muscle mass in women and if the intervention lasted at least 12 weeks. Studies involving participants with sarcopenia were only included in the qualitative analysis, since none provided sufficient data to allow a quantitative synthesis. DISCUSSION: Fiber (whole food)-enriched diets and probiotics improve muscle strength. The latter intervention also improves gait speed. High-protein diets improve muscle mass in women and with intervention durations ≥ 12 weeks. Future studies should include fecal sampling to assess whether GM modulate the observed effects. CONCLUSION: Specific diets and probiotics offer potential to improve sarcopenia parameters. © 2025. The Author(s).

BACKGROUND: Gut microbiota modulation has been proposed as a potential intervention for managing obesity. This meta-analysis aimed to evaluate the effects of prebiotic/probiotic/synbiotic supplementation on cardiometabolic risk factors in obese pediatrics. METHODS: A systematic search was conducted up to January 2025. Randomized controlled trials (RCTs) evaluating biotics in children and adolescents with overweight/obesity were included. The outcomes were weight, body mass index (BMI), BMI-z score, fasting blood sugar (FBS), homeostatic model assessment for insulin resistance (HOMA-IR), insulin, hemoglobin A1C (HbA1c), total cholesterol (TC), triglycerides (TG), low- and high- density lipoprotein-cholesterol (LDL-C and HDL-C). Data were pooled using a random-effects model. RESULTS: Meta-analysis showed no significant effect of prebiotic/probiotic/synbiotic supplementation on weight (WMD = -0.25 kg; 95 % CI: -1.96, 1.47), BMI (WMD = -0.18 kg/m²; 95 % CI: -0.66, 0.29), BMI-z score (WMD = -0.02 unit; 95 % CI: -0.12, 0.05), FBS (WMD = -0.27 mg/dl; 95 % CI: -1.11, 0.57), insulin (WMD = 0.70 μIU/mL; 95 % CI: -1.18, 2.59), HOMA-IR (WMD = 0.24 unit; 95 % CI: -0.28, 0.75), TG (WMD = -0.73 mg/dl; 95 % CI: -7.11-8.57), TC (WMD = 0.99 mg/dl; 95 % CI: -4.24-2.25), LDL-C (WMD = 0.24 mg/dl; 95 % CI: -3.65-3.18), and HDL-C (WMD = -1.04 mg/dl; 95 % CI: -3.18-1.05). However, a significant reduction in FBS was shown with probiotics (P < 0.001). Sensitivity analysis revealed a significant decrease in BW, FBS, and HDL-C (P < 0.05). CONCLUSION: Prebiotic/probiotic/synbiotic supplementation cannot improve cardiometabolic risk factors in overweight and obese children.

BACKGROUND & AIM: The remarkable plasticity of the gut microbiome during the first three years of life offers a critical window of opportunity to influence gut health. The aim of this study is to summarize high quality evidence from randomized controlled trials on the health benefits (respiratory tract infections, diarrheal episodes, febrile days, antibiotic use, microbiome modulation and secretory IgA) of prebiotics, probiotics, synbiotics and postbiotics added to follow-on formula. METHODS: A comprehensive literature search for randomized controlled trials (RCTs) using Medline, Embase, Lilacs, and Cochrane was performed up to February 2025 (PROSPERO CRD42024500457). Only RCTs involving healthy children between six months and three years were considered. Quality assessment was done using the ROBINS II tool. Random effects models were used to obtain odd ratio (OR) and number needed to treat (NNT) via meta-analysis. RESULTS: Out of 2755 search results, 23 studies were included (n = 6984 children) with an overall low risk of bias (14/23) as assessed by the Robins II tool. The OR for respiratory tract infections in pro-,pre- and synbiotics added to a follow-on formula was 0.22 (95 % CI: 0.05-1.09; NNT = 82; CI 95 %: 67-674), 0.84 (95 % CI: 0.66-1.07; NNT = 28; 95 % CI: 11-75) and 0.75 (95 % CI: 0.54-1.05; NNT = 18; 95 % CI: 9-102), respectively. The OR for diarrheal episodes in pre- and synbiotics added to a follow-on formula 1.40 (95 % CI: 0.71-2.79; NNT = 40, 95 % CI: 10-53) and 1.26 (95 % CI: 0.96-1.66; NNT = 17, 95%CI: 8-94), respectively. For the combination of other interventions with other outcomes insufficient studies were available to perform a meta-analysis. CONCLUSION: Pre- and synbiotics may help protect against respiratory tract infection, though they do not appear to offer the same benefit for preventing diarrheal episodes. High quality evidence for the effect of biotics added to follow-on formula on health outcomes is sparse. More research is needed to confirm the observed health effects.

BACKGROUND: Poor growth is one of the major obstacles to human development, affecting millions of children under the age of 5 years, particularly those living in low- and middle-income countries (LMICs). The objective of this review was to evaluate the efficacy of administering pre-, pro- or synbiotics on the growth of children aged 0-59 months living in LMICs. METHODS: Google scholar, Pubmed, clinical trial.org and Science Direct databases were searched in April 2023 for randomised controlled trials of pre-, pro- or synbiotics that evaluated growth in under fives in LMICs. The primary outcome were weight and height gain. Secondary outcomes were head circumference, body mass index gain and Z score. Random-effects meta-analysis was used to calculate mean differences for continuous outcomes. Grading of Recommendations Assessment, Development and Evaluation criteria was used to assess certainty of the evidence. RESULTS: Eight trials involving 1375 children under 5 years of age were identified. Meta-analysis of 6 RCTs (n = 991 children) revealed a significant difference in favor of the experimental group (n = 579) compared the control group (n = 412) for weight gain: (MD = 0.33 kg, 95% CI 0.11 to 0.55); low-certainty evidence. Sub-group analysis revealed that pre-, pro, or synbiotics may be more effective in malnourished that healthy children (p = 0.003). Meta-analysis of height gain for 4 RCTs (n = 845) found that there was no significant difference between the experimental group (n = 496) and the control group (n = 349) (MD = 0.31 cm; 95% CI -0.36 to 0.98); low-certainty evidence. In sub-group analysis, prebiotics had a greater impact on height gain than synbiotics (p = 0.03). In the only study reporting an increase in head circumference (n = 32 children), this was not improved by the administration of synbiotics. However, administration of synbiotics to undernourished children significantly improved BMI gain. CONCLUSION: The evidence for the administration of pre-, pro- or synbiotics on the growth of children in LMICs is weak. Administration of pre-, pro- or synbiotics may improve weight gain in both healthy and malnourished children. Prebiotics and synbiotics ha

BACKGROUND: In recent years, pro-, pre- and synbiotics have been suggested to positively influence the growth outcomes of infants and children. However, the findings have been inconsistent. This umbrella meta-analysis was conducted to evaluate this effect. METHODS: The PubMed, Web of Science and Scopus databases were systematically searched until June 2024 to identify relevant studies. Weight gain, length gain, head circumstance (HC) gain, body mass index (BMI) as well as weight-for-height (WHZ), height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BMIAZ) Z-scores were considered as the outcomes. Standardised mean differences (SMD) along with the 95% confidence interval (CI) were utilised to estimate the overall effect size. Subgroup analyses were conducted to identify the sources of heterogeneity among the studies. RESULTS: We included 26 meta-analyses, which encompassed a total of 72 285 participants. The pooled umbrella analysis revealed positive effects of pro-, pre- and synbiotics on weight gain (SMD = 0.17, 95% CI: 0.09-0.25) and height gain (SMD = 0.10, 95% CI: 0.01-0.19) in both healthy individuals and preterm infants, although significant heterogeneity was observed across the studies (p < 0.001). Furthermore, the subgroup analyses indicated very weak evidence for an increase in BMI and WAZ following microbiome-based interventions. CONCLUSION: Supplementation with pro-, pre- and synbiotics has the potential to enhance weight and height gain in infants and children. Additional large-scale studies are needed to confirm their clinical applications. © 2025 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

AIMS: Type 2 Diabetes is intrinsically linked to cardiovascular disease (CVD) via diabetic dyslipidemia, both of which remain global health concerns with annually increasing prevalence. Given the established links between gut microbiome dysbiosis and metabolic diseases, its modulation is an attractive target to ameliorate metabolic imbalances in such patients. There is a need to quantitively summarise, analyse, and describe future directions in this field. METHODS: We conducted a systematic review, meta-analysis, and meta-regression following searches in major scientific databases for clinical trials investigating the effect of pro/pre/synbiotics on lipid profile published until April 2022. Data were pooled using random-effects meta-analysis and reported as mean differences with 95% confidence intervals (CIs). PROSPERO No. CRD42022348525. RESULTS: Data from 47 trial comparisons across 42 studies (n = 2692) revealed that, compared to placebo/control groups, the administration of pro/pre/synbiotics was associated with statistically significant changes in total cholesterol (-9.97 mg/dL [95% CI: -15.08; -4.87], p < 0.0001), low-density lipoprotein (-6.29 mg/dL [95% CI: -9.25; -3.33], p < 0.0001), high-density lipoprotein (+3.21 mg/dL [95% CI: 2.20; 4.22], p < 0.0001), very-low-density lipoprotein (-4.52 mg/dL [95% CI: -6.36; -2.67], p < 0.0001) and triglyceride (-22.93 mg/dL [95% CI: -33.99; -11.87], p < 0.001). These results are influenced by patient characteristics such as age or baseline BMI, and intervention characteristics such as dosage and duration. CONCLUSIONS: Our study shows that adjunct supplementation with a subset of pro/pre/synbiotics ameliorates dyslipidemia in diabetic individuals and has the potential to reduce CVD risk. However, widespread inter-study heterogeneity and the presence of several unknown confounders limit their adoption in clinical practice; future trials should be designed with these in mind. © 2023 John Wiley & Sons Ltd.

AIM/HYPOTHESIS: The globally escalating diabetes epidemic is responsible for significant morbidity and mortality. Microbiome-modulating nutraceuticals have been investigated for their potential to restore metabolic and floral homeostasis in type 2 diabetic patients METHODS: 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 was pooled using random effects meta-analyses and reported as mean differences with 95% confidence intervals (CIs), followed by univariate linear model meta-regression. RESULTS: Data from 68 trial comparisons across 58 studies (n = 3835) revealed that, compared to placebo/control group, administration of pro/pre/synbiotics was associated with statistically significant changes in fasting plasma glucose (-12.41 mg/dl [95% CI: -15.94; -8.88], p 0.0001), glycated hemoglobin (-0.38% [95% CI: -0.47; -0.30], p 0.0001), fasting insulin (-1.49 µU/mL [95% CI: -2.12; -0.86], p 0.0001), HOMA-IR (-0.69 [95% CI: -1.16; -0.23], p = 0.0031) and QUICKI (0.0148 [95% CI: 0.0052; 0.0244], p = 0.0025), but not C-peptide (-0.0144 ng/mL [95% CI: -0.2564; -0.2275], p = 0.9069). Age, baseline BMI, baseline biomarker value, pro/prebiotic dosage, trial duration, nutraceutical type, and recruitment region significantly affected the potential of pro/pre/synbiotics use as personalized diabetes adjunct therapy. Lastly, we discuss unexplained observations and directives for future trials, with the aim of maximizing our understanding of how microbiome-modulating nutraceuticals can treat various metabolic diseases CONCLUSIONS: 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.

OBJECTIVES: This study investigated the preventive effects of pro-, pre- and synbiotics on ventilator-associated pneumonia (VAP) among critically ill patients. METHODS: The PubMed, Web of Science, Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for relevant articles written before 19 February 2022. Only randomized controlled trials (RCTs) comparing the clinical efficacy of pro-, pre- and synbiotics with placebos or standard treatments for the prevention of incidental VAP were included. RESULTS: A total of 15 RCTs were included. Patients receiving pro-, pre- and synbiotics had a lower risk than the control group of contracting VAP (risk ratio [RR], 0.70; 95% CI, 0.57-0.85; I2 = 67%). The duration of mechanical ventilation was significantly shorter in the study group than in the control group (mean difference [MD], -1.61 days; 95% CI, -2.72 to -0.50; I2 = 86%), and the study group had a shorter duration of stay in the intensive care unit than the control group did (MD, -1.72 days; 95% CI, -3.22 to -0.23; I2 = 87%). CONCLUSIONS: Pro-, pre- and synbiotics can prevent VAP and the use of probiotics for patients who are critically ill should be supported.

BACKGROUND: The role of probiotics, prebiotics, and synbiotics in preventing asthma and other allergic diseases has been widely explored via many randomized controlled trials. However, the results on the effect of their supplementation during infancy to the incidence of allergic rhinitis or asthma, are conflicting.The study was designed to bring to light the potential effects of pro-, pre-, and synbiotics supplementation in early childhood with regard to the future occurrence of allergic diseases. METHOD: The results of randomized controlled trials were searched for in several medical data bases. The study protocol was prepared in accordance with PRISMA guidelines and applied a Revised Cochrane risk-of-bias tool for randomized trials. Two writers were designed to perform studies selection. RESULTS: Eleven randomized controlled trials, among 1659 children (525 in the probiotic group, 342 in prebiotic group, 128 in synbiotic group and 833 in control groups) were analyzed. There was no difference in asthma risk development between the groups that received probiotics or placebo. We observed lower risk of asthma in children receiving prebiotic and synbiotic than in control groups. CONCLUSION: The current study indicates that probiotics supplementation in the first months after birth does not decrease the risk of asthma development in the first years of life in high-risk children, although prebiotics and synbiotics may be the potential preventive factors that reduce the incidence of asthma in children.

In 1954, the term "probiotics" was coined by Ferdinand Vergin in his article. Although there are many clinical reports on the use of pro/synbiotics and other microbial preparations to prevent postoperative infections and related complications in patients with Colorectal cancer (CRC), their effectiveness remains divided. Therefore, we collected relevant high-quality randomized controlled trial (RCT) studies and conducted systematic review and meta-analysis. We electronically searched online databases (the PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Allied and Alternative Medieine (AMED), China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu) for literature published until December 2020. These reports were rigorously screened, and the data extracted, assessed for risk of bias (ROB), and subjected to meta-analysis and subgroup analysis. Postoperative infections were the main criteria for outcomes. Nineteen high-quality articles were included, involving 1975 patients. Compared with the control group, the pro/synbiotics group had reduced total postoperative infections ((odds ratio)OR = 0.28, 95% (confidence interval)CI: 0.20; 0.39, p < 0.0001), which included surgical site infections (SSI) (OR = 0.43, 95% CI: 0.31; 0.58, p < 0.0001) and non-surgical site infections (non-SSI) (OR = 0.28 95% CI: 0.20; 0.39, p < 0.0001).What is more, in aspects of inflammatory factors, intestinal dysbiosis, non-infectious complications, and systemic symptoms, the treatment group was better than the control group. However, there were no differences in perineal infections (OR = 0.45, 95% CI: 0.13; 1.50, p = 0.1933), celiac infections (OR = 0.54, 95% CI: 0.11; 2.66, p = 0.4471), or systemic inflammatory response syndrome (SIRS) incidence (OR = 0.63, 95% CI: 0.31; 1.30, p = 0.2139), etc. There were no differences in intervention (probiotics or synbiotics), strain type (multistrain or non-multistrain probiotics), and intervention time (administration preoperatively or pre-and-postoperatively). Pro/synbiotics can effectively prevent postoperative infections and related complications in patients with CRC. The strain type and intervention time

Background: Optimal nutrition and training regimens are essential for athletes to maximize performance and recovery. Probiotic supplementation, through the modulation of the gut microbiota, and omega-3 fatty acids, known for their anti-inflammatory properties, may enhance physiological adaptations when combined with targeted training. This study evaluated the effects of probiotics and omega-3 supplementation, alongside ultra-short race pace training (USRPT), on performance metrics in competitive sprint swimmers. Methods: In this double-blind, placebo-controlled study, 60 male sprint swimmers (age: 19.2 ± 3.6 years; height: 182.2 ± 5.2 cm; weight: 81.6 ± 4.4 kg) with a minimum of five years of training experience, were randomly assigned to six groups (n = 10 per group): (1) Control (CON), (2) USRPT only, (3) Placebo + USRPT (PLA + USRPT), (4) Probiotics + USRPT (PRO + USRPT), (5) Omega-3 + USRPT (OMEGA + USRPT), and (6) Probiotics + Omega-3 + USRPT (PRO + OMEGA + USRPT). Over the eight-week intervention, the participants in PRO + USRPT consumed one multi-strain probiotic capsule daily (4.5 × 1011 CFU) and a placebo capsule. Those in OMEGA + USRPT ingested 1000 mg of fish oil after lunch (500 mg EPA and 180 mg DHA per capsule) paired with a placebo capsule. The combined supplementation group (PRO + OMEGA + USRPT) received both probiotic and omega-3 capsules. The PLA + USRPT group consumed two starch capsules daily. The USRPT protocol was implemented across all the training groups, where the swimmers performed 17 sets of 25 m and 12.5 m sprints based on weekly recorded race times. Performance assessments included pre- and post-test measurements of sprint times (50 m and 100 m freestyle), vertical jump tests (both in water and on dry land), and other strength and endurance metrics (reaction time, agility T-test, sprint index, fatigue index, and velocity). Results: The combined intervention of probiotics and omega-3 with USRPT produced the greatest improvements in performance. The PRO + OMEGA + USRPT group reduced 50 m freestyle time by 1.92% (p = 0.002, pEta2 = 0.286) and 100 m freestyle time by 2.48% (p = 0.041, pEta2 = 0.229), demonstrating significant Time × Grou

BACKGROUND: Obesity, a multifactorial disorder with pandemic dimensions, is conceded a major culprit of morbidity and mortality worldwide, necessitating efficient therapeutic strategies. Nutraceuticals and functional foods are considered promising adjuvant/complementary approaches for weight management in individuals with obesity who have low adherence to conventional treatments. Current literature supports the weight-reducing efficacy of pro/pre/synbiotics or L-carnitine; however, the superiority of the nutraceutical joint supplementation approach over common single therapies to counter obesity and accompanying comorbidities is well documented. This study was designed to assess the effects of L-carnitine single therapy compared with L-carnitine and multistrain/multispecies synbiotic co-supplementation on anthropometric and cardiometabolic indicators in women with obesity. METHODS: The current placebo-controlled double-blind randomized clinical trial was performed on 46 women with obesity, randomly allocated to either concomitant supplementation [L-carnitine tartrate (2 × 500 mg/day) + multistrain/multispecies synbiotic (1 capsule/day)] or monotherapy [L-carnitine tartrate (2 × 500 mg/day) + maltodextrin (1 capsule/day)] groups for 8 weeks. Participants in both groups received healthy eating dietary advice. RESULTS: Anthropometric, lipid, and glycemic indices significantly improved in both intervention groups; however, L-carnitine + synbiotic co-administration elicited a greater reduction in the anthropometric measures including body mass index (BMI), body weight, and neck, waist, and hip circumferences (p < 0.001, <0.001, <0.001, = 0.012, and =0.030, respectively) after adjusting for probable confounders. Moreover, L-carnitine + synbiotic joint supplementation resulted in a greater reduction in fasting blood sugar (FBS), insulin (though marginal), and homeostatic model assessment of insulin resistance (HOMA-IR) and more increment in quantitative insulin sensitivity check index (QUICKI; p = 0.014, 0.051, 0.024, and 0.019, respectively) compared with the L-carnitine + placebo monosupplementation. No significant intergroup changes were found for the lipid profile

Comment in Gut Microbes. 2023 Dec;15(2):2262618. doi: 10.1080/19490976.2023.2262618. Synbiotics are increasingly used by the general population to boost immunity. However, there is limited evidence concerning the immunomodulatory effects of synbiotics in healthy individuals. Therefore, we conducted a double-blind, randomized, placebo-controlled study in 106 healthy adults. Participants were randomly assigned to receive either synbiotics (containing Bifidobacterium lactis HN019 1.5 × 108 CFU/d, Lactobacillus rhamnosus HN001 7.5 × 107 CFU/d, and fructooligosaccharide 500 mg/d) or placebo for 8 weeks. Immune parameters and gut microbiota composition were measured at baseline, mid, and end of the study. Compared to the placebo group, participants receiving synbiotic supplementation exhibited greater reductions in plasma C-reactive protein (P = 0.088) and interferon-gamma (P = 0.008), along with larger increases in plasma interleukin (IL)-10 (P = 0.008) and stool secretory IgA (sIgA) (P = 0.014). Additionally, synbiotic supplementation led to an enrichment of beneficial bacteria (Clostridium_sensu_stricto_1, Lactobacillus, Bifidobacterium, and Collinsella) and several functional pathways related to amino acids and short-chain fatty acids biosynthesis, whereas reduced potential pro-inflammatory Parabacteroides compared to baseline. Importantly, alternations in anti-inflammatory markers (IL-10 and sIgA) were significantly correlated with microbial variations triggered by synbiotic supplementation. Stratification of participants into two enterotypes based on pre-treatment Prevotella-to-Bacteroides (P/B) ratio revealed a more favorable effect of synbiotic supplements in individuals with a higher P/B ratio. In conclusion, this study suggested the beneficial effects of synbiotic supplementation on immune parameters, which were correlated with synbiotics-induced microbial changes and modified by microbial enterotypes. These findings provided direct evidence supporting the personalized supplementation of synbiotics for immunomodulation.

Synbiotic 2000, a pre + probiotic, reduced comorbid autistic traits and emotion dysregulation in attention deficit hyperactivity disorder (ADHD) patients. Immune activity and bacteria-derived short-chain fatty acids (SCFAs) are microbiota-gut-brain axis mediators. The aim was to investigate Synbiotic 2000 effects on plasma levels of immune activity markers and SCFAs in children and adults with ADHD. ADHD patients (n = 182) completed the 9-week intervention with Synbiotic 2000 or placebo and 156 provided blood samples. Healthy adult controls (n = 57) provided baseline samples. At baseline, adults with ADHD had higher pro-inflammatory sICAM-1 and sVCAM-1 and lower SCFA levels than controls. Children with ADHD had higher baseline sICAM-1, sVCAM-1, IL-12/IL-23p40, IL-2Rα, and lower formic, acetic, and propionic acid levels than adults with ADHD. sICAM-1, sVCAM-1, and propionic acid levels were more abnormal in children on medication. Synbiotic 2000, compared to placebo, reduced IL-12/IL-23p40 and sICAM-1 and increased propionic acid levels in children on medication. SCFAs correlated negatively with sICAM-1 and sVCAM-1. Preliminary human aortic smooth-muscle-cell experiments indicated that SCFAs protected against IL-1β-induced ICAM-1 expression. These findings suggest that treatment with Synbiotic 2000 reduces IL12/IL-23p40 and sICAM-1 and increases propionic acid levels in children with ADHD. Propionic acid, together with formic and acetic acid, may contribute to the lowering of the higher-than-normal sICAM-1 levels.

Obesity, a chronic pandemic disease, is characterized by low-grade chronic inflammation, accompanied by over-expression of pro-inflammatory cytokines, thereby contributing to metabolic disorders pathogenesis. Oxidative-stress, an adverse cellular response to adipocyte hypertrophy, promotes inflammation. Furthermore, gut-microbiota dysbiosis may induce oxidative-stress, low-grade inflammation, and metabolic-endotoxemia as major drivers of obesity. Functional-foods/nutraceuticals have attracted extensive attention due to their plausible anti-inflammatory/anti-oxidative properties; evidence supports the superiority of the nutraceutical combined-supplementation approach versus conventional mono-therapies. Current data suggest the anti-oxidative/anti-inflammatory properties of either L-carnitine or pre/pro/synbiotics. This trial compared the effects of co-supplementing L-carnitine and multi-species/multi-strain synbiotic versusL-carnitine mono-therapy on inflammatory/anti-inflammatory, oxidative-stress, and metabolic-endotoxemia biomarkers in 46 female obese patients, receiving either co-supplementation (L-carnitine-tartrate (2 × 500 mg d-1) + multi-species/multi-strain synbiotic (1 capsule per day)) or mono-therapy (L-carnitine-tartrate (2 × 500 mg d-1) + maltodextrin (1 capsule per day)) for eight weeks. L-Carnitine + synbiotic co-supplementation significantly decreased interleukin-6 (IL-6, -33.98%), high-sensitivity-C-reactive-protein (hs-CRP, -10%), tumor-necrosis-factor-alpha (TNF-α, -18.73%), malondialdehyde (MDA, -21.73%), and lipopolysaccharide (LPS, -10.14%), whereas the increase in interleukin-10 (IL-10, 7.69%) and total-antioxidant-capacity (TAC, 4.13%) levels was not significant. No significant changes were observed for the above-mentioned parameters in the L-carnitine + placebo group, except for a significant reduction in IL-10 (-17.59%) and TNF-α (-14.78%); however, between-group differences did not reach the significant threshold. Co-supplementing L-carnitine + multi-strain synbiotic led to significant amelioration of inflammatory, oxidative, and metabolic-endotoxemia responses in female obese patients; nevertheless, no improving effects were observed

Prebiotics such as fructans, and probiotics such as Lactobacilli or Bifidobacteria, or a combination of prebiotics and probiotics (synbiotics) are thought to be protective against colon cancer. Therefore, we studied whether the prebiotic inulin enriched with oligofructose (Raftilose-Synergy1, briefly, Synergy1, 10% of the diet), probiotics [Bifidobacterium lactis (Bb12) and Lactobacillus rhamnosus (LGG), each at 5x10(8) c.f.u./g diet] or synbiotics (a combination of the two) protect rats against azoxymethane (AOM)-induced colon cancer. Male F344 rats were divided into: Controls; PRE, which were fed a diet containing Synergy1; PRO, fed a diet containing LGG and Bb12; PREPRO, fed a diet containing Synergy1, LGG and BB12. Ten days after beginning the diets, rats were treated with AOM (15 mg/kg s.c. two times); dietary treatments were continued for the entire experiment. Thirty-one weeks after AOM, rats treated with Synergy1 (PRE and PREPRO groups) had a significantly lower (P < 0.001) number of tumours (adenomas and cancers) than rats without Synergy1 (colorectal tumours/rat were 1.9 +/- 1.7, 1.1 +/- 1.1, 2.2 +/- 1.4 and 0.9 +/- 1.2 in Controls, PRE, PRO and PREPRO groups, respectively, means +/- SD). A slight, not significant effect of probiotics in reducing malignant tumours was also observed (P = 0.079). Caecal short-chain fatty acids (SCFA) were higher (P < 0.001) in the groups treated with Synergy1. Apoptosis was increased in the normal mucosa of the PRO group, while no variation was observed in the tumours. Colonic proliferation was lower in the PRE group as compared with Controls. Glutathione S-transferase placental enzyme pi type expression, and to a lesser extent, inducible NO synthase were depressed in the tumours from rats in the PRE and PREPRO groups. Cycloxygenase-2 expression was increased in the tumours of control rats but not in those from PRE, PRO or PREPRO rats. In conclusion, prebiotic administration in the diet decreases AOM-induced carcinogenesis in rats.

INTRODUCTION: Despite available therapies for depression, many patients do not achieve adequate improvement, illustrating the need for innovative treatment strategies. Nutritional psychiatry is an emerging area, with increasing evidence that microbially derived butyrate contributes to the beneficial effects of dietary, pre-, pro- and synbiotics interventions - raising the exciting possibility that direct butyrate administration might alleviate depressive symptoms. The main objective was to systematically review the effects of butyrate on depressive symptoms in humans and depressive-like behavior in animals (PROSPERO; CRD42023g0739). METHODS: A search was conducted in MEDLINE, Embase, PsycINFO, and Web of Science, ICTPR and ClinicalTrials.gov up to October 2025. Studies were included if they examined depressive symptoms in humans or relevant behaviors in animal models of depression/anxiety, involved treatment with butyrate formulations, included a control or pre-post comparison, and reported behavioral or clinical outcomes. Eligible designs included case-control, cohort, (randomized) controlled trials, experimental, or in vivo studies published in English or Dutch. Studies were excluded if depression was not the primary focus or if butyrate was combined with another treatment. Risk of bias was assessed with SYRCLE for animal studies and RoB 2 for the human studies. RESULTS: Of the two randomized controlled trials, one found no measurable effect of 1-week oral butyrate in healthy males, whereas the other found reductions in depressive and anxiety symptoms in patients with ulcerative colitis after 12-weeks oral butyrate. Thirty-two animal studies showed that butyrate generally modulated depressive- and anxiety-like phenotypes in rodents, potentially via anti-inflammatory, neuroplastic, epigenetic and gut-mediated mechanisms. DISCUSSION: Preclinical findings support the therapeutic promise of butyrate as a novel intervention for depression, warranting further clinical investigation. ABBREVIATIONS: BDNF, Brain-derived neurotrophic factor; CRS, Chronic restraint stress; CSD, Chronic social defeat; CUMS, Chronic unpredictable mild stress; DASS, Depression, anxiety, Str

INTRODUCTION: Pathogenesis of systemic scleroderma is a complex subject. Previous research has emphasized a possible contribution of the intestinal microbiome in developing symptoms. The use of probiotic formulas brings benefit in treatment of various autoimmune diseases, but the evidence for scleroderma is still not exhaustive. No official recommendations have been formulated on this topic, nor has the existing evidence been evaluated. OBJECTIVE: We aimed to assess the efficacy of probiotics, prebiotics, or synbiotics in patients with scleroderma with a focus on the improvement of symptoms and change in the quality of life (QoL) both measured using validated scales, small intestinal bacterial overgrowth (SIBO) eradication, as well as change in the intensity of interstitial lung disease and occurrence of pulmonary hypertension. METHODS: We performed a systematic search for randomized trials that assessed the beneficial and harmful effects of pro-, pre-, and synbiotics in patients with scleroderma. Pairs of authors independently selected studies for inclusion, extracted data, and assessed the risk of bias (RoB) of the included studies. We examined the certainty of evidence in accordance with the GRADE approach. RESULTS: We screened 1801 references (after the removal of duplicates), and assessed 16 citations in full text. We identified four randomized controlled trials (RCTs) with 103 participants in intervention and 87 in control groups. The evidence suggests that probiotic intake may not affect gastrointestinal symptoms measured with Visual Analogue Scale for Gastrointestinal Tract (VAS-GIT) (change in the VAS-GIT: MD 0.04, 95% CI -0.31 to 0.40, low certainty, n = 56 probiotic group, n = 57 placebo group) and the evidence is very uncertain about the effect on gastrointestinal symptoms measured with The University of California Los Angeles Scleroderma Clinical Trial Consortium GIT 2.0 instrument (UCLA GIT 2.0) (change in the UCLA GIT 2.0 - total score: MD -0.18 95% CI -0.44, 0.07, very low certainty, n = 76 probiotic group, n = 74 placebo group). Meta-analysis showed that probiotic intake may slightly improve the social functioning measured with UCLA GIT 2.0 comp

BACKGROUND: Fatigue and gastrointestinal (GI) distress are common among athletes with an estimated 30-90% of athletes participating in marathons, triathlons, or similar events experiencing GI complaints. Intense exercise can lead to increased intestinal permeability, potentially allowing members of the gut microbiota to permeate into the bloodstream, resulting in an inflammatory response and cascade of performance-limiting outcomes. Probiotics, through their capacity to regulate the composition of the gut microbiota, may act as an adjunctive therapy by enhancing GI and immune function while mitigating inflammatory responses. This review investigates the effectiveness of probiotic supplementation on fatigue, inflammatory markers, and exercise performance based on randomized controlled trials (RCTs). METHODS: This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PICOS (Population, Intervention, Comparison, Outcome, Study design) framework. A comprehensive search was conducted in Sportdiscus, PubMed, and Scopus databases, and the screening of titles, abstracts, and full articles was performed based on pre-defined eligibility criteria. Of the 3505 records identified, 1884 were screened using titles and abstracts, of which 450 studies were selected for full-text screening. After final screening, 13 studies met the eligibility criteria and were included for review. The studies contained 513 participants, consisting of 351 males and 115 females, however, two studies failed to mention the sex of the participants. Among the participants, 246 were defined as athletes, while the remaining participants were classified as recreationally active (n = 267). All trials were fully described and employed a double- or triple-blind placebo-controlled intervention using either a single probiotic strain or a multi-strain synbiotic (containing both pro- and pre-biotics). RESULTS: This review assesses the effects of daily probiotic supplementation, ranging from 13 to 90 days, on physical performance and physiological markers in various exercise protocols. Ten studies reported improvements in various parameters, such as, enhanc

BACKGROUND & AIMS: Though probiotics, prebiotics and synbiotics have been shown to confer health benefits, their effects on cardiometabolic risk factors remain unclear. Therefore, we conducted an umbrella review to examine their effectiveness on anthropometric, cardiometabolic and inflammatory markers. METHODS: We conducted an umbrella review on eligible systematic reviews with meta-analysis (SRMA) published from journals' inception till 13 January 2023 retrieved from seven electronic databases (CINAHL, EMBASE, ProQuest, PubMed, Scopus, The Cochrane Library, and Web of Science). Methodological quality was appraised using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) tool and certainty of evidence was graded into five classes. Random-effects meta-analyses were performed on outcome effect sizes at the SRMA and primary study levels. Extent of overlapping articles were evaluated using corrected cover area. RESULTS: 24 systematic reviews representing 265 unique studies, 1076 unique effect sizes and 25,973 subjects were included. Synbiotics were evidently more effective in improving weight (-1.91 kg, 95%CI -3.45 kg to -0.37 kg, p = 0.02), total cholesterol (-12.17 mg/dl, 95%CI -17.89 mg/dl to -6.46 mg/dl, p < 0.001), low-density lipoprotein (-12.26 mg/dl, 95%CI -18.27 mg/dl to -6.25 mg/dl, p < 0.01), waist circumference (-1.85 cm, 95%CI -2.77 cm to -0.94 cm, p < 0.01), and fasting plasma glucose (-9.68 mg/dl, 95%CI -16.18 mg/dl to -3.18 mg/dl, p < 0.01). Prebiotics were more effective in improving body mass index (-0.34 kg/m2, 95%CI -0.48 kg/m2 to -0.20 kg/m2, p < 0.01), and HOMA-IR (-0.92, 95%CI -1.91 to 0.07, p = 0.06). Probiotics were shown to be more effective in reducing diastolic blood pressure (-1.34 mmHg, 95%CI -2.14 mmHg to -0.55 mmHg, P < 0.01) improving insulin level change (-0.84 mIU/mL, 95%CI -1.27 mIU/mL to -0.41 mIU/mL, p < 0.01), and the percentage of body fat (-0.66%, 95%CI -0.70% to -0.61%, p < 0.01). For all outcomes, the credibility of evidence was classified as class IV. CONCLUSION: Pre-, pro-, and synbiotics can significantly enhance anthropometric indices, glucose and lipid profiles, blood pressure, and inflammatory markers in indivi

The primary aim of this review was to systematically evaluate the literature regarding the effect of pre-, pro-, or synbiotic supplementation in infant formula on the gastrointestinal microbiota. The Cochrane methodology for systematic reviews of randomized controlled trials (RCTs) was employed. Five databases were searched and 32 RCTs (2010-2021) were identified for inclusion: 20 prebiotic, 6 probiotic, and 6 synbiotic. The methods utilized to evaluate gastrointestinal microbiota varied across studies and included colony plating, fluorescence in situ hybridization, quantitative real-time polymerase chain reaction, or tagged sequencing of the 16S rRNA gene. Fecal Bifidobacterium levels increased with supplementation of prebiotics and synbiotics but not with probiotics alone. Probiotic and synbiotic supplementation generally increased fecal levels of the bacterial strain supplemented in the formula. Across all pre-, pro-, and synbiotic-supplemented formulas, results were inconsistent regarding fecal Clostridium levels. Fecal pH was lower with some prebiotic and synbiotic supplementation; however, no difference was seen with probiotics. Softer stools were often reported in infants supplemented with pre- and synbiotics, yet results were inconsistent for probiotic-supplemented formula. Limited evidence demonstrates that pre- and synbiotic supplementation increases fecal Bifidobacterium levels. Future studies utilizing comprehensive methodologies and additional studies in probiotics and synbiotics are warranted.