In combination with a calorie-controlled diet, the probiotics strain Bifidobacterium breve may help children and adolescents with obesity lose weight, according to a small study to be presented Monday at e-ECE 2020, the 22nd European Congress of Endocrinology.
In 2016, over 340 million children and adolescents worldwide were grappling with childhood obesity, putting them at heightened risk for obesity-related health issues in adulthood, and potentially premature mortality.
One solution to the growing burden could be found by turning attention to kids’ gut health. In combination with a calorie-controlled diet, the probiotic strain Bifidobacterium breve may help children and adolescents with obesity lose weight, according to a small study to be presented Monday at e-ECE 2020, the 22nd European Congress of Endocrinology.
Our gut microbiota are a dynamic population of more than 100 trillion microorganisms within our gastrointestinal tract, and they’re responsible for maintaining immune function, normal metabolism and protection against pathogens.
Diet has been considered a key driver of gut microbiota, and imbalances in the microbiota have been linked with diseases and infections.
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Recent studies indicate a correlation between childhood obesity and probiotics, which are live bacteria and microorganisms known for their potential health benefits when ingested or applied to the body. These beneficial bacteria are commonly found in yogurt, various fermented foods, and dietary supplements, as stated by the US National Centre for Complementary and Integrative Health.
Similar to or the same as the microorganisms naturally present within our bodies, some bacteria of these probiotics can aid digestion, vitamin production and destruction of disease-causing cells.
Bifidobacteria are one of the most common bacteria used in probiotics since they naturally live in our stomachs and intestines, protect against pathogens, regulate our immune system, and provide nutrients by breaking down carbohydrates and fiber.
This strain also produces short-chain-fatty-acids, which also play an important role in regulating gut health, hunger, and weight. Prior research used mixtures of probiotic strains to assess the effect on obesity management, so the authors of the current study sought to find out what happened when they administered Bifidobacteria alone.
Probiotics for weight management
The authors studied 100 children and adolescents between ages 6 and 18 with obesity and insulin resistance — a condition in which cells in the muscles, fat and liver don’t respond well to insulin and can’t easily absorb blood glucose, so the pancreas produces more insulin to help glucose enter the cells. The reduced absorption creates a buildup of glucose in the blood over time, potentially setting the stage for the onset of type 2 diabetes.
Probiotics don’t do much for most people’s gut health, despite the hype. A review finds all children were on a Mediterranean-style diet with a calorie limit tailored to their needs, said the study’s lead author, Dr. Flavia Prodam, an associate professor in clinical nutrition in the department of health sciences at the University of Piemonte Orientale in Italy.
Children then received either the probiotic for eight weeks or a placebo. Both groups ultimately experienced a reduction in body mass index, waist circumference, blood pressure, insulin resistance and concentrations of E. coli bacteria in their guts.
The participants who took probiotics, however, saw greater results in weight loss, insulin sensitivity and reduced E. coli concentrations.
That the effects of the probiotics continued for a few weeks after children stopped taking them is an unusual finding for studies on probiotics, said Dr. Christopher Moran, a pediatric gastroenterologist and director of the Pediatric Gastroenterology and Nutrition Fellowship at Mass General Hospital for Children in Boston who wasn’t involved in the study.
Many studies show that when you stop taking the probiotic, it vanishes in the intestines and doesn’t have long-lasting (effects), added Moran, who is also an assistant professor of pediatrics at Harvard Medical School.
Supporting your child’s gut health
Parents interested in caring for their child’s gut microbiota for weight management or overall health can look to whole food sources.
Many fermented foods and cultured dairy products — such as yogurt, kefir, goat milk, aged cheeses, kimchi, miso and sauerkraut — contain living probiotics. Packaged foods can contain single or multiple probiotic strains, but the ingredients label can delineate which strains are present and whether they’re live and active.
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The consumption of certain foods like wheat, onion, banana, garlic, and leek can nourish the Bifidobacteria in our digestive system, noted Prodam. Moran added that the abundance or scarcity of specific probiotic strains in children can be influenced by genetics and environment. Moreover, the composition of gut microbiota can be directly influenced by dietary habits, including alterations caused by the consumption of highly processed foods, which may contribute to childhood obesity.
“Eating a varied diet and avoiding lots of processed foods is the most important thing,” Moran added. “The more processed foods that you eat, the more likely you are to have a bad effect on the microbiome. That could potentially lead to obesity but also potentially (gastrointestinal) distress and inflammatory conditions of the GI tract such as Crohn’s disease.”
The unknowns of probiotics
Additional, longer studies are necessary for greater understanding of how probiotic supplements could modify the gut microbiota, therefore, metabolism and weight.
Mediterranean diet scores another win for longevity by improving microbiome. “There is data that already exists suggesting that obesity might (be) associated with microbiome changes, although a lot of that data doesn’t describe whether the microbiome changes came first … or the weight changes happened and then microbiome changes”, Moran said in an email. “We also know that many large dietary changes (especially restriction diets) have a large effect on our microbiome.”
Despite how popular probiotic dietary supplements have become, many of them don’t require approval by the US Food and Drug Administration before they hit shelves.
Probiotics sold as drugs or treatments for specific conditions have to first be proven safe and effective through clinical trials and approved by the FDA.
Dr. Geoffrey Preidis, an assistant professor in the department of pediatrics at Baylor College of Medicine and Texas Children’s Hospital, highlighted a significant concern regarding the safety evaluation of probiotics. He emphasized that while probiotics are commonly considered safe, many trials assessing their effectiveness often lack the thorough safety data comparable to pharmaceutical trials. This oversight is critical, especially in contexts like childhood obesity, where ensuring safety is paramount.
Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.”So the risk of side effects might be higher than we think,” Preidis, who wasn’t involved in the study, added. “Parents should consult with their children’s doctors prior to starting any probiotic regimen.”
Originally published at CNN health