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Gut microbiota composition after diet and probiotics in overweight breast cancer survivors: a randomized open-label pilot intervention trial.

  • 2020-06
  • Nutrition (Burbank, Los Angeles County, Calif.) 74
    • Marianna Pellegrini
    • Mirko Ippolito
    • Taira Monge
    • Rossella Violi
    • Paola Cappello
    • Ilario Ferrocino
    • Luca Simone Cocolin
    • Antonella De Francesco
    • Simona Bo
    • Concetta Finocchiaro

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 34
Population
34 BC survivors
Methods
randomly assigned to an MD for 4 mo plus 1 sachet/d of probiotics (Bifidobacterium longum BB536, Lactobacillus rhamnosus HN001) for the first 2 mo (intervention group, n=16) or an MD alone for 4 mo (control group, n=18)
Blinding
Open-label
Duration
4 months
Funding
Unclear

Objectives

Breast cancer (BC) is the most diagnosed cancer in women. Increasing survival rates shift attention to preventive strategies. Obesity and intestinal microbiota composition may be associated with BC. A Mediterranean diet (MD) proved to be protective. The aim of this study was to assess the efficacy of probiotics in addition to an MD versus diet alone in influencing gut microbiota and metabolic profile in overweight BC survivors.

Methods

A total of 34 BC survivors were randomly assigned to an MD for 4 mo plus 1 sachet/d of probiotics (Bifidobacterium longum BB536, Lactobacillus rhamnosus HN001) for the first 2 mo (intervention group, n = 16) or an MD alone for 4 mo (control group, n = 18). Anthropometric and nutritional assessments, adherence to the MD, compliance with physical activity, and metabolic parameters dosage were performed at baseline (T0), at 2 mo (T2), and at 4 mo (T4). Intestinal microbiota analysis was performed at T0 and T2.

Results

After 2 mo of probiotic administration the number of bacterial species (P = 0.01) and the bacterial diversity assessed with the Chao1 index (P = 0.004) significantly increased; no significant variations were detected after diet alone. The Bacteroidetes-to-Firmicutes ratio significantly decreased in the intervention group and increased in controls (P = 0.004). Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased.

Conclusions

Probiotics in addition to an MD positively influence gut microbiota and improve metabolic and anthropometric parameters compared with an MD alone.

Research Insights

  • Bifidobacterium longum BB536→Increased Bacterial Diversity

    After 2 mo of probiotic administration the number of bacterial species (P = 0.01) and the bacterial diversity assessed with the Chao1 index (P = 0.004) significantly increased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Increased Bacterial Species Number

    After 2 mo of probiotic administration the number of bacterial species (P = 0.01) and the bacterial diversity assessed with the Chao1 index (P = 0.004) significantly increased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Reduced Bacteroidetes-to-Firmicutes Ratio

    The Bacteroidetes-to-Firmicutes ratio significantly decreased in the intervention group and increased in controls (P = 0.004)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Reduced Body Mass Index

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Reduced Body Weight

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Reduced Fasting Glucose

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Reduced HOMA-IR

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Bifidobacterium longum BB536→Reduced Insulin Levels

    in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d for 2 months
  • Bifidobacterium longum BB536→Reduced Waist Circumference

    in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d for 2 months
  • Bifidobacterium longum BB536→Reduced Waist-to-Hip Ratio

    in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d for 2 months
  • Lactobacillus rhamnosus HN001→Increased Bacterial Diversity

    After 2 mo of probiotic administration the number of bacterial species (P = 0.01) and the bacterial diversity assessed with the Chao1 index (P = 0.004) significantly increased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Increased Bacterial Species Number

    After 2 mo of probiotic administration the number of bacterial species (P = 0.01) and the bacterial diversity assessed with the Chao1 index (P = 0.004) significantly increased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Reduced Bacteroidetes-to-Firmicutes Ratio

    The Bacteroidetes-to-Firmicutes ratio significantly decreased in the intervention group and increased in controls (P = 0.004)

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Reduced Body Mass Index

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Reduced Body Weight

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Reduced Fasting Glucose

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Reduced HOMA-IR

    Significant reductions of body weight, body mass index, fasting glucose, and homeostasis model assessment of insulin resistance were identified at T4 in both groups; ... in the intervention group ...

    Effect
    Neutral
    Effect size
    Small
    Dose
    1 sachet/d
  • Lactobacillus rhamnosus HN001→Reduced Insulin Levels

    in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d for 2 months
  • Lactobacillus rhamnosus HN001→Reduced Waist Circumference

    in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d for 2 months
  • Lactobacillus rhamnosus HN001→Reduced Waist-to-Hip Ratio

    in the intervention group waist circumference (P = 0.012), waist-to-hip ratio (P = 0.045), and fasting insulin (P = 0.017) also significantly decreased

    Effect
    Beneficial
    Effect size
    Small
    Dose
    1 sachet/d for 2 months
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