¿Es real el efecto probiótico?

Lluís Arola FerrerDirector científico de Eurecat.

Catedrático de Bioquímica y Biología Molecular de la URV

4Unitat de Nutrició i Salut

Visceral obesity estrechamente

relacionado con alteraciones metabólicas a través de

•Mayor susceptibilidad a la lipólisis•Liberación de NEFA•Liberación de citoquinas proinflamatorias

Deposición de Triglicéridos en células no adiposas

Subcutaneous obesity: proporciona un lugar para la deposición de los lípidos.

Prevención Cardiovascular. Estilo de vida

Akesson A et al. J Am Coll Cardiol 2014; 64: 1299-306.

Los estilos de vida saludables están infrautilizados entre los adultos de alto

riesgo y pueden reducir sustancialmente el riesgo de sufrir enfermedad

cardiovascular en prevención primaria.Booth JN et al. Int J Cardiol. 2016;207:196-202.

Basic

Nutrition

need

Additional

value

Reducing risk

of diseases

Prevention

of diseases

Treatment

of diseases

Food Drugs

Conventional

foods

Fortified foods

Nutraceuticals

Funcional foods (natural and new foods)

Nutrient claim & Nutrient

content claim

Structure / function claim

Health claim

Nutraceuticals, also referred to as functional

foods, are causing heated debate because they

blur the traditional dividing lines between foods

and medicine.

Obesity Reviews 19, 219–232, February 2018

Probiotics InterventionParameters with significant

changes VS baseline

Parameters with significant changes VS control group

Visceral fat area

(cm2 and %)

Visceral fat area

(cm2 and %)

Bifidobacterium lactis GCL2505

(Takahaski S, et al., 2016)

Fruit smoothie with prebiotic

12 weeks

BMI: 23.0 to 30.0 kg/m2↓6.6 cm2

Lactobacillus amylovorus CP1563

(Nakamura F, et al., 2016)

Beverage of skim milk, citrate,

flavors, sweeteners, soybean

polysaccharide, food emulsifier

12 weeks

BMI: 25.0 to 30.0 kg/m2

↓4.0 cm2

Lactobacillus gasseri SBT2055

(Kadooka Y, et al. 2010)

Fermented milk

12 weeks

BMI: 24.2 to 30.7 kg/m2

↓5.8 cm2

↓8.5%

↓7.2 cm2

↓7.8%

However, other intervention with Lactobacillus gasseri SBT2055 in fermented milk for 12 weeks not observed

abdominal fat significant results (Kadooka Y, et al.2013).

PROBIOTICS and VISCERAL FAT AREA determined by computed tomography

Obesity Reviews 19, 219–232, February 2018

Investigaciones con

Bifidobacterium animalis subsp. lactis CECT 8145

Bifidobacterium

animalis subsp.

lactis

Screening

DISMINUYE LA

ACUMULACIÓN

DE GRASA

DIETA DE CAFETERÍA

Dieta rica en grasas y azúcares, que contiene diferentes alimentos (galletas con paté,galletas con queso, bacon, magdalenas, zanahorias y leche con azúcar (220 g/L)) queresultan muy palatables para la rata, induciendo hiperfagia.

RMN: resonancia magnética nuclear

• Masa grasa• Masa magra• Agua libre• Agua total

EchoMRI

STD

CAF

139 g

50 g

239%

271%

276%

*

*

*

T3: WAT weights

The protective effect of the probiotic T3 against fat accumulation was more

evident in CAF-fed obese animals than in ST-fed rats. In CAF-fed rats, the

percentatge of decrease was around 10-13% for all WATs analyzed.

0

2

4

6

8

10

12

14

16

18

20

RWAT IWAT MWAT EWAT IA

%o

f b

od

y w

eig

ht

CAF-VEH

CAF-T311.8

% 13.5%

13.0

%

10.2

%

12.0%

p=0.14

6

p=0.13

4

p=0.13

7

RWAT: retroperitoneal white adipose tissue; IWAT: lnguinal white adipose tissue;

MWAT: mesenteric white adipose tissue; EWAT: Epididymal white adipose tissue;

IA: adiposity index: computed for each rat as the sum of the different white

adipose depot weights and expressed as a percentage of the total body weight.

CAF-T3 vs CAF-veh (Student t test). P values are shown

T3: Body mass composition

(RMN)

0

10

20

30

40

50

60

70

80

FAT LEAN AGUA

% o

f b

od

y w

eigh

t

CAF-VEH

CAF-T312.2%

5.5%

5.4%

t, D, Dxt

Statistics: t: effect of time; D: effect of CAF diet; T: effect of treatment; Dxt: interaction between diet and time;

Txt: interaction between treatment and time (repeated measures ANOVA). # CAF-T3 vs CAF-veh (Student t test,

p<0.1).

rmANOVA:T p=0.171; Txtp=0.135

rmANOVA:T p=0.091; Txt p=0.077

#

#

ST-veh

ST-T3

CAF-veh

CAF-T3

rmANOVA:T p=0.064; Txtp=0.112

#

#

End point

The treatment with the probiotic T3 tended to change the body composition

towards lower fat mass and higher lean mass and water contents, mainly in CAF-fed

rats.

RMN: No radioactividadAceptada por EFSA como técnica válida para la determinación del área de la grasa visceral

ESTUDIO PARA EVALUAR LA EFICACIA DEL

PROBIÓTICO Bifidobacterium animalis subsp. lactis –BPL1-

SOBRE LA ACUMULACIÓN DE GRASA ABDOMINAL:

ALEATORIZADO, CONTROLADO, PARALELO Y DOBLE

CIEGO

ESTUDIO BIFFAT

IP: PROF. DRA. ROSA SOLÀ,

CATEDRÁTICA DE MEDICINA DE LA UNIVERSITAT ROVIRA I VIRGILI

Servicio de Medicina Interna del Hospital Universitari Sant Joan, Reus

ClinicalTrials: NCT02921217

Hipótesis:

La hipótesis del estudio es que la administración de 1011 CFU/día durante 12

semanas del probiótico Bifidobacterium animalis subsp. lactis

BPL1 activo y/o inactivado por calor, produce una disminución de la

cantidad de grasa visceral abdominal mayor a la producida por la

administración de un placebo en personas con obesidad abdominal.

V1(W1)

N= 135

RandomizationV(-1)

Pre-selection

BIFFAT INTERVENTION GRAPHIC DESIGN

V2(W6)

V3(W12)

Probiotic

100 mg Bifidobacterium lactis BPL1

(1011 CFU/d)

Heat killed Probiotic

100 mg heat inactivated - Bifidobacterium lactis BPL1

(1011 CFU/d)

Placebo

Maltodextrin

N= 45

N= 46

N= 44

Abdominal Fat (NMR) Anthropometric dataBlood extractionWaist circumferenceBlood pressureHaeces recollectionBioimpedance analysis3d dietary register

Anthropometric dataBlood extractionBlood pressureWaist circumferenceBioimpedanceanalysis

Anthropometric dataWaist circumferenceBioimpedanceanalysisBlood pressure

N > 187

Abdominal Fat (NMR) Anthropometric dataBlood extractionWaist circumferenceBlood pressureHaeces recollectionBioimpedance analysis3d dietary register

Participants

Abdominal obese individuals

Inclusion criteria

•Men and women more than 18 y,

•waist circumference ≥102 cm, in men and ≥88 cm, in women, abdominal obesity

diagnostic according international criteria (Piepoli MF et al, 2016) and

•signed informed consent prior to participation in the study.

Exclusion criteria

•waist circumference below 102 cm, in men and 88 cm, in women;

•body mass index ≥40 kg/m2,

•antibiotic treatment 30 days before the inclusion in study;

•diabetes or/and drugs for blood glucose or for blood pressure control;

•dyslipidemia (cholesterol LDL ≥ 189 mg/dL y/o triglycerides ≥ 350 mg/dL);

•abnormal thyroid hormone concentration…..

Piepoli MF, et al. Eur Heart J. 2016; 37: 2315-2381

-0,40

-0,30

-0,20

-0,10

0,00

0,10

0,20

0,30

0,40

0,50

0 6 12

Ch

ange

s in

BM

I (kg

/m2

)

Ingestion period (week)

Placebo

B. lactis BPL1

B. lactis BPL1 heat-killed

Bifidobacterium animalis subsp. lactis CECT 8145 (BPL1) and Body Mass Index

At 12 weeks, Bifidobacterium animalis subsp. lactis CECT 8145

(BPL1) treatment significantly decreased BMI, the reduction reaching

significance versus the placebo change.

-2,50

-2,00

-1,50

-1,00

-0,50

0,00

0,50

Ch

ange

s in

WC

(cm

)

Ingestion period (week)

Placebo

B. lactis BPL1

B. lactis BPL1heat-killed

Bifidobacterium animalis subsp. lactis CECT 8145 (BPL1) and waist circumference

At 12 weeks, Bifidobacterium animalis subsp. lactis CECT 8145 (BPL1)

treatment decreased waist circumference (-1.6 cm), the reduction reaching

significance with heat-killed form versus the placebo change.

-26

-23

-20

-17

-14

-11

-8

-5

-2

1

4

7

10

Ch

ange

in v

isce

ral f

at (

cm2

)

Results are expressed as mean± 95% CI. *p<0.05

*

Changes in visceral fat area accumulation (cm2) from baseline to end of study

(12 weeks of intervention).

At 12 weeks, Bifidobacterium animalis subsp. lactis CECT 8145 (BPL1) treatment

decreased abdominal visceral fat determined by MNR, the reduction, mean = 7.01

cm2, reaching significance with heat-killed form versus its baseline.

Género Bifidobacterium

Akkermansia spp

Conclusion:

In abdominal obese individuals, consumption of

Bifidobacterium animalis subsp. lactis 8145

(BPL1), both as viable cells and in a heat-killed

form, provided protection on abdominal fat

accumulation.