Randomized Controlled Trial
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2021; 27(1): 107-128
Published online Jan 7, 2021. doi: 10.3748/wjg.v27.i1.107
Effect of probiotic Lactobacillus plantarum Dad-13 powder consumption on the gut microbiota and intestinal health of overweight adults
Endang Sutriswati Rahayu, Mariyatun Mariyatun, Nancy Eka Putri Manurung, Pratama Nur Hasan, Phatthanaphong Therdtatha, Riko Mishima, Husnita Komalasari, Nurul Ain Mahfuzah, Fathyah Hanum Pamungkaningtyas, Wahyu Krisna Yoga, Dina Aulia Nurfiana, Stefanie Yolanda Liwan, Mohammad Juffrie, Agung Endro Nugroho, Tyas Utami
Endang Sutriswati Rahayu, Mariyatun Mariyatun, Nancy Eka Putri Manurung, Pratama Nur Hasan, Husnita Komalasari, Nurul Ain Mahfuzah, Fathyah Hanum Pamungkaningtyas, Wahyu Krisna Yoga, Dina Aulia Nurfiana, Stefanie Yolanda Liwan, Tyas Utami, Department of Food and Agricultural Technology, Faculty of Agricultural Technology, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Endang Sutriswati Rahayu, Mariyatun Mariyatun, Nancy Eka Putri Manurung, Pratama Nur Hasan, Fathyah Hanum Pamungkaningtyas, Dina Aulia Nurfiana, Tyas Utami, Center for Food and Nutrition Studies, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Phatthanaphong Therdtatha, Riko Mishima, Department of Bioscience and Biotechnology, Faculty of Agriculture, Kyushu University, 774 Motooka, Nishi-ku, Fukuoka, Japan
Mohammad Juffrie, Department of Public Health, Faculty of Medicine, Public Health and Nursery, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Agung Endro Nugroho, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Author contributions: Rahayu ES leaded the research project and together with Utami T designed the study; Juffrie M supervised the ethical approval and acted as the consultant for the clinical trial; Nugroho AE supervised the production of probiotic powder; Mariyatun M and Hasan PN supervised the on-site study; Putri Manurung NE, Komalasari H, Yoga WK, Therdtatha P, Mishima R performed the work on-site and maintained the coordination with subject as well as conducted sampling; Nurfiana DA, Mahfuzah NA, Liwan SY performed analysis at the laboratory; Mariyatun M and Pamungkaningtyas FH analysed the laboratory data and took part in preparing the manuscript.
Supported by Ristekdikti Kalbe - Science Awards, No. 048/KF-Legal/RKSA/I/2019.
Institutional review board statement: The study was reviewed and approved by the Ethic Comittee Faculty of Medicine Universitas Gadjah Mada, Institutional Review Board, Approval No. KE/1267/11/2018.
Clinical trial registration statement: This study is registered on the Health Research and Development Agency, Ministry of Health of the Republic of Indonesia, registration No. INA-2A8RG4R.
Informed consent statement: All subjects agreed to participate in this study after informed consent and ethical permission was obtained.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this manuscript.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Endang Sutriswati Rahayu, Dr, Professor, Department of Food and Agricultural Technology, Faculty of Agricultural Technology, Universitas Gadjah Mada, Jalan Flora No. 1, Bulaksumur, Sleman, Yogyakarta 55281, Yogyakarta, Indonesia. endangsrahayu@ugm.ac.id
Received: November 9, 2020
Peer-review started: November 9, 2020
First decision: November 23, 2020
Revised: December 7, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 7, 2021
Processing time: 51 Days and 1.5 Hours
ARTICLE HIGHLIGHTS
Research background

Gut microbiota (GM) play an important role in the nutrient absorption and energy regulation of individuals, thus affecting their nutritional status. GM also affect body weight, especially obesity, a condition wherein the accumulation of abnormal or excessive fat can interfere with health. Obesity in Indonesia showed an increasing prevalence in every province from 2007 to 2018. One study found a link between GM and body weight. Probiotics, as healthy bacteria, can improve an individual’s health status by affecting GM composition. The consumption of probiotics may maintain this status and reduce the weight gain of adults with obesity in Indonesia.

Research motivation

This research aimed to investigate the effect of the consumption of an indigenous probiotic on overweight people. The results obtained may be used to determine the condition of GM in overweight people and the effect of indigenous probiotics on the GM of overweight adults. These results may also be used to determine the treatment of probiotic consumption that is most suitable and effective for overweight individuals in Indonesia to improve their health status.

Research objectives

The objective of this study was to determine the effect of the consumption of the indigenous probiotic powder L. plantarum Dad-13 on overweight adults in Indonesia.

Research methods

Sixty overweight volunteers with body mass index (BMI) equal to or greater than 25 consumed indigenous probiotic powder L. plantarum Dad-13 (2 × 109 CFU/gram/sachet) for 90 d. The study was a randomized, double-blind, placebo-controlled study. The volunteers filled in a diary on a daily basis, which consisted of questions on study product intake (only during the ingestion period), other food intake, number of bowel movements, fecal quality (consistency and color), any medications received, and any symptom of discomfort, such as diarrhea, constipation, vomiting, gassing, sensation of illness, etc. Fecal samples and the subjects’ diaries were collected on the morning of day 10 + 1, marked as the end of the baseline period and the start of the ingestion period. During the ingestion period (from day 11 to day 101), several parameters to measure and analyze the results included body weight and height (once a month), the lipid profile, GM analysis using MiSeq, short-chain fatty acid (SCFA) analysis using gas chromatography, and the measurement of fecal pH using a pH meter.

Research results

The consumption of indigenous probiotic powder L. plantarum Dad-13 by overweight people caused the average body weight and BMI of the probiotic group to decrease from 84.54 ± 17.64 kg to 83.14 ± 14.71 kg and from 33.10 ± 6.15 kg/m2 to 32.57 ± 5.01 kg/m2, respectively. No significant reduction in the body weight and BMI of the placebo group was found. An analysis of the microbiota showed that the number of Bacteroidetes, specifically Prevotella, increased significantly, while Firmicutes significantly decreased. No significant change in lipid profile was observed in both groups. Also, no significant change in SCFAs (butyrate, propionate, acetic acid) and pH level were found after the consumption of the probiotic.

Research conclusions

No significant differences in pH were found before and after ingestion in both the probiotic and placebo groups as well as in the lipid profile of both cholesterol and triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and the LDL/HDL ratio. In addition, no significant changes were observed in the concentration of SCFAs (acetic acid, propionate, and butyrate) after consumption. Interestingly, a significant decrease in body weight and BMI (P < 0.05) was found in the treatment group. An analysis of the GM shows that L. plantarum Dad-13 was able to decrease Firmicutes and increase Bacteroidetes (especially Prevotella).

Research perspectives

These results proved that the consumption of probiotics among overweight adults helps significantly reduce body weight, especially in women, and affects the composition of GM.