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Effect of Very-low Calorie Diet and Synbiotic Supplementation in Gut Microbiota (Pronokal Method)

Not Applicable
Completed
Conditions
Weight Loss
Inflammation
Interventions
Other: Diet
Dietary Supplement: Synbiotic1
Dietary Supplement: Synbiotic2
Registration Number
NCT03530501
Lead Sponsor
Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud
Brief Summary

The present study aimed to investigate the changes produced in gut microbiota by a very-low-calorie-ketogenic diet followed by a low calorie diet, whether the use of synbiotics is able to modulate gut microbiota diversity and composition and its association with gut permeability and inflammation

Detailed Description

All participants followed a very-low-calorie ketogenic diet according to a commercial weight loss program (Pronokal method), which includes lifestyle and behavioural modification support. This method is based on high-biological-value protein preparations which contained 15 g protein, 4 g carbohydrates, 3 g fat and 50 mg docosahexaenoic acid, and provided 90-110 kcal. The study was divided in two phases. The first phase consists of a very-low-calorie ketogenic diet (600-800 kcal/day), low in carbohydrates and lipids. Throughout this ketogenic phase, supplements of vitamins and minerals such as K, Na, Mg, Ca and omega-3 fatty acids were provided. In this study the ketogenic step was maintained for 2 months. Then, the patients started a low-calorie diet (800-1500 kcal/day) which lasted two months.

During the first phase consisting of a very-low-calorie ketogenic diet, subjects were randomly divided into two groups, the treatment group who received synbiotic supplementation as capsules, a complex of B. lactis, Lactobacillus rhamnosus, B. longum ES1 and prebiotics fiber (synbiotic 1) and the control group who received a placebo. During the second phase consisting of a low-calorie diet, the treatment group received synbiotic supplementation as capsules consisting of B. animalis subsp. lactis and prebiotics fiber (synbiotic 2) (synbiotic1 + synbiotic 2 group), while the control group was divided into two groups: one continued receiving a placebo (control group) whilst the other group received synbiotic 2 (placebo + synbiotic2 group).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
Inclusion Criteria
  • body mass index ≥ 30 kg/m2
  • stable body weight in the previous 3 months
Exclusion Criteria
  • Diabetes mellitus
  • Obesity induced by endocrine disorders or by drugs
  • Gastrointestinal disorders
  • Use of antibiotics, probiotic or prebiotic agent which could modify microbiota in the previous 3 months
  • Severe depression or any other psychiatric disease
  • Abuse of narcotics or alcohol
  • Severe hepatic insufficiency
  • Any type of renal insufficiency or gout episodes
  • Neoplasia
  • Previous events of cardiovascular or cerebrovascular disease
  • Renal lithiasis
  • Uncontrolled hypertension and hydroelectrolytic alterations
  • Females with child-bearing potential, who were pregnant, breast-feeding, intending to become pregnant

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboDietVery low calorie ketogenic diet followed by low calorie diet
Synbiotic1+synbiotic2Synbiotic2Very low calorie ketogenic diet supplemented with synbiotic 1 followed by low calorie diet supplemented with synbiotic2
placebo +synbiotic2Synbiotic2Very low calorie ketogenic diet supplemented with placebo followed by low calorie diet supplemented with synbiotic2
Synbiotic1+synbiotic2DietVery low calorie ketogenic diet supplemented with synbiotic 1 followed by low calorie diet supplemented with synbiotic2
Synbiotic1+synbiotic2Synbiotic1Very low calorie ketogenic diet supplemented with synbiotic 1 followed by low calorie diet supplemented with synbiotic2
placebo +synbiotic2DietVery low calorie ketogenic diet supplemented with placebo followed by low calorie diet supplemented with synbiotic2
Primary Outcome Measures
NameTimeMethod
Changes produced in the composition and diversity of gut microbiota by the use of synbiotics during a dietary interventionAt baseline and at 4 months

Fecal samples were collected at baseline and at the end of dietary intervention. Fecal DNA was extracted and Gut microbiota analysis was achieved by using high-throughput sequencing

Secondary Outcome Measures
NameTimeMethod
Changes in microbial translocation markers produced by the use of synbiotics during a dietary interventionAt baseline and at 4 months

Blood samples were collected at baseline and at the end of study. Plasma lipopolysaccharide binding protein levels were measured by enzyme linked immunosorbent assay

Changes in intestinal inflammation markers produced by the use of synbiotics during a dietary interventionAt baseline and at 4 months

Blood samples were collected at baseline and at the end of study. Plasma C-reactive protein levels were measured by enzyme linked immunosorbent assay

Changes in intestinal permeability markers produced by the use of synbiotics during a dietary interventionAt baseline and at 4 months

Blood samples were collected at baseline and at the end of study. Plasma Zonulin levels were measured by enzyme linked immunosorbent assay

Trial Locations

Locations (1)

Hospital Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

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