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Fasting and Probiotics Do Make a Difference

Very low calorie diets and probiotics can not only help in improving blood glucose for those with diabetes, but also help to prevent the development of diabetes.

To show that fasting and probiotics can make a difference, the University of Auckland has received a research grant to study the issue.  Now, we have already run a number of studies that have shown reduced calories as in intermittent dieting can make a difference and when you add a probiotic, the results get even better.

University of Auckland diabetes researcher, Dr Rinki Murphy has received a Health Research Council NZ grant for $149,000 to study probiotics for prediabetes.

“Preventing the progression from prediabetes to type 2 diabetes is a health priority for New Zealand, and lifestyle interventions have been difficult to implement in real world settings,” says Dr. Murphy from the University’s Faculty of Medical and Health Sciences.

In this study they will test the effectiveness of a specific strain of Lactobacillus rhamnosus (HN001) given at different doses to patients with prediabetes, in terms of lowering blood glucose, and the distribution of body fat (specifically within the liver and pancreas) assessed by MRI scans.

The goal of the study is to find out whether the intermittent fasting approach to prevent type 2 diabetes is amplified by probiotic supplementation.  Dr Murphy says about 10 percent of people with prediabetes develop type 2 diabetes each year and are at increased risk for cardiovascular disease and death even before the development of diabetes.

Dr. Murphy says lifestyle changes to combat prediabetes are difficult to sustain and widespread strategies to support them are often too costly for healthcare systems to implement successfully. She added that, “while certain prescription drugs such as metformin, acarbose and orlistat are effective, their side effects and costs make them unsuitable for widespread, long-term clinical use in the prevention of type 2 diabetes…. Probiotics may offer an additional, safe, approach.”

Dr. Murphy says there is increasing evidence that gut microbiota may be important in the pathogenesis of type 2 diabetes by influencing energy extraction from the diet, hunger, inflammation and glucose metabolism. “Probiotics may be able to shift gut microbiota and the resulting alteration in microbial fermentation products may produce favorable metabolic benefits,” she says.

In a number of other studies in mice, it was shown that short periods of fasting can rapidly change gut microbiota to induce favorable metabolic changes. One recent study in overweight people demonstrated that short-term severe caloric restriction rapidly altered gut microbiota towards that seen in healthy populations with lower abundance of species associated with inflammation.

“Overall reduced caloric intake through fasting on two out of seven days a week (such as in the 5:2 diet) may be more achievable and sustainable than continuous modest daily restriction,” she says. A fasting day is below 650 kcal per day for men and below 600 kcal per day for women.

In another recent study presented at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting, in San Diego this past February, researchers reported on the effect of a probiotic capsule intervention on maternal metabolic parameters and pregnancy outcomes among women with gestational diabetes.

Gestational diabetes mellitus (GDM) is among the most frequent metabolic complications of pregnancy. Research into new therapies for glucose control may be of significant benefit for future GDM management. Probiotics (live microorganisms that may confer a health benefit on the host), potentially represent a new and novel mechanism for influencing metabolic health during pregnancy. Only three randomized controlled trials to date have directly investigated the glycemic effects of probiotics in pregnancy, but none specifically investigated the effects among women with GDM.

The study, titled “Impact of Probiotics in Women with Gestational Diabetes Mellitus on Metabolic Health: A Randomized Controlled Trial,” investigated the effect of a daily probiotic supplement versus placebo on fasting glucose, other metabolic parameters and pregnancy outcome among women with a new diagnosis of either impaired glucose tolerance or GDM not treated with pharmacologic therapy. The women were given either a daily probiotic (strain Lactobacillus salivarius UCC118) or placebo capsule from GDM diagnosis until delivery. Among 100 women managed with diet and exercise alone, fasting plasma glucose decreased significantly within both the probiotic and placebo group.

This was likely due to improved dietary habits following healthy lifestyle advice, which was delivered to all women as part of routine care.

The study concluded that a probiotic capsule intervention among women with abnormal glucose tolerance had no impact on control of sugars. However, a significant reduction of the normal pregnancy-related rise in total and LDL cholesterol compared to placebo was observed.

This study indicates a potential role in probiotics to improve the metabolic profile of an obstetric group at risk of future metabolic syndrome and cardiovascular disease.

Practice Pearls:

  • There is increasing evidence that gut microbiota may be important in the pathogenesis of type 2 diabetes.
  • There is also increasing evidence that intermittent fasting or a reduction in calories can have an impact to reverse type 2 diabetes and possibly even prevent it.
  • Excessive calorie consumption has been shown to have a major influence on the increasing numbers of those diagnosed with diabetes and prediabetes, so doesn’t it make sense to reduce the greatest influence?

More information on intermittent Fasting, see Diabetes In Control.

 

Fasting and probiotics may help prevent diabetes,” University of Auckland press release, May 11, 2016

Society for Maternal–fetal Medicine 2016. https://www.smfm.org/meetings/1-smfm-36th-annual-meeting

Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Am J Obstet Gynecol. 2015 Apr;212(4):496.e1-11. doi: 10.1016/j.ajog.2015.02.008.