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Efficacy of Probiotics in Patients of Cardiovascular Disease Risk: a Systematic Review and Meta-analysis

  • Guidelines/Clinical Trials/Meta-Analysis (WJ Kostis, Section Editor)
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Abstract

This meta-analysis examined the effect of probiotics on outcomes associated with cardiovascular disease risk factors (high blood pressure, overweight BMI, high cholesterol and triglycerides, elevated HbA1c and serum glucose). All randomised controlled trials publish on PubMed, Scopus, Embase, Grey Literature and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1990 to 2020 were systematically searched. The PEDro scale was used to assess the quality of studies. A total of 34 studies with 2177 adults were selected for inclusion in the analysis. The mean difference and effect size with a 95% confidence interval (CI) were analysed for the pooled results. Statistically significant pooled effects of probiotics were found in the reduction of systolic and diastolic blood pressure, total cholesterol, LDL-C, serum glucose, HbA1C and BMI; and elevation of HDL-C. No significant changes were observed in the outcome of triglycerides. Subgroup analysis revealed statistically significant effects of probiotics on the treatment of risk factors, with results favouring longer duration of treatment (> 1.5 months), use of alternate formulations (kefir and powder), higher dosage of probiotics (> 1.0 × 109 CFU), lower rate of study attrition (< 15%), double blinding of the study, diabetic patients and female populations. In summary, our meta-analysis showed a highly significant reduction in SBP, DBP associated with type 2 diabetes and in patients with diabetes mellitus, milk intake and more than 1.5 months duration intake. The effect on the reduction of total cholesterol LDL-C was associated with diabetes, hypertension, hypercholesterolemia, yoghurt intake and less than 1.5 months probiotic intake. The effect on the reduction of glucose and HbA1c was associated with diabetes, small dosage of probiotics, milk type and less than 1.5 months duration intake. Additionally, probiotic supplement had a beneficial effect in reducing BMI associated with obesity, higher dosage intake of probiotics and more than 1.5 months duration of intake.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Who.int. Cardiovascular diseases (CVDs). 2020. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) [Accessed 2 Feb. 2020].

  2. Sacco RL, Roth GA, Reddy KS, Arnett DK, Bonita R, Gaziano TA, et al. The heart of 25 by 25: achieving the goal of reducing global and regional premature deaths from cardiovascular diseases and stroke: a modelling study from the American Heart Association and World Heart Federation. Circulation. 2016;133(23):e674–90.

    Article  PubMed  Google Scholar 

  3. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415–28.

    Article  CAS  PubMed  Google Scholar 

  4. Zhang WW, Liu CY, Wang YJ, Xu ZQ, Chen Y, Zhou HD. Metabolic syndrome increases the risk of stroke: a 5-year follow-up study in a Chinese population. J Neurol. 2009;256(9):1493–9.

    Article  PubMed  Google Scholar 

  5. Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep. 2018;20(2):12.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfield MJ, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. Blood Press. 2009;18(6):308–47.

    Article  CAS  PubMed  Google Scholar 

  7. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344(1):3–10.

    Article  CAS  PubMed  Google Scholar 

  8. Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M, et al. Diversity of the human intestinal microbial flora. Science. 2005;308(5728):1635–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jandhyala SM, Talukdar R, Subramanyam C, Vuyyuru H, Sasikala M, Reddy DN. Role of the normal gut microbiota. World J Gastroenterol. 2015;21(29):8787.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Tamboli CP, Neut C, Desreumaux P, Colombel JF. Dysbiosis in inflammatory bowel disease. Gut. 2004;53(1):1–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sheflin AM, Whitney AK, Weir TL. SMMeS| C ce Author manuscript, available in C 2015 October 01. Curr Oncol Rep. 2014;16(10):406.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  12. Henao-Mejia J, Elinav E, Jin C, Hao L, Mehal WZ, Strowig T, et al. Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity. Nature. 2012;482(7384):179–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Li X, Watanabe K, Kimura I. Gut microbiota dysbiosis drives and implies novel therapeutic strategies for diabetes mellitus and related metabolic diseases. Front Immunol. 2017;8:1882.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Levy M, Kolodziejczyk AA, Thaiss CA, Elinav E. Dysbiosis and the immune system. Nat Rev Immunol. 2017;17(4):219.

    Article  CAS  PubMed  Google Scholar 

  15. Yang T, Santisteban MM, Rodriguez V, Li E, Ahmari N, Carvajal JM, et al. Gut dysbiosis is linked to hypertension. Hypertension. 2015;65(6):1331–40.

    Article  CAS  PubMed  Google Scholar 

  16. Le Chatelier E, Nielsen T, Qin J, Prifti E, Hildebrand F, Falony G, et al. Richness of human gut microbiome correlates with metabolic markers. Nature. 2013;500(7464):541–6.

    Article  PubMed  CAS  Google Scholar 

  17. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506.

    Article  PubMed  Google Scholar 

  18. Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59(3):325–32.

    Article  CAS  PubMed  Google Scholar 

  19. D'souza AL, Rajkumar C, Cooke J, Bulpitt CJ. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. Bmj. 2002;324(7350):1361.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis. 2006;6(6):374–82.

    Article  PubMed  Google Scholar 

  21. Ambalam P, Raman M, Purama RK, Doble M. Probiotics, prebiotics and colorectal cancer prevention. Best Pract Res Clin Gastroenterol. 2016;30(1):119–31.

    Article  PubMed  Google Scholar 

  22. Oak SJ, Jha R. The effects of probiotics in lactose intolerance: a systematic review. Crit Rev Food Sci Nutr. 2019;59(11):1675–83.

    Article  CAS  PubMed  Google Scholar 

  23. Klein G, Pack A, Bonaparte C, Reuter G. Taxonomy and physiology of probiotic lactic acid bacteria. Int J Food Microbiol. 1998;41(2):103–25.

    Article  CAS  PubMed  Google Scholar 

  24. Lye HS, Kuan CY, Ewe JA, Fung WY, Liong MT. The improvement of hypertension by probiotics: effects on cholesterol, diabetes, renin, and phytoestrogens. Int J Mol Sci. 2009;10(9):3755–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Ng SC, Hart AL, Kamm MA, Stagg AJ, Knight SC. Mechanisms of action of probiotics: recent advances. Inflamm Bowel Dis. 2009;15(2):300–10.

    Article  CAS  PubMed  Google Scholar 

  26. McFarland LV. From yaks to yogurt: the history, development, and current use of probiotics. Clin Infect Dis. 2015;60(suppl_2):S85–90.

    Article  CAS  PubMed  Google Scholar 

  27. Sun J, Buys N. Effects of probiotics consumption on lowering lipids and CVD risk factors: a systematic review and meta-analysis of randomized controlled trials. Ann Med. 2015;47(6):430–40.

    Article  PubMed  CAS  Google Scholar 

  28. • Gomes AC, Bueno AA, de Souza RGM, Mota JF. Gut microbiota, probiotics and diabetes. Nutr J. 2014;13(1):60. This systematic review and meta-analysis demonstrated significant reductions in TC and BMI following probiotic treatment. Subgroup analyses further revealed that longer treatment duration and the use of multiple species were more efficacious in reducing TC than shorter treatment duration and the use of a single species.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ettinger G, MacDonald K, Reid G, Burton JP. The influence of the human microbiome and probiotics on cardiovascular health. Gut Microbes. 2014;5(6):719–28.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Huang X, Lin J, Demner-Fushman D. Evaluation of PICO as a knowledge representation for clinical questions. In: AMIA annual symposium proceedings, vol. 2006: American Medical Informatics Association.abas; 2006. p. 359.

  31. Abbasi B, Mirlohi M, Daniali M, Ghiasvand R. Effects of probiotic soymilk on lipid panel in type 2 diabetic patients with nephropathy: a double-blind randomized clinical trial. Prog Nutr. 2018;20:70–8.

    CAS  Google Scholar 

  32. Agerholm-Larsen L, Raben A, Haulrik N, Hansen AS, Manders M, Astrup A. Effect of 8-week intake of probiotic milk products on risk factors for cardiovascular diseases. Eur J Clin Nutr. 2000;54(4):288–97.

    Article  CAS  PubMed  Google Scholar 

  33. Asemi Z, Zare Z, Shakeri H, Sabihi SS, Esmaillzadeh A. Effect of multispecies probiotic supplements on metabolic profiles, hs-CRP, and oxidative stress in patients with type 2 diabetes. Ann Nutr Metab. 2013;63(1–2):1–9.

    Article  CAS  PubMed  Google Scholar 

  34. Cavallini DCU, Jovenasso Manzoni M, Bedani R, Roselino M, Celiberto L, Vendramini R, et al. Probiotic soy product supplemented with isoflavones improves the lipid profile of moderately hypercholesterolemic men: a randomized controlled trial. Nutrients. 2016;8(12):52.

    Article  CAS  Google Scholar 

  35. Sadat Ebrahimi Z, Nasli-Esfahani E, Nadjarzade A, Mozaffari-khosravi H. Effect of symbiotic supplementation on glycemic control, lipid profiles and microalbuminuria in patients with non-obese type 2 diabetes: a randomized, double-blind, clinical trial. J Diabetes Metab Disord. 2017;16(1):23.

    Article  CAS  Google Scholar 

  36. Ejtahed HS, Mohtadi-Nia J, Homayouni-Rad A, Niafar M, Asghari-Jafarabadi M, Mofid V. Probiotic yogurt improves antioxidant status in type 2 diabetic patients. Nutrition. 2012;28(5):539–43.

    Article  CAS  PubMed  Google Scholar 

  37. • Feizollahzadeh S, Ghiasvand R, Rezaei A, Khanahmad H, Hariri M. Effect of probiotic soymilk on serum levels of adiponectin, inflammatory mediators, lipid profile, and fasting blood glucose among patients with type ii diabetes mellitus. Probiotics Antimicrob Proteins. 2017;9(1):41–7. This RCT demonstrated that consumption of probiotic soymilk resulted in no significant changes in triglyceride levels in participants with T2D.

    Article  CAS  PubMed  Google Scholar 

  38. •• Firouzi S, Majid HA, Ismail A, Kamaruddin NA, Barakatun-Nisak MY. Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial. Eur J Nutr. 2017;56(4):1535–50. This RCT involving individuals with T2D showed significant improvements in HbA1C without any significant decrease in FBG following consumption of probiotic powder. This study also demonstrated non-significant reductions in TG and TC levels, along with a significant reduction in SBP from baseline within the probiotics group.

    Article  CAS  PubMed  Google Scholar 

  39. Gomes AC, de Sousa RGM, Botelho PB, Gomes TLN, Prada PO, Mota JF. The additional effects of a probiotic mix on abdominal adiposity and antioxidant status: a double-blind, randomized trial. Obesity. 2017;25(1):30–8.

    Article  CAS  PubMed  Google Scholar 

  40. Hata Y, Yamamoto M, Ohni M, Nakajima K, Nakamura Y, Takano T. A placebo-controlled study of the effect of sour milk on blood pressure in hypertensive subjects. Am J Clin Nutr. 1996;64(5):767–71.

    Article  CAS  PubMed  Google Scholar 

  41. Higashikawa F, Noda M, Awaya T, Danshiitsoodol N, Matoba Y, Kumagai T, et al. Antiobesity effect of Pediococcus pentosaceus LP28 on overweight subjects: a randomized, double-blind, placebo-controlled clinical trial. Eur J Clin Nutr. 2016;70(5):582–7.

    Article  CAS  PubMed  Google Scholar 

  42. Inoue K, Shirai T, Ochiai H, Kasao M, Hayakawa K, Kimura M, et al. Blood-pressure-lowering effect of a novel fermented milk containing γ-aminobutyric acid (GABA) in mild hypertensives. Eur J Clin Nutr. 2003;57(3):490–5.

    Article  CAS  PubMed  Google Scholar 

  43. Ivey KL, Hodgson JM, Kerr DA, Thompson PL, Stojceski B, Prince RL. The effect of yoghurt and its probiotics on blood pressure and serum lipid profile; a randomised controlled trial. Nutr Metab Cardiovasc Dis. 2015;25(1):46–51.

    Article  CAS  PubMed  Google Scholar 

  44. Jones ML, Martoni CJ, Parent M, Prakash S. Cholesterol-lowering efficacy of a microencapsulated bile salt hydrolase-active Lactobacillus reuteri NCIMB 30242 yoghurt formulation in hypercholesterolaemic adults. Br J Nutr. 2012;107(10):1505–13.

    Article  CAS  PubMed  Google Scholar 

  45. Jung SP, Lee KM, Kang JH, Yun SI, Park HO, Moon Y, et al. Effect of Lactobacillus gasseri BNR17 on overweight and obese adults: a randomized, double-blind clinical trial. Korean J Fam Med. 2013;34(2):80.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kadooka Y, Sato M, Imaizumi K, Ogawa A, Ikuyama K, Akai Y, et al. Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial. Eur J Clin Nutr. 2010;64(6):636–43.

    Article  CAS  PubMed  Google Scholar 

  47. • Kassaian N, Feizi A, Aminorroaya A, Jafari P, Ebrahimi MT, Amini M. The effects of probiotics and synbiotic supplementation on glucose and insulin metabolism in adults with prediabetes: a double-blind randomized clinical trial. Acta Diabetol. 2018;55(10):1019–28. This RCT observed the effects of probiotic/symbiotic supplementation on pre-diabetic participants. Intervention resulted in significant improvements in FBG and HbA1c levels.

    Article  CAS  PubMed  Google Scholar 

  48. •• Kim M, Kim M, Kang M, Yoo HJ, Kim MS, Ahn YT, et al. Effects of weight loss using supplementation with Lactobacillus strains on body fat and medium chain acylcarnitines in overweight individuals. Food Funct. 2017;8(1):250–61. This RCT showed a significant reduction in BMI in overweight participants who consumed probiotic supplement.

    Article  PubMed  CAS  Google Scholar 

  49. Madjd A, Taylor MA, Mousavi N, Delavari A, Malekzadeh R, Macdonald IA, et al. Comparison of the effect of daily consumption of probiotic compared with low-fat conventional yogurt on weight loss in healthy obese women following an energy-restricted diet: a randomized controlled trial. Am J Clin Nutr. 2016;103(2):323–9.

    Article  CAS  PubMed  Google Scholar 

  50. • Mafi A, Namazi G, Soleimani A, Bahmani F, Aghadavod E, Asemi Z. Metabolic and genetic response to probiotics supplementation in patients with diabetic nephropathy: a randomized, double-blind, placebo-controlled trial. Food Funct. 2018;9(9):4763–70. This RCT enrolled individuals with T2D. When compared with placebo, probiotic supplementation resulted in significant reductions in FBG and TG, along with non-significant reductions in HbA1c and TC.

    Article  CAS  PubMed  Google Scholar 

  51. Mizushima S, Ohshige K, Watanabe J, Kimura M, Kadowaki T, Nakamura Y, et al. Randomized controlled trial of sour milk on blood pressure in borderline hypertensive men. Am J Hypertens. 2004;17(8):701–6.

    Article  PubMed  Google Scholar 

  52. • Mobini R, Tremaroli V, Ståhlman M, Karlsson F, Levin M, Ljungberg M, et al. Metabolic effects of Lactobacillus reuteri DSM 17938 in people with type 2 diabetes: a randomized controlled trial. Diabetes Obes Metab. 2017;19(4):579–89. This study enrolled patients with T2D but demonstrated no significant differences between placebo and probiotic groups in all variables.

    Article  CAS  PubMed  Google Scholar 

  53. Mohamadshahi M, Veissi M, Haidari F, Shahbazian H, Kaydani GA, Mohammadi F. Effects of probiotic yogurt consumption on inflammatory biomarkers in patients with type 2 diabetes. Bioimpacts. 2014;4(2):83.a.

    Google Scholar 

  54. Mohammadi-Sartang M, Bellissimo N, de Zepetnek JT, Brett NR, Mazloomi SM, Fararouie M, et al. The effect of daily fortified yogurt consumption on weight loss in adults with metabolic syndrome: a 10-week randomized controlled trial. Nutr Metab Cardiovasc Dis. 2018;28(6):565–74.

    Article  CAS  PubMed  Google Scholar 

  55. Naito E, Yoshida Y, Kunihiro S, Makino K, Kasahara K, Kounoshi Y, et al. Effect of Lactobacillus casei strain Shirota-fermented milk on metabolic abnormalities in obese prediabetic Japanese men: a randomised, double-blind, placebo-controlled trial. Biosci Microbiota Food Health. 2017:17–012.

  56. Ostadrahimi A, Taghizadeh A, Mobasseri M, Farrin N, Payahoo L, Gheshlaghi ZB, et al. Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Iran J Public Health. 2015;44(2):22.

    Google Scholar 

  57. Raygan F, Rezavandi Z, Bahmani F, Ostadmohammadi V, Mansournia MA, Tajabadi-Ebrahimi M, et al. The effects of probiotic supplementation on metabolic status in type 2 diabetic patients with coronary heart disease. Diabetol Metab Syndr. 2018;10(1):51.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Razmpoosh E, Javadi A, Ejtahed HS, Mirmiran P, Javadi M, Yousefinejad A. The effect of probiotic supplementation on glycemic control and lipid profile in patients with type 2 diabetes: a randomized placebo-controlled trial. Diabetes Metab Syndr Clin Res Rev. 2019;13(1):175–82.

    Article  Google Scholar 

  59. •• Rezaei M, Sanagoo A, Jouybari L, Behnampoo N, Kavosi A. The effect of probiotic yogurt on blood glucose and cardiovascular biomarkers in patients with type II diabetes: a randomized controlled trial. Evid Based Care. 2017;6(4):26–35. Significant reductions in FBG, TG, DBP, and HbA1c were revealed in this RCT following consumption of probiotic yogurt in patients with T2D.

    Google Scholar 

  60. Sharafedtinov KK, Plotnikova OA, Alexeeva RI, Sentsova TB, Songisepp E, Stsepetova J, et al. Hypocaloric diet supplemented with probiotic cheese improves body mass index and blood pressure indices of obese hypertensive patients-a randomized double-blind placebo-controlled pilot study. Nutr J. 2013;12(1):138.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  61. Shakeri H, Hadaegh H, Abedi F, Tajabadi-Ebrahimi M, Mazroii N, Ghandi Y, et al. Consumption of synbiotic bread decreases triacylglycerol and VLDL levels while increasing HDL levels in serum from patients with type-2 diabetes. Lipids. 2014;49(7):695–701.

    Article  CAS  PubMed  Google Scholar 

  62. • Szulińska M, Łoniewski I, Skrypnik K, Sobieska M, Korybalska K, Suliburska J, et al. Multispecies probiotic supplementation favorably affects vascular function and reduces arterial stiffness in obese postmenopausal women—a 12-week placebo-controlled and randomized clinical study. Nutrients. 2018;10(11):1672. This RCT revealed a significant reduction in SBP following probiotic supplementation in obese postmenopausal women.

    Article  PubMed Central  CAS  Google Scholar 

  63. Tajabadi-Ebrahimi M, Sharifi N, Farrokhian A, Raygan F, Karamali F, Razzaghi R, et al. A randomized controlled clinical trial investigating the effect of synbiotic administration on markers of insulin metabolism and lipid profiles in overweight type 2 diabetic patients with coronary heart disease. Exp Clin Endocrinol Diabetes. 2017;125(01):21–7.

    Article  CAS  PubMed  Google Scholar 

  64. Zarrati M, Salehi E, Nourijelyani K, Mofid V, Zadeh MJH, Najafi F, et al. Effects of probiotic yogurt on fat distribution and gene expression of proinflammatory factors in peripheral blood mononuclear cells in overweight and obese people with or without weight-loss diet. J Am Coll Nutr. 2014;33(6):417–25.

    Article  PubMed  Google Scholar 

  65. Kantor ED, Rehm CD, Haas JS, Chan AT, Giovannucci EL. Trends in prescription drug use among adults in the United States from 1999–2012. Jama. 2015;314(17):1818–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Khalesi S, Sun J, Buys N, Jayasinghe R. Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials. Hypertension. 2014;64(4):897–903.

    Article  CAS  PubMed  Google Scholar 

  67. Wang L, Guo MJ, Gao Q, Yang JF, Yang L, Pang XL, et al. The effects of probiotics on total cholesterol: a meta-analysis of randomized controlled trials. Medicine. 2018;97(5).

  68. Ahn HY, Kim M, Ahn YT, Sim JH, Choi ID, Lee SH, et al. The triglyceride-lowering effect of supplementation with dual probiotic strains, Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032: reduction of fasting plasma lysophosphatidylcholines in nondiabetic and hypertriglyceridemic subjects. Nutr Metab Cardiovasc Dis. 2015;25(8):724–33.

    Article  CAS  PubMed  Google Scholar 

  69. Pereira DI, Gibson GR. Effects of consumption of probiotics and prebiotics on serum lipid levels in humans. Crit Rev Biochem Mol Biol. 2002;37(4):259–81.

    Article  CAS  PubMed  Google Scholar 

  70. Yao K, Zeng L, He Q, Wang W, Lei J, Zou X. Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med Sci Monit. 2017;23:3044–53.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Zhang Q, Wu Y, Fei X. Effect of probiotics on glucose metabolism in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Medicina. 2016;52(1):28–34.

    Article  CAS  PubMed  Google Scholar 

  72. John GK, Wang L, Nanavati J, Singh R, Mullin G. Mo1963-Lactobacillus probiotics reduce body mass index, body weight, and fat mass in overweight and obese subjects: a systematic review and meta-analysis of randomized controlled trials. Gastroenterology. 2018;154(6):S–865.

    Google Scholar 

  73. Hernán MA, Hernández-Díaz S, Robins JM. A structural approach to selection bias. Epidemiology. 2004;15:615–25.

    Article  PubMed  Google Scholar 

  74. Zubillaga M, Weill R, Postaire E, Goldman C, Caro R, Boccio J. Effect of probiotics and functional foods and their use in different diseases. Nutr Res. 2001;21(3):569–79.

    Article  CAS  Google Scholar 

  75. Barichella M, Pacchetti C, Bolliri C, Cassani E, Iorio L, Pusani C, et al. Probiotics and prebiotic fiber for constipation associated with Parkinson disease: an RCT. Neurology. 2016;87(12):1274–80.

    Article  CAS  PubMed  Google Scholar 

  76. Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen–gut microbiome axis: physiological and clinical implications. Maturitas. 2017;103:45–53.

    Article  CAS  PubMed  Google Scholar 

  77. Gremeaux V, Drigny J, Nigam A, Juneau M, Guilbeault V, Latour E, et al. Long-term lifestyle intervention with optimized high-intensity interval training improves body composition, cardiometabolic risk, and exercise parameters in patients with abdominal obesity. Am J Phys Med Rehabil. 2012;91(11):941–50.

    Article  PubMed  Google Scholar 

  78. Dimidi E, Christodoulides S, Scott SM, Whelan K. Mechanisms of action of probiotics and the gastrointestinal microbiota on gut motility and constipation. Adv Nutr. 2017;8(3):484–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Q4222, Australia

    Asher Dixon, Tynan Cox, Dylan Robertson, Cheng Chi & Jing Sun

  2. Sydney Medical School, University of Sydney, Camperdown, NSW, Australia

    Asher Dixon, Amanda Yung, Michael Que, Hayden Randall & Don Wellalagodage

  3. St Paul’s College Graduate House, Camperdown, Australia

    Asher Dixon, Hayden Randall & Don Wellalagodage

  4. School of Medical Science, Griffith University, Gold Coast, Australia

    Kai Robertson

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Contributions

The authors’ responsibilities were as follows: AD: conceptualised and designed the study, developed search strategy, collected and extracted the data, interpreted the data, all table formulation, referencing, PEDro table development, article drafting, edited and submitted manuscript, critically revised the article – KR: data extraction – AY: data collection, data extraction, formulated Table 2 – MQ: data extraction, referencing, table formulation, edited manuscript – HR: data extraction, formulated Table 2 – DW: PEDro table development – TC: data extraction, referencing, subgroup table formatting, edited – DR: data extraction – CC: statistical analysis and subgroup calculations – JS: designed the study, statistical analysis and subgroup calculations.

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Correspondence to Jing Sun.

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Dixon, A., Robertson, K., Yung, A. et al. Efficacy of Probiotics in Patients of Cardiovascular Disease Risk: a Systematic Review and Meta-analysis. Curr Hypertens Rep 22, 74 (2020). https://doi.org/10.1007/s11906-020-01080-y

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