Obesity rates are soaring. This pandemic ranks as one of the world’s most damaging public health crises. Solutions of all kinds are being explored as the cost to health and budgets—both personal and national– hits unprecedented figures.

Where do prebiotics and probiotics fit?

A recent review from Europe succinctly covers the present state of knowledge. It is titled Development of functional foods to fight against obesity: opportunities for probiotics and prebiotics by Clara G. De Los Reyes-Gavilan and colleagues in Spain and Belgium.

Some of the key points in the article:

• Gut microbiota dysbiosis disrupts normal balance which could impact predisposition to obesity.
• Functional food ingredients must be identified in their capacity to impact weight management.

More specific points:

• Obese and normal weight individuals harbor different sets of gut microbes with obese subjects showing an increase in the Firmicutes/Bacteroidetes ratio over lean ones.
• After gastric bypass surgery, bacterial populations in obese people change to increased Proteobacteria and Bacteroidetes and a decrease in Firmicutes and Actinobacteria.
• Infant microbiota is affected by mode of delivery and type of feeding. Both have shown impact on obesity later in life.
• Microbes produce metabolites such as short chain fatty acids (SCFA) which are considered in lipid metabolism along with energy harvest.

However, a big question is whether dysbiosis is a cause or effect of obesity?

Nutrition intervention—does it work?

• Probiotic supplements appear to evoke weight loss. However, the studies are often inadequate to show clear links.
• Prebiotics available as complex carbohydrates from natural or industrial sources as well as dietary polyphenols appear to have potential in obesity management, though the authors state that studies are scarce.

The authors conclude:

“Although a promising but limited number of studies support the benefits of specific probiotics and prebiotics in obese people, extensive testing of a large number of probiotics and prebiotics for modulation of human intestinal microbiota in well-designed interventional studies will help us better understanding the microbe-microbe and host-microbe interactions. In this scenario, probiotics and prebiotics could be included in nutritionally adequate formulations for the design and use of more efficient products for helping in the nutritional management of the obesity, one of the biggest silent pandemics of the modern time.”