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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

Khaider K Sharafedtinov12, Oksana A Plotnikova1, Ravilay I Alexeeva1, Tatjana B Sentsova1, Epp Songisepp3, Jelena Stsepetova4, Imbi Smidt4 and Marika Mikelsaar4*

Author Affiliations

1 Federal State Budgetary Institution “Institute of Nutrition” under the Russian Academy of Medical Sciences, 2/14 Ustinsky proezd, Moscow 115446, Russian Federation

2 State Budgetary institution of Continuing Professional Education “Russian Medical Academy of Postgraduate Education”, St. Petersburg 191015, Russian Federation

3 Bio-Competence Centre of Healthy Dairy Products LLC, Kreutzwaldi str. 1, Tartu 51014, Estonia

4 Department of Microbiology, University of Tartu, Ravila str. 19, Tartu 50411, Estonia

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Nutrition Journal 2013, 12:138  doi:10.1186/1475-2891-12-138

Published: 12 October 2013

Abstract

Background

Gut lactobacilli can affect the metabolic functions of healthy humans. We tested whether a 1500 kcal/d diet supplemented with cheese containing the probiotic Lactobacillus plantarum TENSIA (Deutsche Sammlung für Mikroorganismen, DSM 21380) could reduce some symptoms of metabolic syndrome in Russian adults with obesity and hypertension.

Methods

In this 3-week, randomized, double-blind, placebo-controlled, parallel pilot study, 25 subjects ingested probiotic cheese and 15 ingested control cheese. Fifty grams of each cheese provided 175 kcal of energy. Blood pressure (BP), anthropometric characteristics, markers of liver and kidney function, metabolic indices (plasma glucose, lipids, and cholesterol), and urine polyamines were measured. Counts of fecal lactobacilli and L. plantarum TENSIA were evaluated using molecular methods. The data were analyzed by t-test for independent samples and Spearman’s partial correlation analysis.

Results

The probiotic L. plantarum TENSIA was present in variable amounts (529.6 ± 232.5 gene copies) in 16/25 (64%) study subjects. Body mass index (BMI) was significantly reduced (p = 0.031) in the probiotic cheese group versus the control cheese group. The changes in BMI were closely associated with the water content of the body (r = 0.570, p = 0.0007) when adjusted for sex and age. Higher values of intestinal lactobacilli after probiotic cheese consumption were associated with higher BMI (r = 0.383, p = 0.0305) and urinary putrescine content (r = 0.475, p = 0.006). In patients simultaneously treated with BP-lowering drugs, similar reductions of BP were observed in both groups. A positive association was detected between TENSIA colonization and the extent of change of morning diastolic BP (r = 0.617, p = 0.0248) and a trend toward lower values of morning systolic BP (r = −0.527, p = 0.0640) at the end of the study after adjusting for BMI, age, and sex.

Conclusion

In a pilot study of obese hypertensive patients, a hypocaloric diet supplemented with a probiotic cheese helps to reduce BMI and arterial BP values, recognized symptoms of metabolic syndrome.

Trial registration

Current Controlled Trials ISRCTN76271778

Keywords:
Obesity; Hypocaloric diet; Probiotic cheese; Lactobacillus plantarum TENSIA; Cholesterol; Plasma glucose; Plasma lipids; Blood pressure; Body composition; Urine polyamines; Fecal Lactobacilli