You might be surprised that I am writing a blog on the topic of weight loss because it is not usually a topic I focus on.
However, I have been shocked by how many people have asked me this question about probiotics and how they can help with weight loss recently - both in the clinic and in my personal life.
The last few weeks, I have been knee deep in research on the microbiome as I have prepared for the upcoming quarterly community lecture, "Healthy Microbiome 101: Understanding the Foundations of Gut Health". I want to take a few minutes to share what I found about weight loss and probiotics specifically and shed some light on this popular topic.
As a healthcare provider, my interest in weight loss lies in fostering overall health improvement. I believe in improving health markers like nutrition, digestion, inflammation, habit formation, stress management, and immune regulation as a primary focus. Generally, weight adjusts naturally in a sustainable, healthy manner once these other factors are addressed.
The idea that weight and metabolism can be influenced through probiotics and the microbiome intrigues me, given the microbiome's growing recognition for its significant health implications.
So, can probiotics help you lose weight?
The short answer is maybe.
Here is what the scientific research on probiotics and weight loss has to say.
Numerous studies have investigated the potentials benefits of different strains of probiotics in supporting weight loss and metabolic health and the research is very promising, for example Lactobacillus gasseri, Lactobacillus rhamnosus, Bifidobacterium breve and Akkermansia muciniphila have all been shown to have a positive impact on weight loss.
So, how do strains of bacteria in our digestive tract have the ability to affect weight loss.
For me, this is where this topic gets really interesting.
For years, I have been challenging the idea that the equation of caloric intake combined with how many calories we burn daily is the ultimate factor for weight loss. There are other factors that drive our food cravings, metabolism, and inflammation that are equally important.
There are several mechanisms that are behind these bacterium's ability to potentially help human's lose weight that are related to the factors above.
Probiotics support the health of the mucosal gut barrier (the mucus that protects the lining of the digestive tract). So many things are better when our gut barrier is strong. One of the big benefits is that systemic inflammation in the body goes down. This leads to a cascade of effects that eventually effects our fat storage. When inflammation goes down, our insulin resistance improves. When our insulin resistance improves, our overall blood glucose levels also go down. When our blood glucose levels are lower, our body stops storing glucose in the form of fat or adipose tissue. This can lead to an eventual break down of fat stores (rather than a continued increase in fat stores).
Probiotics directly support our mitochondrial health by providing essential nourishment for the mitochondria. Probiotics in the gut lead to the production of post-biotics (substances created by bacteria that can be used like a nutrient in the body). For example, one major bioproduct of healthy gut bacteria is short chain fatty acids (SCFAs). These SCFAs are essential fuel for our mitochondria. Mitochondria play a key role in regulating metabolic rate, which refers to the rate at which the body burns calories to sustain basic physiological functions at rest (basal metabolic rate) and during physical activity. Healthier mitochondria can help maintain a higher basal metabolic rate (how many calories we burn in a resting state), ensuring that the body continues to burn calories efficiently even at rest. Healthy mitochondria can also break down fat in the body to use as fuel. More calories burned at rest means we have a more efficient metabolism. A more efficient metabolism supports weight loss. Imagine two people sitting on couch, one has healthy mitochondria, the other has dysfunctional mitochondria. The one person with healthy mitochondria is burning more calories while sitting on the couch than the person with mitochondrial dysfunction. Having unhealthy or dysfunctional mitochondria is also associated with higher levels of insulin resistance (which we saw up above can lead to increased fat storage in the body).
Probiotics impact satiation and food cravings. Probiotics may influence hormones such as leptin and ghrelin that impact food cravings and appetite, leading to reduced food intake and improved satiety (feeling like you are full and satisfied from your meal). In addition, probiotics may stimulate GLP-1 secretion. GLP-1 is a hormone that plays a crucial role in glucose homeostasis and satiety.
A healthier gut microbiome supports the digestion and assimilation of nutrients. Better nutrition generally has the effect of leading to improvements in energy metabolism, nutrient absorption, and inflammation.
That was a lot of "science talk" so lets break it down and make the information useable.
How can you use probiotics to support weight loss?
Having a healthy gut microbiome is important to our metabolic health and metabolic health is key to our ability to lose weight.
If you have digestive issues or a history of lots of antibiotic use and you are having a hard time loosing weight even though you have tried many things, supplementing with specific strains of probiotics could be supportive in helping you shift your metabolism.
There are a few caveats to make sure that this approach is effective for you.
Whenever you start to shift your microbiome, your bowel habits can change. So it is a good idea to check in with a healthcare provider before you start making any big changes.
Depending on what your digestion is like currently, you might need to add probiotics slowly and at a reduced dose to avoid undesirable digestive symptoms.
If you find that have you increased digestive gas after starting to supplement with probiotics, you should definitely check in with a healthcare provider. This might indicate that you some additional support and testing.
If you are supplementing with probiotics, it is important to make sure you are eating foods that will support the probiotics. Some supplements have the food, or prebiotics included in them. If not, you need to make sure that you have sufficient fiber from whole grains, seeds, legumes fruits and vegetables in your diet (25- 30 grams a day for women and 30-45 g for men daily). If you take probiotics and don't eat sufficient food for the bacteria, they will not be able to thrive in your digestive tract.
The strain Akkermansia muciniphila has been shows to be especially helpful for stabilizing the gut barrier (supporting lower inflammation overall) and for reducing food cravings and increasing satiation.
Another promising avenue of probiotic supplementation is spore based probiotics. These probiotics functionally seed the digestive tract with healthy bacterial spores and therefore shift the microbiome in a slightly different way than conventional probiotics. Spore based probiotics are more robust than traditional probiotics and are more able to survive the acidic environment of the stomach so that they actually reach the intestines.
In my clinical experience, probiotics can be very helpful for many people. However, I have also seen many patients who have had success with spore based probiotics or Akkermansia muciniphila after having very little results supplementing with traditional probiotics.
Fermented foods are another way to positively affect your microbiome. You will have less information about what strains you are getting and how much of the bacteria you are getting but I am a big fan of including these in your diet.
Getting into fermenting some of your own foods is another promising option. There are now many places where you can buy specific strains of bacteria to use to culture your fermented foods.
There are numerous resources in terms of books and websites that can give you information about the ins and outs of home fermentation and how to do it safely.
Do your research on the probiotics that you buy and look for one that has at least two of the strains mentioned above. Consider rotating between different high quality probiotics every few weeks.
Combining healthy eating and exercise habits with support for the gut biome and cellular metabolism has the potential to be more effective in supporting healthy weight loss than just dietary change and activity change alone.
In addition, there are other health benefits associated with taking probiotics and bringing fermented foods into your diet. So, there is very little lose and much to gain with incorporating a strategy of supporting the gut micro-biome.
If you would like to learn more about how the microbiome affects health, I hope you will join us for our quarterly donation based community lecture, Healthy Microbiome 101, at 5:30 pm on Thursday, March 7th, 2024.
If you are interested in checking out different types of probiotics, we invite your visit our Fullscript site where you can peruse hundreds of probiotics and see a list of our favorites (be sure to check out instructions carefully and to check in with health care practitioners for individual guidance).
If you would like some one on one support to figure out if probiotics would be helpful for you and if so, which ones, give us a call and we can get you set up with an appointment.
References:
Million, M., Lagier, J.-C., Yahav, D., Paul, M. (2013). Gut bacterial microbiota and obesity. Clinical Microbiology and Infection, 19(4), 305–313.
Sanchez, M., Darimont, C., Drapeau, V., Emady-Azar, S., Lepage, M., Rezzonico, E., ... Doré, J. (2013). Effect of Lactobacillus rhamnosus CGMCC1.3724 supplementation on weight loss and maintenance in obese men and women. British Journal of Nutrition, 111(8), 1507–1519.
Dao, M. C., Everard, A., Aron-Wisnewsky, J., Sokolovska, N., Prifti, E., Verger, E. O., ... & Clément, K. (2016). Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut, 65(3), 426-436.
Cani, P. D., & de Vos, W. M. (2017). Next-generation beneficial microbes: the case of Akkermansia muciniphila. Frontiers in Microbiology, 8, 1765.