The global prevalence of diabetes is set to increase within the next 10 years, affecting 439 million adults by 2030. Individuals with prediabetes are at an increased risk of cardiovascular disease, and 5–10% of those with prediabetes transition to develop type 2 diabetes each year. Therefore, prevention interventions that are cost-effective and acceptable are crucial.
Recent research into very-low-calorie diets (VLCD) for prevention or reversal of type 2 diabetes has shown success but this is largely dependent on the participants’ ability to adhere to strict diet. A promising alternative, with improved adherence, is intermittent fasting, which has been found to achieve weight loss goals and lead to a significant reduction in glucoregulatory markers.
There is growing evidence linking gut dysbiosis with obesity and diabetes. Specific strains from the Lactobacillus and Bifidobacterium genera have been named the most effective for glucose and weight control. A recent New Zealand study showed that the probiotic Lacticaseibacillus rhamnosus HN001 can result in improved gestational diabetes prevalence despite no changes in body weight.
The authors of the current study, from the University of Auckland, in Australia, say no studies have examined the effect of probiotics in combination with intermittent fasting until now.
Their PROFAST trial (PRObiotics and intermittent FASTing to improve prediabetes) aimed to establish whether intermittent fasting and daily probiotic supplementation can improve HbA1c in individuals with prediabetes.
The pilot, feasibility study was a 12-week, double-blinded, two-armed, randomised 1:1 study of daily probiotic vs. placebo in the presence of intermittent fasting.
The results indicate that daily supplementation of Lacticaseibacillus rhamnosus HN001 probiotic in individuals with prediabetes who practised intermittent fasting did not result in additional glycemic improvement or weight loss when compared with placebo.
However, those supplemented with HN001 showed greater improvements in mental health scores compared to those supplemented with placebo, and this between-group difference was statistically significant. Similarly, scores for social functioning also improved in the probiotic group with no change in the placebo group with the difference between groups reaching the 5% level of significance.
The researchers therefore say their results offer new evidence that probiotics paired with intermittent fasting can improve mental health.
Probiotics for mood
Research backing the link between gut health and cognitive health/mood has gained momentum in recent years. Studies into the 'gut-brain-axis' have led to the term 'psychobiotics' - probiotics for psychological health.
Another New Zealand study investigated the effect of the same probiotic L. rhamnosus HN001 versus placebo on postnatal mood in women with gestational diabetes and found that daily probiotic supplementation was associated with lower depression and anxiety scores in the postpartum period. Animal studies have also consistently shown that probiotics positively impact anxiety-and depressive-like behaviours.
Murphy. R., et al