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The more we learn about gut health, the more it appears to be intimately tied to other aspects of our health and well-being. Some of the latest research suggests that gastrointestinal health may play a role in mental health, autoimmune conditions, cancer, diabetes, heart disease, and healthy aging. Overall, gut health appears to be intimately tied to gut flora—the bacteria that reside throughout the digestive tract.
Basic strategies for supporting gut health and gut flora often include recommendations for a healthy diet and probiotics. Some of the latest research suggests that certain probiotics may have a role in helping with gastrointestinal symptoms like bloating while also contributing to weight loss.
Probiotics are beneficial bacteria (or yeast) that have generally been found to support health and digestion. Due to the numerous types of bacteria found in the gut, numerous different types of probiotics exist with more being discovered on a regular basis. And it’s worth noting that not all probiotics are the same. Based on the species and strain of bacteria included, probiotics can vary in their health effects or benefits.
When naming the bacteria that are found in probiotics, they are typically described by genus and species. Lactobacillus acidophilus is a probiotic bacteria with Lactobacillus as the genus and acidophilus as the species. However, within a single species of bacteria, there is still significant variability. To account for these differences, bacteria are further subdivided into strains, for example, Lactobacillus acidophilus ATCC314 where ATCC314 designates the strain.
Unfortunately, the naming conventions for strains vary from country to country. In addition, companies sometimes make up their own strain names which can further confuse the issue.
Regardless, when it comes to the benefits of a probiotic, it’s typically best if the chosen strain has been shown in the published research to carry the benefits that a person is hoping to achieve. Some commercially available probiotics list the strain names on the label, while others do not, making it difficult to assess their potential benefits.
In people struggling with obesity, the bacteria throughout the digestive tract—the gut flora—change. These changes include a loss of bacterial diversity, changes in abundance of certain bacteria, and increases in inflammatory mediators produced by the bacteria themselves. While the evidence is somewhat mixed, it appears that these changes can sometimes lead to symptoms of bloating, indigestion, and irritable bowel syndrome.
These bacterial changes also appear to have direct relevance for initiating and promoting additional weight gain. Changes in the gut flora can increase calorie extraction from food. These changes can also disrupt blood sugar balance, increasing risks for diabetes which also encourages weight gain. Some evidence is even starting to suggest that gut flora can change the host’s gene expression, affecting aspects of energy storage (like the amount of fat tissue present) and energy expenditure.
Animal studies have found that, if you take the gut flora from an obese mouse and transplant it into a separate animal, they gain weight like their obese counterparts. In humans, studies have shown that antibiotic use, especially in childhood, correlates with obesity later in life. It is well known that antibiotics can damage gut flora and decrease bacterial diversity. These results strongly suggest an influence of gut flora on the development and progression of obesity.
One simple approach to address both indigestion and obesity can include the use of probiotics. Bloating is a common component of irritable bowel syndrome (IBS), although it can be present in people with other gastrointestinal conditions as well. Treatments that improve IBS typically improve bloating.
In cases of patients struggling with bloating, underlying causes should be fully evaluated before treatment. Frequently, bloating can be due to either lactose or fructose intolerance which may be present in up to 50-60% of individuals with functional gastrointestinal disorders that include bloating.
Lactose and fructose are two sugars that can be difficult to digest. Lactose is most often encountered in dairy products, whereas high levels of fructose are often found in honey, some fruits, and processed foods containing high fructose corn syrup. For lactose intolerance, lactase, the enzyme that breaks down lactose, can help. In other cases, reducing or eliminating fructose and lactose from the diet can also be useful.
Bloating is commonly an indication of problems with gut flora. And a recent research review concluded that multistrain probiotics can help with gas and bloating in IBS. A separate review concluded that a multistrain probiotic also helps with bloating in patients with constipation. In general, patients struggling with symptoms of bloating may find benefits from probiotics.
While caution is advised when approaching information on any supplement touted for weight loss, data does suggest that certain probiotics may be of use. A recent 60-day trial of Saccharomyces boulardii DBVPG 6763, a probiotic yeast, found significant benefits with supplementation in obese individuals. Subjects on the probiotic supplement lost an average of six pounds. They also lost fat mass and improved their insulin response over the course of the study.
A longer trial on a combination probiotic included the following bacterial strains:
Over the course of nine months, subjects lost an average of seven pounds while taking the combination probiotic supplement.
In overweight children, a small study found that supplementation of Lactobacillus casei Shirota was able to help. Children given the probiotic lost 3% of their body weight over six months of supplementation. High-density lipoprotein cholesterol levels, or so-called “good cholesterol,” improved as well.
Some of the strongest evidence to date comes from studies on Lactobacillus gasseri (SBT2055 and BNR17 strains). As a probiotic, L. gasseri has been shown to decrease fat absorption from the digestive tract and reduce abdominal fat in both animal and human studies. Weight loss and decreased waist circumference were noted as well.
However, it is worth noting that not all trials with probiotics for weight loss have found success. Some trials found minimal weight loss but still showed decreases in total fat mass, while others did not find any significant improvements. It is likely that the results are influenced by the amount and duration of probiotic supplementation, the strains included, and the health parameters and dietary habits of the subjects. The quality of probiotics also matters as some studies have failed to culture the strains of bacteria that products claimed to contain.
While in some cases a simple probiotic can be helpful, it can also be crucial to consider other factors that influence gut flora when trying to address both bloating and weight loss. Fiber is an indigestible carbohydrate for humans that can be consumed as food by bacteria in the gastrointestinal tract.
Often referred to as prebiotics, these fibers can encourage the growth of healthy gut flora. In patients struggling with bloating, caution is indicated when prescribing prebiotics as certain types of fiber supplements may worsen symptoms. However, some prebiotic supplements over the long term can help.
Partially hydrolyzed guar gum is a soluble fiber that has shown benefits in studies for helping reduce symptoms of irritable bowel syndrome, including bloating. And while less well studied for weight loss, in general, research has shown beneficial results with soluble fiber supplementation. In a study that used a model of the digestive tract, partially hydrolyzed guar gum was shown to decrease fat absorption. Obviously, with decreased fat absorption, weight loss could result.
Acacia gum is another soluble fiber that appears to hold some promise for helping with both bloating and weight loss. Initial animal studies have suggested weight loss potential with acacia gum supplementation. A study in mice found that acacia gum led to decreased body weight, reduced food intake, and less abdominal fat. In mice fed a high-sugar, high-fat diet, the addition of acacia gum resulted in weight loss with improvements in blood sugar and cholesterol.
Human trials also suggest benefits. A clinical trial in patients with type 2 diabetes found a reduction in abdominal fat of 23.7% with supplementation of acacia gum. A study in women found reductions in body mass index and body fat after six weeks of supplementation. Acacia gum has also been shown to increase satiety after meals which can help reduce calorie intake. However, higher doses of acacia gum did cause some transient bloating and mild diarrhea for some patients.
Studies have found that acacia gum is not rapidly fermented, which means it has a much lower risk of producing gas and bloating as compared to other fibers. It also acts as a prebiotic, which can help improve gastrointestinal flora, a contributing factor to bloating.
While high doses do predispose to transient gastrointestinal discomfort, studies have found improvements in bloating and bowel movements with long-term use. When supplementing with acacia gum, starting with a lower dose and increasing slowly based on tolerance is a simple way to avoid most transient gastrointestinal side effects.
Research shows that probiotic supplements likely have significant potential for helping with irritable bowel symptoms, including bloating, along with helping to contribute to weight loss.
Other approaches that also improve gut flora, including certain well-tolerated fiber supplements like partially hydrolyzed guar gum and acacia fiber may also be of use. When combined with a healthy, whole foods diet that reduces processed food, most individuals will likely find improvements in both digestion and weight.
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By Dr. Scott Buesing, N.D.
