Table 2.
Meta-analyses of RCTs with probiotics efficacy towards depressive and anxiety symptoms and recent meta-analyses of RCTs with probiotics efficacy toward metabolic health parameters.
| Depressive and Anxiety Symptoms | |||
| Amirani et al. 2020 [75] | 12 RCTs | 656 subjects | Reduced the HDRS score by 9.60. Reduced CRP by 1.59 mg/L, TNF-α by 0.12 pg/mL, and MDA by 0.38 μmol/L. |
| Chao et al. 2020 [79] | 10 RCTs | 685 subjects | Reduced the depression scale score by 0.47. No significant impact on anxiety symptoms. |
| Goh et al. 2019 [85] | 19 RCTs | 1901 subjects | Reduced the depression scale score by 0.31. |
| Huang et al. 2016 [81] | 5 RCTs | 365 adult subjects | Reduced the depression scale score by 0.30. |
| Liu et al. 2018 [76] | 12 RCTs | 1551 subjects | No significant impact on anxiety symptoms. |
| Liu et al. 2019 [46] | 29 RCTs | ? | Reduced the depression scale score by 0.24 and the anxiety scale score by 0.10. |
| Ng et al. 2018 [82] | 10 RCTs | 1349 subjects | Reduced the depression scale score by 0.684 in mild/moderate depression. No significant difference in mood overall (healthy and clinical population). |
| Nikolova et al 2021 [78] | 7 RCTs | 404 subjects | Reduced the depression scale score by 0.83 as an add-on. No significant impact as a standalone treatment. |
| Nikolova et al. 2019 [80] | 3 RCTs | 229 subjects | Reduced the depression scale score by 1.371. |
| Reis et al. 2018 [61] | 14 RCTs | 1527 subjects | No significant impact on anxiety symptoms. |
| Sanada et al. 2020 [87] | 6 RCTs | 302 subjects | Reduced the depression scale score by 1.62. |
| Obesity, MetS, NAFLD, and metabolic parameters in healthy subjects | |||
| Borgeraas H et al. 2018 [92] | 15 RCTs | 957 subjects | Reduced BW by 0.60 kg, BMI by 0.27 kg/m2 and fat percentage by 0.60% |
| Chatzakis et al. 2019 [103] | 5 RCTs | 1235 overweight or obese pregnant women | No significant impact on GDM risk, nor gestational weight gain. |
| Companys et al. 2020 [96] | 52 RCTs | Overweight/obese/hypercholesterolemia/MetS subjects | Reduced BW, BMI, WC, BFP. Improved lipids profile. |
| Dixon et al. 2020 [97] | 34 RCTs | 2177 hypertension, obesity, CVD, MetS, T2D or hypercholesterolaemia subjects | Reduced SBP by 1.31 mmHg, DBP by 1.87 mmHg, TC by 6.05 mg/dL, LDL-C by 8.77 mg/dL, fGlc by 4.92 mg/dL, HbA1C by 0.18%, BMI by 0.31 kg/m2. Increased HDL-C by 1.05 mg/dL. No significant effect on TG. |
| Dong et al. 2019 [98] | 18 RCTs | 1544 subjects | Reduced BFP by 0.3% and LDL-c by 0.18 mg/dL; No significant differences of BMI, BFM, WC, HC, WHR, SBP, DBP, fGlc, fasting insulin, TC, HDL-C, HbA1c, or TG. |
| Kazemi et al. 2019 [100] | 29 RCTs | Metabolic disorders (e.g., NAFLD and MetS) subjects | No significant impact on BMI. Reduced CRP by 0.32 mg/L. |
| Koutnikova H et al. 2019 [93] | 111 RCTs | 6826 (e.g., obese, NAFLD) subjects | Reduced body weight by 0.94 kg, BMI by 0.55 kg/m2, WC by 1.31 cm, BFM by 0.96 kg, and visceral adipose tissue mass by 6.30 cm2 |
| Kunnackal et al. 2018 [91] | 22 RCTs | ? | Reduced BW by 0.65 kg, BFM by 0.94 kg and BMI by 0.33 kg/m2 |
| Mohammadi et al. 2019 [102] | 9 RCTs | 410 overweight or obese children and adolescents | No significant changes in BMI, WC, BW, BFM, fGlc and lipid profiles. |
| Pan et al. 2020 [113] | 11 RCTs | NAFLD subjects | Reduced TNF-α by 0.52 pg/mL and CRP by 0.62 mg/L. |
| Park S et al. 2015 [99] | 4 RCTs | 449 adult subjects | No significant effect on body weight and BMI |
| Perna et al. 2021 [89] | 20 RCTs | 1411 subjects | Reduced BMI by 0.73 kg/m2, WC by 0.71 cm and HC by 0.73 cm. No significant effect on body weight. |
| Skonieczna-Żydecka et al. 2020 [101] | 61 RCTs | 5422 healthy subjects (including overweight/obese ones) | Reduced BMI by 0.45 kg/m2, WC by 1.21 cm in healthy persons. Reduced TC in overweight/obese subjects. No significant impact on carbohydrate and lipid metabolism |
| Swierz et al. 2020 [104] | 5 RCTs | Morbid obesity undergoing bariatric surgery subjects | No significant effect on body weight. |
| Tang et al. 2019 [112] | 18 RCTs | NAFLD subjects | Reduced weight by 2.31 kg, and BMI by 1.08 kg/m2. Reduced ALT by 7.22 U/L, AST by 7.22 U/L, AP by 25.87 U/L, GTP by 5.76 U/L. Reduced TC by 0.73, LDL-C by 0.54, TG by 0.36 mg/dL. Reduced fGlc by 4.45 mg/dL, insulin by 0.63 µIU/mL. Reduced TNF-α by 0.62 pg/mL, and leptin by 1.14 ng/mL. |
| Wang ZB et al. 2019 [94] | 12 RCTs | 821 adult subjects | Reduced BW by 0.55 kg, BMI by 0.30 kg/m2, WC by 1.20 cm, BFM by 0.91 kg, and BFP by 0.92% |
| Xiao et al. 2019 [95] | 28 RCTs | 1555 NAFLD subjects | Reduced BMI by 1.46 kg/m2, ALT by 13.40 U/L, AST by 13.54 U/L, GTP by 9.88 U/L, insulin by 1.32 𝜇IU/mL, and TC by 15.38 mg/dL; No significant effect on fGlc, lipid profile or TNFα. |
| Zhang Q et al. 2016 [90] | 25 RCTs | 1931 adult subjects | Reduced BW by 0.59 kg and BMI by 0.49 kg/m2 |
Abbreviations: ALT: alanine transaminase; AP: alkaline phosphatase; AST: aspartate transaminase; BMI: body mass index; BFM: body fat mass; BFP: body fat percentage; CRP: C-reactive protein; CVD: cardiovascular disease; DBP: diastolic blood pressure; fGlc: fasting glucose; GDM: gestational diabetes mellitus; GTP: gamma-glutamyl transferase; HbA1c: haemoglobin A1c; HC: hip circumference; HDL-C: high-density lipoprotein cholesterol; HDRS: Hamilton Depression Rating Scale; LDL-C: low-density lipoprotein cholesterol; MDA: malondialdehyde; MetS: metabolic syndrome; NAFLD: non-alcoholic fatty liver disease; SBP: systolic blood pressure; TNF-α: tumour necrosis factor α; RCT: randomized clinical trial; T2D: type 2 diabetes mellitus; TC: total cholesterol; TG: triglycerides; WC: waist circumference; WHR: waist-to-hip ratio.