Fermented Dairy Products, Probiotic Supplementation, and Cardiometabolic Diseases: A Systematic Review and Meta-analysis.
What this study found
Overall, fermented dairy consumption was associated with lower cardiovascular risk and reduced risk of type 2 diabetes and metabolic syndrome in the general population. Probiotic supplementation delivered in a dairy matrix showed beneficial effects on lipid profiles and anthropometric measures, while probiotic capsules or powders showed benefits on diabetic biomarkers and anthropometric outcomes. The authors concluded that the direction of effect was favorable, but results varied across studies because of differences in probiotic strains, doses, durations, and delivery matrices.
- Study & population
- Systematic review and meta-analysis of prospective cohort studies and randomized controlled trials in adults of diverse ages and sexes.
- Intervention
- This systematic review evaluated probiotic supplementation delivered in a dairy matrix, and compared dairy-matrix delivery with capsule or powder probiotic forms across randomized trials.
- Key limitation
- The evidence base was heterogeneous, with substantial variation in probiotic strains, doses, intervention lengths, delivery matrices, and outcome measures.
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Open PDFOriginal abstract
Fermented dairy foods (FDFs) and probiotics are promising tools for the prevention and management of cardiometabolic diseases (CMDs), respectively. The relation between the regular consumption of FDFs and CMD risk factors was assessed by prospective cohort studies (PCSs), and the effect of probiotic supplementation added into a dairy matrix on CMD parameters was evaluated by randomized controlled trials (RCTs). Moreover, the effects of probiotic supplementation added into a dairy matrix were compared with those administered in capsule/powder form. Twenty PCSs and 52 RCTs met the inclusion criteria for the systematic review and meta-analysis. In PCSs, fermented milk was associated with a 4% reduction in risk of stroke, ischemic heart disease, and cardiovascular mortality [RR (95% CI); 0.96 (0.94, 0.98)]; yogurt intake was associated with a risk reduction of 27% [RR (95% CI); 0.73 (0.70, 0.76)] for type 2 diabetes (T2D) and 20% [RR (95% CI); 0.80 (0.74, 0.87)] for metabolic syndrome development. In RCTs, probiotic supplementation added into dairy matrices produced a greater reduction in lipid biomarkers than when added into capsules/powder in hypercholesterolemic subjects, and probiotic supplementation by capsules/powder produced a greater reduction in T2D biomarkers than when added into dairy matrices in diabetic subjects. Both treatments (dairy matrix and capsules/powder) resulted in a significant reduction in anthropometric parameters in obese subjects. In summary, fermented milk consumption is associated with reduced cardiovascular risk, while yogurt intake is associated with a reduced risk of T2D and metabolic syndrome development in the general population. Furthermore, probiotic supplementation added into dairy matrices could be considered beneficial for lowering lipid concentrations and reducing anthropometric parameters. Additionally, probiotic capsule/powder supplementation could contribute to T2D management and reduce anthropometric parameters. However, these results should be interpreted with caution due to the heterogeneity of the studies and the different probiotic strains used in the studies. This trial is registered with PROSPERO (CRD42018091791) and the protocol can be accessed at http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018091791.