Impact of Probiotic/Synbiotic Supplementation on Post-Bariatric Surgery Anthropometric and Cardiometabolic Outcomes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

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#humans #probiotics #bariatric-surgery #randomized-controlled-trials-as-topic #synbiotics

Impact of Probiotic/Synbiotic Supplementation on Post-Bariatric Surgery Anthropometric and Cardiometabolic Outcomes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Rakab et al., 2025 | Nutrients | Meta Analysis

Citation

Rakab Mohamed Saad, Rateb Rahma Mogahed, ... Mahmoud Abeer M. Impact of Probiotic/Synbiotic Supplementation on Post-Bariatric Surgery Anthropometric and Cardiometabolic Outcomes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2025-Jun-30;17(13). doi:10.3390/nu17132193

Abstract

BACKGROUND/OBJECTIVES: Bariatric surgery improves weight and metabolic health in individuals with severe obesity; however, challenges like gut dysbiosis and nutrient deficiencies persist postoperatively. Probiotic supplementation may enhance recovery by modulating gut microbiota. This updated meta-analysis aimed to assess the effects of probiotics/synbiotics on metabolic, anthropometric, and nutritional outcomes after bariatric surgery. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted using PubMed, SCOPUS, Web of Science, and CENTRAL through December 2024. Studies comparing probiotics/synbiotics (which contain both probiotics and prebiotics) versus a placebo in adults post-bariatric surgery were included. Meta-analyses were conducted, with subgroup analyses by surgery type, the timing of the intervention, and probiotic formulation (PROSPERO ID: CRD420251019199). RESULTS: Thirteen RCTs involving 809 patients were included in the analysis. Probiotic use significantly reduced BMI (MD = 0.67, 95% CI: 0.33 to 1.00), HbA1c (MD = -0.19%, 95% CI: -0.36 to -0.01), triglycerides (MD = -16.56 mg/dL), and AST levels (MD = -3.68 U/L), while increasing ALP (MD = 8.12 U/L) and vitamin D (MD = 13.68 pg/mL). Ferritin levels were significantly lower (MD = -18.89 µg/L) in the probiotic group. A subgroup analysis showed enhanced benefits in patients undergoing mini-gastric bypass, with perioperative or synbiotic interventions specifically improving triglycerides, total cholesterol, and HbA1c. CONCLUSIONS: Probiotics may offer modest but significant improvements in BMI, glycemic control, lipid profile, liver enzymes, and vitamin D levels after bariatric surgery. These findings support the potential role of probiotics/synbiotics as an adjunct therapy, though further large-scale trials are warranted to confirm long-term benefits.

Key Findings

Thirteen RCTs involving 809 patients were included in the analysis. Probiotic use significantly reduced BMI (MD = 0.67, 95% CI: 0.33 to 1.00), HbA1c (MD = -0.19%, 95% CI: -0.36 to -0.01), triglycerides (MD = -16.56 mg/dL), and AST levels (MD = -3.68 U/L), while increasing ALP (MD = 8.12 U/L) and vitamin D (MD = 13.68 pg/mL). Ferritin levels were significantly lower (MD = -18.89 µg/L) in the probiotic group. A subgroup analysis showed enhanced benefits in patients undergoing mini-gastric bypass,

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population severe obesity
Sample Size 809
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Probiotics
  • Bariatric Surgery
  • Randomized Controlled Trials as Topic
  • Synbiotics
  • Dietary Supplements
  • Obesity, Morbid
  • Anthropometry
  • Gastrointestinal Microbiome
  • Treatment Outcome
  • Adult
  • Male
  • Female
  • Body Mass Index
  • Middle Aged

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: probiotics

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09