Mikrobiota Usus, Prebiotik, Probiotik, dan Sinbiotik pada Manajemen Obesitas
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Latar Belakang: Usus manusia merupakan tempat tinggal berbagai jenis mikroorganisme baik mikroorganisme menguntungkan maupun merugikan yang membentuk suatu mikrobiota. Mikrobiota usus mempunyai peranan penting terhadap kesehatan manusia, salah satunya menurunkan resiko obesitas.
Tujuan: Tujuan penulisan kajian pustaka ini adalah untuk menjabarkan peran mikrobiota usus dalam menurunkan resiko obesitas baik melalui pemberian prebiotik, probiotik, maupun sinbiotik.
Metode: Penelusuran literatur dilakukan melalui mesin pencari Google Scholar menggunakan kata kunci ‘obesity', ‘prebiotic', ‘probiotic', ‘synbiotic', dan ‘gut microbiota' pada jurnal nasional maupun internasional dengan kriteria inklusi yaitu penelitian dengan desain Randomized Controlled Trial (RCT) dan dilakukan pada subjek kelompok usia dewasa
Diskusi: Hasil literature review menunjukkan bukti bahwa mikrobiota usus yang seimbang memiliki peran dalam menjaga kesehatan serta menurunkan resiko obesitas dengan mempengaruhi metabolisme energi, absorbsi zat gizi, integritas dinding usus, dan adipogenesis. Probiotik dapat menghambat pertumbuhan patogen usus serta meningkatkan sistem imun. Prebiotik berperan dalam mencegah overexpression beberapa gen yang berhubungan dengan adiposa, menurunkan nafsu makan dan massa lemak tubuh. Sinbiotik merupakan gabungan antara probiotik dan prebiotik yang memiliki efek lebih baik karena dengan adanya prebiotik, mikroorganisme probiotik memiliki toleransi yang lebih tinggi terhadap kondisi lingkungan seperti oksigenasi, pH, dan suhu dalam usus. Beberapa penelitian selama minimal 12 minggu menggunakan dosis probiotik dibawah 108 cfu/hari mampu memunculkan efek penurunan lemak adipose. Sedangkan untuk dosis prebiotik antara 12-21 gr/hari mampu memperbaiki regulasi glukosa pada dewasa obesitas.
Kesimpulan: Modifikasi menggunakan prebiotik dapat memicu produksi serta pelepasan bentuk aktif dari GLP"‘1, penurunan ghrelin dan peningkatan PYY yang dapat menurunkan nafsu makan dan asupan energi. Modifikasi menggunakan probiotik dapat menurunkan absorbsi lemak, yang akan menyebabkan penurunan lemak abdomen. Sedangkan modifikasi menggunakan sinbiotik dapat menurunkan nafsu makan setelah peningkatan kadar GLP-1 dan PYY melalui mekanisme peningkatan produksi butirat (SCFA) oleh probiotik.
Kata kunci: mikrobiota usus, prebiotik, probiotik, sinbiotik, obesitas
Abstract
Background: Human intestine is the place of various types of microorganisms both beneficial and harmful microorganisms that form a microbiota. Intestinal microbiota has an important role in human health, one of which is reducing the risk of obesity.
Objectives: The objective of this literature review is to describe the role of intestinal microbiota in reducing the risk of obesity through both prebiotics, probiotics, and synbiotics.
Methods: Literature was conducted through the Google Scholar search engine using the keywords 'obesity', 'prebiotic', 'probiotic', 'synbiotic', and 'gut microbiota' in national and international journals with inclusion criteria, randomized controlled trial design ( RCT) and was carried out in adult age group subjects.
Discussion: The results of this literature review show evidence that a balanced intestinal microbiota has a role in maintaining health and reducing the risk of obesity by affecting energy metabolism, nutrient absorption, the integrity of the gut barrier, and adipogenesis. Probiotics can inhibit the growth of intestinal pathogens and enhance the immune system. Prebiotics play a role in preventing overexpression of some genes associated with adipose, decreasing appetite and body fat mass. Synbiotics are a combination of probiotics and prebiotics which are believed to have a better effect than probiotics or prebiotics.
Conclusions: Modifications using prebiotics can trigger the production and release of active forms of GLP 1, decreased ghrelin and increased PYY which can reduce appetite and energy intake. Modifications using probiotics can reduce fat absorption, which will cause a decrease in abdominal fat. While modification using synbiotics can reduce appetite after increasing GLP-1 and PYY levels through a mechanism of increasing butyrate production (SCFA) by probiotics.
Keywords: gut microbiota, prebiotic, probiotic, synbiotic, obesity
Aronsson, L. et al. (2010) ‘Decreased fat storage by Lactobacillus paracasei is associated with increased levels of angiopoietin-like 4 protein (ANGPTL4)', PLoS ONE, 5(9), pp. 1–7. doi: 10.1371/journal.pone.0013087.
Balitbangkes RI (2018) Hasil Utama Riset Kesehatan Dasar 2018, Kementrian Kesehatan Republik Indonesia.
Brahe, L. K., Astrup, A. and Larsen, L. H. (2016) ‘Can We Prevent Obesity-Related Metabolic Diseases by Dietary Modulation of the Gut Microbiota?', American Society for Nutrition, 7, pp. 90–101. doi: 10.3945/an.115.010587.
Cani, P. D. et al. (2006) ‘Oligofructose promotes satiety in healthy human: A pilot study', European Journal of Clinical Nutrition, 60(5), pp. 567–572. doi: 10.1038/sj.ejcn.1602350.
Cani, P. D. et al. (2009) ‘Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability', Gut, 58(8), pp. 1091–1103. doi: 10.1136/gut.2008.165886.
Delzenne, N. M. et al. (2011) ‘Targeting gut microbiota in obesity: Effects of prebiotics and probiotics', Nature Reviews Endocrinology. Nature Publishing Group, 7(11), pp. 639–646. doi: 10.1038/nrendo.2011.126.
FAO (2015) ‘Food and Agriculture Organization of the United Nations FAO Technical Meeting on', pp. 1–12.
Gibson, G. R. et al. (2010) ‘Dietary prebiotics: current status and new definition', Food Science & Technology Bulletin: Functional Foods, 7(1), pp. 1–19. doi: 10.1616/1476-2137.15880.
Hill, C., Gahan, C. G. M. and Begley, M. (2006) ‘Bile salt hydrolase activity in probiotics.', Applied and environmental microbiology, 72(3), pp. 1729–38. doi: 10.1128/AEM.72.3.1729-1738.2006.
Jackson, K. G. et al. (2004) ‘The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women Jackson KG, Taylor GRJ, Clohessy AM, Williams CM. Br J Nutri 1999;82:23?30', Journal of Manipulative and Physiological Therapeutics, 23(5), p. 375. doi: 10.1016/s0161-4754(00)90230-6.
Kadooka, Y. et al. (2010) ‘Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial', European Journal of Clinical Nutrition. Nature Publishing Group, 64(6), pp. 636–643. doi: 10.1038/ejcn.2010.19.
Kadooka, Y. et al. (2013) ‘Effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity in adults in a randomised controlled trial.', The British journal of nutrition, 110(9), pp. 1696–1703. doi: 10.1017/S0007114513001037.
Kellow, N. J., Coughlan, M. T. and Reid, C. M. (2014) ‘Systematic Review Metabolic benefits of dietary prebiotics in human subjects : a systematic review of randomised controlled trials', pp. 1147–1161. doi: 10.1017/S0007114513003607.
Ley, R. E., Peterson, D. A. and Gordon, J. I. (2006) ‘Ecological and evolutionary forces shaping microbial diversity in the human intestine', Cell, 124(4), pp. 837–848. doi: 10.1016/j.cell.2006.02.017.
Liber, A. and Szajewska, H. (2013) ‘Effects of inulin-type fructans on appetite, energy intake, and body weight in children and adults: Systematic review of randomized controlled trials', Annals of Nutrition and Metabolism, 63(1–2), pp. 42–54. doi: 10.1159/000350312.
Liber, A. and Szajewska, H. (2014) ‘Effect of oligofructose supplementation on body weight in overweight and obese children: A randomised, double-blind, placebo-controlled trial', British Journal of Nutrition, 112(12), pp. 2068–2074. doi: 10.1017/S0007114514003110.
Lozupone, C. et al. (2004) ‘Diversity, stability and resilience of the human gut microbiota Catherine', Appita journal, 57(3), pp. 224–227. doi: 10.1038/nature11550.Diversity.
Madjd, A. et al. (2016) ‘Comparison of the effect of daily consumption of probiotic compared with low-fat conventional yogurt on weight loss in healthy obese women following an energy-restricted diet: a randomized controlled trial.', American Journal of Clinical Nutrition, 103(2), pp. 323–329. doi: 10.3945/ajcn.115.120170.
Mahan, L. K. and Raymond, J. L. (2017) Krause's Food & The Nutrition Care Process. 14th editi, Elsevier. 14th editi.
Markowiak, P. and Åšlizewska, K. (2017) ‘Effects of probiotics, prebiotics, and synbiotics on human health', Nutrients, 9(9). doi: 10.3390/nu9091021.
Parnell, J. A. and Reimer, R. A. (2013) ‘Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults 2', 89(6), pp. 1751–1759. doi: 10.3945/ajcn.2009.27465.Weight.
Patel, R. and Dupont, H. L. (2015) ‘New approaches for bacteriotherapy: Prebiotics, new-generation probiotics, and synbiotics', Clinical Infectious Diseases, 60(Suppl 2), pp. S108–S121. doi: 10.1093/cid/civ177.
Power, S. E. et al. (2014) ‘Intestinal microbiota, diet and health', British Journal of Nutrition, 111(3), pp. 387–402. doi: 10.1017/S0007114513002560.
Rabiei, S. et al. (2018) ‘The Effects of Synbiotic Supplementation on Body Mass Index , Metabolic and Inflammatory Biomarkers , and Appetite in Patients with Metabolic Syndrome : A Triple-Blind Randomized Controlled Trial The Effects of Synbiotic Supplementation on Body Mass Index'. Taylor & Francis, 0211. doi: 10.1080/19390211.2018.1455788.
Rajkumar, H. et al. (2014) ‘Effect of Probiotic (VSL#3) and Omega-3 on Lipid Profile, Insulin Sensitivity, Inflammatory Markers, and Gut Colonization in Overweight Adults: A Randomized, Controlled Trial', Mediators of Inflammation. doi: 10.1155/2014/348959.
Rangueil Institute of Molecular Medicine, I 2 MR, U858 Inserm, IFR31, Toulouse, France, 2 Inserm U558, Toulouse, France' (2009) BioScience, (6), pp. 5107–5117.
Rowland, I. et al. (2010) ‘Current level of consensus on probiotic science report of an expert meeting-London, 23 november 2009', Gut Microbes, 1(6), pp. 436–439. doi: 10.4161/gmic.1.6.13610.
Stenman, L. K., Holma, R. and Korpela, R. (2012) ‘High-fat-induced intestinal permeability dysfunction associated with altered fecal bile acids', World Journal of Gastroenterology, 18(9), pp. 923–929. doi: 10.3748/wjg.v18.i9.923.
Vyas, U. and Ranganathan, N. (2012) ‘Probiotics , Prebiotics , and Synbiotics : Gut and Beyond', 2012. doi: 10.1155/2012/872716.
Yadav, H. et al. (2013) ‘Beneficial metabolic effects of a probiotic via butyrate-induced GLP-1 hormone secretion', J Biol Chem, 288(35), pp. 25088–25097. doi: doi:10.1074/jbc.M113.452516. PMID:23836895.
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