Supplementation of a Combination of Probiotics, L-Glutamine, and Biotin Improves Body Composition and Quality of Life in Subjects with Ulcerative Colitis

by | Jan 24, 2024 | 2023, Digestive Health, Glutamine, Probiotics

Written by Taylor Woosley, Staff Writer. Administration of a supplement containing probiotics, l-glutamine, and biotin, combined with dietary counselling, significantly improved muscular mass, sarcopenic index, and extracellular water to total body water ratio (p < 0.05) and quality of life (p < 0.001) compared to the control group. 

stomach painUlcerative colitis (UC) is a chronic, relapsing and remitting inflammatory disease of the large intestine characterized by debilitating gastrointestinal symptoms accompanied by a reduced quality of life1. Common symptoms of UC include frequent bowel movements, mucus, bloody diarrhea, abdominal pain and discomfort, urgency, and lack of adequate nutrient absorption2. Complex interactions between genetic and environmental risk factors lead to microbial shifts, loss of epithelial integrity, and initiation and propagation of a dysregulated immune response3.

Growing evidence shows that probiotics, live micro-organisms that when consumed may provide health benefits, can be useful for UC through enhancing the activity and volume of the normal gut flora4. Additionally, studies on glutamine, a non-essential amino acid, suggest that glutamine exerts protective properties on the intestinal tract and can alleviate the damage of multiple stress reactions5. Furthermore, biotin, a water-soluble B-complex vitamin, is an essential micronutrient with research indicating that biotin plays a role in the immune response through regulating inflammation and controlling proinflammatory cytokine levels6.

Pavel et al. conducted an observational follow-up randomized study to investigate the clinical efficacy of a dietary supplement featuring probiotics, glutamine and biotin on body composition and quality of life in UC subjects. Subject inclusion consisted of participants aged 18 years or older with a confirmed UC diagnosis. 93 participants (average age: 46.62 ± 16.13 years) were placed in one of two groups: UC-P (n=44, received dietary counselling and supplementation with probiotics) or UC-NP (n=49, received dietary counseling without supplementation). The UC-P participants received the supplements in 3 sessions of 4 weeks and consumed 2 tablets daily, with a 12-week break in between. The probiotic supplement contained a combination of five bacterial strains with at least five billion bacteria (Bifidobacterium infantis, Bifidobacterium animalis, Lactobacillus bulgaricus, Lactobacillus helveticus, and Enterococcus faecium), with L-glutamine and biotin.

Body composition, which included muscular mass (MM), sarcopenic index (SMI), body mass index (BMI), fat free mass (FFM), and extracellular water to total body water ratio (ECW/TBW), was assessed using the multifrequency bioelectrical impedance device. Quality of life was evaluated through completion of the short inflammatory bowel disease questionnaire (SIBDQ). No statistically significant differences were noted between groups regarding the initial BMI and body composition evaluation (p > 0.05). Significant findings of the study are as follows:

  • Body composition parameters (MM, SMI, and ECW/TBW) were significantly improved in the UC-P group (p < 0.05).
  • At the initial study assessment, the UC-P group had a significantly greater proportion of overweight subjects (p < 0.001). At the end of the study, a significantly higher number of normal-weight participants were observed in the UC-P group (p < 0.001).
  • Examination of body composition parameters show a significant improvement in SMI, FM, and AP levels (p < 0.05).
  • Baseline mean values of the total SIBDQ score showed a severe decline in life quality in both groups, with no significant differences between groups (p = 0.061). At the end of the study, mean values of total SIBDQ scores show a significant increase in the UC-P group compared to the control (p < 0.001).

Results of the study show that a combination of dietary counselling and administration of a supplement containing probiotics, l-glutamine, and biotin significantly improved body mass parameters and quality of life scores in UC subjects. Further research including larger scale clinical trials are necessary to better comprehend the potential benefits of probiotic supplementation for subjects with ulcerative colitis.

Source: Pavel, Flavia Maria, Simona Gabriela Bungau, Delia Mirela Tit, Timea Claudia Ghitea, Ruxandra Cristina Marin, Andrei-Flavius Radu, Radu Dumitru Moleriu, Tiberia Ilias, Cristian Bustea, and Cosmin Mihai Vesa. “Clinical Implications of Dietary Probiotic Supplement (Associated with L-Glutamine and Biotin) in Ulcerative Colitis Patients’ Body Composition and Quality of Life.” Nutrients 15, no. 24 (2023): 5049.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Click here to read the full text study.

Posted January 24, 2024.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Pravda J. Can ulcerative colitis be cured? Discov Med. May 2019;27(149):197-200.
  2. Sun Y, Zhang Z, Zheng CQ, Sang LX. Mucosal lesions of the upper gastrointestinal tract in patients with ulcerative colitis: A review. World J Gastroenterol. Jun 14 2021;27(22):2963-2978. doi:10.3748/wjg.v27.i22.2963
  3. Bergemalm D, Andersson E, Hultdin J, et al. Systemic Inflammation in Preclinical Ulcerative Colitis. Gastroenterology. Nov 2021;161(5):1526-1539.e9. doi:10.1053/j.gastro.2021.07.026
  4. Kaur L, Gordon M, Baines PA, Iheozor-Ejiofor Z, Sinopoulou V, Akobeng AK. Probiotics for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. Mar 4 2020;3(3):Cd005573. doi:10.1002/14651858.CD005573.pub3
  5. Yan S, Hui Y, Li J, Xu X, Li Q, Wei H. Glutamine relieves oxidative stress through PI3K/Akt signaling pathway in DSS-induced ulcerative colitis mice. Iran J Basic Med Sci. Sep 2020;23(9):1124-1129. doi:10.22038/ijbms.2020.39815.9436
  6. Erbach J, Bonn F, Diesner M, et al. Relevance of Biotin Deficiency in Patients with Inflammatory Bowel Disease and Utility of Serum 3 Hydroxyisovaleryl Carnitine as a Practical Everyday Marker. Journal of clinical medicine. Feb 20 2022;11(4)doi:10.3390/jcm11041118