A low glycemic index, energy-restricted diet but not Lactobacillus rhamnosus supplementation changes fecal short-chain fatty acid and serum lipid concentrations in women with overweight or obesity and polycystic ovary syndrome

OBJECTIVE: To evaluate if changes in fecal short-chain fatty acids (SCFA) content with an energy-restricted diet and with/ without 12 x 109 CFU/day of Lactobacillus rhamnosus supplementation affect the abundance of selected gut bacteria and lipid profile in overweight and obese women with PCOS. PATIENTS AND METHODS: This randomized controlled trial involved 40 overweight and obese women with a mean age of 28.8 +/- 4.8 years diagnosed with PCOS. The subjects were randomly assigned to an energy-restricted diet group (D group; n = 21) or energy-restricted diet + Lactobacillus rhamnosus supplementation group (DP group; n=19). SCFA, selected gut bacteria (Akkermansia muciniphila, Bifidobacterium longum, and Faecalibacterium prausnitzii) abundance, lipid profile and anthropometric parameters were evaluated at baseline and after twenty weeks of intervention. RESULTS: The energy-restricted diet significantly reduced body weight, BMI, fat mass, acetic and butyric acids, and improved the lipid profile (total cholesterol, low-density lipoprotein cholesterol, and triglycerides) of both groups. Changes in the molar ratio of SCFA towards the correct ratio were also observed. All the results were independent of Lactobacillus rhamnosus supplementation, with no significant differences between the two groups. CONCLUSIONS: Twenty weeks of probiotic supplementation has no additional beneficial effects on selected gut bacteria abundance, SC FA levels, or lipid profile beyond the effect of an energy-restricted diet in overweight and obese women with PCOS.