Effect of probiotic and prebiotic versus placebo on appetite in patients with major depressive disorder: post hoc analysis of a randomised clinical trial.

Abstract

Poor appetite and weight loss are common in melancholic depression. Probiotics and prebiotics have the capacity to affect host behaviour, appetite and weight change by modulating the gut microbiome. The aim of this post hoc analysis was to investigate the effect of supplementation with probiotic and prebiotic on appetite, in parallel withbody mass index (BMI), weight and energy intake, in patients with major depressive disorder (MDD). We extracted data from a clinical trial with 81 patients. The participants were randomly assigned to receive probiotic (Lactobacillus helveticus and Bifidobacterium longum), prebiotic (galactooligosaccharide) or placebo for 8 weeks. Appetite, weight, BMI, dietary intake, serum leptin and physical activity were measured. Subjective appetite rating was evaluated every 2 weeks using visual analogue scales (VAS) to assess satiety, hunger, fullness and desire to eat. Serum leptin was measured by an enzyme-linked immunosorbent assay. Physical activity was measured using the international physical activity questionnaire. A repeated measures analysis of variance modelwas used to analyse VAS data and analysis of variance/analysis of covariance models for dietary intake, BMI, weight and leptin data. VAS data analyses indicated no significant intervention-time interactions but did show a significant increase over time for desire to eat within the probiotic group (P=0.025). No significant difference in either BMI or weight was seen among the groups. Energyintake and leptin weresignificantlyincreased in the probiotic group compared to the prebiotic. Overall, probiotic supplementation for 8weeks among MDD patients resulted in improvement of appetite, whereas prebiotic administration had no significant effect on appetite.