Supplementary material

This systematic review and meta-analysis aimed to determine the ability of Lactobacillus supplementation to improve glycemic control, the lipid profile, and blood pressure in adults who are overweight or obese. Nine eligible RCTs with 598 participants were included. We found that Lactobacillus supplementation significantly reduced low-density lipoprotein cholesterol (MD −5.27 mg/dL; 95% confidence interval [CI] −8.28, −2.25; P=0.0006) and total cholesterol (MD −4.84 mg/dL; 95% CI −8.29, −1.39; P=0.006), particularly when taken in capsule, powder, or tablet form, for 12 weeks, as ≥1×1010 colony forming units/day, or as part of a normal diet. Benefits of Lactobacillus on fasting plasma glucose were seen after 12 weeks of supplementation (MD −1.81 mg/dL; 95% CI −3.08, −0.54; P=0.005) and on triglycerides when taking a normal diet (MD −14.14 mg/dL; 95% CI −24.38, −3.91; P=0.007). Lactobacillus had only a short-term beneficial effect on fasting plasma insulin and blood pressure and no significant beneficial effect on high-density lipoprotein cholesterol.