Efeito do uso de prebióticos, probióticos e simbióticos em medidas antropométricas de pacientes submetidos à cirurgia bariátrica: uma revisão sistemática

Abstract

Obesity is a public health problem that, since it affects many countries in a widespread way, is recognized as a pandemic. Bariatric surgery is among the treatments available and the number of accomplishments grows every year, giving rise to the need to understand the mechanisms that contribute to weight loss in this group. One of the factors involved in the genesis of obesity is the intestinal microbiota, with an increase in the number of bacteria belonging to the phylum Firmicutes being observed in individuals with obesity in detriment of Bacteroidetes, so that the intestinal modulation through prebiotics, probiotics and symbiotics has been described as a possibility of managing obesity and its use could enhance the weight loss promoted by bariatric surgery. Thus, this study aims to investigate the effect of the use of pre, pro and symbiotics in anthropometric measurements of patients undergoing bariatric surgery. This work is divided into two parts, the first is a narrative literature review chapter and the second part consists of an original systematic review article in which seven studies were included in the analysis. There was no effect on the use of probiotics and symbiotics on waist circumference. As for weight loss, reduction of body mass index and percentage of excess weight loss, the use of pre, pro and symbiotics seems, so far, to have an effect only in the short term. However, the number of studies that address this issue is still limited, not supporting the prescription by health professionals, requiring new clinical trials with an adequate sample size and including some evaluation method for changes in the microbiome, such as fecal analysis, in order to confirm the impact of intestinal modulation, or its absence, on anthropometric measurements of bariatric patients.