Probiotics, L-Glutamine, and Biotin Show Promise in Improving Quality of Life for Ulcerative Colitis Patients

The consumption of dietary probiotics along with L-glutamine and biotin could enhance body composition parameters — fat, bone, and muscle percentage in your body — which can increase the overall quality of life for those with ulcerative colitis (UC), according to a study recently published in Nutrients.

The prevalence of inflammatory bowel disease (IBD) has been on the rise, posing a major concern for those in public health.

UC, a chronic and non-curable inflammatory condition affecting the colonic mucosa, or rectum, causes changes in body structure, more specifically a decrease in fat-free mass, which worsens the disease.

Poor nutrition intake, little absorption, nutritional losses and increased nutrient demands are also factors associated to UC.

In addition to these factors, UC has also been linked to biotin deficiency, a vital water-soluble B vitamin.

Rather than a coenzyme in metabolic pathways, such as leucine catabolism and fatty acid synthesis, biotin is also found in cell signaling, epigenetic gene control, chromatin structure and immune response.

Though there aren’t precise dietary recommendations for IBD, more than 70% of patients are aware of the significant impact of poor nutrition on the severity and frequency of symptoms.

Authors of the latest study suggest personalizing nutritional plans to individual patient needs is crucial for a more favorable disease progression and improving the overall well-being of those with UC.

To better understand UC and its therapies, researchers conducted an observational follow-up randomized study to investigate the clinical impact of a unique dietary supplement that combines probiotics, glutamine, and biotin on body composition and quality of life in UC patients.

The supplement was made of five bacterial strains of at least five billion bacteria: bifidobacterium infantis, bifidobacterium animalis, lactobacillus bulgaricus, lactobacillus helveticus, and enterococcus faecium.

Spanning from January 2022 to January 2023, 93 UC patients aged 18 years and above were drawn from specialist outpatient facilities and private clinics in Oradea, Romania.

To ensure accuracy in body composition determination, exclusion criteria was applied, excluding patients with ascites, severe edema, oncological, musculoskeletal or psychiatric pathologies, as well as those who had consumed probiotic supplements in the last six months.

In the end, 107 patients meet the criteria and were enrolled in the study.

The participants, now divided into two groups — UC-P (44 patients with dietary counseling and the probiotic-containing supplement) and UC-NP (49 patients with dietary counseling without the supplement) — underwent assessment of body composition using a multifrequency bioelectrical impedance device.

The quality of life pertaining to UC was also evaluated through the short inflammatory bowel disease questionnaire (SIBDQ).

Found were outcomes in the UC-P group, with significant increases observed in muscular mass (MM) and the sarcopenic index (SMI) (p = 0.043, p = 0.001, respectively).

A good portion of UC-P patients experienced normalization of SMI levels compared to the UC-NP group, according to the study. The extracellular water to total body water ratio (ECW/TBW) also exhibited significantly different mean values, favoring the UC-P group (p = 0.022).

Further research of body composition parameters revealed significant improvements in body mass index (BMI) (p = 0.046), fat-free mass (FFM) (p < 0.001), and ECW/TBW ratio (p = 0.048) within the UC-P group.

Lastly, the SIBDQ total score exhibited a significant increase (p < 0.001) in the UC-P group, showing a strong association with changes in body parameters.

With enough evidence to support the link between body composition and probiotic dietary supplementation in UC patients, this study faces some limitations.

For example, the sample size is small, and crucial factors like illness activity and glucocorticoid exposure were unexplored.

Additionally, adherence to therapy is not known, and only C-reactive protein (CRP) serves as the pro-inflammatory biomarker.

Though there are challenges within the study, it reveals the relation between dietary supplements and positive shifts in body composition and quality of life for folks.

To strengthen these findings, researchers suggest future investigation to address limitations and provide further validation.