都市人因工作繁忙及經常外食,普遍難做到均衡飲食和充足運動,是導致本地肥胖問題越發嚴峻的原因之一。根據衛生署最新公佈的2020-22年度人口健康調查,超重和肥胖率達54.6%,較2014-15年增加超過4%。肥胖是代謝綜合症(Metabolic syndrome)其中的一個主要指標及成因,而肥胖再加上「三高」高血壓、高血糖、高血脂(三酸甘油脂TC)及一低(高密度脂蛋白膽固醇HDL-C偏低)五項中有超過三項便是患有代謝綜合症。
根據國際糖尿病聯合會、美國心臟協會及多個研究組織的聯合聲明指出,代謝綜合症患者的心血管疾病風險明顯比正常高兩倍,而糖尿病風險更高出五倍。巴西亦有研究發現,58.2%糖尿病前期患者、76.1%糖尿病患者及57.1%高心血管疾病風險人士都有代謝綜合症。新冠疫情提高了市民對腸道菌、腸道健康及免疫力的重視,其實腸道菌對肥胖及代謝綜合症亦有很大影響。
肥胖增代謝病風險 腸道菌成健康關鍵
英國有大型研究分析近千對雙生兒3-9年間的BMI變化、飲食習慣,以至腸道菌組成,發現近六成的BMI變化和基因並無關聯,但腸道微生物多樣性越高,增重的風險明顯較低。丹麥亦有研究分析近三百名成年人的腸道菌組成及健康紀錄後指出,腸道菌基因較少(即腸道菌種較少)組別的體重、體脂、血糖及血脂水平明顯較高,可見腸道微生物群與肥胖,以至代謝綜合症都緊密相關。
要維持腸道菌平衡、腸道健康,攝取足夠的益生菌及益生元尢其重要。有研究將高脂飲食的無菌小鼠分為三組,分別餵飼益生菌、益生元及共生質(Synbiotics,即益生菌加上益生元)十二週。結果發現,雖然益生菌和益生元分別都對因高脂飲食而增加的體重、血糖、膽固醇等有改善作用,但兩者結合的共生質組別對改善高脂飲食引發的健康問題效果最為明顯,故服用共生質的補充劑比單獨服用益生菌或益生元更為有效。
健康飲食利減重 配益纖菌更有效
最近香港中文大學食品及營養科學課程、食品研究中心及海山基因團隊發表了全港首項針對超重及肥胖人士服用共生質的臨床研究。研究邀請55名有肥胖或超重問題的成年人,分成膳食組、共生質組和膳食共生質組,於8週內分別增加來自水果和蔬菜的膳食纖維(達至平均每日30克),和/或補充共生質,以探討膳食纖維及共生質對腸道微生物群和代謝綜合症的影響。研究採用含嗜酸乳桿菌 NCFM (Lactobacillus acidophilus NCFM)、雙歧桿菌 HN019 (Bifidobacterium lactis HN019) 及聚葡萄糖(Polydextrose)的金裝益纖菌為共生質。結果顯示膳食組和膳食益纖菌組均能顯著減少體重、BMI、脂肪量、軀幹脂肪量和內臟脂肪評級,而膳食益纖菌組在受試前後的變化最為明顯,尤其是空腹血糖、胰島素、胰島素阻抗指數(HOMA-IR)、三酸甘油脂和高密度脂蛋白膽固醇等。此外,膳食益纖菌組腸道中的壞菌巨型單胞菌(Megamonas) 減少了,並與BMI、身體脂肪量和軀幹脂肪量呈正向關係,顯示高纖維加上益纖菌的飲食方案能調節腸道微生物,以至影響體態。但膳食組在早期增加膳食纖維量期間,部份受試者有腹漲、腸胃不適等適應問題,而膳食益纖菌組則無此問題。
增加蔬果攝取是飲食減重的關鍵,而同時配搭共生質補充劑如金裝益纖菌,比只增加膳食纖維更有效,突顯出膳食纖維與益生菌的協同作用。蔬果加上益纖菌的攝取,是簡單而更有效,且能持續的減重及改善代謝綜合症策略。
參考資料/延伸閱讀:
<益生第一關>2023/07/14--『益纖菌加膳食纖維 減重纖體保障健康』
https://hskgene.com/blogs/probiolife-first/dietary_fiber_probiotics?_pos=58&_sid=2b2c298c7&_ss=r
<益生第一關>2021/01/22--『膳食纖維種類多 腸道菌最佳拍檔』
https://hskgene.com/blogs/probiolife-first/dietaryfiber_microbiome
<益生第一關>2018/08/03--『體重控制「PEAS」小貼士』
https://hskgene.com/blogs/probiolife-first/weight_management_peas?_pos=34&_sid=2b2c298c7&_ss=r
Easy Reading:
肥胖 | 衞生防護中心 | 04-26-2023
https://www.chp.gov.hk/tc/healthtopics/content/25/8802.html
代謝症候群是什麼?代謝症候群症狀檢測、飲食5招改善 |康健雜誌 |04-28-2023
https://www.commonhealth.com.tw/article/88021
Metabolic Syndrome - What Is Metabolic Syndrome? | NHLBI, NIH |05-18-2022
https://www.nhlbi.nih.gov/health/metabolic-syndrome
Synbiotic supplementation combined with increased ...|Nutraingredients-Asia|10-16-2023
Google Images:
學術論文:
Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120: 1640–1645. doi:10.1161/CIRCULATIONAHA.109.192644
do Vale Moreira NC, Hussain A, Bhowmik B, Mdala I, Siddiquee T, Fernandes VO, et al. Prevalence of Metabolic Syndrome by different definitions, and its association with type 2 diabetes, pre-diabetes, and cardiovascular disease risk in Brazil. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14: 1217–1224. doi:10.1016/j.dsx.2020.05.043
https://www.sciencedirect.com/science/article/pii/S1871402120301612#sec4
Guembe MJ, Fernandez-Lazaro CI, Sayon-Orea C, Toledo E, Moreno-Iribas C, Cosials JB, et al. Risk for cardiovascular disease associated with metabolic syndrome and its components: a 13-year prospective study in the RIVANA cohort. Cardiovasc Diabetol. 2020;19: 195. doi:10.1186/s12933-020-01166-6
https://link.springer.com/article/10.1186/s12933-020-01166-6
Ke X, Walker A, Haange SB, Lagkouvardos I, Liu Y, Schmitt-Kopplin P, et al. Synbiotic-driven improvement of metabolic disturbances is associated with changes in the gut microbiome in diet-induced obese mice. Molecular Metabolism. 2019; 22: 96-109. doi:10.1016/j.molmet.2019.01.012
https://www.sciencedirect.com/science/article/pii/S2212877818312699
Lauw S, Kei N, Chan PL, Yau TK, Ma KL, Szeto CYY, et al. Effects of Synbiotic Supplementation on Metabolic Syndrome Traits and Gut Microbial Profile among Overweight and Obese Hong Kong Chinese Individuals: A Randomized Trial. Nutrients. 2023; 15: 4248. doi: 10.3390/nu15194248
https://www.mdpi.com/2072-6643/15/19/4248
Le Chatelier E, Nielsen T, Qin J, Prifti E, Hildebrand F, Falony G, et al. Richness of human gut microbiome correlates with metabolic markers. Nature. 2013;500: 541–546. doi:10.1038/nature12506
https://www.nature.com/articles/nature12506
Menni C, Jackson MA, Pallister T, Steves CJ, Spector TD, Valdes AM. Gut microbiome diversity and high-fibre intake are related to lower long-term weight gain. International Journal of Obesity. 2017;41: 1099–1105. doi:10.1038/ijo.2017.66
https://www.nature.com/articles/ijo201766
Saklayen MG. The Global Epidemic of the Metabolic Syndrome. Current Hypertension Reports. 2018;20: 12. doi:10.1007/s11906-018-0812-z
https://link.springer.com/article/10.1007/s11906-018-0812-z?aff_id=1262
Schütz F, Figueiredo-Braga M, Barata P, Cruz-Martins N. Obesity and gut microbiome: review of potential role of probiotics. Porto Biomedical Journal. 2021;6: e111. doi:10.1097/j.pbj.0000000000000111
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817278/
Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006; 444, 1027-1031. doi:10.1038/nature05414