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Randomized Controlled Trial
. 2024 Jun 13;16(12):1852.
doi: 10.3390/nu16121852.

A Symbiotic Meal Containing Extruded Sorghum and Probiotic (Bifidobacterium longum) Ameliorated Intestinal Health Markers in Individuals with Chronic Kidney Disease: A Secondary Analysis of a Subsample from a Previous Randomized and Controlled Clinical Trial

Haira Guedes Lúcio  1 , Rita de Cassia Stampini Oliveira Lopes  1 , Mariana Juste Contin Gomes  1 , Alessandra da Silva  1 , Mariana Grancieri  2 , Ceres Mattos Della Lucia  1 , Valéria Aparecida Vieira Queiroz  3 , Bárbara Pereira da Silva  1 , Hercia Stampini Duarte Martino  1
Affiliations
Randomized Controlled Trial

A Symbiotic Meal Containing Extruded Sorghum and Probiotic (Bifidobacterium longum) Ameliorated Intestinal Health Markers in Individuals with Chronic Kidney Disease: A Secondary Analysis of a Subsample from a Previous Randomized and Controlled Clinical Trial

Haira Guedes Lúcio et al. Nutrients. .

Abstract

Background: Chronic kidney disease increases uremic toxins concentrations, which have been associated with intestinal dysbiosis. Sorghum bicolor L. Moench has dietary fiber and bioactive compounds, while Bifidobacterium longum can promote beneficial health effects.

Methods: It is a controlled, randomized, and single-blind clinical trial. Thirty-nine subjects were randomly separated into two groups: symbiotic group (SG), which received 100 mL of unfermented probiotic milk with Bifidobacterium longum strain and 40 g of extruded sorghum flakes; and the control group (CG), which received 100 mL of pasteurized milk and 40 g of extruded corn flakes for seven weeks.

Results: The uremic toxins decreased, and gastrointestinal symptoms improved intragroup in the SG group. The acetic, propionic, and butyric acid production increased intragroup in the SG group. Regarding α-diversity, the Chao1 index was enhanced in the SG intragroup. The KEGG analysis revealed that symbiotic meal increased the intragroup energy and amino sugar metabolism, in addition to enabling essential amino acid production and metabolism, sucrose degradation, and the biosynthesis of ribonucleotide metabolic pathways.

Conclusions: The consumption of symbiotic meal reduced BMI, improved short-chain fatty acid (SCFA) synthesis and gastrointestinal symptoms, increased diversity according to the Chao1 index, and reduced uremic toxins in chronic kidney disease patients.

Keywords: SCFAs; Sorghum bicolor L. Moench; gut microbiota; symbiotic meal; uremic toxins.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study design of research.
Figure 2
Figure 2
Consort flow diagram of study design of intervention protocol.
Figure 3
Figure 3
Effect of extruded sorghum BRS 305 plus Bifidobacterium longum on α-diversity index. (A) Chao1 index at baseline and endpoint, (B) Shannon–Weiner index at baseline and endpoint, (C) Simpson index at baseline and endpoint. CG: control group; SG: symbiotic group. The data were subjected to a paired t-test or unpaired t-test (α = 0.05) in GraphPad version 9.0.
Figure 4
Figure 4
Effect of extruded sorghum BRS 305 plus Bifidobacterium longum on the β-diversity estimated by principal coordinate analysis (PcoA), based on the Jaccard similarity distance of gut microbial communities in chronic kidney disease patients. (A) PCoA of the symbiotic group at baseline and endpoint; (B) PCoA of the control group at baseline and endpoint; (C) PCoA of the control and symbiotic groups at baseline; (D) PCoA of the control and symbiotic groups at endpoint. Permutational multivariate analysis of variance (PERMANOVA) was conducted using the STAMP software system version 2.0.2 considering α = 5%.
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