Abstract
Purpose
No study has summarized earlier findings on the effect of probiotic supplementation on inflammatory biomarkers. This systematic review and meta-analysis was conducted to systematically review the available placebo-controlled clinical trials about the effect of probiotic supplementation on several inflammatory biomarkers in adults.
Methods
Relevant papers published up to March 2018 were searched up through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using following suitable keywords. Clinical trials that examined the effect of probiotic supplementation on inflammation in adults were included.
Results
Overall, 42 randomized clinical trials (1138 participants in intervention and 1120 participants in control groups) were included. Combining findings from included studies, we found a significant reduction in serum hs-CRP [standardized mean difference (SMD) − 0.46; 95% CI − 0.73, − 0.19], TNF-a (− 0.21; − 0.34, − 0.08), IL-6 (− 0.37; − 0.51, − 0.24), IL-12 (− 0.47; − 0.67, − 0.27), and IL-4 concentrations (− 0.48; − 0.76, − 0.20) after probiotic supplementation. Pooling effect sizes from 11 studies with 12 effect sizes, a significant increase in IL-10 concentrations was seen (0.21; 0.04, 0.38). We failed to find a significant effect of probiotic supplementation on serum IL-1B (− 0.17; − 0.37, 0.02), IL-8 (− 0.01; − 0.30, 0.28), and IFN-g (− 0.08; − 0.31, 0.15) and IL-17 concentrations (0.06; − 0.34, 0.46).
Conclusions
Probiotic supplementation significantly reduced serum concentrations of pro-inflammatory cytokines including, hs-CRP, TNF-a, IL-6, IL-12, and IL-4, but it did not influence IL-1B, IL-8, IFN-g, and IL-17 concentrations. A significant increase in serum concentrations of IL-10, as a anti-inflammatory cytokine was also documented after probiotic supplementation.
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Abbreviations
- SMD:
-
Standardized mean difference
- T2DM:
-
Type 2 diabetes mellitus
- MtS:
-
Metabolic syndrome
- CVD:
-
Cardiovascular disease
- NAFLD:
-
Non-alcoholic fatty liver disease
- SCFAs:
-
Short-chain fatty acids
- IBD:
-
Inflammatory bowel disease
- IBS:
-
Irritable bowel syndrome
- CRP:
-
C-reactive protein
- TNF-a:
-
Tumor necrosis factor-a
- SD:
-
Standard deviation
- SE:
-
Standard error
- MD:
-
Mean difference
- RCT:
-
Randomized clinical trial
- GALT:
-
Gut-associated lymphoid tissue
- IL:
-
Interleukin
- IL-1B:
-
Interleukin 1 beta
- IFN-g:
-
Interferon-gama
References
Robertson CM, Coopersmith CM (2006) The systemic inflammatory response syndrome. Microbes Infect 8(5):1382–1389
Huang Y, Chen Z (2016) Inflammatory bowel disease related innate immunity and adaptive immunity. Am J Transl Res 8(6):2490
Pradhan A (2007) Obesity, metabolic syndrome, and type 2 diabetes: inflammatory basis of glucose metabolic disorders. Nutr Rev 65(suppl_3):S152–S156
Guarner V, Rubio-Ruiz ME (2015) Low-grade systemic inflammation connects aging, metabolic syndrome and cardiovascular disease. Interdiscip Top Gerontol 40:99–106
Başaranoğlu M, Örmeci N (2014) Nonalcoholic fatty liver disease: diagnosis, pathogenesis, and management. Turk J Gastroenterol 25:127–132
Speer K, Upton D, Semple S, McKune A (2018) Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review. J Inflamm Res 11:111
Ashtary-Larky D, Lamuchi-Deli N, Milajerdi A, Salehi MB, Alipour M, Kooti W, Ashtary-Larky P, Alamiri F, Sheikhi A, Afrisham R (2017) Inflammatory and biochemical biomarkers in response to high intensity resistance training in trained and untrained men. Asian J Sports Med 8(2):1A–1A
Kaluza J, Harris H, Melhus H, Michaëlsson K, Wolk A (2018) Questionnaire-based anti-inflammatory diet index as a predictor of low-grade systemic inflammation. Mary Ann Liebert, Inc., New Rochelle
Ozawa M, Shipley M, Kivimaki M, Singh-Manoux A, Brunner EJ (2017) Dietary pattern, inflammation and cognitive decline: the Whitehall II prospective cohort study. Clin Nutr 36(2):506–512
McLoughlin RF, Berthon BS, Jensen ME, Baines KJ, Wood LG (2017) Short-chain fatty acids, prebiotics, synbiotics, and systemic inflammation: a systematic review and meta-analysis. Am J Clin Nutr 106(3):930–945
Li M, van Esch BC, Wagenaar GT, Garssen J, Folkerts G, Henricks PA (2018) Pro-and anti-inflammatory effects of short chain fatty acids on immune and endothelial cells. Eur J Pharmacol 831:52–59
Campbell AW (2016) Inflammation and a solution: probiotics. Altern Ther Health Med 22(5):8
Wang Z-J, Chen X-F, Zhang Z-X, Li Y-C, Deng J, Tu J, Song Z-Q, Zou Q-H (2017) Effects of anti-Helicobacter pylori concomitant therapy and probiotic supplementation on the throat and gut microbiota in humans. Microb Pathog 109:156–161
Goldin B, Gorbach S (2008) Clinical indications for probiotics: an overview. Clin Infect Dis 46(Supplement_2):S96–S100
Kaur IP, Kuhad A, Garg A, Chopra K (2009) Probiotics: delineation of prophylactic and therapeutic benefits. J Med Food 12(2):219–235
Alberda C, Gramlich L, Meddings J, Field C, McCargar L, Kutsogiannis D, Fedorak R, Madsen K (2007) Effects of probiotic therapy in critically ill patients: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 85(3):816–823
Han SH, Suk KT, Kim DJ, Kim MY, Baik SK, Kim YD, Cheon GJ, Choi DH, Ham YL, Shin DH (2015) Effects of probiotics (cultured Lactobacillus subtilis/Streptococcus faecium) in the treatment of alcoholic hepatitis: randomized-controlled multicenter study. Eur J Gastroenterol Hepatol 27(11):1300–1306
Pineda Mde L, Thompson SF, Summers K, de Leon F, Pope J, Reid G (2011) A randomized, double-blinded, placebo-controlled pilot study of probiotics in active rheumatoid arthritis. Med Sci Monit 17(6):CR347–C354
Bajaj JS, Heuman DM, Hylemon PB, Sanyal AJ, Puri P, Sterling RK, Luketic V, Stravitz RT, Siddiqui MS, Fuchs M, Thacker LR, Wade JB, Daita K, Sistrun S, White MB, Noble NA, Thorpe C, Kakiyama G, Pandak WM, Sikaroodi M, Gillevet PM (2014) Randomised clinical trial: Lactobacillus GG modulates gut microbiome, metabolome and endotoxemia in patients with cirrhosis. Aliment Pharmacol Ther 39(10):1113–1125. https://doi.org/10.1111/apt.12695
Maslova E, Bhattacharya S, Lin S-W, Michels KB (2010) Caffeine consumption during pregnancy and risk of preterm birth: a meta-analysis. Am J Clin Nutr 92(5):1120–1132
Akkasheh G, Kashani-Poor Z, Tajabadi-Ebrahimi M, Jafari P, Akbari H, Taghizadeh M, Memarzadeh MR, Asemi Z, Esmaillzadeh A (2016) Clinical and metabolic response to probiotic administration in patients with major depressive disorder: a randomized, double-blind, placebo-controlled trial. Nutrition 32(3):315–320
Alipour B, Homayouni-Rad A, Vaghef-Mehrabany E, Sharif SK, Vaghef-Mehrabany L, Asghari-Jafarabadi M, Nakhjavani MR, Mohtadi-Nia J (2014) Effects of Lactobacillus casei supplementation on disease activity and inflammatory cytokines in rheumatoid arthritis patients: a randomized double-blind clinical trial. Int J Rheum Dis 17(5):519–527. https://doi.org/10.1111/1756-185x.12333
Andreasen AS, Larsen N, Pedersen-Skovsgaard T, Berg RM, Moller K, Svendsen KD, Jakobsen M, Pedersen BK (2010) Effects of Lactobacillus acidophilus NCFM on insulin sensitivity and the systemic inflammatory response in human subjects. Br J Nutr 104(12):1831–1838. https://doi.org/10.1017/s0007114510002874
Asemi Z, Zare Z, Shakeri H, Sabihi SS, Esmaillzadeh A (2013) Effect of multispecies probiotic supplements on metabolic profiles, hs-CRP, and oxidative stress in patients with type 2 diabetes. Ann Nutr Metab 63(1–2):1–9. https://doi.org/10.1159/000349922
Behrouz V, Jazayeri S, Aryaeian N, Zahedi MJ, Hosseini F (2017) Effects of probiotic and prebiotic supplementation on leptin, adiponectin, and glycemic parameters in non-alcoholic fatty liver disease: a randomized clinical trial. Middle East J Dig Dis 9(3):150–157. https://doi.org/10.15171/mejdd.2017.66
Borges NA, Carmo FL, Stockler-Pinto MB, de Brito JS, Dolenga CJ, Ferreira DC, Nakao LS, Rosado A, Fouque D, Mafra D (2018) Probiotic supplementation in chronic kidney disease: a double-blind, randomized, placebo-controlled trial. J Ren Nutr 28(1):28–36. https://doi.org/10.1053/j.jrn.2017.06.010
Costanza AC, Moscavitch SD, Faria Neto HC, Mesquita ET (2015) Probiotic therapy with Saccharomyces boulardii for heart failure patients: a randomized, double-blind, placebo-controlled pilot trial. Int J Cardiol 179:348–350. https://doi.org/10.1016/j.ijcard.2014.11.034
Ebrahimi-Mameghani M, Sanaie S, Mahmoodpoor A, Hamishehkar H (2013) Effect of a probiotic preparation (VSL#3) in critically ill patients: a randomized, double-blind, placebo-controlled trial (pilot study). Pak J Med Sci 29(2):490–494
Firouzi S, Majid HA, Ismail A, Kamaruddin NA, Barakatun-Nisak MY (2017) Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial. Eur J Nutr 56(4):1535–1550. https://doi.org/10.1007/s00394-016-1199-8
Flichy-Fernández A, Ata-Ali J, Alegre-Domingo T, Candel-Martí E, Ata-Ali F, Palacio J, Peñarrocha-Diago M (2015) The effect of orally administered probiotic Lactobacillus reuteri-containing tablets in peri-implant mucositis: a double-blind randomized controlled trial. J Periodontal Res 50(6):775–785
Gomes AC, de Sousa RG, Botelho PB, Gomes TL, Prada PO, Mota JF (2017) The additional effects of a probiotic mix on abdominal adiposity and antioxidant status: a double-blind, randomized trial. Obesity (Silver Spring Md) 25(1):30–38. https://doi.org/10.1002/oby.21671
Groeger D, O’Mahony L, Murphy EF, Bourke JF, Dinan TG, Kiely B, Shanahan F, Quigley EM (2013) Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut. Gut Microbes 4(4):325–339. https://doi.org/10.4161/gmic.25487
Gupta N, Kumar A, Sharma P, Garg V, Sharma BC, Sarin SK (2013) Effects of the adjunctive probiotic VSL#3 on portal haemodynamics in patients with cirrhosis and large varices: a randomized trial. Liver Int 33(8):1148–1157. https://doi.org/10.1111/liv.12172
Hatakka K, Martio J, Korpela M, Herranen M, Poussa T, Laasanen T, Saxelin M, Vapaatalo H, Moilanen E, Korpela R (2003) Effects of probiotic therapy on the activity and activation of mild rheumatoid arthritis—a pilot study. Scand J Rheumatol 32(4):211–215
Jafarnejad S, Djafarian K, Fazeli MR, Yekaninejad MS, Rostamian A, Keshavarz SA (2017) Effects of a multispecies probiotic supplement on bone health in osteopenic postmenopausal women: a randomized, double-blind, controlled trial. J Am Coll Nutr 36(7):497–506. https://doi.org/10.1080/07315724.2017.1318724
Jenks K, Stebbings S, Burton J, Schultz M, Herbison P, Highton J (2010) Probiotic therapy for the treatment of spondyloarthritis: a randomized controlled trial. J Rheumatol 37(10):2118–2125. https://doi.org/10.3899/jrheum.100193
Jones M, Martoni C, Prakash S (2012) Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial. Eur J Clin Nutr 66(11):1234
Kouchaki E, Tamtaji OR, Salami M, Bahmani F, Daneshvar Kakhaki R, Akbari E, Tajabadi-Ebrahimi M, Jafari P, Asemi Z (2017) Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled trial. Clin Nutr 36(5):1245–1249. https://doi.org/10.1016/j.clnu.2016.08.015
Minami J, Kondo S, Yanagisawa N, Odamaki T, Xiao JZ, Abe F, Nakajima S, Hamamoto Y, Saitoh S, Shimoda T (2015) Oral administration of Bifidobacterium breve B-3 modifies metabolic functions in adults with obese tendencies in a randomised controlled trial. J Nutr Sci 4:e17. https://doi.org/10.1017/jns.2015.5
Mohseni S, Bayani M, Bahmani F, Tajabadi-Ebrahimi M, Bayani MA, Jafari P, Asemi Z (2017) The beneficial effects of probiotic administration on wound healing and metabolic status in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. Diabetes Metab Res Rev. https://doi.org/10.1002/dmrr.2970
Nagata Y, Yoshida M, Kitazawa H, Araki E, Gomyo T (2010) Improvements in seasonal allergic disease with Lactobacillus plantarum no. 14. Biosci Biotechnol Biochem 74(9):1869–1877. https://doi.org/10.1271/bbb.100270
Natarajan R, Pechenyak B, Vyas U, Ranganathan P, Weinberg A, Liang P, Mallappallil MC, Norin AJ, Friedman EA, Saggi SJ (2014) Randomized controlled trial of strain-specific probiotic formulation (Renadyl) in dialysis patients. BioMed Res Int 2014:568571. https://doi.org/10.1155/2014/568571
Panahi Y, Ghanei M, Vahedi E, Mousavi SH, Imani S, Sahebkar A (2017) Efficacy of probiotic supplementation on quality of life and pulmonary symptoms due to sulfur mustard exposure: a randomized double-blind placebo-controlled trial. Drug Chem Toxicol 40(1):24–29. https://doi.org/10.3109/01480545.2016.1166250
Pinto-Sanchez MI, Hall GB, Ghajar K, Nardelli A, Bolino C, Lau JT, Martin FP, Cominetti O, Welsh C, Rieder A, Traynor J, Gregory C, De Palma G, Pigrau M, Ford AC, Macri J, Berger B, Bergonzelli G, Surette MG, Collins SM, Moayyedi P, Bercik P (2017) Probiotic Bifidobacterium longum NCC3001 reduces depression scores and alters brain activity: a pilot study in patients with irritable bowel syndrome. Gastroenterology 153(2):448–459 e448. https://doi.org/10.1053/j.gastro.2017.05.003
Rajkumar H, Mahmood N, Kumar M, Varikuti SR, Challa HR, Myakala SP (2014) Effect of probiotic (VSL#3) and omega-3 on lipid profile, insulin sensitivity, inflammatory markers, and gut colonization in overweight adults: a randomized, controlled trial. Mediat Inflamm 2014:348959. https://doi.org/10.1155/2014/348959
Redondo N, Nova E, Gheorghe A, Díaz LE, Hernández A, Marcos A (2017) Evaluation of Lactobacillus coryniformis CECT5711 strain as a coadjuvant in a vaccination process: a randomised clinical trial in healthy adults. Nutr Metab 14(1):2
Sepideh A, Karim P, Hossein A, Leila R, Hamdollah M, Mohammad EG, Mojtaba S, Mohammad S, Ghader G, Seyed Moayed A (2015) Effects of multistrain probiotic supplementation on glycemic and inflammatory indices in patients with nonalcoholic fatty liver disease: a double-blind randomized clinical trial. J Am Coll Nutr. https://doi.org/10.1080/07315724.2015.1031355
Shariaty Z, Mahmoodi Shan GR, Farajollahi M, Amerian M, Behnam Pour N (2017) The effects of probiotic supplement on hemoglobin in chronic renal failure patients under hemodialysis: a randomized clinical trial. J Res Med Sci 22:74. https://doi.org/10.4103/jrms.JRMS_614_16
Sharma B, Srivastava S, Singh N, Sachdev V, Kapur S, Saraya A (2011) Role of probiotics on gut permeability and endotoxemia in patients with acute pancreatitis: a double-blind randomized controlled trial. J Clin Gastroenterol 45(5):442–448. https://doi.org/10.1097/MCG.0b013e318201f9e2
Shoaei T, Heidari-Beni M, Tehrani HG, Feizi A, Esmaillzadeh A, Askari G (2015) Effects of probiotic supplementation on pancreatic beta-cell function and C-reactive protein in women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial. Int J Prev Med 6:27. https://doi.org/10.4103/2008-7802.153866
Sierra S, Lara-Villoslada F, Sempere L, Olivares M, Boza J, Xaus J (2010) Intestinal and immunological effects of daily oral administration of Lactobacillus salivarius CECT5713 to healthy adults. Anaerobe 16(3):195–200
Soleimani A, Zarrati Mojarrad M, Bahmani F, Taghizadeh M, Ramezani M, Tajabadi-Ebrahimi M, Jafari P, Esmaillzadeh A, Asemi Z (2017) Probiotic supplementation in diabetic hemodialysis patients has beneficial metabolic effects. Kidney Int 91(2):435–442. https://doi.org/10.1016/j.kint.2016.09.040
Vaghef-Mehrabany E, Alipour B, Homayouni-Rad A, Sharif SK, Asghari-Jafarabadi M, Zavvari S (2014) Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition 30(4):430–435. https://doi.org/10.1016/j.nut.2013.09.007
Villar-Garcia J, Guerri-Fernandez R, Moya A, Gonzalez A, Hernandez JJ, Lerma E, Guelar A, Sorli L, Horcajada JP, Artacho A, G Knobel DA H (2017) Impact of probiotic Saccharomyces boulardii on the gut microbiome composition in HIV-treated patients: a double-blind, randomised, placebo-controlled trial. PLoS One 12(4):e0173802. https://doi.org/10.1371/journal.pone.0173802
Wang I-K, Wu Y-Y, Yang Y-F, Ting I-W, Lin C-C, Yen T-H, Chen J-H, Wang C-H, Huang C-C, Lin H-C (2015) The effect of probiotics on serum levels of cytokine and endotoxin in peritoneal dialysis patients: a randomised, double-blind, placebo-controlled trial. Benef Microbes 6(4):423–430
Xiao J (2006) Effect of probiotic Bifidobacterium longum BBS36 in relieving clinical symptoms and modulating plasma cytokine levels of Japanese cedar pollinosis during the pollen season. A randomized double-blind, placebocontrolled trial. J Investig Allergol Clin Immunol 16:86–93
Yamamoto K, Yokoyama K, Matsukawa T, Kato S, Kato S, Yamada K, Hirota T (2016) Efficacy of prolonged ingestion of Lactobacillus acidophilus L-92 in adult patients with atopic dermatitis. J Dairy Sci 99(7):5039–5046
Zamani B, Golkar HR, Farshbaf S, Emadi-Baygi M, Tajabadi-Ebrahimi M, Jafari P, Akhavan R, Taghizadeh M, Memarzadeh MR, Asemi Z (2016) Clinical and metabolic response to probiotic supplementation in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled trial. Int J Rheum Dis. https://doi.org/10.1111/1756-185x.12888
Mazidi M, Rezaie P, Ferns GA, Vatanparast H (2017) Impact of probiotic administration on serum C-reactive protein concentrations: systematic review and meta-analysis of randomized control trials. Nutrients 9(1):20
Ma Y-Y, Li L, Yu C-H, Shen Z, Chen L-H, Li Y-M (2013) Effects of probiotics on nonalcoholic fatty liver disease: a meta-analysis. World J Gastroenterol 19(40):6911
Liu D, Jiang X-Y, Zhou L-S, Song J-H, Zhang X (2016) Effects of probiotics on intestinal mucosa barrier in patients with colorectal cancer after operation: meta-analysis of randomized controlled trials. Medicine 95(15):e3342
Aqaeinezhad Rudbane SM, Rahmdel S, Abdollahzadeh SM, Zare M, Bazrafshan A, Mazloomi SM (2018) The efficacy of probiotic supplementation in rheumatoid arthritis: a meta-analysis of randomized, controlled trials. Inflammopharmacology 26:67–76
Tam CS, Redman LM (2013) Adipose tissue inflammation and metabolic dysfunction: a clinical perspective. Horm Mol Biol Clin Investig 15(1):19–24
Morita H, He F, Fuse T, Ouwehand AC, Hashimoto H, Hosoda M, Mizumachi K, Kurisaki J (2002) Adhesion of lactic acid bacteria to caco-2 cells and their effect on cytokine secretion. Microbiol Immunol 46(4):293–297
He F, Ouwehand AC, Isolauri E, Hashimoto H, Benno Y, Salminen S (2001) Comparison of mucosal adhesion and species identification of bifidobacteria isolated from healthy and allergic infants. Pathog Dis 30(1):43–47
Pankevich E, Astakhova A, Chistyakov D, Sergeeva M (2017) Antiinflammatory effect of rosiglitazone via modulation of mRNA stability of interleukin 10 and cyclooxygenase 2 in astrocytes. Biochemistry 82(11):1276–1284
Calcinaro F, Dionisi S, Marinaro M, Candeloro P, Bonato V, Marzotti S, Corneli R, Ferretti E, Gulino A, Grasso F (2005) Oral probiotic administration induces interleukin-10 production and prevents spontaneous autoimmune diabetes in the non-obese diabetic mouse. Diabetologia 48(8):1565–1575
Kaji R, Kiyoshima-Shibata J, Tsujibe S, Nanno M, Shida K (2018) Probiotic induction of interleukin-10 and interleukin-12 production by macrophages is modulated by co-stimulation with microbial components. J Dairy Sci 101(4):2838–2841
Icaza-Chávez M (2013) Gut microbiota in health and disease. Revista de Gastroenterología de México 78(4):240–248 (English edition)
Shacklett BL, Cox CA, Sandberg JK, Stollman NH, Jacobson MA, Nixon DF (2003) Trafficking of human immunodeficiency virus type 1-specific CD8+ T cells to gut-associated lymphoid tissue during chronic infection. J Virol 77(10):5621–5631
Malin M, Verronen P, Korhonen H, Syväoja E-L, Salminen S, Mykkänen H, Arvilommi H, Eerola E, Isolauri E (1997) Dietary therapy with Lactobacillus GG, bovine colostrum or bovine immune colostrum in patients with juvenile chronic arthritis: evaluation of effect on gut defence mechanisms. Inflammopharmacology 5(3):219–236
Vitaliti G, Pavone P, Guglielmo F, Spataro G, Falsaperla R (2014) The immunomodulatory effect of probiotics beyond atopy: an update. J Asthma 51(3):320–332
Rautava S, Kalliomäki M, Isolauri E (2005) New therapeutic strategy for combating the increasing burden of allergic disease: probiotics—a Nutrition, Allergy, Mucosal Immunology and Intestinal Microbiota (NAMI) Research Group report. J Allergy Clin Immunol 116(1):31–37
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AM, BL, and AE designed research; AM, SMM, AS, ASM, and MP conducted research; AM analyzed data; AM and AE wrote the paper; and AE had primary responsibility for final content. All authors read and approved the final manuscript.
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Milajerdi, A., Mousavi, S.M., Sadeghi, A. et al. The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials. Eur J Nutr 59, 633–649 (2020). https://doi.org/10.1007/s00394-019-01931-8
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DOI: https://doi.org/10.1007/s00394-019-01931-8