Probiotics could lower risk of metabolic syndrome, study suggests

Using data from the National Health and Nutrition Examination Survey (NHANES), researchers from Guangdong Women and Children Hospital in China studied the link between live microbe intake and the risk of metabolic syndrome and survival outcomes.

The study found that higher dietary live microbe intake was significantly associated with a lower risk of metabolic syndrome, all-cause mortality and cardiovascular disease-induced mortality.

“These findings suggest that dietary live microbes may be a promising modifiable factor for the prevention and management of metabolic syndrome and may improve long-term health outcomes through improvements in lipid metabolism, blood pressure control and attenuation of inflammation,” the researchers wrote in Frontiers in Nutrition.

Probiotics and metabolic syndrome

Metabolic syndrome refers to a group of health problems that increase the risk of type 2 diabetes. This includes abdominal obesity, high blood pressure, high blood sugar, high triglyceride levels and low HDL (good) cholesterol. Having three or more of these five health conditions indicates presence of the syndrome.

Research shows that probiotics could benefit a number of these parameters, including improving cholesterol levels, and controlling blood pressure and blood sugar levels.

However, to date, no studies have specifically examined the relationship between live microbe intake and metabolic syndrome as a composite condition, or the related mortality outcomes.

The researchers therefore set out to address this knowledge gap by conducting a cross-sectional and longitudinal study analyzing this potential relationship.

Study details

Using data from the NHANES database, Huang et al. reviewed health information and dietary recall data from 38,462 individuals. The participants were then split into three categories based on their live microbe intake: low, medium and high.

The low dietary live microbe intake group consumed only low-level foods, typically pasteurized foods, the medium group consumed medium levels of microbes, i.e. unpeeled fresh fruits and vegetables, and the high group consumed unpasteurized fermented foods and probiotic supplements.

The amounts of these foods were also analyzed using a continuous measure (MedHi) to investigate the potential dose-response relationship.

Associations between live microbe intake, the prevalence of metabolic syndrome and the associations with all-cause mortality and cardiovascular disease mortality were then evaluated.

After adjusting for confounding variables (including energy intake), the researchers reported a 12% reduction in metabolic syndrome in the high-intake group that had a compared to the low-intake group.

In addition, medium and high levels of dietary live microbe consumption were significantly associated with reduced all-cause and cardiovascular mortality risk in people with metabolic syndrome, with particularly pronounced reductions in cardiovascular mortality (roughly 28% to 29%).

Regarding dosing, the researchers reported that each 100 g increase in MedHi foods was associated with 6% lower all-cause mortality and 8% lower cardiovascular disease mortality.

“The protective association was particularly pronounced for specific metabolic syndrome components, [such as] low high-density lipoprotein cholesterol (23% lower risk), elevated serum triglycerides (10% lower risk) and elevated blood pressure (10% lower risk) in the high intake group,” the researchers wrote.

Do live microbes have cardiovascular benefits?

According to the researchers, the observed mortality benefit pattern deserves particular attention.

“The reduction in cardiovascular disease mortality risk was considerably more pronounced than the more modest reduction in all-cause mortality,” they explained. “This differential impact suggests that dietary live microbes may specifically target cardiovascular pathophysiology beyond their metabolic effects.”

This aligns with emerging evidence on the gut-heart axis, they added, and may reflect the cumulative benefits of improved lipid profiles, better blood pressure control and potential direct effects on vascular system pathways not captured in the analysis.

“This research provides novel insights into the potential role of dietary live microbes in metabolic health and mortality risk, with important implications for public health recommendations and clinical practice,” the researchers concluded. “Understanding these relationships is crucial for developing evidence-based dietary strategies to combat the rising prevalence of metabolic syndrome and its associated mortality burden.”

Source: Frontiers in Nutrition. doi: 10.3389/fnut.2025.1592969. “Higher dietary live microbe intake is linked to reduced risk of metabolic syndrome and mortality: a cross-sectional and longitudinal study”. Authors: S. Huang, et al.