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Boyajian et al. Microbiome Res Rep 2024;3:29 https://dx.doi.org/10.20517/mrr.2024.05 Page 23 of 35

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18-strain blend of Lactobacillus, Lactococcus and Capsule Elderly men and women 42 4 × 10 3 months • Enhanced cognitive function Increased: Fei et al.
[219]
Bifidobacterium genera with MCI in China (aged ≥ CFU/day (i.e., attention, calculation, recall, Bacteroidetes (2023)
60) executive function, visuospatial) Ruminococcus
• Improved sleep quality Prevotellaceae
• Improved GI symptoms (e.g., Lachnospiraceae
abdominal pain, acid reflux,
constipation)
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Bifidobacterium longum BB68S Powder Healthy elderly men and 50 5 × 10 2 months • Improved cognitive function Increased: Shi et al.
[220]
women in China (aged 60- CFU/day (e.g., list learning, story recall, Firmicutes (2022)
75) figure recall) Actinobacteria
Bifidobacterium
Lachnospira

Decreased:
Proteobacteria
Eubacterium

BMI: Body mass index; CFU: colony forming units; N/A: not applicable; MCI: mild cognitive impairment; BDNF: brain-derived neurotropic factor; GI: gastrointestinal.

synbiotic combinations for obesity and aging. Notably, a novel synbiotic formulation comprised of probiotics B. longum spp. infantis NCIMB 702255,
L. fermentum NCIMB 5221, and L. plantarum NCIMB 8826, and Triphala, a polyphenolic-rich Ayurvedic herb, was investigated by Westfall et al. for
therapeutic effects on obesity and systemic metabolic markers . Although the individual probiotics demonstrated beneficial effects, as discussed earlier,
[187]
treatment with the synbiotic formulation resulted in the greatest impact. Specifically, in diet-induced obese Drosophila, beneficial variations in the gut
microbiota (e.g., decreased F/B ratio), improved metabolic markers (e.g., lipogenesis, insulin resistance), and weight loss were most significant in flies treated
with the probiotic or synbiotic formulations. Westfall et al. also studied the therapeutic potential of this synbiotic formulation in aging Drosophila and found it

to have more robust combinatorial effects compared to its individual constituents, extending lifespan by a remarkable 60% and reducing metabolic parameters
(e.g., total weight, total glucose, total triglycerides) . Age-dependent elevations in inflammation and oxidative stress were also attenuated by the synbiotic
[223]
formulation. These findings suggest that longevity and age-associated metabolic impairment and inflammation may be improved simultaneously with

probiotics and prebiotics, or their combination, due to a synergistic effect. Another synbiotic formulation containing L. acidophilus, B. lactis, B. longum, B.
bifidum and a prebiotic GOS mixture beneficially modulated the gut microbiota (e.g., increased abundance of Lactobacillus and Bifidobacterium and microbial

diversity) in humans on a low-carbohydrate, high-protein, reduced energy diet, although body composition was not altered . Along with prebiotics,
[224]
probiotics may be combined with other nutraceuticals for health benefits. A recent clinical trial investigated the efficacy of supplementation with Bacillus
coagulans combined with other nutraceuticals (i.e., antioxidant formulation, fish oil, cinnamon, and fiber supplement) in healthy overweight and obese

[225]
subjects with cardiometabolic risk factors on a strict Mediterranean diet . Findings revealed a significant improvement in longevity and cardiometabolic risk
factors in treated subjects, including reduced serum lipids, inflammation (e.g., high-sensitivity CRP), blood pressure, insulin resistance, and a remarkable 50%

reduction in diagnostic criteria for cardiometabolic syndrome and 38% decrease in Framingham 10-year cardiovascular risk. Supplementation of probiotics
with fish oil and Vitamin D has also been investigated in overweight or obese individuals, resulting in decreased systemic inflammation after an eight-week