Alterações da microbiota intestinal após uso de fitoterápicos em indivíduos com sobrepeso e obesidade: revisão sistemática

Abstract

Introduction: Obesity is associated with several comorbidities, being one of the main causes of death in the world. Phytotherapy has been a less expensive alternative and increasingly applied in the treatment against obesity. Also, with the advent of bioinformatics, research on gut microbiota reveals a close relationship with the pathogenesis of obesity. Discussing and discovering possible effects of herbal medicine on the intestinal microbiota of the overweight population may open new frontiers in reversing obesogenic processes. Objective: to systematize studies that evaluated the effects of herbal medicine on the intestinal microbiota of overweight and obese people and identify outcomes related to anthropometry and available laboratory biomarkers. Methods: A systematic review study was carried out guided by the question: “Does the use of herbal medicine change the composition of the intestinal microbiota of people with obesity?” Randomized clinical trials were identified and selected from electronic database searches. Inclusion criteria were defined by the PICOS strategy (patients, intervention, comparison, outcomes, study design). The search strategy used a combination of terms and keywords related to herbal medicine, intestinal microbiota and obesity. Two reviewers independently performed the screening and selection of studies, data extraction, and risk of bias assessment. Results: 803 articles were identified in the databases. After removing duplicate publications, reading the title and/or abstract, 13 publications were fully evaluated, of which 5 were considered eligible. The herbs analyzed were: moringa oleifera, scutellaria baicalensis, schisandra chinensis and punica granatum. The analysis of the intestinal microbiota of the clinical trials showed high taxonomic heterogeneity among themselves, not being possible to establish comparable parameters. The effects of schisandra Schisandra chinensis and scutellaria Scutellaria baicalensis on the intestinal microbiota of the intervention group resulted in changes in certain bacterial genera and species, but in a different way for each participant. There was no change in the bacterial diversity of the host microbiota from the articles that carried out the research. There were also no significant changes in anthropometry and laboratory biomarkers of the population that received the intervention with herbal medicines. Conclusion: The present work reveals that clinical trials involving phytotherapy, intestinal microbiota and obesity are still incipient, whether for ethical or logistical reasons. More stratified studies can avoid interference from confounding factors and allow new discoveries about the effects of herbal medicine at longer dosages and intervention times.