Randomized Controlled Trial
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2021; 27(1): 107-128
Published online Jan 7, 2021. doi: 10.3748/wjg.v27.i1.107
Effect of probiotic Lactobacillus plantarum Dad-13 powder consumption on the gut microbiota and intestinal health of overweight adults
Endang Sutriswati Rahayu, Mariyatun Mariyatun, Nancy Eka Putri Manurung, Pratama Nur Hasan, Phatthanaphong Therdtatha, Riko Mishima, Husnita Komalasari, Nurul Ain Mahfuzah, Fathyah Hanum Pamungkaningtyas, Wahyu Krisna Yoga, Dina Aulia Nurfiana, Stefanie Yolanda Liwan, Mohammad Juffrie, Agung Endro Nugroho, Tyas Utami
Endang Sutriswati Rahayu, Mariyatun Mariyatun, Nancy Eka Putri Manurung, Pratama Nur Hasan, Husnita Komalasari, Nurul Ain Mahfuzah, Fathyah Hanum Pamungkaningtyas, Wahyu Krisna Yoga, Dina Aulia Nurfiana, Stefanie Yolanda Liwan, Tyas Utami, Department of Food and Agricultural Technology, Faculty of Agricultural Technology, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Endang Sutriswati Rahayu, Mariyatun Mariyatun, Nancy Eka Putri Manurung, Pratama Nur Hasan, Fathyah Hanum Pamungkaningtyas, Dina Aulia Nurfiana, Tyas Utami, Center for Food and Nutrition Studies, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Phatthanaphong Therdtatha, Riko Mishima, Department of Bioscience and Biotechnology, Faculty of Agriculture, Kyushu University, 774 Motooka, Nishi-ku, Fukuoka, Japan
Mohammad Juffrie, Department of Public Health, Faculty of Medicine, Public Health and Nursery, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Agung Endro Nugroho, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Author contributions: Rahayu ES leaded the research project and together with Utami T designed the study; Juffrie M supervised the ethical approval and acted as the consultant for the clinical trial; Nugroho AE supervised the production of probiotic powder; Mariyatun M and Hasan PN supervised the on-site study; Putri Manurung NE, Komalasari H, Yoga WK, Therdtatha P, Mishima R performed the work on-site and maintained the coordination with subject as well as conducted sampling; Nurfiana DA, Mahfuzah NA, Liwan SY performed analysis at the laboratory; Mariyatun M and Pamungkaningtyas FH analysed the laboratory data and took part in preparing the manuscript.
Supported by Ristekdikti Kalbe - Science Awards, No. 048/KF-Legal/RKSA/I/2019.
Institutional review board statement: The study was reviewed and approved by the Ethic Comittee Faculty of Medicine Universitas Gadjah Mada, Institutional Review Board, Approval No. KE/1267/11/2018.
Clinical trial registration statement: This study is registered on the Health Research and Development Agency, Ministry of Health of the Republic of Indonesia, registration No. INA-2A8RG4R.
Informed consent statement: All subjects agreed to participate in this study after informed consent and ethical permission was obtained.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this manuscript.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Endang Sutriswati Rahayu, Dr, Professor, Department of Food and Agricultural Technology, Faculty of Agricultural Technology, Universitas Gadjah Mada, Jalan Flora No. 1, Bulaksumur, Sleman, Yogyakarta 55281, Yogyakarta, Indonesia. endangsrahayu@ugm.ac.id
Received: November 9, 2020
Peer-review started: November 9, 2020
First decision: November 23, 2020
Revised: December 7, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 7, 2021

Shifting on lifestyle, diet, and physical activity contributed on increasing number of obese people around the world. Multiple factors influence the development of obesity. Some research suggested that gut microbiota (GM) plays an important role in nutrient absorption and energy regulation of individuals, thus affecting their nutritional status. Report of Indonesia Basic Health Research showed that the prevalence of obesity in every province tended to increase. Although the root cause of obesity is excessive calorie intake compared with expenditure, the differences in gut microbial ecology between healthy and obese humans may affect energy homeostasis. GM affect body weight, especially obesity. Probiotics that are consumed while alive and able to colonize in the intestine are expected to increase the population of good bacteria, especially Bifidobacteria and Lactobacilli, and suppress pathogens such as Enterobacteriaceae and Staphylococcus. The strain of L. plantarum Dad-13 has been demonstrated to survive and colonize in the gastrointestinal tract of healthy Indonesian adults who consume fermented milk containing L. plantarum Dad-13. The consumption of probiotic L. plantarum Dad-13 powder decreased E. coli and non-E. coli coliform bacteria in school-aged children in Indonesia. L. plantarum is a dominant bacterium in the average Indonesian’s GM. For this reason, this bacterium is probably a more suitable probiotic for Indonesians.


To determine the effect of the consumption of indigenous probiotic Lactobacillus plantarum Dad-13 powder in overweight adults in Yogyakarta (Indonesia).


Sixty overweight volunteers with a body mass index (BMI) equal to or greater than 25 consume indigenous probiotic powder L. plantarum Dad-13 (2 × 109 CFU/gram/sachet) for 90 d. The study was a randomized, double-blind, placebo-controlled study. The volunteers filled in a diary on a daily basis, which consisted of questions on study product intake (only during ingestion period), other food intake, number of bowel movements, fecal quality (consistency and color), any medications received, and any symptom of discomfort, such as diarrhea, constipation, vomiting, gassing, sensation of illness, etc. Fecal samples and the subjects’ diaries were collected on the morning of day 10 + 1, which was marked as the end of the baseline period and the start of the ingestion period. During the ingestion period (from day 11 to day 101), several parameters to measure and analyze the results included body weight and height (once a month), the lipid profile, GM analysis using MiSeq, short-chain fatty acid (SCFA) analysis using gas chromatography, and the measurement of fecal pH using a pH meter.


The consumption of indigenous probiotic powder L. plantarum Dad-13 caused the average body weight and BMI of the probiotic group to decrease from 84.54 ± 17.64 kg to 83.14 ± 14.71 kg and 33.10 ± 6.15 kg/m2 to 32.57 ± 5.01 kg/m2, respectively. No significant reduction of body weight and BMI in the placebo group was observed. An analysis of the microbiota showed that the number of Bacteroidetes, specifically Prevotella, increased significantly, while that of Firmicutes significantly decreased. No significant change in lipid profile in both groups was found. Also, no significant change in SCFAs (e.g., butyrate, propionate, acetic acid) and pH level was found after the consumption of the probiotic.


No significant differences in pH before and after ingestion were observed in both the probiotic and placebo groups as well as in the lipid profile of both cholesterol and triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and the LDL/HDL ratio. In addition, no significant changes in the concentration of SCFAs (e.g., acetic acid, propionate, and butyrate) were found after con-sumption. Interestingly, a significant decrease in body weight and BMI (P < 0.05) was determined in the treatment group. An analysis of GM shows that L. plantarum Dad-13 caused the Firmicutes population to decrease and the Bacteroidetes population (especially Prevotella) to increase.

Keywords: Obesity, Body mass index, Lipid profile, Gut microbiota, Short chain fatty acid, Probiotic Lactobacillus plantarum Dad-13

Core Tip: Obesity and overweight are corelated with unhealthy lifestyle that affect the health of intestine and affect the ecosystem of gut microbiota (GM). Consumption of probiotics help to maintain the ecosystem of GM to stay balance and healthy. L. plantarum Dad-13 is potential probiotics for Indonesians to maintain health of the gastrointestinal ecosystem. This research was conducted to investigate and determine the effect of consumption of indigenous probiotic L. plantarum Dad-13 powder in overweight adults in Yogyakarta (Indonesia). The results show decreasing body mass index and weight on overweight subject and increasing of Bacteroidetes specifically Prevotella.