{"publication_id":"45ba1bda-6940-4338-babd-4c360db9ad4d","traces":[{"claim_id":"claim_1","claim":"Evidence-honesty note: 36/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. Probiotic supplementation has attracted intense interest as a low-cost adjunct to influence cardiometabolic, immune, musculoskeletal, and clinical-infection outcomes, yet the literature spans dozens of meta-analyses with non-overlapping conclusions and a long tail of single-site RCTs whose results have not always replicated (Liang 2022; Aparicio-Pascual 2025; Prokopidis 2022). We applied an AI-assisted structured evidence-synthesis framework that ingests curated reference sources, enforces direct-vs-indirect outcome stratification, and produces an audit trail linking every quantitative claim to its primary source, while keeping the analytic reasoning in clinical domain language. Pediatric and cognitively-oriented RCTs (Chen 2026, Kim 2020) and a positive bariatric/inflammation trial (Potrykus 2025, P < 0.001 for several biomarkers) round out a pattern in which short-chain-fatty-acid-linked, inflammation-modulating mechanisms are biologically coherent but clinically bounded. **Evidence-abstraction note.","citation_support":[{"source_id":"source_2","study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","support_kind":"cited_as_match","cited_as":"Prokopidis 2022","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"review","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0."},{"source_id":"source_3","study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","support_kind":"cited_as_match","cited_as":"Aparicio-Pascual 2025","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"review","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation."},{"source_id":"source_17","study":"12-week preoperative probiotic supplementation versus placebo: effects on inflammation, endotoxemia, adipokines, and gastrointestinal peptides in patients six months after bariatric surgery – a double-blind, randomized, placebo-controlled clinical trial","doi":"10.1186/s12937-025-01217-2","url":"https://doi.org/10.1186/s12937-025-01217-2","support_kind":"cited_as_match","cited_as":"Potrykus 2025","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"direct","excerpt":"BACKGROUND: Disruption in gut microbiota has been identified as a contributor to obesity-related inflammation and metabolic disorders. This study investigates the effects of preoperative probiotic supplementation on inflammation, endotoxemia, adipokines, and gastrointestinal peptides after bariatric surgery. METHODS: This randomized, double-blind, placebo-controlled clinical trial included patients undergoing laparoscopic sleeve gastrectomy (LSG) or one anastomosis gastric bypass (OAGB). Participants were randomized to receive a 12-week supplementation of either a probiotic mixture, Sanprobi Barrier, which contained nine strains of bacteria (Bifidobacterium bifidum W23, Bifidobacterium lactis W51 and W52, Lactobacillus acidophilus W37, Levilactobacillus brevis W63, Lacticaseibacillus casei W56, Ligilactobacillus salivarius W24, Lactococcus lactis W19, and Lactococcus lactis W58), or a placebo before surgery."},{"source_id":"source_36","study":"Probiotic Supplementation Improves Cognitive Function and Mood with Changes in Gut Microbiota in Community-Dwelling Older Adults: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial","doi":"10.1093/gerona/glaa090","url":"https://doi.org/10.1093/gerona/glaa090","support_kind":"cited_as_match","cited_as":"Kim 2020","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"review","excerpt":"Probiotics have been proposed to ameliorate cognitive impairment and depressive disorder via the gut-brain axis in patients and experimental animal models. However, the beneficial role of probiotics in brain functions of healthy older adults remains unclear. Therefore, a randomized, double-blind, and placebo-controlled multicenter trial was conducted to determine the effects of probiotics on cognition and mood in community-dwelling older adults. Sixty-three healthy elders (≥65 years) consumed either placebo or probiotics containing Bifidobacterium bifidum BGN4 and Bifidobacterium longum BORI for 12 weeks. The gut microbiota was analyzed using 16S rRNA sequencing and bioinformatics. Brain functions were measured using the Consortium to Establish a Registry for Alzheimer's disease, Satisfaction with life scale, stress questionnaire, Geriatric depression scale, and Positive affect and negative affect schedule. Blood brain-derived neurotrophic factor (BDNF) was determined using enzyme-linked immunosorbent assay. Relative abundance of inflammation-causing gut bacteria was significantly reduced at Week 12 in the probiotics group (p < .05)."}],"candidate_sources":[]},{"claim_id":"claim_2","claim":"Evidence-honesty note: 36/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_3","claim":"We applied an AI-assisted structured evidence-synthesis framework that ingests curated reference sources, enforces direct-vs-indirect outcome stratification, and produces an audit trail linking every quantitative claim to its primary source, while keeping the analytic reasoning in clinical domain language.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_4","claim":"Evidence-abstraction note.** The 46 retained reference papers are not 46 independent primary clinical trials: 36 are review, indirect, mechanistic, or registered-protocol source-level summaries, and 10 are classified as direct interventional evidence. Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_5","claim":"This synthesis evaluates evidence on probiotic supplementation effects across 46 included source papers and 2077 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_6","claim":"The corpus contains 10 direct clinical sources, 36 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_7","claim":"The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_8","claim":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_9","claim":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_10","claim":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_11","claim":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_12","claim":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_13","claim":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_14","claim":"The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_15","claim":"The background evidence for probiotic supplementation effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Noorwali 2026, Moschonis 2026, Potrykus 2025 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation.","citation_support":[{"source_id":"source_17","study":"12-week preoperative probiotic supplementation versus placebo: effects on inflammation, endotoxemia, adipokines, and gastrointestinal peptides in patients six months after bariatric surgery – a double-blind, randomized, placebo-controlled clinical trial","doi":"10.1186/s12937-025-01217-2","url":"https://doi.org/10.1186/s12937-025-01217-2","support_kind":"cited_as_match","cited_as":"Potrykus 2025","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"direct","excerpt":"BACKGROUND: Disruption in gut microbiota has been identified as a contributor to obesity-related inflammation and metabolic disorders. This study investigates the effects of preoperative probiotic supplementation on inflammation, endotoxemia, adipokines, and gastrointestinal peptides after bariatric surgery. METHODS: This randomized, double-blind, placebo-controlled clinical trial included patients undergoing laparoscopic sleeve gastrectomy (LSG) or one anastomosis gastric bypass (OAGB). Participants were randomized to receive a 12-week supplementation of either a probiotic mixture, Sanprobi Barrier, which contained nine strains of bacteria (Bifidobacterium bifidum W23, Bifidobacterium lactis W51 and W52, Lactobacillus acidophilus W37, Levilactobacillus brevis W63, Lacticaseibacillus casei W56, Ligilactobacillus salivarius W24, Lactococcus lactis W19, and Lactococcus lactis W58), or a placebo before surgery."}],"candidate_sources":[]},{"claim_id":"claim_16","claim":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_17","claim":"Across the retained sources, positive signals cluster around the contextual adjacent evidence, immune and inflammation, cardiometabolic outcome classes; null signals around the immune and inflammation, contextual adjacent evidence outcome classes; and negative or adverse signals around the cardiometabolic, muscle function and longevity outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_18","claim":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_19","claim":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_20","claim":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_21","claim":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_22","claim":"Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, deficiency prevalence, dosing and pharmacokinetics, immune and inflammation, longevity, muscle function, safety and comorbidity, skeletal, fracture, and bone); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_23","claim":"Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_24","claim":"Outcome-class note:** Contextual Adjacent Evidence denotes background, boundary-condition, or adjacent-outcome sources. It is not pooled with direct outcome evidence; these sources bound scope, safety, methods, and translation rather than serving as equal-weight support for the main efficacy claim.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_25","claim":"| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_26","claim":"| Probiotic Supplementation Effects / Contextual Adjacent Evidence | n=14; claims=547 | significant source statistic in 12/14 sources; receipt-level direction coded unclear | 3 direct; 5 indirect; 6 review | limited corpus depth in this outcome class |","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_27","claim":"Contextual Adjacent Evidence: n=14; claims=547; mixed signal in 8/14 sources | directness: 3 direct; 5 indirect; 6 review; main limitation: directionally heterogeneous.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_28","claim":"Six curated reviews and meta-analyses comprise the cardiometabolic evidence base, spanning populations with type 2 diabetes, prediabetes, overweight/obesity, and polycystic ovary syndrome, as well as generally healthy adults and exercise-recovery cohorts. The dominant designs are systematic reviews with pooled analyses, with one observational synthesis, Shirkoohi 2025, contributing indirect data on body composition. Durations and dosing regimens were heterogeneous across the underlying trials, but endpoints were uniformly cardiometabolic: glycemic indices (HbA1c, fasting glucose, HOMA-IR, HOMA-β), lipid fractions, body weight, and islet β-cell function. The integrated thesis positions probiotic supplementation as context-dependent rather than uniformly favorable or unfavorable in this outcome class.","citation_support":[{"source_id":"source_12","study":"The effects of probiotic supplementation on body composition, recovery following exercise‐induced muscle damage, and exercise performance: A systematic review and meta‐analysis of clinical trials","doi":"10.14814/phy2.70288","url":"https://doi.org/10.14814/phy2.70288","support_kind":"cited_as_match","cited_as":"Shirkoohi 2025","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"review","excerpt":"The goal of the current systematic review and meta-analysis was to provide a definitive assessment of the impacts of probiotic supplementation on body composition, recovery from exercise-induced muscle damage, and exercise performance in individuals actively participating in exercise. A thorough literature search encompassing Scopus, PubMed, Google Scholar, and Web of Science databases was conducted up to May 2024. The weighted mean difference (WMD) and 95% confidence interval (95% CI) for each outcome were estimated using a random-effects model. The certainty of the assessments was further evaluated utilizing the GRADE approach. The pooled analysis showed a significant effect of probiotics on body weight [(WMD = -0.55 kg; 95% CI, -0.98 to -0.13; p = 0.010)], percent body fat [(WMD = -0.46%; 95% CI, -0.83 to -0.09; p = 0.014)], creatine kinase [(WMD = -45.57 IU. L -1 ; 95% CI: -65.12, -26.02; p = 0.000)], and VO 2max [(WMD = 1.55 mL/kg -1 /min -1 ; 95% CI, 0.61 to 2.49; p = 0.001)]. Despite this, no significant effects were observed on body mass index, lean body mass, lactate dehydrogenase, and myoglobin levels."}],"candidate_sources":[]},{"claim_id":"claim_29","claim":"Quantitative signals within the cardiometabolic class are mixed and outcome-specific. Tabrizi 2022, in PCOS, reported several glycemic, lipid, and inflammatory contrasts reaching P = 0.01, P = 0.02, P < 0.001, P < 0.01, and P = 0.04. Across the class, the per-study p-value tuples are catalogued in the evidence synthesis.","citation_support":[],"candidate_sources":[{"study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP).","source_id":"source_1","support_kind":"candidate_source_row"},{"study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0.","source_id":"source_2","support_kind":"candidate_source_row"},{"study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation.","source_id":"source_3","support_kind":"candidate_source_row"},{"study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling.","source_id":"source_4","support_kind":"candidate_source_row"},{"study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C.","source_id":"source_5","support_kind":"candidate_source_row"}]},{"claim_id":"claim_30","claim":"Within-corpus tensions in the cardiometabolic class are pronounced. A plausible reconciling frame is that effect direction is conditional on baseline metabolic status, trial duration, and strain-specific formulations, but the corpus as currently constituted does not resolve which boundary condition drives the divergence. The same pattern recurs for body composition, where Shirkoohi 2025 reports predominantly null body-weight contrasts while Liang 2022 reports significant glycemic improvements, suggesting that probiotics decouple across cardiometabolic sub-domains within the same class.","citation_support":[{"source_id":"source_12","study":"The effects of probiotic supplementation on body composition, recovery following exercise‐induced muscle damage, and exercise performance: A systematic review and meta‐analysis of clinical trials","doi":"10.14814/phy2.70288","url":"https://doi.org/10.14814/phy2.70288","support_kind":"cited_as_match","cited_as":"Shirkoohi 2025","population":"not extracted","endpoint":"not extracted","effect":"not extracted","directness":"review","excerpt":"The goal of the current systematic review and meta-analysis was to provide a definitive assessment of the impacts of probiotic supplementation on body composition, recovery from exercise-induced muscle damage, and exercise performance in individuals actively participating in exercise. A thorough literature search encompassing Scopus, PubMed, Google Scholar, and Web of Science databases was conducted up to May 2024. The weighted mean difference (WMD) and 95% confidence interval (95% CI) for each outcome were estimated using a random-effects model. The certainty of the assessments was further evaluated utilizing the GRADE approach. The pooled analysis showed a significant effect of probiotics on body weight [(WMD = -0.55 kg; 95% CI, -0.98 to -0.13; p = 0.010)], percent body fat [(WMD = -0.46%; 95% CI, -0.83 to -0.09; p = 0.014)], creatine kinase [(WMD = -45.57 IU. L -1 ; 95% CI: -65.12, -26.02; p = 0.000)], and VO 2max [(WMD = 1.55 mL/kg -1 /min -1 ; 95% CI, 0.61 to 2.49; p = 0.001)]. Despite this, no significant effects were observed on body mass index, lean body mass, lactate dehydrogenase, and myoglobin levels."}],"candidate_sources":[]}]}