## 3 Results
### Effects of Probiotics on the Intestinal Microbiome, Obesity and Metabolic Syndrome  
An interventional clinical trial investigated the impact of the combination of a probiotic supplement of 30 g/day of carob and probiotic bacteria _L. heleticus_, _B. longum_, _S. Thermophilus_, _L. Lactis_ on body composition and metabolic biomarkers in obese volunteers. Forty-five patients were randomly separated into three groups. The first group was called \"diet only\" and received a low-calorie diet without any intervention (15 patients). The second group was called \"prebiotic group\" and 15 patients followed the same diet plan but consumed a prebiotic supplementation (2 carob beans/day of about 30 g). The third group called \"probiotic group\" and the volunteers consumed the same diet with probiotic supplementation (n = 15). The probiotic constituent used in the study was one tablet containing an association of four microbiological strains and especially _Bifidobacterium_ _tarium longum_, _Lactobacillus heleticus_, _Lactococcus lactis_, _Streptococcus thermophilus_ (1 tablet (10 \(\times\) 10\({}^{9}\) CFU/capsule)/day). After one month supplementation, in both the prebiotic and probiotic group, there was a significant reduction in fat mass and insulinemia and a beneficial effect on carbohydrate metabolism. In the probiotic group, an important reduction in fasting blood glucose was observed compared to the control group. Microbiome lipopolysaccharideschedarides reduction caused by pre- and probiotics may induced appetite reduction by increasing satiety. Prebiotics act on microbiota by increasing the production of SCFAs. SCFA are responsible for a cascade of modifications that may lead to weight reduction and improvement in metabolic parameters [31]. A 3-week, randomized, double-blind, placebo-controlled, parallel pilot study evaluated the effect of a low-calorie diet accompanied by the consumption of a moderate-fat cheese containing the probiotic _Lactobacillus plantarum_. Forty patients compatible with the inclusion criteria were selected. Inclusion criteria were age 30-69 years, and diagnosis of MetS characterized by obesity and accompanied by arterial hypertonia (>130/85 mm Hg). To produce the probiotic cheese, _L. plantarum_ was added to the cheese milk in a concentration of 1.5 \(\times\) 10\({}^{11}\) CFU/g before renting. Microbial composition of the test and control cheees did not vary in the counts and predominance of non-starter microbiota. In probiotic cheese _L. plantarum_, viability was evaluated before the clinical trial. In this study, 25 subjects consumed 50 g/day of probiotic cheese and 15 consumed the same amount of cheese without probiotics. In the probiotic group, there was a significant reduction in body mass index (BMI) compared to the control group. _Lactobacillus plantarum_ colonization was positively correlated with the extent of reductions in morning diastolic blood pressure (BP) and systolic BP values. The hypocaloric diet accompanied with the consumption of a probiotic cheese causes a reduction in BMI and arterial blood pressure, both risk factors of MetS. After the consumption of 50 g of cheese containing 26% fat for 3 weeks, a reduction in total cholesterol and low-density lipoprotein (LDL) was also observed. A significant reduction in plasma triglyceride levels was detected only in the probiotic group [32]. In another randomized study, 51 patients with MetS were allocated into two groups, a control group of 25 subjects and a probiotic group of 26 subjects. The probiotic group consumed probiotic-fermented milk for 45 days. The probiotic milk, ready for consumption, exhibited a high probiotics concentration with 3.4 \(\times\) 10\({}^{8}\) CFU/mL of _B. animalis ssp. lactis ssp._, 0.38% acidity, pH 5.15, 2.80% protein, 7.54% carbohydrates, 0.0% fat, 12.08% total solids and had 33.09 calories per bottle. Pathogens were not found, as requested by legislation; thus, the product was defined as suitable for consumption.