Hostname: page-component-77f85d65b8-2tv5m Total loading time: 0 Render date: 2026-04-16T23:56:01.890Z Has data issue: false hasContentIssue false

Mental health and health-related quality of life response to curcumin-probiotic drink powder co-supplementation in adults with overweight/obesity and metabolic syndrome: a four-arm randomised, double-blind, placebo-controlled, clinical trial

Published online by Cambridge University Press:  16 May 2025

Mohammad Ali Mohsenpour
Affiliation:
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Farzaneh Mohammadi
Affiliation:
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Zahra Sohrabi
Affiliation:
Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Mehrdad Niakousari
Affiliation:
Department of Food Science and Technology, College of Agriculture, Shiraz University, Shiraz, Iran
Marjan Jeddi
Affiliation:
Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad Hassan Eftekhari*
Affiliation:
Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
*
Corresponding author: Mohammad Hassan Eftekhari; Email: eftekharim@sums.ac.ir

Abstract

Metabolic syndrome (MetS) is associated with deteriorated mental health and health-related quality of life (HRQOL). Curcumin and probiotics improved MetS, mental health and HRQOL. The present study aimed to investigate the effect of curcumin-probiotic (CurPro) co-supplementation in the form of drink powder on mental health and HRQOL in adults with overweight/obesity and MetS. A four-arm, randomised, double-blinded, placebo-controlled clinical trial with factorial design was conducted for adults with overweight/obesity and MetS (n 128). Participants were randomly allocated into four groups to receive one drink powder sachet containing 1 g curcumin, 109 colony-forming unit (CFU) probiotic (Lactobacillus acidophilus and Lactobacillus rhamnosus strains), CurPro (1 g curcumin and 109 CFU probiotic) or placebo along with a low-calorie diet. Participants were assessed for dietary intake, physical activity, mental health and HRQOL before and after the study. After 8 weeks of intervention, 104 participants finished the study. The CurPro intervention reduced stress (P = 0·001) and anxiety (P = 0·019) and improved general health (P = 0·024) and overall HRQOL (P = 0·011) scores of participants in comparison with the Placebo group. Results were NS for depression and HRQOL subdomains such as physical functioning, role limitations due to physical problems, bodily pain, vitality, social functioning and role limitations due to emotional problems. Curcumin-probiotics co-supplementation could improve the mental health and HRQOL of adults with overweight/obesity and MetS. Further investigations in various populations or with different dosages or durations are recommended.

Information

Type
Research Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Nilsson, PM, Tuomilehto, J & Rydén, L (2020) The metabolic syndrome – what is it and how should it be managed? Eur J Preventative Cardiol 26, 3346.CrossRefGoogle Scholar
Tabatabaei-Malazy, O, Saeedi Moghaddam, S, Rezaei, N, et al. (2021) A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions. PLOS ONE 16, e0241926.CrossRefGoogle ScholarPubMed
Hosseini-Esfahani, F, Alafchi, B, Cheraghi, Z, et al. (2021) Using machine learning techniques to predict factors contributing to the incidence of metabolic syndrome in tehran: cohort study. JMIR Public Health Surveill 7, e27304.CrossRefGoogle Scholar
Guembe, MJ, Fernandez-Lazaro, CI, Sayon-Orea, C, et al. (2020) Risk for cardiovascular disease associated with metabolic syndrome and its components: a 13-year prospective study in the RIVANA cohort. Cardiovasc Diabetology 19, 195.CrossRefGoogle ScholarPubMed
Lee, Y-B, Kim, DH, Kim, SM, et al. (2020) Risk of type 2 diabetes according to the cumulative exposure to metabolic syndrome or obesity: a nationwide population-based study. J Diabetes Investig 11, 15831593.CrossRefGoogle ScholarPubMed
Machado-Fragua, MD, Fayosse, A, Yerramalla, MS, et al. (2022) Association of metabolic syndrome with incident dementia: role of number and age at measurement of components in a 28-year follow-up of the Whitehall II cohort study. Diabetes Care 45, 21272135.CrossRefGoogle Scholar
Limon, VM, Lee, M, Gonzalez, B, et al. (2020) The impact of metabolic syndrome on mental health-related quality of life and depressive symptoms. Qual Life Res 29, 20632072.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Salazar de Pablo, G, De Micheli, A, et al. (2020) What is good mental health? A scoping review. Eur Neuropsychopharmacol 31, 3346.CrossRefGoogle ScholarPubMed
Haraldstad, K, Wahl, A, Andenæs, R, et al. (2019) A systematic review of quality of life research in medicine and health sciences. Qual Life Res 28, 26412650.CrossRefGoogle ScholarPubMed
Rahimlou, M, Mirzaei, K, Keshavarz, SA, et al. (2016) Association of circulating adipokines with metabolic dyslipidemia in obese versus non-obese individuals. Diabetes Metab Syndr 10, S605.CrossRefGoogle ScholarPubMed
Ushula, TW, Mamun, A, Darssan, D, et al. (2022) Dietary patterns and the risks of metabolic syndrome and insulin resistance among young adults: evidence from a longitudinal study. Clin Nutr 41, 15231531.CrossRefGoogle ScholarPubMed
Schweren, LJS, Larsson, H, Vinke, PC, et al. (2021) Diet quality, stress and common mental health problems: a cohort study of 121,008 adults. Clin Nutr 40, 901906.CrossRefGoogle Scholar
Rahimlou, M, Morshedzadeh, N, Karimi, S, et al. (2018) Association between dietary glycemic index and glycemic load with depression: a systematic review. Eur J Nutr 57, 23332340.CrossRefGoogle ScholarPubMed
Morshedzadeh, N, Rahimlou, M, Shahrokh, S, et al. (2021) The effects of flaxseed supplementation on metabolic syndrome parameters, insulin resistance and inflammation in ulcerative colitis patients: an open-labeled randomized controlled trial. Phytother Res 35, 37813791.CrossRefGoogle ScholarPubMed
Fahed, G, Aoun, L, Bou Zerdan, M, et al. (2022) Metabolic syndrome: updates on pathophysiology and management in 2021. Int J Mol Sci 23, 786.CrossRefGoogle ScholarPubMed
Ramaholimihaso, T, Bouazzaoui, F & Kaladjian, A (2020) Curcumin in depression: potential mechanisms of action and current evidence—a narrative review. Front Psychiatry 11, 572533.CrossRefGoogle ScholarPubMed
Khodadadegan, MA, Azami, S, Guest, PC, et al. (2021) Effects of curcumin on depression and anxiety: a narrative review of the recent clinical data. In Studies on Biomarkers and New Targets in Aging Research in Iran: Focus on Turmeric and Curcumin, pp. 283294 [Guest, PC, editor]. Cham: Springer International Publishing.CrossRefGoogle Scholar
Spanoudaki, M, Papadopoulou, SK, Antasouras, G, et al. (2024) Curcumin as a multifunctional spice ingredient against mental disorders in humans: current clinical studies and bioavailability concerns. Life 14, 479.CrossRefGoogle ScholarPubMed
Sadeghian, M, Rahmani, S, Jamialahmadi, T, et al. (2021) The effect of oral curcumin supplementation on health-related quality of life: a systematic review and meta-analysis of randomized controlled trials. J Affective Disorders 278, 627636.CrossRefGoogle ScholarPubMed
Hill, C, Guarner, F, Reid, G, et al. (2014) Expert consensus document: the international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterology Hepatol 11, 506514.CrossRefGoogle ScholarPubMed
Stavropoulou, E & Bezirtzoglou, EJ (2020) Probiotics in medicine: a long debate. Front Immunol 11, 554558.CrossRefGoogle Scholar
Johnson, D, Thurairajasingam, S, Letchumanan, V, et al. (2021) Exploring the role and potential of probiotics in the field of mental health: major depressive disorder. Nutrients 13, 1728.CrossRefGoogle ScholarPubMed
Ma, T, Jin, H, Kwok, L-Y, et al. (2021) Probiotic consumption relieved human stress and anxiety symptoms possibly via modulating the neuroactive potential of the gut microbiota. Neurobiol Stress 14, 100294.CrossRefGoogle ScholarPubMed
Le Morvan de Sequeira, C, Kaeber, M, Cekin, SE, et al. (2021) The effect of probiotics on quality of life, depression and anxiety in patients with irritable bowel syndrome: a systematic review and meta-analysis. J Clin Med 10, 3497.CrossRefGoogle ScholarPubMed
Pathak, R, Tirumalai, PS & Kashyap, S (2023) Exploring the microbiome through probiotics and psychobiotics: deciphering the gut-brain link. Acta Sci Microbiol 6, 321.CrossRefGoogle Scholar
Asadi, S, Gholami, MS, Siassi, F, et al. (2020) Beneficial effects of nano-curcumin supplement on depression and anxiety in diabetic patients with peripheral neuropathy: a randomized, double-blind, placebo-controlled clinical trial. Phytother Res 34, 896903.CrossRefGoogle ScholarPubMed
Uchio, R, Kawasaki, K, Okuda-Hanafusa, C, et al. (2021) Curcuma longa extract improves serum inflammatory markers and mental health in healthy participants who are overweight: a randomized, double-blind, placebo-controlled trial. Nutr J 20, 91.CrossRefGoogle ScholarPubMed
Mohammadi, F, Mohsenpour, MA, Sohrabi, Z, et al. (2024) The effects of powdered drinks enriched with curcumin and probiotics on lipid profile and atherogenic indices in patients with metabolic syndrome: a randomized, double-blinded, placebo-controlled clinical trial. Food Sci Nutr 12, 12571267.CrossRefGoogle ScholarPubMed
Zafar, U, Khaliq, S, Ahmad, HU, et al. (2018) Metabolic syndrome: an update on diagnostic criteria, pathogenesis, and genetic links. Hormones 17, 299313.CrossRefGoogle ScholarPubMed
Fusar-Poli, L, Vozza, L, Gabbiadini, A, et al. (2020) Curcumin for depression: a meta-analysis. Crit Rev Food Sci Nutr 60, 26432653.CrossRefGoogle ScholarPubMed
El Dib, R, Periyasamy, AG, de Barros, JL, et al. (2021) Probiotics for the treatment of depression and anxiety: a systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN 45, 7590.CrossRefGoogle ScholarPubMed
Mahan, LK & Raymond, JL (2016) Krause’s Food & the Nutrition Care Process. Amsterdam: Elsevier.Google Scholar
Lee, PH, Macfarlane, DJ, Lam, TH, et al. (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Physical Activity 8, 111.CrossRefGoogle ScholarPubMed
Akin, A & Çetin, B (2007) The depression anxiety and stress scale (DASS): the study of validity and reliability. Kuram ve Uygulamada Eğitim Bilimleri 7, 260.Google Scholar
Sahebi, A, Asghari, MJ & Salari, RS (2005) Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Lexington, MA: ScienceOpen, Inc.Google Scholar
Instrument Ware, J Jr & Sherbourne, CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30, 473483.CrossRefGoogle Scholar
Ware, JE (2008) Improvements in short-form measures of health status: introduction to a series. J Clin Epidemiol 61, 15.CrossRefGoogle ScholarPubMed
Montazeri, A, Goshtasebi, A, Vahdaninia, M, et al. (2005) The short form health survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 14, 875882.CrossRefGoogle ScholarPubMed
Hadi, A, Sepandi, M, Marx, W, et al. (2019) Clinical and psychological responses to synbiotic supplementation in obese or overweight adults: a randomized clinical trial. Complementary Ther Med 47, 102216.CrossRefGoogle ScholarPubMed
Esmaily, H, Sahebkar, A, Iranshahi, M, et al. (2015) An investigation of the effects of curcumin on anxiety and depression in obese individuals: a randomized controlled trial. Chin J Integrative Med 21, 332338.CrossRefGoogle ScholarPubMed
Lee, HJ, Hong, JK, Kim, J-K, et al. (2021) Effects of probiotic NVP-1704 on mental health and sleep in healthy adults: an 8-week randomized, double-blind, placebo-controlled trial. Nutrients 13, 2660.CrossRefGoogle ScholarPubMed
Kazemi, A, Noorbala, AA, Azam, K, et al. (2019) Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: a randomized clinical trial. Clin Nutr 38, 522528.CrossRefGoogle ScholarPubMed
Haghighat, N, Mohammadshahi, M, Shayanpour, S, et al. (2021) The effect of synbiotic and probiotic supplementation on mental health parameters in patients undergoing hemodialysis: a double-blind, randomized, placebo-controlled trial. Indian J Nephrol 31, 149156.Google ScholarPubMed
Mohammadi, AA, Jazayeri, S, Khosravi-Darani, K, et al. (2016) The effects of probiotics on mental health and hypothalamic–pituitary–adrenal axis: a randomized, double-blind, placebo-controlled trial in petrochemical workers. Nutr Neurosci 19, 387395.CrossRefGoogle Scholar
Zhang, N, Zhang, Y, Li, M, et al. (2020) Efficacy of probiotics on stress in healthy volunteers: a systematic review and meta-analysis based on randomized controlled trials. Brain Behav 10, e01699.CrossRefGoogle ScholarPubMed
Sharma, H & Bajwa, J (2022) Approach of probiotics in mental health as a psychobiotics. Arch Microbiol 204, 30.CrossRefGoogle Scholar
Al-Karawi, D, Al Mamoori, DA & Tayyar, Y (2016) The role of curcumin administration in patients with major depressive disorder: mini meta-analysis of clinical trials. Phytother Res 30, 175183.CrossRefGoogle ScholarPubMed
Nouri-Vaskeh, M, Afshan, H, Malek Mahdavi, A, et al. (2020) Curcumin ameliorates health-related quality of life in patients with liver cirrhosis: a randomized, double-blind placebo-controlled trial. Complementary Ther Med 49, 102351.CrossRefGoogle ScholarPubMed
Johnston, T, Korolenko, T, Pirro, M, et al. (2017) Preventing cardiovascular heart disease: promising nutraceutical and non-nutraceutical treatments for cholesterol management. Pharmacol Res 120, 219225.CrossRefGoogle ScholarPubMed
Karolin Kamel, A-AJF & Sciences, N (2011) Comparative evaluation of the anti-ulcer activity of curcumin and omeprazole during the acute phase of gastric ulcer—efficacy of curcumin in gastric ulcer prevention against omeprazole. Food Nutr Sci 2, 628640.Google Scholar
Rohanizadeh, R, Deng, Y & Verron, E (2016) Therapeutic actions of curcumin in bone disorders. Bonekey Rep 5, 793.CrossRefGoogle ScholarPubMed
Vollono, L, Falconi, M, Gaziano, R, et al. (2019) Potential of curcumin in skin disorders. Nutrients 11, 2169.CrossRefGoogle ScholarPubMed
Venkataraman, R, Jose, P & Jose, J (2019) Impact of probiotics on health-related quality of life in type II diabetes mellitus: a randomized single-blind, placebo-controlled study. J Nat Sci Biol Med 10, 27.CrossRefGoogle Scholar
Arnold, LE, Luna, RA, Williams, K, et al. (2019) Probiotics for gastrointestinal symptoms and quality of life in autism: a placebo-controlled pilot trial. J Child Adolesc Psychopharmacol 29, 659669.CrossRefGoogle ScholarPubMed
Ale, EC & Binetti, AG (2021) Role of probiotics, prebiotics, and synbiotics in the elderly: insights into their applications. Front Microbiol 12, 631254.CrossRefGoogle ScholarPubMed
Abd El-Hack, ME, El-Saadony, MT, Swelum, AA, et al. (2021) Curcumin, the active substance of turmeric: its effects on health and ways to improve its bioavailability. J Sci Food Agric 101, 57475762.CrossRefGoogle ScholarPubMed
GBD 2019 Mental Disorders Collaborators (2022) Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry 9, 137150.CrossRefGoogle Scholar
Supplementary material: File

Mohsenpour et al. supplementary material

Mohsenpour et al. supplementary material
Download Mohsenpour et al. supplementary material(File)
File 21.3 KB