{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:08:48Z","timestamp":1778735328048,"version":"3.51.4"},"reference-count":56,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis evaluated the effects of probiotic and synbiotic supplementation on metabolic and hepatic outcomes in children and adolescents with obesity, including those with obesity\u2010related metabolic dysfunction\u2013associated steatotic liver disease (MASLD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search of PubMed, Scopus and Web of Science was conducted up to September 2025. Randomised controlled trials (RCTs) investigating probiotic or synbiotic supplementation in paediatric populations with obesity or MASLD were included. Data were pooled using a random\u2010effects model, and the Cochrane Risk of Bias tool and GRADE framework were used for quality assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009848) were included. Pooled analyses demonstrated significant reductions in total cholesterol (WMD: \u22126.40\u2009mg\/dL, 95% CI: \u22128.78, \u22124.01), LDL\u2010C (WMD: \u22122.68\u2009mg\/dL, 95% CI: \u22124.85, \u22120.50) and alanine aminotransferase (ALT) (WMD: \u22126.15\u2009U\/L, 95% CI: \u221210.14, \u22122.16). No significant improvements were observed in BMI\n                      <jats:italic>z<\/jats:italic>\n                      \u2010score, waist circumference, triglycerides, HDL\u2010C or fasting blood sugar. A significant increase in HOMA\u2010IR was found (WMD: 0.68, 95% CI: 0.53, 0.83). Evidence certainty was high for lipid outcomes but low or very low for most other measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite these mixed results, substantial heterogeneity and limited evidence quality underscore the need for well\u2010designed, strain\u2010specific trials. Probiotic and synbiotic supplementation show promise for specific metabolic outcomes in paediatric populations, though caution is warranted regarding glucose homeostasis, and personalised approaches should be considered in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70344","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:45:04Z","timestamp":1775843104000},"page":"678-696","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Probiotic and Synbiotic Supplementation on Metabolic and Hepatic Outcomes in Children and Adolescents With Obesity, Including Those With Obesity\u2010Related Metabolic Dysfunction\u2013Associated Steatotic Liver Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3856-0595","authenticated-orcid":false,"given":"Pedram","family":"Pam","sequence":"first","affiliation":[{"name":"Food and Beverages Safety Research Center Urmia University of Medical Sciences  Urmia Iran"},{"name":"Student Research Committee Urmia University of Medical Sciences  Urmia Iran"},{"name":"Department of Nutrition, School of Medicine Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Safari","sequence":"additional","affiliation":[{"name":"Student Research Committee Tabriz University of Medical Sciences  Tabriz Iran"},{"name":"Faculty of Nutrition and Food Sciences Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3632-7435","authenticated-orcid":false,"given":"Ali","family":"Hojati","sequence":"additional","affiliation":[{"name":"Student Research Committee Tabriz University of Medical Sciences  Tabriz Iran"},{"name":"Faculty of Nutrition and Food Sciences Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasoul","family":"Zarrin","sequence":"additional","affiliation":[{"name":"Department of Nutrition, School of Medicine Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-7267","authenticated-orcid":false,"given":"Amir Hossein","family":"Faghfouri","sequence":"additional","affiliation":[{"name":"Maternal and Childhood Obesity Research Center Urmia University of Medical Sciences  Urmia 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