The Gut Microbiota: The Gateway to Improved Metabolism

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Key points

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    Shifts in the gut microbiome are inseparably associated with the development of obesity and comorbidities.

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    Transfer of dysbiotic microbial communities confers disease phenotypes in recipients, supporting a central role for microbe-mediated regulation of metabolism.

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    Bariatric surgery, the most effective treatment of morbid obesity, results in rapid changes in the gut microbiota, with concurrent improvements in metabolic parameters.

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    Deeper understanding of host-microbe interactions may hold promise

Introduction: obesity and the gut microbiota

The increase of obesity and its related comorbidities in westernized countries over the past 4 decades presents an emerging global epidemic with profound challenges to world health care economies and societies. In the past 35 years, the rate of adult obesity has risen by 75% globally.1, 2 This number is greater among children.3, 4 Stratified assessment of body mass index further shows disproportionate increases among the most severely obese (≥35 kg/m2), compared with the lesser obese (≥30 kg/m2

Obesity-Driven Alterations in Gut Microbiota

The human body contains huge numbers of microbes, including thousands of bacterial species, in addition to many eukaryotes, Achaea, protists, and viruses, which collectively contain an estimated 5 million genes that have profound metabolic and immunomodulatory effects on their mammalian hosts.8 The community of microbes is termed the microbiota, whereas their collective genes are called the microbiome. Both the state of obesity and westernized diets are associated with microbial dysbiosis,

Host-microbe interactions driving obesity

The observation that GF mice are resistant to diet-induced obesity has created a foundation for understanding the contribution of microbes and host-microbe interactions to the development of obesity and its comorbidities. Several mechanisms to explain microbe-mediated obesity have been proposed, including (1) SCFA production; (2) regulation of food intake and sensory perception of food; (3) nutrient absorption; (4) circulation of microbe-derived enterotoxins like lipopolysaccharides (LPS) and

Treatments targeting microbiome to fight obesity and metabolic syndrome

The host-microbiome field is moving toward improving metabolism and weight maintenance through modulating gut microbial communities using a variety of supplements such as prebiotics and probiotics, synbiotics, FMT, and postbiotics. Prebiotics are foods or dietary supplements that encourage the growth of saccharolytic bacteria that metabolize nondigestible carbohydrates such as inulin and oligofructose. Several criteria must be met for a supplement to be considered a prebiotic and these include

Summary

Obesity and metabolic disease have various underlying causes, including genetics and environmental factors, making appropriate and effective treatments difficult to identify. The emergence of high-throughput sequencing has recently made it possible to examine the intestinal microbiome in the context of obesity. Understanding how the microbiota structure and function changes in states of obesity as well as bariatric surgery may resolve the role of the microbiome in regulating host metabolic set

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    Disclosure: This work was supported by NIH NIDDK DK42086 (DDRCC), DK097268, T32DK07074 to K.B. Martinez; F32DK105728-01A1 to J.F. Pierre.

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