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Intestinal Microbiota Associated With Obesity, Lipid Metabolism, and Metabolic Health
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The authors review how alterations in the intestinal microbiome play a role in developing metabolic diseases. In murine models, fecal microbiota transplantation from obese mice to lean mice resulted in higher weight gain among the lean mice. In addition, mice subjected to high-fat diets had similar intestinal microbiota, and mice receiving low-fat diets had similar intestinal microbiota; these two groups of mice had major differences in their microbiota when compared. These differences, in turn, were shown to affect cholesterol absorption as well as lipid metabolism and regulation.
- Molecular and functional mechanisms of intestinal microbiota regarding weight gain, lipid metabolism, and insulin resistance have been studied in murine models, but the findings are difficult to translate to humans and therefore to therapeutic approaches.
abstract
This abstract is available on the publisher's site.
Access this abstract nowChanges in the intestinal microbiome have been associated with obesity and type 2 diabetes, in epidemiological studies and studies of the effects of fecal transfer in germ-free mice. We review the mechanisms by which alterations in the intestinal microbiome contribute to development of metabolic diseases, and recent advances, such as the effects of the microbiome on lipid metabolism. Strategies have been developed to modify the intestinal microbiome and reverse metabolic alterations, which might be used as therapies. We discuss approaches that have shown effects in mouse models of obesity and metabolic disorders, and how these might be translated to humans to improve metabolic health.
Additional Info
Disclosure statements are available on the authors' profiles:
Metabolism and Metabolic Disorders and the Microbiome: The Intestinal Microbiota Associated With Obesity, Lipid Metabolism and Metabolic Health: Pathophysiology and Therapeutic Strategies
Gastroenterology 2020 Nov 27;[EPub Ahead of Print], J Aron-Wisnewsky, MV Warmbrunn, M Nieuwdorp, K ClémentFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Primary Care
Creating a Lean Microbiome
The composition of the gut microbiome influences weight, metabolic function, lipid composition, and insulin sensitivity. This comprehensive summary of mainly mice studies helps explain this dynamic interplay in the gut ecosystem.
Some interesting findings supporting the role of the microbiome on obesity come from mice with sterile guts being transplanted with stool from various donors.
Although most of the above research was done in mice, there are some human studies to back it up. When fecal transplant was used to treat resistant c.diff infections, there was more weight gain when stool was transplanted from obese human donors. This finding led to international screening of donor stool being used for fecal transplant.
What Can Be Done to Create a Lean Microbiome?
Recommendations from least harmful and expensive to most harmful and expensive.
Mode of Delivery
Although most don’t have a choice, if someone is contemplating an elective C-section, educate her about the fact that babies colonized with bacteria from hospital operating rooms are more likely to develop obesity than those delivered through the microbiome of the mother’s birth canal.2 And the bacteria obtained through breast feeding are much healthier than the ones obtained through a bottle.
Calorie Restriction and Intermittent Fasting
Although this is an obvious therapy for obesity, this can establish a microbiome that helps sustain weight loss over time.
Nutrition
A high-fiber, plant-based diet with fish (pesco–vegetarian) is most likely to establish a lean microbiome while also reducing the risk of heart disease.1
Polyphenols (Resveratrol)
One of the original studies that put resveratrol on the map was published in Nature.3 It showed that mice genetically bred for diabetes and obesity did not develop either when their diet was supplemented with resveratrol. The high dose of resveratrol used in the mice studies would be excessive in humans. Until we can figure the appropriate dosing, encourage intake through eating dark-colored grapes and berries, green tea, and dark chocolate.
Soluble Fiber
Supplementing with 1 tsp of soluble fiber (eg, psyllium) before meals in 8–10 oz of water reduces weight by stimulating satiety, lowers triglycerides, and results in a drop in HbA1c by −0.58%.4 Fiber is also needed to create a healthy mucous layer in which the microbiome lives and aids fermentation-producing short-chain fatty acids (eg, butyrate) which reduce the risk of colon cancer, gut inflammation, and insulin resistance. Soluble fiber costs just pennies a day.
Olive Oil
Consuming olive oil while reducing red meat and dairy decreases TMAO production from the microbiome. TMAO production has been associated with atherosclerosis and major adverse cardiac events.5 This is helped by eating a Mediterranean diet.
Ginseng Extract
Panax ginseng is known as an adaptogen often used for fatigue; it has a long history in traditional Chinese medicine. It is expensive to grow and often adulterated in over-the-counter supplements. But, if a dependable product can be obtained, the extract has been found to support a “lean” microbiome, stimulate weight loss, and increase energy expenditures in mice.
Statins and Metformin
Two of the most prescribed pharmaceuticals in medicine today also support a lean microbiome.
Fecal Transplant
Getting a fecal transplant from your thin cousin may help temporarily; but, if not supported by healthy nutrition, the lean microbiome will likely not be sustained.
Bariatric Surgery
This is a pretty drastic, potentially harmful, and expensive way to change to a lean microbiome. But studies support its effectiveness.
Humans often want the quick fix through surgery or a pill, but it is healthy behaviors from the top of this list that will reduce cost and harm and support the lean microbiome needed for sustained long-term metabolic function and health.
References