A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome

Abstract

Chronic inflammation induced by endotoxin from a dysbiotic gut microbiota contributes to the development of obesity-related metabolic disorders. Modification of gut microbiota by a diet to balance its composition becomes a promising strategy to help manage obesity. A dietary scheme based on whole grains, traditional Chinese medicinal foods, and prebiotics (WTP diet) was designed to meet human nutritional needs as well as balance the gut microbiota. Ninety-three of 123 central obese volunteers (BMI ≥ 28 kg m−2) completed a self-controlled clinical trial consisting of 9-week intervention on WTP diet followed by a 14-week maintenance period. The average weight loss reached 5.79 ± 4.64 kg (6.62 ± 4.94%), in addition to improvement in insulin sensitivity, lipid profiles, and blood pressure. Pyrosequencing of fecal samples showed that phylotypes related to endotoxin-producing opportunistic pathogens of Enterobacteriaceae and Desulfovibrionaceae were reduced significantly, while those related to gut barrier-protecting bacteria of Bifidobacteriaceae increased. Gut permeability, measured as lactulose/mannitol ratio, was decreased compared with the baseline. Plasma endotoxin load as lipopolysaccharide-binding protein was also significantly reduced, with concomitant decrease in tumor necrosis factor-α, interleukin-6, and an increase in adiponectin. These results suggest that modulation of the gut microbiota via dietary intervention may enhance the intestinal barrier integrity, reduce circulating antigen load, and ultimately ameliorate the inflammation and metabolic phenotypes.

Effect of Diet Change on Gut Microbiota: Observational Pilot Study of Four Urban Couples

“…Those results suggest that modulation of the gut microbiota via dietary intervention could enhance the intestinal barrier integrity, reduce the circulating antigen load, and relieve the chronic inflammation that underlies metabolic syndrome. 25 That study is similar to our study in its use of a dietary intervention, fecal sample collection, and analysis of gut microbiota with pyrosequencing. However, Xiao et al 25 excluded participants with various pathologic conditions and used a stricter dietary intervention with three ready-to-use food formulas.…”

“…25 That study is similar to our study in its use of a dietary intervention, fecal sample collection, and analysis of gut microbiota with pyrosequencing. However, Xiao et al 25 excluded participants with various pathologic conditions and used a stricter dietary intervention with three ready-to-use food formulas. In addition, they examined the effects of their intervention using changes in the biomarkers along the pathway that likely connects gut microbiota to the pathogenesis of obesity, rather than focusing on subjective improvement in symptoms.…”

“…25 Xiao et al 25 designed a dietary scheme based on whole grains, traditional Chinese medicinal foods, and prebiotics (WTP diet) to meet human nutritional needs and balance gut microbiota. Obese volunteers completed a self-controlled clinical trial consisting of a 9-week intervention on the WTP diet followed by a 14-week maintenance period.…”

Beyond gut microbiota: understanding obesity and type 2 diabetes

“…26 Similarly, a 9-week intervention trial in 93 obese volunteers supplemented with a prebiotic showed concomitant changes in the intestinal microbiota and a reduction in intestinal permeability, assessed with a dual-sugar-absorption test. 27 Increased plasma concentrations of zonulin have also been reported in a cohort of 25 patients with sepsis compared with a healthy control group, stressing the potential role of tight junction proteins in sepsis, resulting in disruption of the structural integrity of the intestinal mucosa and increased intestinal permeability. 28 A high-fat diet dramatically increased intestinal permeability via a mechanism associated with reduced expression of epithelial tight junction proteins, including zonulin and occludin.…”

Participation of the microbiome in the pathogenesis of diabetes mellitus

“…Modification of the gut microbiota by a diet to balance its composition becomes a promising strategy to help manage obesity [18].…”