Specific Dietary Components and Gut Microbiota Composition are Associated with Obesity in Children and Adolescents with Prader–Willi Syndrome

Abstract

Prader–Willi syndrome is a rare genetic disorder associated with impaired body composition, hyperphagia, and excessive weight gain. Strict dietary restrictions from an early age is crucial to prevent or delay the early onset of obesity, which is the main driver of comorbidities in these patients. The aim of this study was to identify dietary and gut microbiota components closely linked to weight status of these patients. We studied a cohort of children and adolescents with genetic diagnosis of Prader–Willi syndrome (N = 31), in which we determined adiposity by Dual-energy X-ray absorptiometry (DXA) and dietary composition with 4-day food records. Furthermore, we obtained fecal samples to assess microbiota composition by 16S sequencing. Multivariate regression models showed that body mass index standard deviation score (BMI-SDS) and body fat mass were directly associated with saturated fat intake and meat consumption, and inversely associated with fruit consumption. Furthermore, the gut microbiome from normal weight patients was characterized by higher phylogenetic diversity compared to those overweight or obese, with differential abundance of several genera, including Alistipes, Klebsiella, and Murimonas. Notably, Alistipes abundance was inversely correlated to adiposity, lipid and glucose homeostasis parameters, and meat intake. Our results suggest that limiting meat and increasing fruit intake might be beneficial for body weight management in children and adolescents with Prader–Willi syndrome.

Effects of Bifidobacterium animalis Subsp. lactis (BPL1) Supplementation in Children and Adolescents with Prader–Willi Syndrome: A Randomized Crossover Trial

“…Olsson et al studied the gut microbiome in 17 adult subjects with PWS and a matched group with non-genetic obesity, concluding that gut bacteria play an active role in insulin sensitivity [ 20 ]. We recently reported the gut microbiota associated with obesity in children with PWS, finding similar alterations to those found in simple obesity [ 21 ]. Finally, Peng et al described several differences in intestinal bacterial genera and fungal communities in children with PWS compared to those in controls [ 22 ].…”

“…Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated as previously described [ 24 ]. We also collected parental-reported 4-day food records that were analyzed with the DIAL software [ 25 ] to assess daily energy intake as previously reported [ 21 ]. Hyperphagia was assessed with the Hyperphagia Questionnaire for Clinical Trials (HQ-CT, validated Spanish version), a nine-question questionnaire (score 0–36) developed for patients with PWS.…”

“…In this organism, BPL1 targets both energy homeostasis and tryptophan metabolism [ 17 ], an important regulator of central nervous system processes including satiety, anxiety, and depression [ 13 , 18 ]. Only a small number of studies have examined the gut microbiome in PWS [ 19 , 20 , 21 , 22 ]. Zhang et al studied the effects of a hospitalized hypocaloric dietary intervention on 17 children and adolescents with PWS and showed that diet-induced changes in the gut microbiome directly contributed to improved adiposity and metabolic health [ 19 ].…”

The Gut Microbiota Profile in Children with Prader–Willi Syndrome

“…These differences might be merely the consequence of the disease, environmental factors, or covariates unrelated to PWS that are not examined here. Garcia-Ribera et al also recently analyzed the fecal microbiota composition in children with PWS and observed higher phylogenetic diversity in normal weight subjects compared to those who were overweight or obese [ 21 ]. Our subgroup analyses, however, found no differences in microbial diversity between OWOB PWS and NW PWS.…”

The Effects of Limosilactobacillus reuteri LR-99 Supplementation on Body Mass Index, Social Communication, Fine Motor Function, and Gut Microbiome Composition in Individuals with Prader–Willi Syndrome: a Randomized Double-Blinded Placebo-Controlled Trial

“…Bifidobacterium is widely regarded as beneficial to gut health and weight reduction [43,44]. Alistipes, although its abundance has been inversely correlated to adiposity, lipid, and glucose homeostasis parameters, [45] has been both negatively and positively associated with to autism spectrum disorders and remains controversial [46,47]. Roseburia and Faecalibacterium are butyrate-producing, anti-inflammatory bacteria.…”