Obesity, metabolic comorbidities and microbiome modulation in pediatrics

Abstract

The prevalence of obesity in childhood and adolescence has multiplied in recent decades. This is coupled with an increasing prevalence of associated non-communicable diseases and thus an increased and premature risk of mortality. Obesity and metabolic comorbidities are associated with the diversity and a specific composition of the microbiome. In the first 3 years of life environmental influences, such as maternal health and nutrition during pregnancy, the mode of birth, the type of neonatal and infant nutrition and antibiotic treatment have a significant impact on the gut microbiome. Concepts for targeted therapeutic modulation of the gut microbiota by prebiotics, probiotics and synbiotics are being elaborated. Specific bacterial species, such as Verrucomicrobiae appear to be metabolically favorable, while others such as Proteobacteria have an unfavorable effect. Short-chain fatty acids serve as essential mediators for the regulation of intestinal permeability, inflammation control, bile acid metabolism and associated immunological processes. A modification of the gut microbiome during pregnancy and infancy provides attractive time frames for targeted nutritional interventions, be it through dietary change or supplementation with probiotics or prebiotics. At present there is a lack of high-quality studies on children to be able to draw clear conclusions or even give recommendations for treatment with prebiotics, probiotics and synbiotics.